Archive for June 8th, 2009

Why National Health Care Is Necessary for a Viable Food System

Sharon June 8th, 2009

A while back, at a talk I gave, a small scale farmer asked me why my family didn’t farm full time.  I observed that one of the reasons we don’t is simply that we have young children and we feel that we have a need for benefits.  He pointed out that my state, New York, has a program to provide health insurance for the children of the uninsured, and that we could rely upon that.  My own observation was (beyond the fact that I prefer not to burden state safety nets if we can avoid it and the insurance provided is vastly inferior to the one we have now) that I do not expect that program to continue for very long, and thus, we would not give up my husband’s existing benefits to switch to a state program that I suspect will at some point be cut in the vast rush of states to cut social service programs to balance their budgets.  While I suspect that my husband’s university may also eventually cut benefits, I’d still say the odds were a little better for hanging on to health insurance via his job.

And, of course, we can see that other states are leading the way here - most notably California, which plans to resolve its budget crisis not by legalizing pot or releasing non-violent drug offenders,  by stripping benefits from children, the disabled and the elderly.  But California isn’t alone -  children’s health care is threatened or there are pushes to curtail it in nine other states, and I suspect it is only a matter of time before more states make the push to cut health care programs for children and the working poor.

Now with luck, the state budget cuts won’t matter all that much - if we can pull together a functional and meaningful national health care system.  The problem is that that’s a bigger “if” than it may seem.  Besides the endless debate about what type of national health care system to provide, there’s the very real possibility that our enormous deficits and bailouts may have made it truly impossible for us to have a system that looks like the one we have at present, and is sustainable.  Even if we can implement national health care, the question becomes whether we can sustain it over the long term, as our demographic situation shifts towards an older and sicker population, and our national economic, ecological and energy system puts us closer to crisis.  So far, as far as I can tell, most of the proposed programs for national health care do comparatively little to regulate costs, and assume levels of growth that we simply may not see.

In _Depletion and Abundance_ I included a chapter on health care - on the ways that could keep national lifespans up and spend much, much less than we do now - half as much or even less than that.  It involves a great deal of system triage and difficulty, but it is possible - and IMHO, in the end, as long as we imagine that the goal of national health insurance is not keeping infant mortality low and lifespans high, but the serving of people accustomed to a large range of drugs and interventions with as may drugs and interventions as possible, we are facing trouble.

And yet, we need national health care desperately - we already have a tiered class system in the US where those who are poor and lack health insurance get sicker, die younger and suffer more.  We already have a lifespan pathetic in the developed world - we are 44th, and lifespans are declining in many poor counties in the US.   

We need national health care because otherwise we will see that class division, and the differences in lifespans and infant mortalities between rich and poor grow and grow.  We need it because our current system is too costly and devours too many resources in every sense.  We need it because it is a basic issue of justice, and because having the crappiest medical care system in the developed world is not an honor.  We need it because we already bear the costs of medical care for the uninsured in our society, both directly and indirectly - we all pay for the poor mother who takes their daughter to the ER in the middle of the night for an ear infection that could have been handled with a ten minute  office visit.  We already pay for the people who age into Medicare with uncontrolled diabetes and high blood pressure, whose medical costs are double the costs they would have been if they’d had basic preventative care.  We already pay - the question is whether we pay honestly and directly, or inhumanely and dishonestly.

But we need national health care for another reason as well.  We need it because we need sustainable food systems, and national health insurance is the key to ensuring that we can have the Nation of Farmers we so desperately need to be.   Because one of the things preventing people from farming, one of the things small farmers off their land is the cost of medical care.

Nationally, a survey showed that farmers pay twice as much out of pocket for health care as the average American.  Most farmers large enough have to buy their health care coverage as individuals, driving up the cost, and because of the risks of farming, their premiums are higher than average.  Others have no insurance, and have to put their insurance on credit cards, or pay with their savings.  The average US farmer is nearly 60 years old, and many have pre-existing conditions that come with age - either forcing insurance costs out of reach, or driving them up.  No wonder so many of today’s farmers, when polled, say they wouldn’t want their children to follow in their footsteps - but that leaves us with the very real question of where the population that grows our food will come from.

Among younger small farmers getting started, I’ve watched many of them struggle with the insurance conundrum - they start out young and healthy, and often are willing to forgo health insurance because they truly and honestly want to do something good.  But farming pays poorly, and the first serious injury can be a disaster - and working outside all day, you get hurt sometimes.  Or perhaps they have a child - even those able to take on a homebirth find that the cost of having a child is a few thousand dollars or more - on a small household income.  Those who must have a hospital birth or more interventions can find themselves rapidly indebted.  Soon, finding a job with health care coverage starts to look awfully good - and there goes the farm, or it goes down to a part-time venture.

Farmers who experience a major injury or illness risk losing their land to bankruptcy - while losing your home is always traumatic, there’s a big difference between losing the house you love but that mostly provides shelter and a good school district, and losing the land you use to make your living.  Up to 10% of all agricultural bankruptcies are linked to illness and injuries - mostly among the uninsured.  Once the land is lost, it is gone - most farmers once out of agriculture, are out for good. 

Without a national health care system, we can become a nation of hobby farmers and victory gardeners, but that won’t resolve the grain production problem, and it won’t feed our cities.  A lot can be done by home scale agriculture, and I am an ardent proponent of it - but we need professional, full time farmers as well, and without insurance, the lure of any other work that covers the child’s asthma medication or the husband’s heart pills will always drive agriculture.  What parents wants their child to go into a profession that leads in so many ways to heartbreak and loss at so many levels - including the fact that one medical crisis is the end.

We have spent four trillion dollars bailing out the banks already, and committed another 9 trillion at last estimate.  Now whether you are a fan of big central government or not (and I’m not for many purposes), I think there can be little debate between honest people on the left and the right that the money would have been better spent serving the needs of people in need than bailing out the banks.  And we simply cannot allow our venal foolishness in subsidizing the rich to allow us to forget that we can and should take care of the basic needs of the population. 

It is certain that there will be costs and losses in whatever system arises - in _Depletion and Abundance_ I strive to acknowledge that we cannot do all the things we do at present, and that will hurt some people.  That said, however, enormous cuts could be made in the costs we incur at critical times in our lives - for example, 1/3 of all medical interventions take place in the last 3 years of life.  Some of that is inevitable - someone who gets cancer, has major interventions, but then dies two years later will fall in that category.  But an enormous number of those interventions operate simply to draw out the process of death and add to suffering - my great-aunt, visibly dying, was pressured into having open heart surgery a few months before she died, simply because no one would say “you are dying, it is time to talk about relieving your pain.”  My husband’s grandmother was pressured into giving her dying husband medications to prevent a heart attack that caused him great discomfort - at a point where a heart attack was the most benign and merciful sort of death possible. 

Even if we were simply to radically cut back our interventions at the time of death and birth - for birth too is radically overmedicalized, and many nations successfully demonstrate that the safest form of birth, barring medical complications that affect only a small percentage of the population, is home birth with a midwife - and shift our emphasis not to treating disease, but to preventing it, we could afford health care that would keep lives long and infant mortality low, that would minimize suffering and allow us to keep our farmers farming and every other useful person engaged in subsistence and cottage industry business going, doing what we desperately need - increasing the self-sufficiency of our nations, states and communities.

Few of us think of the debate on health care in terms of food security and our agriculture - but we are on the cusp of a great shift in our food system, mostly driven by demographics.  The average age of US farmers is approaching 60 years old, and there are not enough young farmers to follow them.  If we do not make it possible to go into farming a profession - if we make it only the province of the young, the healthy, the childless, we risk facing a national food crisis far more acute that the one shadowing us due to other causes.  The reality is that all of us have a real investment in our country’s continuing to produce sufficient food, and the right kind of food - and that investment requires that it be possible to become a farmer without sacrificing your health.

I do not doubt that we will struggle to afford the kind of national health care system being discussed right now.  I do not doubt that we will find ourselves at some kind of impasse at some point in the political process. I do not doubt that our spiraling debts and unfunded mandates will stress our ability to provide health insurance - but we should not believe that this means we cannot achieve health care for the masses that meets most of our basic needs.  And that we must do so.


Independence Days Week 6:Not Even Summer Yet, But Winter is Coming

Sharon June 8th, 2009

We’ve been talking in homeschool about cycles - birth, life, death and composting; the seasons of the year and the way farmers must think ahead when they plant, harvest, etc…; and touching lightly on the cycles of history.   We’re still planting madly, of course - it is only really just warm enough now for the heat lovers to go in, and the garden redesign is still in progress, but it is time to get serious about harvesting and preserving as well - we picked the first strawberries. 

While rhubarb, asparagus and a few spring leaves and herbs offer a slow ease into preservation here, I don’t think of it as harvesting and preserving season for real until we eat the first ripe strawberries.  We haven’t made jam or dehydrated any yet - we’re still eating the early ones, and not enough yet to be willing to put any aside.  But it is coming.  Despite two large strawberry beds, we never have enough, and have already marked Thursday down on the calendar as the day our favorite local pick-your-own opens.

Underneath it all is the realization that most of what we will do is collecting summer’s warmth and heat in the form of fruit and vegetables, and putting them by to warm us through the winter.  In the north, where I live, winter is always coming, and you can never have too much summer sun in jars to compensate.  It is hard, as they days warm and lengthen, to realize that summer hasn’t even begun, but we can already see winter on the horizon, but, of course, that is the way of things in cold places.

And it is the way of life on our farm - if I want to expand our egg business for next spring, I need to order layers now.  If I want to buy a buck this fall, I need to build a pen this summer.  If I want kids in May, I must plan for breeding in December or January.  If I want strawberry jam left next April, I must beginning making jam in mid-June.  If I want winter luxury pumpkins to roast in November, I must order seeds in February and plant in May.  To every thing there is a season, and a time to every purpose - and it is never fully possible to live in the moment when each season pushes you towards the future.

So every day we plant things, and every day we harvest something, and soon, we will try to preserve something, if not every day, but a few things every week.  For soon, the rush will be upon us - the strawberries and peas will go past, and then will come July with the corn and the cucumbers, the blueberries and the currants, the raspberries and the peaches, the tomatoes and the beans, and the siren song of “not enough, but too much, but it will be wanted when the snow blows.”

Ok, winter may be coming, but it isn’t here yet - lovely, lovely weather this week, although we could use the rain I’m told is coming.  Still, along with looking forward, there’s enjoying what you’ve got.

 Oh, and btw, for those of you asking for kid photos, Selene decided she was not pregnant ;-) .  We’d been debating back and forth for a while “is she, or isn’t she?”  Despite three good breedings, before witnesses, she was awfully thin for a pregnant goat, and clearly not because she wasn’t eating ;-) .  We were dubious, but our friends assured us that she just tended to carry thin - but since no baby goats appeared ;-(, we’re off kidding watch.  She’s been in with a buck for almost two months now (Wiggy, who has to go back home soon, but will be incredibly missed - he’s such a sweet animal - my kids adore him), so all I can say is that there had better be kids in September - both she and Maia should kid then.  Meanwhile, we’re buying two more does, and I’m trying really hard to resist the temptation to ask for this little girl as my birthday present (Eric’s rolling his eyes as I write this, but he’s the one who said to me recently “we need more goats.” ;-)) - I’m having baby goat envy!

Planted: Queen Anne Raspberries, Seaberries, Gojiberries, Strawberries, Beets, Good King Henry, Sorrel, Forsythia (who knew it was medicinal ;-) ?), thyme, basil, peppermint, marshmallow, valerian, meadowsweet, green beans, red noodle beans, asparagus beans, peppers, tomatoes, eggplant, onions, parsnips, carrots, zinnias, dill, cucumbers, pumpkins, squash, melons, gourds, kohlrabi, cabbage, daikon, mustard greens, lettuce, calendula, gladioli, bachelor’s buttons, rue, horehound, rhubarb, blueberries, wintergreen, bearberry, ginkos.

Harvested: Strawberries, shelling peas, snap peas, bok choy, chinese cabbage, napa cabbage, lettuce, spinach, arugula, rhubarb, chives, nettles, lambsquarters, dandelion root, eggs, angora fleece.

Preserved: dried chives, raspberry leaves, canned rhubarb sauce, froze beaten eggs, made more apple cider vinegar with last of the wrinkly apples.

Waste not (someone in comments is using this, and I really like it - thanks!): Used up next to last chicken in freezer and made laotian chicken soup, asorted out bins and combined oatmeal, began making more closet space for food, brought last year’s pickles and rhubarb sauce to community picnic, discarded last year’s dried herbs, unpicked a really pretty hat that I made for baby Asher, to reuse yarn.

Preparation and storage: Picked up a couple more air-tight glass jars at a yard sale on Friday, bartered plants and future seed starting with a friend for speedling trays, added more black beans and brown rice to storage, bought Eric a swiss army knife and dulcimer and fiddle playing materials for birthday, traded remaining hay for composted horse manure, priced a ton of goat feed - Agway no longer carries the local, organic feed, and am not sure we want to buy by the ton, but am considering it.  Finally organized yarn, sewing supplies and sewing box. 

Community Food Systems: Gave a talk at a local foods group, met cool new goat farming Jews and began evil plan to form a new “Union of Agrarian Jews” ;-) .  Anyone want to join?  Not entirely about food, but began discussions with editor about a new book…more on that soon.

Eat the food - ate all the peas out of hand, same with the strawberries.  Using up last of last year’s sweet potatoes, discovered that they are *fabulous* with chipotle-cheese sauce on them and whatever greens are lying around.  Made a rhubarb-sauce cake for a friend, decided I like it better with applesauce - but I had rhubarb and was out of apple. 

How about y’all?