A DANISH STUDENT’S PERSPECTIVES ON HEALTHCARE

Denmark's Largest Hospital

By Param Bhatter
Staff Writer

The Affordable Care Act, otherwise known as Obamacare, will face multiple challenges during its implementation over the next few years. The act is attempting to increase affordability and quality of health insurance, expand public health coverage and mandate similar coverage rates for those with preexisting conditions, in what is often portrayed as a collective effort to socialize healthcare. Even though the United States is far from a fully subsidized healthcare system, there is much to learn going forward if this goal is to be met. Denmark, where the social healthcare system has overcome adversities and flourished, is a rather interesting place to look to as an example. In Prospect’s exclusive interview with a Danish international exchange student, Peter Hjorth Vindum revealed his views on the benefits and issues the Danish healthcare system has faced.

Peter began by describing an overview of the Danish healthcare system. Fully subsidized by the government, there is truly only one hospital system that operates over the entire country. These hospitals treat all Danish citizens completely free of charge, regardless of their age, preexisting medical conditions or employment. Because of this centralization of healthcare, the overall system runs more efficiently; for example, the centralized infrastructure allows faster patient data transfer. While this seems to work extremely well in Denmark, it is important to note that Obamacare takes a different approach by focusing on increasing competition between providers, as this is expected to cause the overall quality of healthcare to rise. Even though allowing citizens to compare and select the best insurance providers is currently a valid strategy for accomplishing the goals of the ACA, in the future it may also be in America’s best interest to centralize the system for total efficiency, as Denmark has done.

Peter then described some of the issues that have plagued the healthcare system in Denmark for the past couple of years, and what the government has done to combat these problems. Peter argued that the worst part of having a centralized healthcare system is that treatment is often inaccessible in rural parts of Denmark, as all hospitals and most outpatient clinics are located in cities or suburban areas. People often have to drive up to 50 miles for a weekly checkup, or even further for access to surgical treatments. To counteract this problem, the Danish government has been focusing on developing more outpatient clinics and on increasing the number of emergency care centers in rural areas. While not all treatment types are available for patients at these outpatient clinics, patients don’t have to encounter long ambulance lines and waits at the emergency rooms.

One of the unsolved issues that still remains for Danish citizens’ concerns the quality of care at these mega-hospitals. One major issue is overcrowding at hospitals, creating long waits for procedures in cases that are not immediately life threatening. Hospitals are usually fully booked, with patients sharing rooms and being rushed out as soon as possible. Additionally, there are long waiting lines for surgeries, often more than a month, and patients are forced to cope with their problems while they wait. However, Peter claims that this trend is increasingly accepted as the norm, as people understand that it is impossible to have excellent, individualized care for every single citizen. No matter the socio-economic status of the patients, the facility and doctors that treat them are the same. This equality is what drives the system effectively and allows it to work with minimal issues.

If America looks to move forward in improving the overall quality of life for all of its citizens, healthcare must be of the utmost political importance. In Denmark, Peter says, the healthcare system is considered to be sacred. Just as in the United States, fiscal issues and deficit spending plague Denmark continuously. However, the Danish citizens and their government refuse to even touch the healthcare portion of the budget, which in turn leads to better treatment and care throughout the country. Obamacare is projected to decrease the national deficit by cutting down on overhead spending in various areas of healthcare, if the ACA is enacted as written. Now that we have instituted the ACA, we will only have to wait and see if this actually will lead to better quality healthcare with less debt, which at best could even outdo the Danish healthcare system’s successes.

Image by Karen Mardahl

PROTECTING CHINA’S VULNERABLE: PUBLIC INTEREST LAWYER GUO JIANMEI

Chinese Graffiti

By Kirstie Yu
Staff Writer

With a surging economy and rapid development in China attracting the most attention, little is being paid to the civil society sector and issues such as the protection of human rights in China. For a country that recently gained a seat on the United Nations Human Rights Council (UNHRC), China certainly seems to be moving in the right direction toward addressing such concerns. After an early November meeting with top party officials, President Xi Jinping announced plans to ease China’s “one-child” policy, abolish labor camps without trial, grant more property rights to peasants, potentially allow for more online expression and much more in his reform package. However, as critics of the addition of China to the UNHRC contend, China still has a long way to go before it can fully be considered a country that protects human rights.

Jianmei Guo is a Chinese public interest lawyer, human rights activist and founder of the first nonprofit legal aid clinic in China (the Center for Women’s Law & Legal Services of Peking University, which was shut in 2010 and is now the Beijing Zhongze Women’s Legal Counseling and Service Center). She won the Simone de Beauvoir Prize in 2010, an international human rights award for women’s freedom. I had the privilege of interviewing Ms. Guo after attending her roundtable discussion on protecting the rights of women and the underprivileged hosted by UCSD’s 21st Century China Program. She offered great insight into the reasons she became a public interest lawyer, the challenges faced by public interest lawyers and non-governmental organizations (NGO) in China, the issues that are at the forefront of their agenda and the importance of the young generation and international support for these new Chinese NGOs.

Guo Jianmei Accepts Award

Ms. Guo expressed that oftentimes, those who study the law are unwilling to become public interest lawyers especially with the economy taking off and the potential to make a lot of money elsewhere. However, she became a public interest lawyer because “as a person in law, you always want to contribute to push legislation and build the rule of law. In China, we need public interest lawyers to push legislation and democracy… To be a public interest lawyer will help us gain the greatest satisfaction for our career aspirations.” In addition, her personal experience has influenced her career path, as she grew up in a small rural village in Henan province; “most of my family, relatives, and friends are the typical most underprivileged people. I understand those people and their rights. Personally, for me there is some special sentiment for those people. My personality is like a knight, chivalrous. I like to defend against injustice…I don’t like to see bullying. I like this job because of my personality.” Most public interest lawyers in China are like Ms. Guo, possessing a passion to fight for the rights of others despite the odds against them.

Public interest lawyers face many challenges in China, especially under the political and legal system in place. It is difficult for these lawyers, and the NGOs they represent, to receive any type of legal recognition from the government. Ms. Guo explains further, saying that the term “‘Public Interest Lawyer’ can be used privately, but not in public. Under the Chinese legal system, there is no such term as ‘Public Interest Lawyer.’ We have also been told that we cannot mention these four words [in Chinese, public interest lawyer is four characters] in public. About two years ago, I made a commercial. I wanted to push this image of ‘Public Interest Lawyer’ to the public to let them know that if they have hardships, they can find us, public interest lawyers, to help them. The commercial was cut not long after it was on. The government does not recognize this group of lawyers. We cannot officially register as an NGO. There is no incentive system for us, like pension and retirement. We don’t have legal status. We can only register as a business, but then we will face the problem of taxes.”

Second, there are also political risks because the bulk of the work done by these lawyers is essentially challenging the rule of law. Since many of the ideas and missions they have are against the government, the government sees these public interest lawyers as dissidents and human rights lawyers, which is why these lawyers have limited freedoms and are sometimes even sent to jail.

A third major challenge faced by Ms. Guo and other public interest lawyers is the lack of personnel. She notes that “we are critically lacking civil society power but are also lacking the power of public interest lawyers who contribute so much to push legislation that is so valuable.” It is already difficult enough to be the founder of legal aid in China, but to find young lawyers who are willing to fight for and believe in public interest rights for society as a whole in this day and age is just another problem that Ms. Guo and her colleagues face. Young lawyers do not want to carry the torch for the next generation because of the strength of the rule of law, lack of an incentive system, the reality of the task at hand, the high living standard, and political risks involved. She says that “our voices are loud and our influence is huge, but still only a handful of people are willing to do this. More and more contradictions are rising up as China’s economy roars. We need more of this kind of people to help out. People now don’t want to get into trouble; they always have the ‘it has nothing to do with me’ attitude.”

Despite these challenges, the work of Chinese public interest lawyers is vital to advancing rights in many different fields, including “politics rights, education rights, property rights, marriage and family rights, personal rights, and employment rights.” Ms. Guo asserts that the cases she and her colleagues take on “must be valuable for women’s rights, valuable for pushing the rule of law for women, valuable for advocacy, and valuable for research.” As Chinese society develops and the economy takes off, new issues will arise. Ms. Guo believes it is difficult for the Chinese government to establish the rule of law quickly enough to address all of the new issues. Thus, she and other Chinese public interest lawyers must push the government to improve the law for current issues such as “moving population, rural land expropriation, protecting of farmer’s rights and interests, and women’s employment rights.” For rural land expropriation, she explains, “lots of rural women lose their land, their home but do not get the compensation in time. They become homeless and beg on the street.”

There is discrimination against women when they try to find jobs but also after they get hired, which only adds to the glass ceiling that women face in the workplace. In addition, women’s education rights are an issue “because lots of girls drop out of school due to the poor traditional concept of male dominance and the moving population. Parents move to a different city to work but they don’t have a household register (census register) so their children will not be able to go to school in the city. Getting an education will be a big issue for our new generation in the future.” For women specifically, there are also the issues of “discrimination towards women in education, domestic violence, corporate sexual harassment, and rape of young girls.” Chinese women face all of these current issues, and it is Ms. Guo and her legal aid clinic’s mission to change the way the government recognizes these women’s rights.

Another current issue that Ms. Guo is attempting to tackle is the lack of female representation in the highest levels of Chinese government. She puts it best when she expresses that “basically, [the Chinese government] doesn’t pay attention to training and selecting women to be leaders. They discriminate and exclude women. Also, women become vulnerable because of our culture, traditional concepts, and history. Women themselves think they can’t compete with men. Plus, there is some discrimination in educational and employment aspects that has resulted in women not being able to compete with men. The government has not yet established a platform and channel to help women in this field. This will definitely affect women’s rights and development. A group of people who make up half of the population lacks the voice to fight for their rights and benefits. Our organization is always trying to push this part. It is a long and tough road.”

With all of these issues to tackle, Ms. Guo knows that the Chinese constitution itself is not to blame for the divide between its guarantee of human rights and the actual practices of the state. She believes that from a legal point of view, the constitution actually has “really good rules to protect human rights. The law is comprehensive and the rules are well set.” On the contrary, “the problem is execution. China has not been a juridical society. When people are implementing the law based on the well-written constitution, they don’t enforce it.” Furthermore, “the concept of the law for most people is weak. Not only the public, but also the law enforcement doesn’t know what the law is. For them, the law is not as important as their own rule in their rural village.”

When government officials do not have the right concept of the law, it is more likely that certain basic rights will not be protected. In addition, “when all the factors such as judicial corruption, bureaucracy, local protection, industry protection, and administrative interference come to interfere with the judge, the case might not be sentenced properly.” Identifying the problem as the execution of laws and not the law in general is the first step. Ms. Guo then “uses the law as my tool to fight for justice. If we all follow the law to enforce it, to judge the case, order within the society will be established. But in reality, people don’t follow and carry out the rule of law.” She contends that “if we can implement even half of the rule of law, our legal system will improve dramatically.”

Ms. Guo sees the support of both the young generation in China and international NGOs as the key to expanding pertinent women’s rights in the future. First, she has already noticed a great change in the concept of Chinese culture in the young generation. She notes that a lot of young women are standing up to fight for their rights where there is sexual discrimination against women. An example of this is that in China, female students are held to a higher points requirement than male students for the national university entrance exam. This was widely protested in the past few years, and the government has since changed the requirements to be equal for both male and female students. She believes that the Chinese public has already become more aware of the “importance of their rights, the concept of law, human rights, and the concept of democracy” in the last 20 to 30 years. This will only be furthered with the return of Chinese students who went to America or Europe to get a western education back to China, where they will bring with them what they have learned about democracy, freedom, and the law. She contends that many people feel disappointed in young people for not caring about politics, but she believes that “they will still influence people with their thoughts, ideals, concepts and culture in their fields,” and thus, will still have a substantial impact on Chinese society.

Next, Ms. Guo believes collaboration with international NGOs to be key to spreading the message of Chinese public interest lawyers and showing the world the work that they are doing. This past summer, she held a seminar with the International Labour Organization (ILO) on corporate sexual harassment prevention in Beijing, China. She wants to be able to introduce global concepts from organizations such as the ILO to China. There are more “globally advanced concepts, new strategies, and more effective techniques” brought up around the world that could benefit China as a whole. Furthermore, having support from the international community not only helps with the financial assistance that Chinese public interest lawyers need, but also helps Chinese NGOs keep up to date with the latest information. Furthering collaboration with international organizations is one of the vital missions Ms. Guo and her legal aid organization are currently working on.

Ms. Guo’s dedication to her work is truly inspiring. To be so willing to fight for others despite contention from the government is a difficult task indeed. Ms. Guo best summarizes her feelings towards her work when she said, “There is no way back. The more I am doing the job, the more I love this job. There is no return. For those people who have only worked for a short term like half a year or a year, it is easy for them to go back to their regular job. For me, it has been almost 20 years. It is very hard for me to give it up. In the process of doing this public interest in the long term, your emotions (affection), spirit and thoughts (cognition) have already solidified. You cannot change.”

With the aid of international organizations and a new generation of young lawyers willing to take up the fight for civil rights, China is already changing both socially and legally, in addition to the constantly growing economy. If Ms. Guo and her colleagues continue to make the public aware of their rights, the inequalities in their society, and the potential to change the country for the better, China will earn the respect of its peers for recognizing human rights while dominating as a world power.

Images by iamsheep and Medill DC

Special thanks to Cathy Yu for translating, Logan Ma for interpreting, and 21st Century China for hosting the event and allowing me to interview Ms. Guo.

PROJECT UNITY: ONE VETERAN’S EFFORTS TO PROMOTE TOLERANCE AND OPEN DIALOGUE

By Alexsandra McMahan
Staff Writer

When American combat troops return from the Middle East, the words of advice often provided are to the tune of reacclimation, as if you can just “get used to” the United States again after a life changing wartime experience on the front lines. For Richard Gilbert, a retired Marine Corps sniper, these words were not enough. In his view, returning to the U.S. isn’t so much a reacclimating procedure, but instead, a blending of lessons learned both overseas and in his home country. Returning to the U.S., and particularly to San Diego, Gilbert did not only experience happiness and relief. Some welcomed him with coldness, and others with outright anger. “This is my third quarter [at UCSD],” Gilbert mentioned, “and I’ve been called a murderer here, I’ve been told I went to the Middle East and killed babies…” All of those things. It’s really interesting because there are things that are offensive to specific groups that neither one of us even knows are offensive.”

In some ways, Gilbert’s circumstances are not typical – he suffered a traumatic brain injury from his second tour in Iraq, held a very high-pressure and personal position in combat tours as a sniper, and when he returned to the U.S., decided to relocate to a city thousands of miles from where he was raised. However, with the number of brain injuries on the rise and the increased understanding that any position in combat is highly stressful, Gilbert’s story has common threads with those of many other veterans. Although the ways in which these servicemen and women cope with their different experiences vary, Gilbert stands by certain principles as key not only for veterans, but all human beings, to cope with intolerance, stress, and alienation.

Gilbert has extended these ideas of tolerance and open dialogue into a life of action, taking this course to a new level last spring. At San Diego’s Mesa Community College, Gilbert founded Project Unity, a blood drive aimed to bring together Muslim and veteran students. Project Unity became something every individual could take part in as a blood donor or volunteer, and a project that can be brought to other communities with ease.

The need for this project was cemented for Gilbert during some particularly formative experiences at Mesa Community College. Although Gilbert found animosity in many different places when he returned to the U.S., he realized that he encountered it most frequently within communities where veterans and Muslim students had to share space. The most notable example in his mind was during his fall semester at Mesa.

“When I was at Mesa, the Muslim Student Association had a tent, and at the time, I was rocking the aviators, I had my big red ‘Marine Corp retired’ hat on, and I saw a poster that said ‘WAR’ at the top of it. [I thought], ‘That looks very interesting, I should probably read what they have to say about it, because it would be interesting to get their take on it.’ So I approached the tent, and there were four young females there, and as I approached, they literally took three steps back.”

This drastic response stuck in Gilbert’s mind, particularly because he “was pretty surprised that [his] viewpoints on war coincided with their viewpoints a lot.” This experience wouldn’t leave his thoughts, and finally, he brought the discussion to the attention of his Vice President of the Student Veterans Organization at Mesa. Together, they determined something should be done to guide these two groups into a more comfortable relationship.

“I started thinking,” Richard said, “if our opinions are the same and I view people from Iraq, Middle Easterners, and Muslims as my brothers, and they don’t view me that way, then obviously there’s something wrong. We need to do something about that. On top of that, you add the fact that we’re all Americans, which automatically makes us brothers, and the fact that they didn’t even know who I was, they didn’t know my name — all they knew was my outward appearance…They seemed a little uncomfortable around me, and that made me uncomfortable, and I was like, ‘Surely, there’s something we can do to remedy that, to take care of that, to change their perspective of veterans.’” An important first step was Gilbert’s acknowledgment that this discomfort occurs on both sides: “There are also veterans who have a very blindsided viewpoint of Muslims and Middle Easterners, so there’s something we need to do to change their perspectives as well.”

Project Unity, Gilbert makes clear, was not a personal effort to justify his experiences or promote his viewpoints on war. “The overall goal, when I first started,” Gilbert emphasizes, “was just to get people to realize… the founding fathers’ ideology of what America is. That no matter what color you are, what religion you are, no matter what you believe in or who you love, the fact that we are all Americans, we are all brothers, and we are all human beings.” He feels that goal is still true within Project Unity’s efforts today, and contends that it is a project that can help everyone open dialogue and reduce ignorance on key issues at the same time without forcing students to change their beliefs.

“The awesome thing is that Project Unity — it’s not about getting us to see the same point of view. It’s not about me saying, ‘This is what I think and this is what I’m trying to get you to think.’ We’re not trying to change political beliefs, religious beliefs, [or] political points of view within Project Unity, whatsoever. It’s not pro-war, it’s not anti-war, it’s not pro-veterans, it’s not anti-veterans, it’s not pro-muslim or anti-muslim. It’s pro-American, and it’s pro-human.”

Gilbert has continued to learn from his experiences with transferring to UC-San Diego this year and joining a new community. He has not lost sight of Project Unity’s success last year and he would like to bring this experience to UCSD in the future. He has spent the past year establishing ties with the Muslim Student Association, Afghan Student Association, Student Veteran Organization, and the Arab Student Union. Eventually, Gilbert hopes this program could spread nationwide and help serve as a physical space where groups can take the first steps towards opening dialogue on tense issues. During our interview, he asked me, “You know the breast cancer walk that they do every year? All sorts of people come out, pink ribbon is everywhere, it’s all over the country. I would love for Project Unity to be coast-to-coast on every major university [campus]. Because that’s really where dialogue starts.”

Ultimately, Gilbert’s experiences are important because they shaped who he has become and his actions have become a product of that; however, he stresses that what he really wants above all is for others to feel comfortable discussing difficult questions. Without dialogue, open communication, and – sometimes – saying the wrong thing, Gilbert believes it is difficult to ever reach a level of comfort about yourself and your beliefs. It is after communication, Gilbert stresses that people can move past understanding and towards concrete action. This, he says, is where change will happen to make the world a better place.

“There’s so many things that we see and it’s like, ‘Oh that’s awful, that’s horrible, how can we change it?’ and there’s so many things that are so far out of our reach that we feel insignificant about, and we think, ‘Okay, that’s some bad shit that happened, but I can’t change it.’ I find myself saying, ‘Well, that’s not really an acceptable answer for me.’…[How] I look at it, if I can get you… to see things from a different perspective, if I get you to respect everybody’s points of view — not that you don’t, but — if I get you to do that, who are you going to talk to tomorrow? Who are you going to affect tomorrow? And then who are they gonna affect?”

Gilbert admits this isn’t easy. As a veteran, he has sometimes struggled with the viewpoints of others on war, duty, and respect for individual life, but he has always overcome these differences to form authentic personal and business relationships. It is possible, he argues, and we, as individuals, can all have a part in educating ourselves and learning from those around us. Sometimes the hardest part is getting started, but here, Richard Gilbert – as always – has a few things to say. His advice?

“Don’t be afraid. I feel like…our country is so busy being politically correct that we are now afraid to approach people. We are now afraid to open dialogue, we are afraid to say ‘oh, well, this is what I think.’ We’re afraid that what we think is offensive, and it might be, but what we think is offensive because we don’t know any better. We’re not going to know any better unless we open this dialogue and we educate ourselves.”

As a university, UC San Diego often promotes its work to create dialogue and safe speaking spaces. Richard Gilbert’s efforts are amongst the most honest and dedicated actions, I have seen to truly encourage individuals to reach a more open understanding of the lives and struggles that affect others. Project Unity serves as an example of what opening dialogue really can do: bring together groups, foster understanding, and ultimately save lives.

To find out more about Project Unity and how to participate, please visit the facebook page or contact the team. Additional information about Project Unity is available here.

Photos courtesy of Richard Gilbert.