The media is all-abuzz with the Sterling Scandal. The 80 year old attorney and real estate baron from Los Angeles, Donald Sterling appears to have been captured on tape telling a girl friend that he doesn’t want her hanging out with black people or bringing them to his basketball team’s games. He is the owner of the Los Angeles Clippers who for first time in their history may make the second round of the NBA playoffs. He has even explicitly said that he doesn’t want the revered Earvin “Magic: Johnson at his arena with her. Nor does he want her posting images with Blacks.

What to do?

The league as Charles Barkley has said is a “Black League”. 80% of the players are African American. Kobe Bryant says he wouldn’t play for an owner with those racist views. Talk is swirling about the Clipper players boycotting their games with the Warriors in the first round of the playoffs. But unfortunately it looks like “cooler” heads are prevailing. The crisis reveals the innate conservatism of the leaders of most of the sports unions who have been seduced by the myth of attorneys as the best choice for union leader. Too often the sports unions and more broadly many of the entertainment unions choose “smart” attorneys to represent them because the producers or the owners have smart attorneys. What they need instead are organizers and union leaders not attorneys. They need to break out of the innate conservatism of legal training and be willing to take the risks necessary to win. The great Marvin Miller who led the Major baseball players out of servitude in the early 70’s was formerly a leader with the United Steelworkers union.

In the case of the Sterling scandal we have the NBA Players Association seeking counsel and guidance from the Mayor of Sacramento and former NBA and Cal guard Kevin Johnson. KJ is a corporate Democrat. But there is another course of action to be taken rather than playing for the good of the league as Doc Rivers and his LA Clippers have decided to do at this juncture.

Here we go with a daisy chain boycott strategy

The Clippers refuse to play in the next game, Game 5 of the playoffs against the Warriors. What does the league do? Default the game to the Warriors? Default the series to the Warriors? Then the Warriors refuse to play in the next series and you get the idea. The other owners would quickly see to it that the daffy and racist Donald is removed by the league as an owner. This is peak season for their TV revenues and earnings. Instead we will see a “thorough” investigation and maybe fines for Sterling, but he will be allowed to continue as an owner.

This is an industry where the players are the game, and this is a moment where the crisis and public opinion would support such a daisy chain direct action approach to removing Sterling. James Earl Jones said it in the great political baseball movie. “Bingo Long and his Traveling All Stars and Motor Kings, “ WEB Dubois says we have to seize the means of production.” This is one of those situations where strategic workers through their actions can force dramatic change.

Time for action, not civility and docility!

In early May, 1971 200,000 veterans, youth and students converged on Washington DC to “Stop the Government and Stop the War” as the call to action said. Peaceful protests of millions had not changed the minds of the rulers about the Vietnam War so many felt more aggressive actions were needed. On Monday morning, May 3 we organized ourselves into affinity groups and sat down at key intersections in Washington to block morning traffic and keep the government from functioning. While at the ground level all we seemed to be doing was pissing off angry commuters it appears in retrospect that the protest had impact. National Airport was closed as an emergency precaution due to the level of traffic disruption. President Nixon called the Army’s 82nd Airborne in with helicopters and 12,000 of us were arrested-the largest mass arrest in US history.

Several of my comrades from Harvard who had been jailed together in DC decided that we should all live together that summer. We recruited other friends: a total of eight in all to rent an old ramshackle house at the end of a cul-de-sac called Fiske Place in the Central Square neighborhood of Cambridge. We had a vague sense that we would function as a community and at least for the summer share resources and chores like cooking and groceries. The “Commune” was named Lewd Moose from the Seuss story, “Thidwick the Big Hearted Moose”. One of my sister communards thought I was big like Thidwick, generally good hearted, but “lewd” in that I failed to wash my dishes and clean up after meals.

Most of us had gainful employment. My two Harvard friends Buck B and Tom F were working on the assembly line at the General Motors plant in Framingham. My roommate Nucci and I worked at the New England Produce Center in Chelsea. We rode our bicycles every night about 5 miles to work the graveyard shift unloading giant trailers loaded with fruits and vegetables. We were members of the Teamsters union, but never saw a union representative. All we saw was a weekly deduction from our paycheck for union dues. We would unload trucks in from North Carolina loaded with cucumbers, watermelons or frozen crates of corn on the cob. It was hard, hot and sweaty work, but a piece of cake for two ex footballers. Watermelons were the best cargo, because every load would have a “damaged” melon that we would be obligated to take home to the commune. In fact we kept the Fiske Place household stocked with produce all summer!

Nucci and I would arrive back at Fiske Place in time to see some of our cohabitants leaving for their day jobs. Weekends were the only time when we would all hang out together. We took trips to Maine, to the beach and to the North End for the feast of Saint Anthony, but most of the memories I have of that summer are working with Nucci in the back of an icy trailer digging out crates of frozen corn.

The FBI seems to have thought the name Lewd Moose Commune implied a deep level of political commitment. They took us seriously enough to reference Lewd Moose in some of our files, but it was more a gathering of folks who shared some vague cultural and political and personal attachments. Some of us however have remained life long friends, and we even convened a couple of Lewd Moose reunions.
The most vivid memory I have of the summer occurred late one morning after I returned from lumping freight. My lifelong friend Jeff was living with us that summer with his girlfriend M.J.. Jeff’s brother was a big shot in the Progressive Labor Party (PLP), which dominated Harvard SDS while I was there. PLP was distinguished by its rigidity and workerism. Cadres always had short hair, got married and lived the idealized and imaginary life of the workers they so desperately were trying to rouse to revolution.

Jeff’s’ connection meant that the Party was interested in recruiting our Commune. That morning in July of 1971 we received a visit from two earnest looking PLPers asking for Jeff. Buck B answered the door and without hesitation led the two cadres upstairs to Jeff and M.J.’s bedroom. He opened the door to find them in bed together. The PLPers recoiled at the door, but Buck jumped into bed and gathered his communards in his arms and exclaimed, “Don’t worry we are one big happy family here.” Needless to say that was the last recruitment visit we received from the PLP that summer!

Many of the radicals who helped to form and shape my old union, the International Longshore and Warehouse Union (ILWU), were merchant seamen before they worked “along shore”. They had traveled to exotic places around the world and been confronted with different realities and turbulence and revolution. The union owes much of its glorious past to these pioneers whose worldview was expanded by world travel.

Consciousness is often elevated by a radical change in one’s environment.

My life was radically changed by my experience of a year abroad in Florence – Firenze, Italia. Many Americans end up in the Tuscan cradle of the Renaissance because of a professed urge to study art history. I got to Florence because of language and then love.

I had studied Latin since the 7th grade. During my five years of classical study, I had read the Odyssey and the Iliad in Latin and performed in Latin theater. Deciding I wanted to be able to watch Italian movies without subtitles I took a course in Italian as a senior elective in the fall of 1968.

That was the first year Italian was offered at Andover. Taught by Mr. Markey, a French instructor who had never studied Italian, he stayed one lesson ahead of the students. The class was three of my Italian American teammates from football and a 6 foot 2 Brit who later became a Labor Member of Parliament. On the last night of class the Professor invited us all to ride into the North End, the traditional Italian neighborhood of Boston for an Italian meal. He dined us and maybe wined us at a white tablecloth Italian restaurant on Parmenter Street off Hanover, the main street of the district. Quite a sight; the diminutive Mr. Markey escorted by 4 hulking footballers and a big Brit.

That summer, 1969, I returned volunteering at the North End Neighborhood Center where I was hired to tutor young Italian kids in English. Soon the kids discovered that I was trying to learn Italian and spent the rest of the summer tormenting me with their rapid fire Neapolitan dialect. One day in June we chaperoned the children to Scusset beach just north of Cape Cod on the South Shore of Massachusetts. On the beach I met another tutor in the program, Marinella, an Italian from Firenze. We talked all the way home on the bus. She tolerated and teased me about my Italian. She had a warm smile and a seductive laugh. I was smitten, and I insisted on walking her home to the family she was living with on Beacon Hill. With that began my almost two year courtship of La Biava, la Fiorentina.

Marinella had witnessed the devastating flood in Florence in 1966 and the whole situation had so depressed her that her mother and her older brother decided it would be best if she got out of Italy and went to the USA as a nanny. She started out in Evanston, Illinois caring for young children of a family there, and then moved to Boston to live with a wealthy old Brahmin family on Beacon Hill. We were a couple by the time I began my freshman year that fall at Harvard University. It was my relationship with her that would lead me to live in Italy in 1971-72.

“Many of my teammates were ethnic Italian and Irish working class kids from the greater Boston area…”

But first a little of my experience at Harvard. I was assigned to live in Strauss Hall right on the edge of the Harvard Yard in Harvard Square. I took Italian and a lot of courses in Political science, which I thought, might become my major and kind of befitted the turbulent times. I remember taking a course with Carl Friedrich, a Professor and German national who had written the post war constitution of West Germany. I would sit in the front row of a giant hall to listen to his lectures; inevitably falling asleep only to awake in an embarrassed start, feeling like the whole lecture hall was looking at me. The fatigue was not just the product of his boring lectures, which consisted of him reading chapters from his book. I was tired because I was playing football and worn out from practice and the endless meetings and film study sessions.

Football was an intense experience even at a non-powerhouse like Harvard. It was also the place along with the hockey team where Harvard sought to infuse the ruling class with some new blood, some toughness from the other side of the tracks. Many of my teammates were ethnic Italian and Irish working class kids from the greater Boston area who were there to play football or hockey. Many of them had brothers and friends who were in Vietnam. Some of them were not real enthused by my anti-war attitudes and politics. Long bus rides to games were often punctuated with intense and emotional discussion over the war and the protest against it sweeping across college campuses. I managed to hold my own in those discussions because I had held my own on the gridiron. I remember being charged by multiple teammates in the “bull in the ring” drill during practice. I fended off the charges of my line mates and emerged standing bleeding profusely because the bridge of my nose had been broken. One of my teammates slapped me on the helmet and said, “Not bad Prep”. The “bull in the ring” drill has since been banned from all levels of football.

The war even bled onto the field. I’ll never forget the head football coach telling us in my sophomore year that if anti-war protestors invaded the field during a game, we were to dutifully retreat to our dressing room under the stadium.

I participated in most of the public protest on campus against the war and Harvard’s complicity in it. Shrill rhetoric about the leading roll of workers in revolutionary struggle was never much substantiated by actual blue-collar participation except for the occasional presence of a few Harvard custodians. There was no lack of debate about the issues however, and there were plenty of “bull in the ring” intellectual encounters in which my clever and intelligent classmates would spar over the issues of the day and spread their oral genius. I was never much for these discussions because they reminded me of prep school sparring that was predicated on wit and clever remarks, not grounding in real experience.

The most dramatic moment in my time at Harvard occurred in the spring of 1970. The US began to bomb the dykes in North Vietnam and protests escalated throughout the country culminating on May 4, 1970 when the National Guard gunned down four students at Kent State. Eleven days later at a Mississippi black college, Jackson State, two protesting students were killed without much of the national anguish over the four at Kent State.

But prior to Kent and Jackson a major protest was called for the Boston Common on April 15th. I went to the protest on the MTA Red Line from Cambridge to Park Street station. I stayed for the whole rally. Abbie Hoffman, the leader of the Yippies (Youth International Party) gave a stirring speech in which he pointed at the John Hancock building, then the second tallest building in Boston and shouted, “See that hypodermic needle, John Hancock was a revolutionary not a fucking insurance salesman.”

After the rally I climbed up over Beacon Hill on my way to Marinella’s. Four or five hours later I decided to ride the MTA to my dorm in Harvard Square. As we approached the square the train stopped unexpectedly several times. Finally the train pulled into the station and the few of us still on, got off. I rode up the clackety old wooden escalator and emerged into a darkened eerie square with fires burning everywhere. The Cambridge Trust and the Harvard Bank’s windows were both smashed in and trashcans burned throughout the square. I looked north along Massachusetts Avenue and saw Cambridge riot police massing to charge down into the square to clear the area. A group of Weathermen had marched back from the Common along Massachusetts Avenue and smashed store windows, trashed banks and gutted two police cars with fire.

“…“impaled” on the Yard fence.”

Well the Weathermen were no longer in the square but I was, and I was all alone. My roommates and friends were inside the Yard and the giant metal gates had been shut and chained. They yelled for me to climb over the fence. The fence was over ten feet tall and the wrought iron bars were capped with metal spikes. I started to scale the fence and got one leg over the spike when my back foot slipped. I was wearing dress shoes with slippery soles. The knee of my right leg became caught on the tip of the fence. Fortunately my friends were able to raise me up and over the fence to safety just before the Cambridge cops swarmed into the area. They would have most certainly pulled me backwards and done severe damage to my knee.

My adrenaline was rushing so I felt very little pain in my leg, but then I examined the tear in my pants and discovered a gaping wound. My knee had been impaled on the Harvard Yard fence!

Friends escorted me thru police lines to the student infirmary where med students took turns looking at my wound, which was deep enough to offer them an opportunity to study human anatomy up close. Finally they stitched me up and sent me back to the Yard.

Among all the news radio reports of the Harvard Square riots one story emerged of the Harvard freshman that had been “impaled” on the Yard fence. Harvard’s attorney at the time was a law school professor named Archibald Cox, who had been Solicitor General for four years under Presidents Kennedy and Johnson. He would later be one of the casualties of the “Saturday Night Massacre” of October 20, 1973 when he was dismissed by President Nixon from his post as Special Prosecutor during the Watergate scandal.

At a press conference later that evening Cox was asked by the media about the impaled freshman. All imagined a human body run through front to back by the sharpened spikes of the yard fence. Cox calmly faced his questioners and demonstrated his acute legal mind and attention to detail by saying,” Let’s find out where he was impaled.”

Needless to say I remember very little of academics from my two years in Cambridge. I was absorbed by my relationship with Marinella, who was my first serious girlfriend and love. I would visit Italy with her in the summer after my freshman year. She stayed in Italy at the end of the summer, and I returned to the USA alone. Our relationship continued in unsatisfactory fashion via snail mail letters and strained phone calls at odd hours because of the time difference. I decided that if we were going to make it I would need to move to Firenze. I applied and was accepted into a junior year abroad program with the State University of New Jersey, Rutgers. The program was attractive because rather than isolating American students in a Villa with each other, the Rutgers program inserted its students directly into the Universita di Firenze.

Soon after my acceptance however my relationship with Marinella fell apart, but I decided to push on to Firenze anyway. In the fall of 1971 I set out for Italy

In the next installment I describe my year in Italy; on strike at the University, giving an anti-war speech in the Piazza della Signoria, playing rugby and being attacked by a fascist gang in Rome.

Correction: After the Forum posted Olney Odyssey #1, Jeff Crosby, the retired President of IUE local 201 in Lynn Massachusetts, wrote in to say that Al Coulthard Sr. played a key leadership role in the early days of Local 201, but he noted that as far as he has discovered in his research, Coulthardt was a socialist not a communist. Thanks to Brother Crosby for the correction and thanks to him for his years of service to the working class.

“External causes are the condition of change and internal causes are the basis of change” On Contradiction, Mao Tse Tung 1937

Some baby boomers were propelled down the road to working class radicalism by the clash between the values that the “greatest generation” nurtured in us and the external social realities of racism and war.  Each of our journeys is unique and yet each is the same.

My father, Peter B. Olney Jr., was one of those young men who in 1943, fresh out of high school, enlisted. He was a medic and while he saw much, he said little but for one story. He told me of an incident when the driver of a flatbed truck popped the clutch lurching the truck forward and throwing the soldier standing on the fantail to the ground. That soldier was Black and the white driver roared with laughter. My Dad rushed the cab, grabbed the driver by the neck and punched him in the face. “Don’t you ever f…ing do that again,” he said. I will never forget that story and what it taught me.

Through sports my father taught us a lot about values. As manager he enraged Little League parents when he insisted on playing all the team members even if it meant losing a close one. He made sure the football was equally distributed to all ages in the family touch football games.  My youngest cousin, Sarah, would always be dramatically escorted into the end zone by a phalanx of the biggest males that warded off any members of the opposing team. My Dad would vex and perplex other fathers who were obsessed with winning even in family touch football.

At home honesty and integrity were taught by example and never compromised. My mother, Elinor Bowman Olney is the same as my Dad, although she could be tougher.  I remember her actually threatening to wash out my mouth with soap for uttering some cuss words. She is a no-nonsense New Englander who revels in telling me on the phone every time it snows and ices over in Massachusetts that, “We will survive, we are a hearty people and used to it”. She also has a great sense of irony and humor. I think it was three Christmases in a row in the early Seventies that she received a Mao Tse Tung calendar from me and each year with a twinkle in her eye she exclaimed that, “How did you know I needed this calendar. What a wonderful surprise.”

“She had marched with Martin Luther King in Selma and with King and Walter Reuther in Washington, DC in August of 1963”

Values in the home led us to challenge hypocrisy in the world and to seek big answers. These were the bases of change fostered at a very young age, but ironically it was my Grandmother’s choice of Sunday school that sent me on my path to the working class.

Until 1963 when I went off to a summer camp for two weeks in Ferry Beach, Maine, my connection with my grandmother, Anne Stewart Bowman was very traditional. Sundays and holidays were a time to visit the Bowman house at 87 Cedar Street in Malden, Massachusetts. Grandmother always put out a fine traditional meal topped off with a homemade baked pie. The house was big. It was great to roam around in with a wooden standup bowling alley in the back room that my sister Anne, my brother Steve and I entertained ourselves on…. and fought over. The Malden house had a tell tale aroma to it that followed Grandmother and Grandfather all over the world so that when I visited them in 1972 on Via Sistina in Rome I could close my eyes and imagine with my nose that I was back in their Malden house and a child again. Grandfather enjoyed listening to his vast classical and opera LP collection and took particular relish in playing my sister, brother and I the first Beatles album before we even knew who the British mop heads were.

But during those two weeks in ’63 at Ferry Beach at the mouth of the Saco River I experienced something that was to happen to me many times in the more than thirty years after. I was introduced to a woman named Alice Harrison who was a friend of my grandmother’s and the Director of Youth Programs for the Unitarian Universalist Association on Beacon Street in Boston. Alice puzzled over my last name and she asked if I was Elinor’s son. I said yes. She then exclaimed, “Why you are Anne Bowman’s grandson.”

Those summers in the mid sixties at Ferry Beach were discovery days filled with the fervor of the civil rights movement as Unitarian Universalist (U-U) ministers returned from the the South to tell us of their adventures and spur us on to activism. One of those ministers, James Reeb (here and here), was murdered by a white racist mob in 1965 in Alabama.  I discovered that my grandmother knew Reeb and all of these activists. She had marched with Martin Luther King in Selma and with King and Walter Reuther in Washington, DC in August of 1963. In later years I loved listening to her recount her stories of marching and protesting for civil rights and justice. But her mentoring always included the stern admonishment to “Be sure and get your degree.”

In 1995 just before my grandmother passed away I attended a service at the U-U church in San Francisco. I was browsing in their study after church and I came across a book entitled, The Larger Faith, a Short History of American Universalism by Charles Howe. I rushed quickly to the chapter on the 1961 merger between the Universalists and the Unitarians and there found a reference to my grandmother: “Anne Bowman, who had been elected secretary of the new association, had done such an excellent job that in 1965 she won the denomination’s highest honor, its Award for Distinguished Service to the Cause of Unitarian Universalism.”

“My grandmother’s simple and practical decision to enroll her children in a Universalist Sunday school, her skills as a nutritionist and her basic sense of fair play created the environment within which I found my life’s path.”

How did the daughter of a Scots Irish immigrant to Pittsburgh Pennsylvania become a top leader of America’s most liberal and socially active church denomination? Anne Stewart grew up in a strict Presbyterian household in Beaver Falls.  Her father, David Stewart, was the superintendent of the Jones and Laughlin Steel mill. If suitors came calling for Anne or her sisters, the first question from her father to the young man would be, “What parish were you raised in?” Needless to say the local Catholic parish was the wrong answer and entrance was denied.

My grandmother studied nutrition at Carnegie Institute of Technology and graduated and then met my grandfather J. Russell Bowman at a summer session at Edinboro State College, where he was a teacher and she the campus nutritionist. They moved to Cambridge, Massachusetts where he received his doctorate in English at Harvard and then relocated to the working class suburb of Malden during the depression. Grandfather became an English teacher at Malden High School, and grandmother a homemaker raising her children, the oldest of whom was my mother born in 1927. In 1934 it was time to find a Sunday school for the children and there was no room at the Presbyterian Church so grandmother made a practical decision to enroll my mother and my uncles in the nearby Universalist Church. She became active in the women’s federation as she cooked the meals for the Sunday Socials and rose to a national leadership position before the merger of the U-U in 1961 when she became the national secretary of the association’s board of directors.

My grandfather Bowman, the descendant of Pennsylvania Deutsch immigrants, grew up in Lebanon PA. He was a brilliant man who did not suffer fools and ideologues. He had a particular distrust of the Catholic Church, partly because a priest in Malden had launched an attack on his “Good Reading and Discussion Group”. This was a great books discussion group that he led from 1948 to 1965 when he retired. During the height of the McCarthy period in the early fifties this priest questioned whether the readings were sufficiently patriotic and loyal. In 1965 my grandmother was honored at the Statler Hilton Hotel in Boston at the Unitarian Universalist Association Annual Banquet. She received “the annual award” on the occasion of her retirement for her service to the church. The theme of the evening was the newly emerging “ecumenical” movement and many other leaders of other faiths were honored also.  But his eminence, Richard Cardinal Cushing, the Archbishop of Boston paid eloquent tribute to my grandmother. My grandfather Russell had to sit thru the Catholic tribute to his wife and stew over his stew.

My grandmother’s simple and practical decision to enroll her children in a Universalist Sunday school, her skills as a nutritionist and her basic sense of fair play created the environment within which I found my life’s path. As I wrote when she passed in 1995, “Anne Stewart Bowman was a mover and shaker and a delicious pie maker!” Thank you grandma.

In Olney Odyssey #3 I will recount my two years at Harvard playing, football, protesting the war and studying Italian.

“… there needs to be imagination”

We need a new indicator of economic success other than GDP.

We must change our thinking fundamentally: that GDP, or simply put, the aggregate growth of an economy is almost meaningless unless that growth is clearly defined in the context of democratic principles.

Let us measure GDP at home and abroad based on the path toward attainment of the social contract that achieves life, liberty, and the pursuit of happiness.  Let us build solutions to the issues of health, education, housing, employment, and retirement measureable by outcomes that equate to nothing short of the achievement of the full capacity of every child, woman, and man. 

To me the essence of organizing and social movement is that before there can be planning, strategizing, or even investment in change, there needs to be imagination, the ability to truly see a new place for people to create a peaceful and just society.  Indeed such a place requires new public policies, but the creation of such policies that actually result in transformed lives for people to be able to achieve their dreams first requires clarity about what the dream actually is. I think consensus can be achieved about the dream.   The means to get there is when we challenge ourselves with the facts.

Often people who want positive change complain that our nation lacks the constitutional commitments that exist in Europe and elsewhere that “guarantees” certain social and economic benefits to its citizens. We often complain that the struggle here in the U.S. is quite different. Perhaps.

I would suggest that such paradigms and constitutional mandates change over time…just look at the creation of the Eurozone and the current convulsions and threats to the economic security there. Sadly and predictably, all across Europe, even in what seem to be unlikely places such as Scandinavia are experiencing the rise of racist and fascist parties that are in large measure responses to Great Depression-era unemployment levels and dislocation. The social contract in Europe is under severe threat of falling apart. It will take much convulsion and reconciliation to arrive at up-to-date and workable solutions.

What about in the U.S.?

“Having won this race, all are complicit in both a major crime against humanity and against workers everywhere and here in the US.”

Let’s look at just how far off track we have gone:

In my view, a recent New York Times story in its way scratches the surface of these questions by detailing the misery this nation’s and others’ manufacturing, labor, and trade policies cause to so many.

On December 22, 2013, the New York Times provided a very important piece of research and journalism which explains what we already know:  the race to the bottom of wages and working conditions in the clothing industry has been won by the manufacturers, distributors, and purchasers of clothing world-wide.  Having won this race, all are complicit in both a major crime against humanity and against workers everywhere and here in the US. 

Sadly, but unfortunately all too consistent with what is wrong with our nation in its essence, is that the U.S. government spends about $1.5 billion directly aiding this aspect of the race to the bottom through direct purchases of clothing from the lowest wage and inhuman working condition manufacturers in the world.

The race to the bottom in the clothing industry has been underway for more than a century.

There is no telling just how far the cynicism and fear among workers here and abroad will go.  The nearly vertical direction of wealth flowing to the top 10%, 1%, .1%, and .01% both in the US and around the world by definition creates so much misery that the mind cannot really comprehend it. Yes, the race to the bottom has been going on for a long time.  And the cynicism and fear in the hearts and minds of workers everywhere stokes the passions of dangerous ideology.  Have we learned nothing from our past?

How much longer will we tolerate low wages and inhuman working conditions? 

And how much longer will we tolerate the self-fulfilling prophecy that people “want” low-cost items because they cannot afford more?  There is just too much data that we all know all too well that the race to the bottom is what capitalism has achieved.  It is time for all stakeholders to discuss and plan for a much different set of outcomes.

This should not be a radical idea.

We must have a vision of how to attain high quality health outcomes for all while achieving manageable and affordable costs.

“I believe there is a grand experiment that we can undertake: change our thinking about GDP in the health care sector.”

There is a different path:

Health care in the US has also been a race to the bottom. 20% of our GDP, that amorphous super macro measure of growth hides the race to the bottom in US healthcare: 50 million uninsured, with health costs being the single highest cause of personal bankruptcy, and for all of our highest in the world spending, the World Health Organization ranks the US 37th in the world in health care outcomes for its people.

A vision known as The Triple Aim summarizes a new vision, a realizable state of consensus in which 1.) each individual, and 2.) the population in aggregate achieves health, and in so doing, 3.) the cost to achieve health is substantially reduced.  There is a growing consensus among stakeholders in the healthcare sector of the economy that The Tripe Aim ought to be achieved. Obviously there are differences about how to get there…but the vision is demanding and actually quite specific in its intent. The Triple Aim demands that the 20% of GDP spent on health care be measured, improved, and substantially reduced.

We must have a vision of how to attain high quality health outcomes for all while achieving manageable and affordable costs. Our nearly $3 trillion annual spend in healthcare must be reduced if our economy and our people are to have money for other needs.

Through Medicare, Medicaid, the Federal Health Insurance programs, the Veteran’s Administration, and now the Affordable Care Act, we say as a people that care must be extended to all, care that is of the highest quality, highest safety, with gentle and caring patient experience. If actually achieved, care for all will become much less costly because health is maintained for everyone, not just for those who can afford care.

To accomplish this, we need systems thinking: the cost, safety, quality, and access to care requires a different delivery system of care and a different payment system that rewards outcomes as opposed to activity: outpatient and preventive care should be the emphasis, with clinics available near everyone; outpatient care must emphasize early childhood preventive care, including dental care and behavioral/mental health care. We need care that is based on popular education methods so that people learn to own their own health and understand their bodies.

There is a broad consensus that these transformations in health care would if implemented over time, save about $1 trillion of the $3 trillion annual spend. To achieve this outcome, we must start the investments in transformed health care thinking and delivery systems as soon as possible.

“Social dialogue must replace the politics and confrontation of self interest in all venues.”

All of these changes that must take place require a much different dialogue among practitioners, employers, employees, administrators, insurers, government, unions, and community stakeholders.  Inherent in the changed dialogue is a commitment to put self-interest aside, and plan change in a collaborative fashion based on measureable improvement and value creation.

Social dialogue must replace the politics and confrontation of self interest in all venues.

Health care transformation should be part of a broader social movement, part of an imagined, but real vision of the hopes and dreams of our people.

If everyone is covered by insurance, the “risk pool” is broadened and spreads the cost across the largest population, the healthy and the not healthy.  Since healthy people use the system less, the overall cost is reduced.  Emphasis on prevention and patient education is the key to success:  pre-natal care, teaching healthy eating/active living and pro-active management of chronic conditions like diabetes, heart ailments, asthma, and mental health saves money over the long haul.  All of these changes require investment in new infrastructures outside of hospitals and other large institutions which create new opportunity and new forms of employment. Payments to providers must be based on achieving these goals.

“We have seen the race to the bottom…”

Like anything else, a system that works requires management and regulation:  you cannot have utilities, transportation, or construction of buildings or housing without strict regulation and systems to ensure safety and service. Health care requires the same kind of planning. No more sacred cows!

Wholesale cuts in expenditures or services are not the answer. Clinicians and providers can only cut their own expenses so much, and these cuts will impact small group and individual practitioners and advantage large systems that can scale back costs through consolidation and volume. Such cuts will demoralize the workforce, which instead must be fully supported. It is the workforce that must be fully engaged to solve the problems of waste, error, efficiency, safety, and patient experience.

The Triple Aim envisions substantial reduction of the unsustainable amount of our nation spends and wastes on health care. Let the Triple Aim serve as a path to new thinking about a New New Deal:  a fundamental alteration of priorities with a vision to create high wage employment, reduction of military spending, advance universal health care, alter the tax codes, make pension plans a right, universal early childhood development a right, with a parallel emphasis on “employment transition”; that is, long term planning for skilling up for the jobs we will forecast for the future.

We have seen the race to the bottom in the clothing sector and in manufacturing. We have seen the race to the bottom in health care. What these tragic experiences have in common has been a reluctant but wrong acceptance that we cannot have prosperity for all and products and services for all.

And through it all we keep measuring our economy with something we call GDP.

Without measures of improvement in our people, we will continue to mask democracy with incomplete and amorphous data. The Triple Aim is inherently measureable, and should serve as a path to how we think about and measure our economic activity.

This is hard, but it is much harder and dangerous to have a society in which the basics are missing for so many.