Archive for August, 2012

Understanding the (Untapped) Power of Women

August 26, 2012

LA Progressive posted my piece a few minutes ago:

When you walk into a room and fewer than 50% of the people there are women, “it should look peculiar,” said Madeline Di Nonno, executive director of the Geena Davis Institute on Gender in Media, “and it doesn’t.”

Madeline Di Nonno

Marianne Williamson, in her lead-up to the upcoming November conference: SISTER GIANT: Women, Non-Violence and Birthing a New American Politics, points out that woman make up only 16.8% of our elected representatives in Congress–a figure very close to the 17% cited by Di Nonno as the percentage of female characters we see “in the environment” in film and on TV.
What’s going on here and how do we change it?

On Friday, the West Hollywood Women’s Advisory Board observed Women’s Equality Day with Understanding Our Power, a roundtable discussion moderated by Dianne Callister, academic, theologian, and director of foundations that benefit children and mothers around the world. Di Nonno brought her expertise in media; attorney Angela Reddock spoke from her experience in labor and employment law and city politics while licensed clinical social worker Judi Miller Levy based her remarks on extensive work in the field of domestic and sexual violence.

In spite of the power women clearly have and 92 years after we won the right to vote, the speakers considered why, in Di Nonno’s words, “women have stalled out.”

Women in Public Life

“Men just automatically think they should run,” Di Nonno said. “Women think they have to be asked.”

But it’s more complicated than just waiting for an invitation. “We are balancing so many interests and family and other obligations,” said Reddock, but we need to be present. “In LA”–unlike West Hollywood–”we face the possibility of not having a woman on the LA City Council. Many of the male council members are my friends,” she said, “and so is the mayor, but I know, having been in so many closed-door sessions, that a woman’s voice is so important. We have to be in the room.” (Reddock got a big response from the audience when she wished women had a voice in designing women’s bathrooms.)

Angela Reddock

The experience of violence holds women back, said Levy. “A lot of energy is expended just surviving. Depression and PTSD use up energy and resources” that would otherwise be given to families and communities. “Even if you’re not a survivor, the fear is a reality for so many women, it’s a fear in all women.”

Gender-Based Violence
“Are we afraid to show our power,” Callister asked, “because it promotes those negative aspects?”

Levy advocated considering the approach of Jackson Katz, the anti-sexist male activist. We have to stop thinking of the violence as a “women’s problem.” Violence perpetrated by men is a men’s problem, she said, “and it won’t be resolved by working only with women. Men are being acculturated in such a way that violence against women is allowed.” We need to confront in our culture the negative ideas of how to be a man and masculine and powerful and see how these ideas threaten the well being not just of women, but of men, she said.

Levy thinks the recent initiative by the City of Santa Monica is on the right track, a “large scale collaborative effort in male violence prevention” aimed at “acculturating boys to see themselves in a different way.” The program enlisted the participation of everybody who works with young people–coaches, teachers, religious leaders, afterschool care workers–in a broad effort so that the values were expressed and modeled throughout the youth environment, not only by women, but by male role models as well.

Judi Miller Levy

A Global Perspective
According to the UN, gender-based violence is the #1 factor holding women back, Callister said. But there’s more: the majority of the world’s women cannot legally own land or property or wealth and have no access to credit. Less than 1% of sales to multinational corporations are from women who are “a growth reserve” of enormous untapped economic power. Even now, though often unpaid, women do more than 66% of the world’s work.

“Everything affects women,” Di Nonno said. “Climate change, war, economy.” The success of microfinance programs targeting woman has shown that when a woman starts a small business, she improves life not only for herself and her family but for her entire village. When women have access to capital, said Di Nonno, “you will see change in the world.” And it’s getting easier, she said. “With digital technology and smart phones, women can now access microfinancing on-line instead of walking three hours to a bank.”

In the US, our situation isn’t as dire, but true equality has not been achieved. When Abbe Land, West Hollywood mayor pro tem, welcomed the audience on Friday, she pointed out that the movement for women’s suffrage began in 1878 and it took 42 years to reach the goal.

(Only a fraction of the time African Americans still struggle for equality. But those 42 years reinforce the reality that activists must take the long view in working for change.)

Today, women still make 70 cents for every dollar paid to men, Callister said. In the extremely lucrative financial sector, the disparity is even greater: 50 cents to the dollar.

Since the Wal-Mart gender discrimination and pay case, Reddock sees many more women taking employers to court. Especially as women take on the major corporations, “we will start to see change.” But wherever you are employed, she said, you can start in small ways working for an equal playing field. Does your employer offer “a welcoming environment? Are accommodations made for us?” The City of Los Angeles, for example, just opened a room for employees where working mothers of infants can breastfeed.

Which brings us to the inevitable question.

Can We Have It All?

“Can men have it all?” asked Di Nonno. “Can anyone have it all?” She thinks the entire controversy aimed specifically at women was contrived by the media and not based in reality.

“It’s impossible to do everything,” Reddock said. “The real question is having choices. Not having it all, but having choices” and having your choice respected.

“Being a woman in power shouldn’t mean you distance yourself from your womanhood,” said Levy. Being powerful and being a woman. “That’s having it all.”

Posted: Saturday, 25 August 2012

Health Care Reform: California’s Next Steps

August 24, 2012

My article in LA Progressive

“The way the health care delivery system developed in this country has been a global scandal,” said Michael Hiltzik, author and Los Angeles Times columnist, as he concluded the community program he moderated Wednesday on the effects of the Affordable Care Act.

Speaking at the National Council of Jewish Women Los Angeles, expert panelists acknowledged the obvious limitations of the Act which was found Constitutional (for the most part) by the Supreme Court at the end of June. They also cited new benefits flowing from the legislation. But what became very clear was that there are steps we in California can take to make reform more meaningful even without action on the federal level.

If you want to skip the context and the bad news and go straight to what we can do now, please jump down the page to Recommendations for Action.

What’s Wrong

The whole insurance-based health care system in the US “violates the Hippocratic Oath,” said Paul Song of the board of directors of Physicians for a National Health Program California. Thirty-five thousand people die each year because they don’t have insurance while 75% of people forced into bankruptcy due to health care costs actually carried health insurance. And if the ACA looks like it was written by private insurance companies, he said, there’s a reason for it: 3300 lobbyists descended on the Hill when Congress was tasked with drafting the legislation.

This week, the news media reported that America’s beleaguered middle class has shrunk to barely more than 50% of the population. The poor aren’t even in the picture and 21% of all US children live in poverty. While all this was happening in the last ten years, according to Song, profits in the private insurance industry went up by 450%.

Questions of Access

Susan Fogel directs the reproductive health and justice program at the National Health Law Program. Instead of jumping into the current controversy over whether our female bodies have magical powers, she pointed out that 24% of women in California are uninsured, with women of color disproportionately going without insurance, with Latinas more likely to have diabetes, African American women more likely to die of complications of pregnancy and childbirth. She celebrated the fact that the expansion of Medicaid (called Medi-Cal here) will bring coverage to more low-income women. For example, until now, women who were childless or whose children were grown, were ineligible for coverage no matter how dire their poverty. “But never confuse coverage with access,” she warned. Though all women, including those in low-income communities, are now covered for preventive care, screenings, contraception and maternity care at no cost, there may not be physicians available and willing to treat them. As for pregnancy terminations, half of California’s counties lack even a single abortion provider, she said. And the single largest health care system in the state–the network of Catholic hospitals and providers–functions with severe restrictions on reproductive health services.

Undocumented immigrants and green card holders who haven’t been here long get no coverage, but a huge number of Americans–more than 30 million people–will be newly insured. Where will all the doctors we need–especially general practitioners–come from?

The average debt from going to medical school comes to about $200,000, said Song, and that’s on top of student debt from college, training, and the cost of malpractice insurance. This makes the more lucrative specialties more attractive than ever. Of course it may also mean that “people have to love it and go into it for the right reasons,” said Song. “If they want a 13% tax rate, they have to go into finance.”

While Obama’s policies take nothing away from Medicare beneficiaries, they do cut some reimbursement rates to providers. Romney-Ryan aren’t all wrong here: some doctors may begin to refuse Medicare patients–another factor in the expected shortage.

(An interesting aside from Michael Hiltzik: Romney-Ryan now assure seniors that their Medicare benefits won’t change at all while telling younger voters that Medicare must be changed to a voucher system if–because of those greedy seniors!–it’s to exist at all by the time they reach retirement. This is exactly the strategy recommended in an article published in 1983 in the journal of the rightwing Cato Institute by authors disappointed in Ronald Reagan’s failure to privatize–i.e., destroy–Medicare. Take a page from Lenin’s playbook, they urged, and weaken the opposition by isolating its constituent parts.)

Rising Costs:
Given the benefits the Act guarantees to the insurance and pharmaceutical industries, how will it meet the goal of containing health care costs?

Get ready for overall costs to rise–in the short term. “The population is expanding and aging so increased costs will naturally occur,” said Jim Lott, executive vice president of the Hospital Association of Southern California. But the costs of treating individuals–the per capita costs–can come down with greater efficiency, holistic care, more risk-reduction and more primary care (from those primary care physicians we sorely lack).

With the expansion of coverage, said Susan Fogel, “we have to have a long view and not be sidetracked by the fact that costs will go up in the short term as we are going to be bringing into the system the uninsured people who are sicker and have put off care.”

Mark Patterson, professor of Public Policy, Political Science, and Law at UCLA’s School of Public Affairs, agrees that more clinical prevention–screenings–for more people will increase costs. But “the Affordable Care Act is about more than insurance. Title IV is all about preventive care”–not only for individuals. The public health model in the Act is aimed at “transforming population health–helping communities design programs to combat diabetes, obesity, tobacco-related illness,” all of which can save both money and lives. “Ten percent of mortality is a function of health care,” he said. “The rest is environment, genetics, and behavior. If you deal with problems in utero and the early years of life, you reduce the need for health care later. You can trace heart disease back to what was happening in the neighborhood when a kid was three years old.”

The public health model that has been so successful in controlling and preventing infectious disease is now a part of federal law and policy when it comes to chronic disease.

Recommendations for Action

1. Create a braking mechanism for rate hikes.

With Assembly Bill 52 (introduced by Mike Feuer), Insurance Commissioner Dave Jones sought the power to reject excessive increases to health insurance premiums, co-pays, and deductibles.
While AB 52 passed in the Assembly last year, it stalled out in the Senate.

We need to try again, support this bill, and get it through.
As Paul Song explains, the ACA does mandate that insurance companies spend 80-85% of revenues on actual patient care. Sounds good, but there’s a loophole: Nothing in the Act stops them from “charging more to make up the difference” and maintain existing levels of compensation, administrative overhead, and profit. AB 52 would close the loophole.

2. Pass legislation to empower “physician extenders”

With the general practitioner or family practice doctor now a vanishing breed, yes we could and should put in place incentives to encourage more medical students to go into the field. But we also need to address the problem without delay.

“Utilize physician extenders,” said Jim Lott.

When I worked for Maine Medical Center in Portland in the 1970′s, the Department of Community Medicine spearheaded the use of nurse practitioners and physicians assistants in rural areas that had no doctor or only part-time medical personnel. The patients I interviewed were satisfied and grateful for the care they received from these new-fangled (at the time) health care providers.

Underserved communities in California–both rural and urban–deserve as much.

Especially as health care delivery becomes more “holistic” under the requirements of the ACA, Lott said. Patients will have a universal health record. “Nothing short of a sea change,” he said. Hospitals won’t be paid based on the number of ‘heads in beds’, but instead, hospitals, doctors, and insurance companies will have to cooperate and be paid on how well they contribute to the overall health of individuals and communities. Without primary care providers, it seems unlikely to me that this cooperative paradigm will work. “We are going to be forced to do something we haven’t done before,” said Lott. “Talk to each other.”

Here in California, one immediate step is to support AB 2348 to allow RNs and nurse practitioners to write prescriptions for birth control. As I reported earlier this month, thousands of women seeking contraception are currently being turned away from clinics because there aren’t enough doctors to see them.

Then we should move forward with ways to empower and employ more nontraditional providers of primary care.

Continue to work toward a single payer system

There is nothing to stop California from creating our own Medicare-for-all or other single-payer system.

Instead of blaming Obama for falling short, let’s see what we can do here at home.

And keep in mind the context provided by Mark Patterson. Theodore Roosevelt, inspired by social programs in Europe, first tried to reform US health care in 1912. Truman wanted a single-payer system. Nixon, Carter, and Clinton all put plans forward. And? “There was never a single vote in Congress, in the House or Senate.” Bills never got out of committee. Obama’s plan was the first time there was ever actually a vote on health care reform, and with its compromises, it passed. “You have to figure out how to do the politics first,” Patterson said. (And here I’ve been wishing for years that Obama would handle Congress like LBJ. In this case, I guess he did.)

Paul Song, a champion in California’s fight for a single-payer system, pointed out we already came close to achieving it, having lost out in the Senate by only two votes. He thinks more people will begin to see the advantages: eliminate administrative waste, negotiate bulk drug pricing, save doctors $70,000 year and valuable time by reducing paperwork. Last time around, according to Song, Jerry Brown said if the single-payer bill passed, he would sign it.

We have “a platform to build on, but for that to happen, the Affordable Care Act has to stay in place,” said Jim Lott, adding, “I don’t have to tell you what outcome is required in November.”

Posted: Thursday, 23 August 2012

Right vs. Right

August 16, 2012

from Hunger Mountain, August 15

On Characters: Dual Capacities

A Craft Short

from: Diane Lefer



It must be eight years since A Tale of Love and Darkness was published in English and Israeli author Amos Oz spoke at Vroman’s Bookstore in Pasadena. In his memoir, Oz writes about the troubled marriage of his parents as well as the conflict in his country between Jews and Arabs, Israelis and Palestinians. At the bookstore, he explained that in telling these stories, he had tried not to take sides: “I’m no longer interested in the conflict between right and wrong, but the conflict between right and right.”

His words startled and excited me then and came immediately to mind as I watched Asghar Farhadi’s Oscar-winning film from Iran, A Separation.

In the film, every character tries to do the right thing. For guidance, they look to religion, to secular law, to ethical standards of family loyalty, human rights, ideas of reputation and friendship. Yet every time a decision is made, no matter how sincerely, someone gets hurt and something goes awry. There are no guns, no car chases, and yet the tension in this film had me on the edge of my seat.

Both Oz and Farhadi come from the Middle East, from societies that are polarized. Maybe that explains why both have used art to question the demonization of the Other and of those who disagree. But American society is also polarized. Except for Andre Dubus III’s House of Sand and Fog which concerns—coincidentally?—an Iranian man, I can’t think of an example from our literature, including my own fiction, that recognizes the legitimacy of opposing claims. Is such complexity beyond us? If fiction must (as we’re often told) involve conflict, must it mean the clash between Good and Evil?

What if I drop the distinction between protagonist and antagonist? Instead I see two people on a seesaw, only momentarily in balance. When one goes up, it’s unavoidable that the other will go down but they are in this dynamic together and I must respect them both.

Look at the last story or memoir section you wrote, or the last short story you read. Did you (or the author) make it clear which character was right? How might the piece change if no one had a monopoly on justice?

When there’s a character I really don’t like, I try to keep in mind that everyone has dual capacities though we don’t all (or always) act on them. This exercise helps me:

Close your eyes and imagine. What experience makes you feel empowered, expansive, strong? Then, what does it feel like to be insignificant, unnoticed? Go into your memory to find the experiences that have triggered these feelings. Now think of your characters and imagine what triggers these emotions in them and how they express those feelings in action. Imagine your characters feeling greed/generosity, love/hate, fear/security, rage/forgiveness, truthfulness/deceit.

Our favored character isn’t a saint, and the character we don’t like shares our humanity.

*Warning: Seesaws, now considered a safety hazard, are being removed from playgrounds all around the country. Use this metaphor at your own risk.

In tribute: tatiana de la tierra

August 1, 2012

tatiana de la tierra now lifts away from the earth: tribute to a friend

When she was a little girl, at a time long before I knew her, tatiana de la tierra had a different name, and she stopped speaking. She went mute. By the time we met in 2010, tatiana had grown into her energy and her courage and her power and her free, uncensored tongue. tatiana said whatever she felt, believed, wanted to say. That doesn’t mean her words were ever cutting or cruel. She was funny and honest and out there, a voice of joyous and uninhibited liberation.

We met after The Blessing Next to the Wound was published. tatiana was going to review it for La Bloga but before she wrote anything, she wanted to interview Hector Aristizábal and me. The book upset her, reminding her of events from her own past she would prefer to forget. She wanted to know from us why Hector would want to probe the pain in his life, his arrest and torture, his brother’s murder, and more. tatiana, like Hector, emigrated from Colombia.

She, too, had trauma and violence in her past, but she preferred to heal herself in spiritual ways and put the pain behind her. It was not her way, though, to say someone else was wrong. With her openheartedness and ever alive curiosity, she wanted to understand Hector better, not to criticize or condemn him.

That day, tatiana performed some of her poetry for us, her rollicking, funny, wild celebrations of women’s bodies and lesbian love. She revealed herself a force of nature.
I came away from our meeting with her Chibcha Press book, Píntame una mujer peligrosa, and a new friend.

tatiana invited me and Hector to her apartment in Long Beach–a magical space with ritual objects and her extensive collection of folk art and books and record jackets from all over Latin America. And the two beautiful cats, Shakira and Mojito. tatiana was was initiated into Munay-ki and in a ritual ceremony she invoked for us mystical bands of protection.

Anyone who knows me knows I’m not a believer, but I was glad tatiana had spiritual protection, this impressive goddess of a woman who was struggling with kidney disease and dialysis (which didn’t stand in the way of her trekking to ecoaldeas in Colombia or shamanic trainings in both Americas or drumming on full moon nights in the mountains in Altadena) and her beloved brother’s murder and her difficult father’s recent death.

And she began to look at those wounds. tatiana began to write her own memoir and send me chapters. They should be published and read and the only reason I’m not posting them here is so that on-line publication won’t stand in the way of Olga Garcia, her literary executor, shepherding them into print.

Last year, she seemed to be at a low point. She was laid off from her library job. The IRS decided to audit her. A long distance relationship fizzled.
The diagnosis of cancer came soon after. It spread through her whole body like quicksilver. To her bones. Tumors popped out everywhere, you could touch them bulbing against the skin of her arms. Inoperable.

When tatiana was too exhausted and in too much pain to do anything but lie in bed, Shakira and Mojito, curled up around her.

Taken onto the plane in a wheelchair, tatiana traveled alone to a healing center in New Mexico where she lay naked on a buffalo robe in the wind and sun. This was not the first time in her life that doctors had told her she was terminal and yet she had gone on living. So while she began to make final arrangements–writing her will; arranging for her archives to go to UCLA–while her mother flew in from Miami to be with her and aunts arrived from Colombia, tatiana said she was refusing to die.

Hector and I visited her in the hospital after the colostomy which was done not in hopes of a cure but to keep her a little more comfortable because of the large tumors blocking the passage and causing excruciating pain. She looked so healthy and joked around about her colostomy bag with her accustomed lack of inhibition and good cheer and told about the new apartment she was moving to–on the ground floor, to make life easier–it was tempting to believe she would be all right.

Maylei Blackwell contacted tatiana’s friends and family with an invitation. On Thursday, July 12, we gathered for a healing ceremony at the home of Qween Hollins in Long Beach, a place where the LGBT community gathers for non-patriarchal spiritual practice, where we were saged and then went down steps carved into the earth, into the pit–“the womb of Mother Earth”–with a fire pit in its center. About 25 of us took our seats. Above us, trees and towering sunflowers, and a light rain fell.

Qween Hollins is gifted and absolutely genuine. She led the 2-hour ritual which, though many of us hoped for healing and cure, we understood the ritual was aimed at leaving the outcome open and letting the spirit guide tatiana to wherever it was she was meant to be. At one point, tatiana transformed before my eyes to a 5-year-old little girl. She just grew younger and younger, a look of total trust and innocence.

Then, inside the house, we were joined by her mother and her aunts. tatiana, exhausted, had to lie down on the bed. We shared food and then tatiana got off the bed and we presented our gifts of poetry and memories. So many people simply adore tatiana. they have been so inspired by her courage, not just in how she has faced the pain, but they have felt liberated by her refusal to censor herself. tatiana had taken down the necklaces that used to hang over her bed and had them in a basket so everyone could take one.

True to tatiana’s spirit, there was a lot of laughter and sexual commentary. Her mother spoke in tribute not just to tatiana but to her community. “Everyone has heard of witches, but you don’t know they really exist and you’ve never actually seen one. To me, that’s what lesbians were. I couldn’t believe it. But I’ve learned that you have been mother to my daughter and sisters to my daughter. When she first had her kidney disease, I told her to come home where I could take care of her and she said, no, I’m staying here. Then I came to visit and I saw you are her true family. I love you all and I consider you my family and I’m proud you are part of my family. Thank you for loving my daughter.”

Once everyone had a chance to speak, we lit candles, tall white candles that burn for seven days and we placed them in the center of the room on two trays and spoke our intentions.

Qween invited tatiana’s mother and aunts to lead us in prayer. This was so open of her because I’m sure she knew where those prayers would go, back to patriarchal religion, but she showed the women this respect. tatiana’s mother asked the Lord for blessings and to care for and comfort tatiana and ended it in Jesus’ name, and the aunts led us in the Padre Nuestro.

We sang De Colores and an African song that Qween taught us.

tatiana said she was exhausted but happy.

I did not see her again. The apartment was crowded and hectic. I didn’t want to intrude. On Monday, though, Maylei suggested I visit but told me to text first. I don’t have a cell phone, so I phoned instead. tatiana could barely speak she was so weak. she was too exhausted for a visit then but said she would call me back the next day, Tuesday, if she felt stronger. Instead, Tuesday afternoon, July 31, I got word that she had left us. The world is diminished.

* * *

Gore Vidal also died on Tuesday. These words of his apply so well to tatiana de la tierra: “Style is knowing who you are, what you want to say, and not giving a damn.”

* * *

Tatiana’s memorial service will be held on Saturday, August 11 at 2:00 pm at Forest Lawn Cathedral Chapel, 4885 Cherry Avenue, Long Beach, CA 90807

The family requests that no floral arrangements be sent. Instead, friends and family are welcome to bring loose flowers that everyone will arrange together.

* * *

News: February 2015, Olga Garcia reports that thanks to Mario Garcia and Maritza Alvarez tatiana’s website is live again: Please visit!