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Kamis, 04 Oktober 2012

The Conspicuous Exception: History and Healthcare in Germany and the United States

[Editor's Note: Today's entry is a guest post from Fred W. Beuttler of Carroll University (WI). Fred is a S-USIH member and long-time supporter of the conference and blog. - TL]

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This past summer semester, I had the honor of teaching on a Fulbright at the University of Tuebingen, in Germany, returning at the end of July. Reading Elisabeth Lasch-Quinn’s reports from her Fulbright in Rome left me somewhat intimidated to add my thoughts to the mix, but I wanted to get some sense of how other historians approached a couple of key topics in American history.

One of the main themes of my lecture course at Tuebingen was the question of American exceptionalism. I was there as a political rather than an intellectual historian, but I was trying to approach political topics from the perspective of the history of ideas. Coming back to academia after a number of years working for the Federal government, I wanted to raise issues of national policy to my students in Germany, seeking to get a different perspective.

The obvious point of difference between Germany and the United States is over the question of national or universal health care. Universal health insurance originated from the Right in Germany, from Chancellor Bismarck seeking to undercut socialist movements through state sponsored social insurance. American Progressives looked closely at German models for many of their policy proposals, a history that is well known to members of the USIH.

But that leaves an open question: Why is it that the platform of the Progressive Party of 1912 has been almost entirely enacted in American law, except for health insurance?

Clearly America is an exception to the European consensus: one of the biggest differences is the almost unquestioned acceptance of universal health insurance in Europe, and the strong opposition to universal coverage in the United States. This is not just reflected in current public opinion polls on the Affordable Care Act, but also in the long history of opposition dating back at least to Franklin Roosevelt’s Economic Bill of Rights speech in 1944, if not to 1912 itself.

My question to the USIH, is what is the explanation for this? Why the opposition, for so many Americans, to the idea of national or universal health care?

What I am interested in is our thinking on particularly intellectual reasons for the opposition, rather than merely financial reasons, such as lack of affordability, or costs, etc. Questions of “interests” should probably be excluded too – for example, the opposition of the American Medical Association to President Truman’s attempt to create national health insurance in the late 1940s. It is also too easy to give some variation of the argument that the American people are trapped in false consciousness, or are too stupid to know their own interests, or other such explanations. Yes, some are, but that does not explain the persistence over decades, of significant opposition.

One thing that I did notice while I was in Germany was a strange lack of curiosity as to why so many Americans were opposed to national or universal health insurance. Typical was an article that appeared in the English version of Der Spiegel, in May, before the Supreme Court decision.

Under a picture of a Tea Partier dressed in American revolutionary garb, the opening paragraph read: “In Germany, people are baffled by how hostile a country as religious as the United States can be to the principle of mandatory healthcare insurance. Not even conservatives question the system, which businesspeople say gives Europe's largest economy a competitive advantage.”

That was basically the point of the article – how Germans were “bewildered” about why so many Americans “appear to be against universal coverage.” Yet there was not even a reason given to this opposition – the article just said that Germans were bewildered by it, but it basically stopped there, after interviewing an expat American who was also bewildered.

In lecturing a number of times on the politics of health care to German audiences, I found similar attitudes. Germans were mystified over this American opposition, but they were also uncurious as to reasons why. Most were content to just raise the issue, rather than seeking to discover what about Americans had led them to this opposition.

It was strange, having German students doing presentations on it, which turned into advocacy for such universal coverage, rather than seeking as historians to understand the intellectual issues present there.

Part of our job as intellectual historians, it seems to me, is to get beyond this bewilderment, and actually explain to our audiences the reasons for the significant opposition of Americans to what to Europeans is a settled issue. Regardless of where we stand politically, it seems important that we understand this. For the politics of health care reform are central, I believe, to what makes America an exception.

I have some ideas on this, and if there is interest in the USIH community, I would like the opportunity to expand a little on what I sketched out in my lectures in Germany. But first, I would be interested in how others approach this topic. What reasons do intellectual historians give for American popular opposition to national or universal health insurance? Are there significant intellectual rather than economic or financial or interest-based reasons for such attitudes? Or are the reasons given simply reducible to economic interests?

Unlike the bewildered Germans, I’m very curious as to what we think about this conspicuous exception.

Senin, 21 Mei 2012

From Rome with Love III

by Elisabeth Lasch-Quinn

In the battle merely to survive physically, food and shelter are essential, clothing (except as shelter) optional. That seems relatively simple, especially since these basic needs have been with us since our infancy at the so-called dawn of civilization.

Each of us tries for survival now with the means available in the postmodern economy. But what is remarkable, in these individualized times, is when one of us tries for the survival of someone else as well. So when a whole group tries, even better, not only for other people's survival but for their flourishing, it is doubly, triply, quadruply remarkable. This is one of those rare times, with manipulation and murkiness abundant, when a distinctly un-fuzzy math can actually prevail. Just multiply by the number of people and you get the degree of remarkability.

By this measure, Italy deserves perhaps not to be romanticized, exactly, as we can allocate its rather substantial flaws. But I think it should be considered a prime candidate for re-romanticization. It stands for food--good food. And now many are trying to describe a particular definition of good in a conversation that has ramifications well beyond food itself.

A few days ago I had the opportunity to travel to a small town in northern Italy named Pollenzo, near the city of Turin. The occasion was a half-day conference on food and sustainability put on by the Fulbright Commission. What I saw there was truly inspiring.

The conference took place at the University of Gastronomic Sciences (UNISG), a new university just founded in 2004. (See its website or this brief New York Times article.) The audience for the conference was largely comprised of students in the graduate programs there.

Housed in a rectangular layout of renovated farm buildings in the Piedmont region, with castle-like turrets at the corners and a central square, the university is one of the most pleasant places I have ever been. Even with its students congregating for the conference in clusters here and there, as well as the occasional tourist (there are two hotels, a restaurant, a wine bank, a chapel, gardens, a tiny orchard of indigenous trees, and preserved ruins, along with the classrooms and library), the atmosphere was one of bucolic serenity. Its silence, in this noisy age, was a balm.

Those intrigued by all aspects of food, from its problems to its pleasures, might recognize or be interested to learn about this location in northeast Italy. The University of Gastronomic Sciences was started by Carlo Petrini, who also founded the Slow Food Movement in 1986, and the international headquarters for the movement is in nearby Bra. The movement was spurred by the plan to erect a McDonalds at the Spanish Steps in Rome. With some 100,000 members in over 150 nations, the Slow Food Movement's stated aim is to promote "good, clean, and fair food for all":

"GOOD a fresh and flavorsome seasonal diet that satisfies the senses and is part of our local culture;
CLEAN food production and consumption that does not harm the environment, animal welfare or our health;
FAIR accessible prices for consumers and fair conditions and pay for small-scale producers."

The movement is dedicated to protecting and celebrating local culinary knowledge and practices, heirloom seeds and other precious products, small-scale farming and processing, and a slowed down process of food preparation and ingestion, for maximum health benefits and enjoyment. It is against agribusiness, factory farms, genetic engineering, the use of pesticides, and fast food. As such, it is a movement of resistance and radicalism, on the one hand, and preservation and conservation, on the other. It resists easy division along standard political lines of liberal versus conservative.

The university's name belies one of the most exciting things about it and the movement that produced it: both of them combine concern for the right way of doing things-morally, socially, culinarily--with the best way, in terms of our ultimate pleasure and contentment. It is that rare blend--all but nonexistent in the U.S., with its legendary focus on change, innovation, and "creative destruction," all in the name of progress--of the motivation to change deeply disturbing practices and conditions and the desire to protect treasured traditions. This is all about taste. In the deepest and most resonant senses of the word.

Like the conference's subject, which sounds as though it might have centered narrowly on future policy, the "gastronomic sciences" could sound off-putting to everyone except those interested in applied horticulture, biology, or perhaps cooking. But these initiatives have everything to do with ideas more broadly, and with history. This was evident throughout the presentations. For instance, Daniel J. Philippon, who teaches in the Department of English at the University of Minnesota, spoke on his current book project, an intriguing study of the shift from environmentalism to the sustainability movement through writings in key genres on land, food, and culture. As he laid out his approach and chapter organization, this work promises to be essentially an intellectual history of the sustainable food movement. Currently a Fulbright Professor at UNIGS and the University of Turin, he is the author of Conserving Words: How American Nature Writers Shaped the Environmental Movement and writes about many of the authors that are our stock in trade in U.S. Intellectual History, from Whitman to Berry. And Maria Grazia Quieti, Executive Director of the U.S.-Italy Fulbright Commission, delivered a talk entitled “Discourses on Food and Sustainability in Trade Negotiations,” in essence a recent intellectual history of sustainability, with the Seattle WTO protests rendered as a pivotal point at which the official "technical forum" was called into question and competing discourses on issues formerly the preserve of policy experts and academics became apparent. Her discussion of how ideas become institutionalized, powerfully shape "intersubjective reality," and can be challenged was helpful theoretically, and hints of her portrait of her experiences while at the UN's Food and Agriculture Organization--a project on which she is currently at work--were fascinating. Her humble, clarion call for a method of paying detailed attention to conversations seems akin to what we do.

My intent in this brief sketch is only to tell you enough to pique your interest if not in this particular subject or region, then in some of the intellectual vibrancy I see here--here as in Italy and in fields differing quite a bit in name from ours yet part of a common pursuit. If we really care about the history of ideas in cultural context, we can benefit from important projects underway seemingly far afield from our own specialties. We can possibly learn from them and savor them, both.

Minggu, 13 Mei 2012

From Rome with Love, II

By Elisabeth Lasch-Quinn

When encountering something outside one's usual experience, one's first instinct is to draw comparisons and contrasts with what one knows. Trite and true, right?

It sounds so simple.

But of course there are deep philosophical and psychological questions about what makes us us and what makes them them--and ethical questions about whether it should. Layer onto this questions from theology, cognitive science, anthropology, and history, let alone art and literature, and we must ask, in more ways than one, who do we think we are?

When we take note of so-called cultural differences, is a generalization about our own or another culture ever accurate? Many recent reviews of Woody Allen's To Rome with Love (still haven't seen it) judge it replete with superficial stereotypes. Are works of cultural history or social criticism often that different, however careful they might try to be? Isn't the risk of over-simplifying--or, obversely, of over-complicating, more au courant in academia these days--a pitfall of generalizing at all, and thus of characterizing, portraying, or observing?

I am excited about the "For the Love of Film" preservation blogathon that begins today. (Look out for the upcoming posts by some of my fellow USIH bloggers later this week.) Musing on the Italian/American film connection, I came across a blog that compared Italian and American posters for the same classic American films by setting the posters side by side (here for Hitchcock film posters). They really do seem different. As with album cover art or wine labels, movie posters become increasingly intriguing the more I see.

This blogger and those who commented on her posts see the Italian posters as largely more compelling because "more artistic/intriguing/seductive." Other people, though, argue that translation isn't always an improvement, as when Eternal Sunshine of the Spotless Mind in English becomes the equivalent of If You Leave Me, I Delete You in Italian. (For this and other amusing examples from countries in addition to Italy, see here)

If we see differences, do we automatically conclude they are the result of cultural differences? If we see similarities, do we assume cultural similarity? Or perhaps these are gross generalizations, categorical simplifications.

Study after study these days, no matter what the subject matter, concludes: it was complex. Isn't that how it always is, once one gets to know anything better? That is is more complicated than it first appeared?

Not necessarily. Some of us actually might be predisposed to think of things as more complicated than they really are, only to find out, upon closer acquaintance that they are more understandable. People whose differences scared us through their foreign-ness might have seemed complicated until we see the patterns of their lives up close. Unfortunately, a workable simplicity only comes to some people by discovering that others are "just like us." This can do injustice to others, and to ourselves, as much as the famous faux pas (or worse) of "othering." To make matters worse, an excessive fear of "othering" can actually lead to the "othering" of oneself, I think, through the self-accusation: otherer. Like Hester Prynne, only with an "O."

The aim of the Fulbright Commission, by whose good graces I am living and teaching in Rome this semester, is "to increase understanding between the people of the United States and the people of other countries." With so much to be wary of today in terms of self-advertisement and what institutions really deliver, it is refreshing to see the ways Fulbright actually does make this possible. By supporting scholars at all levels for different lengths of time in numerous locations, but always in service of this kind of mutual learning, Fulbright offers opportunities for intellectual exchanges of the humble, day-to-day sort. It could be an inspiration to USIH, but then it seems that this is precisely what USIH is doing.

As we often see others as though through veils of our own past, present, and hopes or fears of the future, it is amazing we can ever see anyone at all. (As the Dylan line goes, "It's a wonder we can even feed ourselves." And of course, it remains to be seen if we can. In an upcoming post, I hope to describe my experience in Pollenzo, where the Slow Food movement took root.) As in an earlier Woody Allen film, in a bedroom scene in which he cannot abandon himself to love making because of the superimposition of the image of his mother on his lover's face, our imaginations--whether from guilt or another state--often make it impossible to glimpse one another at all. Other people become figments of our fantasies, whether pleasant or horrifying, and another place at best a mere utopia, from the Greek, meaning "no place."

To get beyond this might be a worthy goal, but it might also be an impossible one. And it may be undesirable, in any event. Worse than superficiality and stereotyping, it casts the multitudinous veils, which are just as much a part of anyone as anything else, as irrelevant. Drawing them back is a particular technique of observing. But it is when we strive for abstracted knowledge (abstracted from them, yes; abstracted from ourselves as well) of other people and places, we are prone to over-simplify or over-complicate. Understanding is another thing entirely.

[Updated: 5/14/2012, 7:40 am CST]

Kamis, 22 April 2010

Fulbright Lectureship in U.S. Intellectual History in Rome

An exciting opportunity: Fulbright Lectureship in U.S. intellectual history in the American Studies Department at the University in Rome for spring 2012. You can find information at this link (scroll to the bottom of the page). Casey Nelson Blake, Alex Bloom, George Cotkin, and Greg Sumner have held this lectureship in the past.

Fulbright Lectureship in U.S. Intellectual History in Rome

An exciting opportunity: Fulbright Lectureship in U.S. intellectual history in the American Studies Department at the University in Rome for spring 2012. You can find information at this link (scroll to the bottom of the page). Casey Nelson Blake, Alex Bloom, George Cotkin, and Greg Sumner have held this lectureship in the past.