Israel & Foreign Aid

Let me begin by saying that I believe in foreign aid.  I think properly used, foreign aid can be a significant tool in our national security in addition to making the world a generally better place. 

We give a significant amount to Israel each year - $3 Billion.  It is the largest recipient of US government aid.  That equals a little more than 1% of their entire GDP and almost 4% of the government budget.  It essentially goes there with no strings attached.  A group of legislators have proposed that we raise that amount to about $3.7 Billion and Israel is hoping to see it raised to between $4 & $4.5 Billion.

To put those numbers in context.  The population of Israel is roughly the same as either New Jersey or Virginia.  New Jersey is the state with the lowest return on its federal tax dollars in the US and actually ends up with roughly a negative $23 Million each year.  That is, NJ sends $23 million more to the federal government than comes back to the state.  Virgnia is the state with the highest amount of return from the federal government.  It receives about $97 million more than it sends in in federal taxes.  Look at those numbers for a second and realize that the state with the highest return on its federal tax dollars gets back less than 1/3 of what we sent to Israel this year... and there are obviously strings on much or most of that money.  Israel, on the other hand, continues to break international law with the building of settlements.  Additionally, 1 of 3 Israeli families receive some kind of government welfare including large numbers of ultra-orthodox Jews who live on state subsidies for religious study.  Some studies show that 65% of ultra-orthodox men do not work but instead spend their time being paid by the government to study torah and scripture. The ultra-orthodox are also the fastest growing Jewish segment of the Israeli population.

Some economists are arguing that the Israeli economy will collapse under the weight of its welfare system.  It is no wonder that they are hoping for a significant increase in our aid... On top of those who are paid to not work, Israeli citizens receive other benefits that US citizens do not.  All universities are subsidized by the state and students pay only a small percentage of the actual costs.  Health insurance is universal and looks to me roughly like Medicare for All.  One could easily argue that we subsidize all of these benefits.

So what do I think we should do?  I think that aid should be tied to real actions that reflect our values.  Should we dictate to Israel how they should live?  No.  But neither should we subsidize their choices when they conflict with our own.   Here are two examples.  We refuse welfare to criminals in the US... tie our aid to the dismantling of settlements and to better treatment of the Palestinians.  We hold as one of our deepest values separation of church and state... tie some aid to the removal of special perks for ultra-orthodox sects.

An Imagined Reality

Folk who know me know that I'm feelin' the Bern.  I've had some good conversations with friends who definitely don't feel the same and some have raised interesting critiques of Bernie Sanders.  One friend said that Bernie should not be president because he simply doesn't understand how the world works.  I disagreed and responded that perhaps it is not that he doesn't understand how the world works but instead he is offering a different paradigm as to how it should or could work.

Recently I read a really fascinating book called Sapiens: A Brief History of Humankind.  Of all of the ideas in the book, the one that really caught my imagination is that everything works because of our unique ability to imagine a paradigm and then agree upon it.  Those imagined realities enable large groups of humans to work together, to trade with one another, to form societies.  Basically the author, Yuval Noah Harari, says that there is nothing in human society that does not depend upon those imagined realities upon which we have agreed to agree.  And those imagined realities can be changed.

I was thinking about one of those imagined realities the other day when an editorial in our local paper complained that the problems with the dollar began when its value was cut off from anything real - i.e. gold.  But, the value of gold is also tied to nothing "real."  The book uses gold as an illustration of imagined realities.  While the metal does have some iteresting properties, there is no reason beyond a cultural agreement that it should hold any more value than some other metal, many of which are significantly more useful.  Ineed, when the Spaniards arrived in the new world, searching for gold,  the native people were confused.  Gold is pretty, they thought, but too soft for any important uses.  They imagined much lower value for that soft yellow metal.

Back to Bernie... there is no reason beyond the fact that we have all imagined the world as it is that it should remain that way.  We have decided that some people should be incredibly wealthy while others struggle and even die from want.  We have decided that a freakishly tall, athletic man should make tons of money for entertaining us with incredible feats that we cannot accomplish while the one who picks our food, bent over in the hot sun in a field day after day, struggles.  Why?  The list could go on.

Now Bernie is not calling for crazy changes.  Indeed, many of the changes he envisioned are already part of the imagined reality in much of the world but it is a different reality than the one we've adopted together in the US at this point.  That is why he is revolutionary.  That is why he challenges the powers that be.  That is why I'm feelin' the Bern.  I want to see a new paradigm and the one he is offering is a lot more like the one I believe that God imagines for us than the one we currently have.

Medicare

My spouse becomes eligible for Medicare this year so we've been paying attention.  We've had to pay attention to insurance for a number of years as I have a genetic condition that causes a chronic disease.  It has been under control for me since 1987 but that is irrelevant.  On the open market, I was not insurable at any price.  I had medical insurance available through our denomination but it was nearly $4K a month and was no longer affordable by my employer or my family.  The ACA saved us... me... literally. (This is not about the ACA and I see serious problems there which I have addressed before a number of times).  So paying attention to Medicare didn't feel unusual.

I noticed quickly that while some folk have complaints, few of them are the elderly folk on Medicare... and the complaints that population does have are no different than the general population dealing with any insurance company - costs, restricted access, complexity...  I do hear younger folk who say that Medicare is proof that the government can't run a healthcare insurance system.  They say it is nearly bankrupt and doesn't work anyway.

So, with those thoughts in mind, we went to a two hour seminar yesterday to get a basic understanding of Medicare presented by a non-profit that advocates for the elderly and helps them with issues around Medicare.  I came away with some impressions... Medicare is too complicated.  Negotiating part D and supplemental plans is difficult and clearly a lot to ask of some seniors.  $300-400 a month for a newly retired person in California for part B, a reasonable part D, and an F class supplemental plan is a lot of money, especially for someone on a fixed income... and it will only go up.  The "free market" alternative - Medicare Advantage - may work somewhere, but it requires a population density that we don't have where we live so the choices here are thinning rapidly (there are only three plans available in Santa Barbara county now and only one that covers the entire county) as the companies can't make the level of profits they desire.  Even where it might work, it still has the significant limitations commonly associated with HMO's.  The donut hole is scary for someone with a chronic condition but the way that the ACA is filling in the hole is at least a little heartening.

It seems that making Medicare a single payer system, eliminating the need for Part D and supplemental plans would go a long way to simplifying the system.  Both pieces feel to me like compromises made with the private sector so they can continue to get some portion of income from this group of high consumers of medical care.  We are worried about the realities of paying that much money a month for insurance after having employer provided insurance our entire lives but I am more than glad to know that I will at least have coverage.  I anticipate that at least one of my meds (which is stupidly expensive) may not be covered but that will be what it is.  I have 3+ more years until I become eligible and another year beyond that until retirement so some of those worries are meaningless.  A Republican president and congress could make the entire program go away.  A Democratic one of each might strengthen the programs... time will tell there.

Of course there are the big public policy questions that continue... Is healthcare a right that everyone should be provided regardless of their economic condition? For me as a theologian, what are the theological implications of that question?  How do we control costs while at the same time insuring good care?  And for me a central question, what role should the profit motive have in healthcare?  (I would argue none)