Need good healthcare? Need it now? Short on cash? Be Icelandic.

Today on Facebook I posted a link to this article: "An American In Iceland Found A Lump On Her Body And Her Viral Twitter Thread Shows How Much Better Their Healthcare Is." If you've ever encountered the U.S. healthcare system, you might want to read the article too.

A reliably and sometimes knee-jerk conservative friend of mine left this comment on my post:

"Iceland has a population of 338,349, with practically no illegal (excuse me, undocumented) immigration. The Personal Income Tax Rate in Iceland stands at 46.30 percent. In addition, according to the Trip Savvy website, "VAT in Iceland is charged at two rates: the standard rate of 24 percent and the reduced rate of 11 percent on certain products. Since 2015, the 24-percent standard rate has been applied for almost all goods, whereas the 11-percent reduced rate is applied to things such as accommodations; books, newspapers, and magazines; and food and alcohol." One imagines it might be possible for the United States government to fund all sorts of things under a similar tax regime, not including state and local taxes. How much LIVING the average American would be able to do, however, is another question."

I'm not sure what he's saying there. If we had fewer immigrants, our healthcare system would be as good as Iceland's? If we paid more taxes, our lives would somehow be impoverished?

My friend is right, of course, that the U.S. has a much larger population than Iceland. He is also right that the U.S. has a higher percentage of immigrants: the U.S. population is 15.3% immigrant, whereas Iceland's is 12.5%. I don't know how many of those are undocumented; I do know that many economists have found that immigration (documented or un) is mostly beneficial. A report from the Wharton School (President Trump's alma mater) concludes, "Economists generally agree that the effects of immigration on the U.S. economy are broadly positive."

But let's look at some countries with a higher percentage of immigrants than the U.S. and see how they fare with regard to health and happiness. Here are seven. Ireland: 16.9%. Sweden: 17.6%. Austria, 19.0%. Canada, 21.5%. New Zealand, 22.7%. Australia, 28.8%. Switzerland, 29.6%. Golly, their healthcare costs must be enormous!

Well, no. The per capita yearly healthcare cost in those seven countries averaged $5,352 in 2017, or about half the per capita yearly healthcare cost in the United States, which was $10,209. The costs ranged from $3,683 (New Zealand) to $8,009 (Switzerland). (Iceland's cost was $4,581.)

Ah, but the U.S. has better healthcare, right? Maybe not. Interestingly, people in these seven countries have significantly longer lifespans than people in the United States. U.S. residents' average lifespan is 79.772 years. People in the other seven countries, on average, live three years longer, ranging from 81.884 years to 83.706 years (In Iceland, the average resident lives to 83.152 years). And if you think residents of those countries have to wait longer for healthcare, read the comments on the Iceland article.

But sheesh, those taxes! Yes, U.S. residents pay less tax and have more disposable income than residents of those other seven countries, on average. But the difference is not as great as it might appear, partly because those taxes pay for things that U.S. residents pay for out of pocket, and partly because the U.S. has much more inequality (multibillionaires have a way of skewing the averages). The Gini Index ranks 157 countries from #1--the most unequal--to #157, the most nearly equal. On their list, you want a high number. The U.S. is #39. The other seven countries range from #88 to #152 (Iceland is #141).

So how much LIVING can people in these seven countries do, compared with the average American? Well, with enormous healthcare costs and huge educational debt, life can be rough for average Americans. And when you and your neighbors are poor in a country run by obscenely rich people, you may not feel so good either. Maybe that's why Americans aren't as happy as people from those other seven countries. The U.S. took 19th place in the yearly happiness index. The other seven countries ranked at place 16 (Ireland), 11 (Australia), 10 (Austria), 9 (Canada), 8 (New Zealand), 7 (Sweden), and 6 (Switzerland). (Iceland came in at 4th place.)

Summary: Immigrants are not the reason for high healthcare costs. High costs are not a predictor of good care or good results. Low taxes are not a predictor of happiness.

If you want to terrify Europeans, just suggest replacing their healthcare system with one that resembles the U.S. system. President Trump didn't realize that a few days ago when he went to the U.K. and made comments that worried supporters of Britain's National Health System, but the strong blowback made him quickly change his tune.

America deserves a healthcare system that covers more people, costs less, and produces better results. I wonder why more Americans don't pay attention to systems that are already doing that.

A Trump wall everyone will love

Here's an idea for President Trump and his supporters. Let's build an impenetrable border wall around maybe a third of the United States. Make sure that no immigrants can enter. Make equally sure that no Democrats (or Republicans, for that matter) who favor universal healthcare can enter. Likewise, don't allow any Democrats (or Republicans) who favor gun limitation and regulation to breach the wall.

To live inside the walled paradise, you must be an American citizen who wants to pay for your own healthcare or health insurance with no help from the government, or to go without healthcare altogether. You must own a gun, because only good guys with guns can stop bad guys with guns. And you must be willing for everyone inside the wall to get any kind of weapon they wish to have. Don't worry - since everyone inside the wall will be a Trump supporter too, there won't be any bad guys to contend with. (Pssst - you can keep out people who aren't white, if you wish. I mean, you'll be armed. Heck, you can keep out anyone you don't like.)

Only thing is, you must stay inside the wall. Well, unless you change your mind and unaccountably want to have your guns regulated (or, in some cases, even confiscated) and be forced to buy health insurance. Insurance that would help your neighbor but might never help you! And you'd have to live with all those people you don't like. Some of them don't even speak English! Would you really want to do that?

I mean, look at the financial advantage of living inside your walled community. Treating gunshot wounds costs American hospitals some $2.8 billion a year. That adds up to a lot of insurance premiums. If you choose not to buy health insurance, you won't have to pay a dime of it! But anyway, since you'll all be armed, gunshot wounds won't be a problem. I mean, who would shoot an armed person, right?

And here's the best part - you won't have to pay for this paradise yourself. Tell those immigrant-loving, gun-hating, socialist-healthcare-promoting Democrats (and Republicans) that you'd like your own walled country, and they'll jump at the chance to build it for you!

And then, finally, you can make America - or at least your walled-off portion of it - great again.

Maybe the fighting is almost over ...

[The Brooklyn Tabernacle Choir singing at
President Obama's second inauguration]

"Faith in America's Future" - that's the theme of today's inauguration activities.

Watching the prayers, the songs, the speeches, the crowd massed on the Washington Mall, I felt the faith. We don't have to hate each other. We can work together for a future that will be good for our country and for us as individuals. We can, as the President charged us to do, make the "values of life and liberty and the pursuit of happiness real for every American."

Inaugurations are times for setting aside differences and wildly celebrating.  While Richard Blanco read his inaugural poem, even John Boehner looked teary-eyed.

The political divisions will be back in full force tomorrow, of course. And yet we Americans are in the midst of some really big changes--changes that may make today's partisan squabbles look hopelessly antiquated in just a decade or two. Today's events are highlighting these changes.

This morning a Hispanic woman justice of the Supreme Court administered the oath of office. An African-American civil rights leader and a Cuban-American Episcopal priest, once a refugee, prayed. A gay Cuban-American, the son of exiles, wrote and read the inaugural poem. Music was provided by a white woman, a black woman, a white man, and the magnificent multi-colored Brooklyn Tabernacle Choir.

As a Boomer woman of mostly British descent whose paternal ancestors came to America in 1634, I felt wonderfully, happily, and mercifully irrelevant. Once people like me--well, people like my father--ran America. They did a good job of it in their day, and we honor them as war heroes, institutional founders, philanthropists, and thought leaders. But the day of white Protestant male supremacy is almost over.

It's been a rocky ride as women, people of color, gays, immigrants, and people with unusual religions have moved onto the stage. We've clashed. We've attacked. We've huddled in fear with people of our own kind. But looking at this morning's participants I couldn't help thinking: the changes are almost complete.

Non-Hispanic whites now make up less than 2/3 of the American population; in less than 30 years we will be a minority. WASPs--white Anglo-Saxon Protestants--are already a minority.

When the 113th Congress convened, 101 women took their seats. Three women sit on the Supreme Court. A woman is a serious contender for the 2016 presidential nomination.

People of both parties seriously working on immigration reform and on equal justice for non-heterosexuals. There is rising concern for those marginalized by poverty, race, gender, sexual orientation, and inadequate healthcare and educational resources.

Most of these changes have occurred during the tumultuous administrations of our three Boomer Presidents, Bill Clinton (1993-2001), George W. Bush (2001-2009), and Barack Obama (2009-present). These have been contentious years: change is never easy. It often feels dangerous. It divides people, and nations.

But looking at the people on the inaugural platform this morning, I felt renewed hope. In another decade or two, the changes that are rocking the Boomer years may have produced an America in which people are truly equal--or at least a lot more equal than we are today. "America’s possibilities are limitless," President Obama exhorted the nation, "for we possess all the qualities that this world without boundaries demands: youth and drive; diversity and openness; an endless capacity for risk and a gift for reinvention."

Step up to the plate, youngsters. It's almost your turn.

Two political conventions, two Catholic leaders

New York's Cardinal Dolan may have tried to offend everybody in just eight days, though the Republicans seem not to have noticed his blessing on recent immigrants who have come to America in search of jobs. Democrats, however, did not miss his call for protection of the unborn, his veiled allusion to gay marriage, and his call for "religious freedom in full," which to him means freedom for Catholic institutions to deny contraceptive coverage to employees. (You can read the full text of both benedictions here.)

It must be tricky, being a bishop-politician. The Republican position on abortion sounds very Catholic, but its approach to the economy goes counter to over a century of Catholic social teaching. The Democratic platform upholds Catholic social teaching, but it also affirms Roe v. Wade.

Faced with this split, Cardinal Dolan, a great admirer of Paul Ryan, did what the Catholic hierarchy has typically done, at least in recent years--he paid little attention to social justice and focused mainly on sex. No wonder Andrew Sullivan, in a blistering op-ed piece, dubbed him "The Republican Party Cardinal."

Enough about the Cardinal. Another Catholic speaker at the Democratic National Convention was much more inspiring. Here's Sister Simone Campbell, executive director of Network, a social-justice lobby criticized by the Vatican last spring for spending too much time fighting poverty and too little time fighting abortion and gay marriage. Like Cardinal Dolan, she offered to speak at both conventions. The Republicans did not get back to her.

Give me your tired, your poor - but only if they have a really good lawyer

Everybody agrees - the U.S. immigration system is broken. Americans strongly disagree as to how it should be fixed. But there's one fix, desperately needed, that just about all of us can agree on. When people flee to the U.S. because staying in their home countries means almost certain torture and death, we need to help them.

Alas, we don't.

I became aware of how the U.S. treats refugees when my husband and I became friends with a lovely family who escaped their home country at night, by boat, and eventually ended up in the Chicago area. For over 20 years they have been fighting to become citizens or even permanent residents. They have fought maybe half a dozen deportation orders. They have spent vast sums on lawyers. Twice a Senate bill has been introduced for their relief (and has subsequently died in committee). They don't want to be "illegal aliens"  - they are conservative, law-abiding, tax-paying, hard-working people. But they don't dare return to their country of origin. It looks like their green cards are finally coming through. They will believe it when they see them.

For all their uncertainty, fear, and dollars spent, my friends have had it easy compared to Regina and David Bakala, refugees from the Democratic Republic of Congo featured in Josephe Marie Flynn's gripping new book, Rescuing Regina (the link will take you to my brief preview; my full review will appear in a couple of months in Christian Century). A coalition of Midwesterners, whose politics ranged from Tea Party to left-wing Democrat, worked hard to get Regina out of jail and to keep her from being sent back to the warlords who had promised to kill her.

Or check out this unfinished story about Edmond Demiraj, published yesterday in the New York Times. Demiraj agreed to be a government witness against a mobster and was then virtually delivered to the mobster's doorstep in Albania. He eventually made it back to the U.S. - legally - but now his wife and son are in grave danger. He is hoping the Supreme Court will hear their case.

If you prefer happy endings, read this story about Chicagoans Tony and Janina Wasilewski in Sunday's Chicago Tribune or the more extensive New York Times account. Twenty-two years ago, Janina applied for asylum. Four years ago, she and their six-year-old son were deported. Thanks to a persistent husband, a tenacious lawyer, a documentary filmmaker, several politicians, and a Supreme Court decision, the family was reunited yesterday.

Folks, it shouldn't have to be this difficult.

Understanding the immigration debate: the necessary context

If I hadn't just read Moving Millions, I might not have noticed how many of this morning's news stories relate to immigration.

Jeffrey Kaye, a freelance journalist and special correspondent for The PBS NewsHour, subtitled his book How Coyote Capitalism Fuels Global Immigration. It's a book that goes way beyond what I'm used to reading in news stories or op-ed pieces about Arizona's new law. Kaye looks at immigration around the world, not just in America. He frequently puts today's stories in historical context. Most of all, he looks at business practices and government policies that either entice or drive people to leave their homes in search of a better life.

There's a lot of data in the book, and Publishers Weekly called it "a dense read." It isn't, really--Kaye injects enough stories and interviews to keep eyes from glazing over. If I sometimes found it hard going, it was because each chapter examines a different facet of immigration, and sometimes the evidence seems to lead to contradictory conclusions. In the final chapter Kaye ties things together and clearly states his own views, though he offers no policy recommendations. Since it majors on information, not advocacy, Moving Millions will probably appeal more to wonks than to activists.

But back to this morning's news stories, and how Kaye helped me understand them:

"Immigrant Maids Flee Lives of Abuse in Kuwait." Indentured servitude seems to be par for the course in some Middle Eastern countries where the elite have an obscenely luxurious lifestyle and immigrants, whose passports are confiscated so they can't run away, are forced to do all the work. Moving Millions includes a damning chapter about immigrants in Dubai.

"U.S. Official Boost Efforts to Protect Immigrant Crime Victims." Good enough - but why should immigrant laborers, whose work keeps our food prices low, need special visas in order to have basic human rights? Is it really necessary to be mugged in order to seek justice?

"Christiane Amanpour Takes On ABC News' 'This Week.'" Immigrants contribute to the American economy at all levels, as you've no doubt noticed if you've looked for a doctor lately. Amanpour, a British citizen, is the daughter of an Iranian named Mohammad and a British Christian. She is married to an American Jew and recently moved from London to New York.

"Border Deployment Will Take Weeks." Yup, and it's not going to accomplish anything except possibly help re-elect politicians who should know better. Fences and guns don't keep people out when businesses lure them in. And if businesses stop hiring illegal immigrants, expect the American cost of living to skyrocket.

Interestingly, some companies are trying to have it both ways. According to one Arizona politician quoted in the book, "Many of the companies that made a profit off the backs of migrant workers were the same companies donating money to anti-immigration proponents." See my April 29 post in which I suggest that many businesses want immigrants here, but they want them scared. They are so much easier to exploit when they're terrified of being sent home.

Fixing immigration: President Obama's speech at American University

President Obama is getting no respite from contentious issues. Today, speaking at American University’s School of International Service, he tackled immigration reform, held hostage for decades, he said, by political posturing. “We will not just kick the can down the road,” he promised his audience of faculty, students, and select legislators, police chiefs, mayors, and evangelical religious leaders. Despite the fact that the topic of immigration reform arouses emotions and "lends itself to demagoguery," he said, "I believe we can put politics aside and finally have an immigration system that's accountable."

I hope he is right. I have friends who are undocumented immigrants, despite more than 20 years of trying desperately to become legal residents. At last count they had spent over $30,000 on lawyers. They have appeared before panels of judges who manifested complete ignorance of their home country and the reason they need political asylum before turning down their petitions. Their amnesty applications were improperly handled by bureaucrats, who then said the deadline had passed and nothing could be done. They have been ordered to take time off work, only to wait for hours in immigration offices while the office staff rudely ignored them.

I'm not telling you their name or their country of origin, because I suspect they have simply given up and are now flying beneath the radar. There are networks of fellow refugees who will help them, but this is not the way they want to live. They are law-abiding people who work and pay taxes. They have raised their children in America (in fact, one child was born here so is a U.S. citizen) and now have American grandchildren. In fact, many in their extended family are Americans. And yet, due to a series of departmental snafus, they continue to wait for permission to stay in their adopted country. Apparently it would take an Act of Congress to legally admit this fine family to the United States - and indeed, two Senate bills have been introduced in their favor. Both bills died in committee.

As I watched President Obama's speech, I was thinking about my friends. They are part of the "steady stream of hard-working and talented people" that have allowed our country to thrive. If the president is right that "being American is not a matter of blood and birth, but of faith," then my friends are more American than I am. They still hold on to the hope that someday the system will be fixed and they will be fully welcome in the land they love. I hope so too, but unless something drastically changes the political climate, my faith is weak.

As the president pointed out, people are afraid of immigrants - especially during economic downturns. This was true in 1798, just 11 years after the adoption of the U.S. Constitution, when the Alien and Sedition Acts were passed. It was true in the 19th century when waves of immigrants from Ireland, Italy, and Poland swarmed our shores. It was true at the turn of the 20th century when Jewish immigrants fled persecutors in Eastern Europe, and from 1882 to 1943 when Chinese immigrants were routinely detained and deported. It is certainly true now.

As the president also pointed out, "without bipartisan support, we cannot solve this problem. Reform cannot pass without Republican votes."

Bipartisan action is possible. Some Republicans, "including my predecessor, President Bush," Mr. Obama said, "have shown courageous leadership." For example, Senators John McCain (R-AZ) and the late Ted Kennedy (D-MA) worked together on the Comprehensive Immigration Reform Act of 2007, though it failed to get through Congress. Senators Charles Schumer (D-NY) and Lindsey Graham (R-SC) have collaborated on a proposal to mend our "badly broken" immigration system that sounds a great deal like President Obama's suggestions in this morning's speech. And yet, as the president said, "the natural impulse among those who run for office is to turn away and defer decisions for another day, another year, another administration."

Perhaps that is why the White House invited evangelical leaders to join the audience this morning, and why megachurch pastor Bill Hybels was asked to introduce the president. Evangelicals, though far from a solid bloc, tend to vote Republican. However, as Hybels pointed out, many evangelicals know that "a recurring theme in Scripture is a mandate from God to care for widows, strangers, and orphans." Believing that religious salvation depends on faith, not on blood or birth, they may be receptive to the president's suggestion that faith (presumably in American ideals) is also the basis of citizenship. If Hybels is correct, "today an earnest bipartisan conversation begins that those of us in the faith community have been praying about for years."

I hope that good people of both parties will unite to fix our immigration system. I hope that we can find a just approach that is both hospitable and responsible. I hope that businesses who exploit undocumented immigrants will be forced to straighten up or shut down, and that people who wish to move here and work hard will be given the means to do so legally. I hope that my friends will someday be able to say the Pledge of Allegiance along with other new American citizens.

As the president said, "Fixing our broken immigration system is a moral imperative."

Why Arizona's immigration bill won't make much difference

Arizona's Senate Bill 1070, signed by Governor Jan Brewer last Friday, has the nation's knickers in a knot. I agree with President Obama, who called the law

a "misguided" piece of legislation that "threaten[s] to undermine basic notions of fairness that we cherish as Americans, as well as the trust between police and their communities that is so crucial to keeping us safe. "

In spite of the law's claim to reject racial profiling, its first effect will surely be to increase harassment of Hispanics. For many of the law's supporters, however, this is not a drawback. Indeed, it is the main benefit of the legislation - not to send all undocumented immigrants back to their countries of origin, but to scare the ones who stay.

Think about it. If you ran a business that required a large number of unskilled workers - people who would pick vegetables, for instance, or slaughter pigs - fear could be your ally. Hire a man who is desperate for money and tell him that one misstep will put him on the bus to Nogales. He's not going to complain too loudly if his wages drop below the federally mandated minimum, or if he doesn't get health insurance or sick leave, or if he is required to work 12 or more hours a day with no overtime pay, or even if he is injured while working in dangerous conditions. He's certainly not going to join a union and demand fair labor practices. In fact, he may make his pre-adolescent children join him in the fields. He'll let you get away with a lot, because your small paycheck beats no paycheck at all. And then, when you don't need him anymore, you can lay him off. He can't do anything about it.

Yes, if you treat him that way, you are breaking Arizona's law, which -  like federal law and the laws of all other states - makes it illegal to employ and then mistreat undocumented immigrants. The problem is that these laws are rarely enforced. According to journalist and political activist Deborah White,

In 1999, under President Bill Clinton, the US government collected $3.69 million in fines from 890 companies for employing undocumented workers. In 2004, under President George Bush, the federal government collected $188,500 from 64 companies for such illegal employment practices. And in 2004, the Bush Administration levied NO fines for US companies employing undocumented workers.

Has there been a change under President Obama? Law professor Kris W. Kobach, defending Arizona's law in today's New York Times, says that "the Obama administration has scaled back work-site enforcement and otherwise shown it does not consider immigration laws to be a high priority." By contrast, Greg Moran, writing Sunday in San Diego's Union-Tribune, refers to "a stepped-up effort by the Obama administration to attack illegal immigration by cracking down on the employers who hire them." Whatever the truth about the present administration, the situation continues to be grave. According to the United Farm Workers of America's website,

Federal reports indicate between 50 percent and two-thirds of U.S. farm workers are undocumented. The UFW’s experience in areas where it is active, including the Central Valley, is that it is 90 percent or more.

Q. Why aren't we conducting massive raids on businesses so grossly violating federal and state law? Wouldn't that be more effective than targeting the immigrants themselves?
 
A. Yes, of course. Mexicans don't move to Arizona because they like the sunsets. But if every American business that employs undocumented workers were heavily fined, repeat violators were shut down, and undocumented employees were returned to their native lands, the food industry would collapse.

The collapse would not be permanent, of course. We have to eat. Businesses that formerly hired illegal immigrants would scramble to hire American citizens and legal immigrants. In order to do so, they would have to give their employees legally mandated protections. This would in turn dramatically increase the price of food. Voters - even the ones that backed get-tough laws against illegal immigrants - would be outraged.

Interestingly, if we changed our laws in the other direction and gave every undocumented worker in America a green card, prices would also skyrocket. Legal workers get legal protections, and this greatly increases the cost of human resources. Voters - even the ones that backed amnesty and permanent residency for illegal immigrants - might be less enthusiastic about paying double for food.

And that is why I think Arizona's legislation - and indeed, reforms currently under discussion by the administration - won't make much difference. Politicians depend on voters, and voters do not like rising prices. Politicians also depend on major financial contributors, and agribusiness spends big on PAC contributions and lobbying. One of the easiest ways to keep food prices low and agribusiness happy is to keep the workforce scared.

So I expect to see a flurry of state laws aimed at pacifying nativists and frightening foreigners. Some undocumented workers will be rounded up and shipped home. Most will not. Business will continue as usual. In the words of Amos the shepherd, we affluent Americans will continue to "sell the righteous for silver, and the needy for a pair of sandals, ... [to] trample the head of the poor into the dust of the earth, and push the afflicted out of the way."

"Probable cause" : driving while appearing hispanic

Last weekend my friend Ben Lowe was heading toward Chicago with three friends, all Wheaton College graduates, when an unmarked police car pulled them over. One of the cops explained to the driver that there is "a problem with Hispanics coming from the western suburbs into Chicago" and "carrying drugs in their vehicles."

As it happens, none of the men is Hispanic (which is irrelevant anyway, since ethnicity is no reason to stop a law-abiding driver), and there were no drugs in the vehicle. Ben, however, is the Democratic nominee from the 6th Congressional District, and Ben is not happy.

You can read his account of what happened on his blog. If you'd like to read the raw notes he took shortly after the incident, continue reading this post. Predictably, the police are denying the incident to reporters.