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David Nichtern

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Health Care and the Mandate for Compassion

Posted: 10/29/10 10:34 AM ET

In the midst of my taiji lesson with Sat Hon, we paused (as we sometimes do) and chatted for a moment. In this case, what was on my mind was my ailing mother-in-law and my recent experience with our health care system. Sifu ("teacher" in Chinese) simply said that if a measure of the level of civilization a society has achieved is its ability to care for it those who are less fortunate and more vulnerable, then our society would get a failing grade. I agreed.

Developing compassion for others is emphasized in the Mahayana Buddhist tradition, as well as in every other great religious tradition in the world. The Buddhist approach is to begin by developing a base of clarity, strength and well-being within oneself, and then to work hard to extend the benefits toward the welfare of all beings.

Again and again, we hear from the great teachers (like the Dalai Lama) that expanding our compassion and empathy are the main focus of spiritual practice, and also the main source of true happiness for ourselves.

The ongoing conversation about health care in our country strikes right to the core of who we are as a nation. Of course there will be differences of opinion about how to create, support and maintain the best possible health care systems, but you really have to wonder why there would be any discussion at all about the notion of providing the best possible health care to all our citizens without any consideration whatsoever regarding how their circumstances have arisen and what their capacity to care for themselves is.

Compassion simply does not have that kind of filter. Of course there has to be skillful means and practicality mixed in with our compassion. We have an aging population, an increasingly overstretched Medicare and Medicaid system, national dietary and health issues and all the rest of it. But I think we all have to take a good look in the mirror and seriously ask ourselves why, if we can have the most powerful military in the world, we can't we also have the best health care system in the world. We should have that.

I'm not really in a position to debate all the various solutions, proposals and counter-proposals that are out there, nor would I be the best person to ask what the best solution is. I just know that in my heart of hearts, and I think for many of us, the notion that we cannot really compete with many smaller and less developed nations in this area is a source of heartbreak and confusion.

A recent trip to Copenhagen completely blew my mind. There are literally no homeless people there. It is considered the obligation of the larger society to care for all the citizens, and it seemed that most people I talked to had no problem at all with being part of that kind of community.

Call me a socialist if it makes you feel better, but I don't believe that "greed is good," and I do believe that some people getting rich from other people's misfortunes is just not acceptable. If that is the benefit of capitalism, I am over it. We can do better. I think all of us so-called "spiritual" practitioners need to come out of our caves and figure some of these things out.

Your thoughts?

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In the midst of my taiji lesson with Sat Hon, we paused (as we sometimes do) and chatted for a moment. In this case, what was on my mind was my ailing mother-in-law and my recent experience with our h...
In the midst of my taiji lesson with Sat Hon, we paused (as we sometimes do) and chatted for a moment. In this case, what was on my mind was my ailing mother-in-law and my recent experience with our h...
 
 
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HUFFPOST SUPER USER
ljkcan
Yes, I am prone to spelling errors
03:42 PM on 11/03/2010
Last year I started to comment more on the health situation in the US. When I saw on TV hundreds of people showing up for free health care in California. When the town hall meetings on health care began I won't lie I was disgusted with the behaviour of people.

I know first hand what it is like to live with a chronic illness. Illness is not something we ask for in life nor should it be ridiculed and subjected to humiliation by our fellow man.

I live in Canada and we have had health care since the 60's. We pay our share through income taxes. We don't yell or belittle our fellow Canadians if they are ill. When I saw that young woman being shouted down I thought "there for the grace of God go I". If we do not care for our fellow man and show compassion when they are ill something is very wrong with the society.

I know I will get an angry response but I stand my ground . That man sitting on the street with Parkinson's getting dollar bills thrown on him, should have made any compassionate person cringe.

I have to ask why on earth would anyone want the insurance to be in complete control of their health to give permission or deny someone care. Not much compassion when they are looking at the bottom line.
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HUFFPOST BLOGGER
David Nichtern
04:13 PM on 11/03/2010
Right on all the way. DN
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ljkcan
Yes, I am prone to spelling errors
01:34 AM on 11/04/2010
I think it is important for Americans to understand our system and not buy into the "Socialist mantra". No we are a country with good social programs. Is the system perfect of course not but it works and we don't care if other people are getting healthcare as we all pay into it.
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Joseph Burgo PhD
Clinical Psychologist, Blogger
11:13 AM on 11/03/2010
I'm a clinical psychologist and I find many Eastern practices useful; what I object to is the idea that one meditates with the goal to feeling compassion. The goal is to clear the mental space and notice what you DO feel, regardless of what it might be. I don't think you can actually instill compassion by recommending it, either through governmental edict or spiritual guidance that points you toward the right way to feel.
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David Nichtern
04:16 PM on 11/03/2010
Thanks for writing in Joseph.... actually.... in the Buddhist tradition, clearing the mental space and noticing what you do feel is absolutely definitely a ground, fundamental practice.... beyond that, however, there are many further practices to open oneself further (supposedly completely in line with one's true nature) toward becoming more awake, compassionate and genuinely helpful to others.... this is very much part of the Mahayana Buddhist tradition.... it is not considered forcing an unnatural outcome.... more like cultivating a natural, but positive outcome.... does that make sense?

Best, DN
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OtayPanky
You're welcome
05:40 PM on 11/01/2010
I don't disagree with you, David, about your concern and your vision for a compassionate state.

But honestly, using HHDL to make your point is like using the words of the current Pope and his predecessor to advocate for protecting children. Unfortunately, Tibet was run like a religious racket for centuries. There was an accumulation of wealth and power by religious leaders, who were also the temporal leaders - and misuse of the mass of people for what was essentially slave labor.

I'm not justifying the Chicom terror tactics at all - but their removal of the Tibetan Buddhist power structure was certainly intellectually defensible.

We don't need to take our cues here from religious leaders who have a poor track record of practicing what they preach - whether it is the Catholic shielding of pedophiliac priests, or the Tibetan perpetuation of an unjust society for the religious elites.

A sane discussion of the issues is much better served by having a discussion based on what our common values really are, and how to best implement them. As with all complex problems, the devil (or god, if you prefer) is in the details.
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David Nichtern
09:49 AM on 11/02/2010
Hmmm.... not sure if we see eye to eye here .... linking the Dalai Lama to protecting pedophile priests (by inference) is perhaps a bit harsh. Most Tibetans I have ever met, even if they might acknowledge some corruption in the theocratic setup in Tibet, would not find any semblance of "intellectually defensible" in the Chinese takeover of Tibet. For example, many Americans would have some critique of our own government and its policies, but that doesn't mean they would advocate the invasion of a foreign power to bring about change and improve the situation.

In my discussion on line here, I brought the Dalai Lama in as one of many top shelf Buddhist teachers who advocate compassion for everybody as a major center piece of spiritual development. In my eyes he seems to work tirelessly to actually help make that a real possibility in this world.

I'm curious what in your PRESENT experience regarding the Dalai Lama's activities would lead you to the conclusion you are coming to here.... In any case, I welcome your input here and agree that a real discussion regarding our common values and how to implement them is essential. Best regards, David N.
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OtayPanky
You're welcome
12:17 PM on 11/02/2010
David: linking the Dalai Lama to protecting pedophile priests (by inference) is perhaps a bit harsh.

---

I'm not saying that, any more than I'm saying the last two popes were part of the cabal protecting pedophile priests. What I'm saying is that the institution of Tibetan Buddhism has a long history of creating and maintaing a religous-political structure that depends on creating and sustaining a permanent serf class.

---

David: Most Tibetans I have ever met, even if they might acknowledge some corruption in the theocratic setup in Tibet, would not find any semblance of "intellectually defensible" in the Chinese takeover of Tibet.

---

HHDL himself has said that he believes the Chicom takeover is karmic retribution for the creation and maintenance of a society that violated Buddhist ethics. So if you have a problem with the intellectual defense of this bit of history, you should probably take it up with him. Next time you see him ask why he thinks it is karmic retribution.

My point is simple: An inclusive discussion of morals, ethics and their application to society is much more useful if we decouple it from leaders of religious institutions that are so obviously flawed. Often, the leaders themselves have been very slow to recognize basic principles that are obvious to the rest of us, because their primary concern is maintaining their institutions.

Historically, that''s been a problem for HHDL as well as the recent Popes.
04:03 PM on 11/01/2010
Nichtern. the opposition of compassion is the 'ignorance' Buddha talks about--he is not talking about dummheit, but the egocentricity of Beck and Palin.

'skillful means' interestingly, means that Buddha, and the rest of must, necessarily, not be concerned about causing any 'other' to be better off. Skillful Means, Pye, Michael, 1978. The notion of 'skillful means' frees the Buddha from even the 'desire' to save others. This is because the common self does not need 'saving', as it is identical with the Buddha nature. Buddhist hermeneutic requires a subtlety of interpretation and a precise type of non-intervention (almost) in the hermeneutical act. Since most of us lack the insight into past causes (or past lives karma) of any specific individual, the best recourse is often 'silence', which was Buddha's answer when asked about reincarnation, etc.
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chw777
07:37 AM on 11/01/2010
I believe it is wrong for the government to try and force people to be compassionate. They simply should not have the right to take money that you earned and give it to someone else. When you see those people who stand on the corner with signs that say "will work for food" , have you ever offered them work? They refuse to work. They want a hand out. Are these people entitled to your money that you worked for? Is any able bodied person entitled to a free ride? If someone experiences hardship in life, does that mean they have a right to take some of your money?
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David Nichtern
09:30 AM on 11/01/2010
Greetings.... glad you presented this point of view.... it is actually the key to this whole discussion. I think I agree that, ideally, those who can work to support themselves, those who are able to do so, assuming that they could be connected with work they were capable of doing, should work and share in the process in that way. But, my personal opinion is that there are many many people who could use some kind of help for whatever reason, who do not fit into the category your are describing here.

And that, as a society, it would be wonderful if we could give people in such circumstances a helping hand, especially for basic health care needs. It's a fair question you are asking. My answer would be (and it seems to be the answer of many people writing in here), that I personally would be willing to have some of my tax dollars go toward creating a more compassionate and supportive society for all of its citizens. I think the payoff is that we are all living in a more uplifted and caring society, where it is not a dog eat dog, every man/woman for themselves kind of place.
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David Nichtern
09:33 AM on 11/01/2010
(Continued)

The U.S. healthcare system, in all its aspects, was noted as 37th in the world in an important study in 2000. That really is food for thought. Even for those of us fortunate enough to have financial resources and good health care plans, there are many many aspects of our system that simply do not serve the people holding those plans, but do serve the interest of the insurance companies. Our system has lots of room for improvement, even if you think it should not support the people you are describing who won't work even if offered a job. Take those people out of the mix and figure out another solution there and we still have big problems.
10:07 AM on 10/30/2010
"I don't believe that "greed is good," and I do believe that some people getting rich from other people's misfortunes is just not acceptable. If that is the benefit of capitalism, I am over it. We can do better."

I agree totally with this statement. But I am also aware I am a minority never having bought into the "realty TV" "vote them off the island" mentality. And let's be honest with each other a lot of people were brought up on that sort of fare, they joyously participated in phoned in voting to send at least one person home each week. It's going to be a hard mindset to change.
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David Nichtern
01:53 PM on 10/30/2010
Ironically was just talking about Survivor in
this exact context at this morning's
meditation workshop at OM yoga here in
NYC! DN
08:49 AM on 10/30/2010
Compassion begins with non-violence.

The State, through coercion, violently takes what is mine (if you doubt this, try not paying your taxes). To believe that The State = Society is the problem. I have compassion for my neighbor. When the State stops coercing me to care for her, I will be in a much better position to do this effectively. Read anything by Dr. Mary J Ruwart (Healing Our World in an Age of Aggression is a good place to start).

People who live in the United States are some of the most generous, capable people in the world. Habitat for Humanity has been able to accomplish what no tool of the State has been able to accomplish, without coercion, without carrots and sticks. I believe that we can do the same in healthcare, but to be coerced with sticks or bribed with carrots pollutes my altruism.
09:51 AM on 10/30/2010
Habitat for Humanity does accept federal dollars.

Altruism:
1: unselfish regard for or devotion to the welfare of others
2: behavior by an animal that is not beneficial to or may be harmful to itself but that benefits others of its species

I see no room in those definitions for any form of pollution, or self interested protectionism. You are either altruistic or your not.
07:54 PM on 10/30/2010
Thanks for clarifying about Habitat.

I think my point however, remains the same. I hope that I have unselfish regard for the welfare of others; I just don't want to be forced to be unselfish. In fact, I don't think that force employed for even the best of ends ever results in good things. The roots of altruism in individuals and communities comes from an intrinsic and inherent desire to do good - pointing a gun at people and telling them that they must share only begets bad outcomes.

Using politicians (from any party) and policies to direct the gun of government in a different direction is not what altruism is all about.
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LynneE
A not-so-elite liberal.
10:44 PM on 10/30/2010
Why should those who are ill or poor be forced to hope for the charity of their neighbors? I am an RN, and the things I have seen in our society and healthcare system would horrify you...altruism is a myth. People living in cardboard boxes with their limbs infiltrated by maggots, human beings freezing to death because they are homeless.

If you don't like the government taking your money to help others, then you are not altruistic. You want to keep your money for yourself. Human beings need to be able to have food and shelter, and I for one am willing to pay more taxes to ensure that they do. Yes, I am just another dirty socialist I suppose.

Habitat for Humanity has built 350,000 homes, a paltry drop in the bucket compared to what the homeless need. From their own website:
•Habitat is not a giveaway program. In addition to a down payment and monthly mortgage payments, homeowners invest hundreds of hours of their own labor (sweat equity) into building their Habitat house and the houses of others.
•Habitat houses are sold to partner families at no profit and financed with affordable LOANS.

Loans on which banks make a profit. There's no such thing as a free lunch, and HFH ain't givin out free houses.
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LynneE
A not-so-elite liberal.
09:19 PM on 10/31/2010
Correction, should have read:

"Do you realize studies have found that uninsured children were 60 percent more likely to die? (Johns Hopkins Children's Center study).
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HUFFPOST SUPER USER
knucklelady
The prettiest dresses are worn to be taken off.
07:54 AM on 10/30/2010
I completely agree with you. And I often find myself disheartened by the angered words of people who would rather fend for themselves than lend a hand. I hate to say it, but America is not a community. We are, for the most part, a country of individuals who would rather be left alone to do for their own and take care of their own and have NO ONE depend on them outside their own immediate family, than be any part of a community.
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David Nichtern
09:38 AM on 11/01/2010
I think the point you are making here is powerful... sense of harmonious community and harmonious society is perhaps at a low ebb these days..... DN
03:51 AM on 10/30/2010
i completely agree i'm just glad to know i'm not the only person that is thinking this..
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David Nichtern
09:40 AM on 11/01/2010
Many people are thinking like this I think.... have to keep expressing this view to encourage representatives to consider it and also to have good healthy (not divisive) debate about how to move forward together to create a better society for the benefit of all concerned... thanks for writing in!

DN
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HUFFPOST SUPER USER
Amber Berglund
Got Mashed Potato, ain't got no T-Bone
11:44 PM on 10/29/2010
The drive for profit has driven a wedge between doctor and patient in the United States. Socialized Medicine (The Single Payer Option) would make Health Care accessible to all Americans. Standard of living would improve.
But, as Noam Chomsky pointed out, Socialized Medicine lacks political support, even though the majority of Americans wants Socialized Medicine.
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David Nichtern
09:41 AM on 11/01/2010
Hmmm.... that is a challenging proposition .... if the majority of Americans want socialized medicine, and yet it lacks political support... we have to figure out how to bridge that gap.... in your opinion, is it because special interest groups have too much sway in the political process?

DN
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HUFFPOST SUPER USER
Amber Berglund
Got Mashed Potato, ain't got no T-Bone
08:27 PM on 11/01/2010
Yes, David. I think special interest groups have too much sway in the political process.
America has become a crony capitalist country. The globalists have too much power. I don't think we have a democracy, laws are passed based on who controls the money.
I also think those who hold power in this country are trying to kill-off the majority of the Baby Boomers, (before they start to collect Social Security) through lack of access to health care.
But, that's only one facet of what's wrong with American Government.
Government is corrupt from the top down, and everyone needs to be audited.
This user has chosen to opt out of the Badges program
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10:06 PM on 10/29/2010
The compassion-based society. That is exactly right. An end to the "me, me, me" mentality and the beginning of a global worldview. If we would only turn away from greed and take a few minutes to reflect, it would all be so obvious. We human beings have an amazing capacity to get things done. Let's let go of the hatred and decide to transform our world, focusing on solving problems together. Everybody has a right to basic things like safe, clean shelter; food; healthcare; education; and so on.
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David Nichtern
09:43 AM on 11/01/2010
Thanks for writing this in.... there are people who dismiss such comments as naive and idealistic.... but most important historical documents (like the Declaration of Independence and the Constitution) have exactly this kind of quality.... DN
08:52 PM on 10/29/2010
"A recent trip to Copenhagen completely blew my mind. There are literally no homeless people there. It is considered the obligation of the larger society to care for all the citizens, and it seemed that most people I talked to had no problem at all with being part of that kind of community."

This statement reminds me of the opposite view that is prevalent in our society about the foreclosing homeowners. Punish those that foreclose, they say. Let them be homeless and learn a lesson, they say. Pull yourself up by your bootstraps, they say. I got mine, they say. Don't tread on me, they say. You get the picture.

We are a long way off from denmark and our sense of commonality and community with one another, let alone trying to translate that into what constitutes humane treatment in healthcare here. Do we even want to be humane if it sacrifices profit? Sadly, I'd say, most don't.
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David Nichtern
09:44 AM on 11/01/2010
For one thing, we are a much much bigger country than Denmark and far less homogeneous. To create this kind of vision and unity in a country our size with the kind of diversity we have would be history in the making, but would be incredible and inspiring for sure.... Thanks for your comments! DN
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Sharon Corcoran
08:40 PM on 10/29/2010
One of the themes of the whole HCR debate was those who had health insurance vs those who do not or are losing their insurance- The most disturbing thing that is going on in America is the lack of compassion - lives are reduced to an insurance policy
if you can't afford insurance, are unemployed, company doesn't offer insurance, your insurance company denies your claim, increase deductibles the message is too bad-

During the HCR debate MSNBC &its viewers sponsored free clinics. It was
shocking to see how many working people do not have insurance and have not had life threatening conditions treated-

We started this election with a vision of hope and change- forces are trying very hard to stop it- imagine what is possible if we join together again and stop listening to the neg narrative-
Van Jones has an inspiring column today check it out- about what is possible if we join together- and it looks like CA is doing that-
There is a great candidate running in Iowa- http://www.thenation.com/blog/155631/francis-thicke-iowa-secretary-agriculture
Francis Thicke offers hope to the call for more sustainable and safe food and agriculture production systems is being heard. He is unafraid to stand up to Big Ag, and has the courage to fight for economic justice in the countryside. He has a chance to win- if you know anyone in Iowa pass the information-
change is happening its being drowned out the the neg
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khanti
Cultivator
05:23 PM on 10/29/2010
Welcome back David. Excellent article to create awreness of what is much needed in this country. We share the same thoughts and compassion for sentient beings.
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Syrlinus
03:02 PM on 10/29/2010
As a Canadian living in the US, I have found Healthcare here a bit weird. There is so much focus on the money and the actual care seems secondary. Part of that is due to the American culture. It is different than Canada. Although both are capitalist, the evolution of the two cultures are very different. We are more interested in the person and their culture while the US is more interested in what value that person will bring to the nation (and by value, it seems largely a monetary one).

That said, I will say that I've been lucky thus far in my healthcare here as to how I've been treated. But it hasn't been without a lot of searching. As a transsexed individual, I am in a position to face lots of discrimination and even be turned down for care. So when I search out providers I try to find ones that are truly compassionate and truly live the Hippocratic Oath to the fullest. If they do not, I take my business elsewhere. And maybe that is what needs to be done..
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David Nichtern
05:19 PM on 10/29/2010
Thanks Syrlinus for writing in and sharing your experience.... Sounds like there are some positives and some negatives in your experience of U.S. health care.... best, DN