What Makes America Perfect??

Jersay

House Member
Dec 1, 2005
4,837
2
38
Independent Palestine
Now this is not to make you think that America is perfect. It's not and it is that simple.

If it was perfect, it wouldn't have millions of people in poverty.

37.0 million people in poverty

There is significant disagreement about poverty in the United States; particularly over how poverty ought to be defined. Using radically different definitions, two major groups of advocates have claimed variously (a) that the United States has eliminated poverty over the last century; or (b) that it has such a severe crisis of poverty that it ought to devote significantly more resources to the problem.

Much of the debate about poverty focuses on statistical measures of poverty and the clash between advocates and opponents of welfare programs and government regulation of the free market. Measures of poverty can be either absolute or relative.

In recent years, there have been a number of concerns raised about the official U.S. poverty measure. In 1995, the National Research Council's Committee on National Statistics convened a panel on measuring poverty. The findings of the panel were that "the official poverty measure in the United States is flawed and does not adequately inform policy-makers or the public about who is poor and who is not poor."

The panel was chaired by Robert Michael, former Dean of the Harris School of the University of Chicago. According to Michael, the official U.S. poverty measure "has not kept pace with far-reaching changes in society and the economy." The panel proposed a model based on disposable income:

According to the panel's recommended measure, income would include, in addition to money received, the value of noncash benefits such as food stamps, school lunches and public housing that can be used to satisfy basic needs. The new measure also would subtract from gross income certain expenses that cannot be used for these basic needs, such as income taxes, child-support payments, medical costs, health-insurance premiums and work-related expenses, including child care.

Eighty-nine percent of American households were food secure throughout the entire year 2002, meaning that they had access, at all times, to enough food for an active, healthy life for all household members. The remaining households were food insecure at least some time during that year. The prevalence of food insecurity rose from 10.7 % in 2001 to 11.1 % in 2002, and the prevalence of food insecurity with hunger rose from 3.3 % to 3.5 %. This report, based on data from the December 2002 food security survey, provides statistics on the food security of U.S. households, as well as on how much they spent for food and the extent to which food-insecure households participated in Federal and community food assistance programs

There are numerous perceived direct and indirect causes of poverty in the United States. They include:

Unfavorable economic conditions
Mental illness
Substance abuse
Poor education
Institutional racism: The gross disparities among impoverished people in the United States along racial lines have led many to believe that historic and/or ongoing institutional racism is responsible for much of the poverty in the United States today.
Genetic Disadvantages
Limited job opportunities appear to exist for significant subgroups of some races and ethnic groups. This is reflected by the low-income nature of large sections of the economy, as divided along racial/ethnic lines: 21 % of all children in the United States live in poverty, but 46 % of African American children and 40 % of Latino children live in poverty. (Center for the Future of Children, The Future of Children. Vo. 7, No 2, 1997).
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Fighting poverty
There have been many governmental and nongovernmental efforts to make an impact on poverty and its effects. These range in scope from neighborhood efforts to campaigns with a national focus. They target specific groups affected by poverty such as children, immigrants, or the homeless. Efforts to alleviate poverty use a disparate set of methods, such as advocacy, education, social work, legislation, direct service or charity, and community organizing.

Politicians often make fighting poverty a central part of their political platforms. John Edwards has established an anti-poverty think tank in Chapel Hill, North Carolina, and works closely with ACORN and other organizations of low income families. President George W. Bush has chosen to speak on promoting an ownership society.

http://en.wikipedia.org/wiki/Lowest-income_counties_in_the_United_States

http://en.wikipedia.org/wiki/Human_Poverty_Index

http://en.wikipedia.org/wiki/Poverty_in_the_United_States#The_official_measure_of_poverty
 

Jersay

House Member
Dec 1, 2005
4,837
2
38
Independent Palestine
Claims that it is the beacon for human rights, but it has a bloody background in that issue.

The principles of legal egalitarianism underlying the United States Constitution, upon which the United States is founded, were and are tempered with a political pragmatism that has occasionally undercut the human rights ideals that the document espouses. The Constitution created what was, in 1787, a distinguished progressive democracy that guaranteed unprecedented social and economic rights for much of its citizenry. Yet at the same time, the very same founding document implicitly [1] sanctioned slavery, which was not completely abolished until 1865 after the American Civil War, and lynching of blacks was relatively common into the middle 1900s. Only in 1968 did the Supreme Court rule explicitly against racial segregation laws.

This mixture of idealism and compromise has produced a paradoxical human rights record. The American system aims at a free society where life, liberty and a host of inalienable human rights are guaranteed by its Constitution and the Bill of Rights. Human rights in the United States of America are built on the self-evident truth that all men are created equal and endowed by their creator with natural human rights. Some confuse equal rights with equal authority and thus assume that those with less authority lack these rights which gives birth to the mistaken hypothesis that by "men" the Declaration of Independence meant, white males.

The Constitution guarantees freedom of speech, freedom of the press, the right to a fair trial, freedom of religion, equal suffrage, and property rights. Such affirmations of human rights are the product of nearly four centuries of struggle and social progress aiming for a fair and just society, with its beginnings in 1634 when the first colonies in Maryland were founded on the basis of religious tolerance. However, some Americans attempting to exercise these fundamental human rights have been persecuted at various times throughout the country's history.[citation needed]

Most citizens tend to be optimistic about the United States Constitution and point out it is still a work in progress and changes to it are continuously under consideration as the needs of the society of the United States change. An example of this is how the status of human rights in the United States recently have come under scrutiny for the government's positions on capital punishment, police brutality, the War on Drugs, and sexual morality.

Finer points which are sometimes debated are a perceived media concentration that might drown out voices of dissent, campaign finance in the United States preventing a "fair" election, details of the justice system minimum sentencing guidelines, coercion into plea bargains and inadequate public defenders. Such issues often come up because of different interpretations of what is constitutional by the various authorities. Some rights issues are portrayed as a political split, pitching the rights of one group against another. For example, Americans have the right to form trade unions but some states have passed laws to guarantee an individual's right to work, a right not guaranteed in states with Collective bargaining statutes, and which have made it difficult for unions to negotiate contracts. However, in the vast majority of states, at-will employment (an employee can be fired for any or no reason) is the norm and unions have very little power to fight this. Also, in the more conservative states (red states), generally in the Deep South and Midwest, union influence is limited in general. In regards to abortion, the right of women to terminate a pregnancy is generally contrasted with the rights of unborn children.[citation needed]

After the September 11, 2001 attacks, pressure from the government for more surveillance of suspected terrorist cells activities has led to heightened criticism of the government's violation of suspected terrorists' privacy and of control measures that do not respect suspected terrorist prisoners' dignity. In the aftermath of those attacks, there have been signs from the Federal government of the United States of a noticeable shift away from United States Constitution safeguards traditionally afforded American citizens, notably:

Two Pakistani Americans allegedly affiliated with the Islamic militant group Harakat ul-Ansar were arrested in Pakistan by Pakistani authorities and held and allegedly tortured in a Pakistani jail. The two allege that they were interrogated by men flashing FBI agent shields. [2]
The detention without charge, for months on end, of United States citizens suspected of ties to insurgents in Iraq (for instance, for carrying washing machine timers in their car trunks). [3]. (The Associated Press reported on July 7, 2005, that the United States was holding five Americans in Iraq.)[citation needed]
The arrest, without charge, of large numbers of Muslim men as "material witnesses" in cases related to Terrorist activities in the United States.[4].
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Slavery and racial discrimination
Main articles: History of slavery in the United States, Racism in the United States
At the time of the American Revolution, slavery was an established institution, especially in the southern states. The "peculiar institution" was a potentially contentious issue at the Philadelphia Convention. In order to maintain unity among the former colonies, the Three-Fifths Compromise counted slaves as three-fifths of a person, for the purposes of allocating Congressional representation, and a guarantee of tax-free slave imports was written into the document, but only for a limited time. Slavery continued, but remained a controversial national issue, generating considerable regional conflict over the practice and its expansion into new states. Half the states in the Union maintained slavery until 1865.

Most historians consider the economic and ethical conflicts over slavery to be one of the primary causes of the American Civil War, which began in 1861. The wartime Emancipation Proclamation of Union President Abraham Lincoln turned northern soldiers into slave liberators. Following the northern victory, the Thirteenth Amendment to the United States Constitution abolished slavery, and the Fourteenth Amendment to the United States Constitution established Black citizenship rights and "equal protection".

These legal protections did not change popular sentiment, especially in the southern states, and substantial racial discrimination persisted. Discriminatory practices continued to be institutionalized in law for the next century, including Jim Crow laws and the separate but equal theory endorsed by the Supreme Court in the 1896 Plessy v. Ferguson decision. It was not until 1954 when the Court reversed its decision, in Brown v. Board of Education. In time, slow cultural changes and the Civil Rights Movement won the passage of strong anti-discrimination legislation, such as the Civil Rights Act of 1964. Strong federal guarantees now provide the ability to sue any national, state, or local government agency for racial discrimination. Private prejudice is somewhat protected as a form of free expression and free association, but in many business dealings is illegal. Significant economic inequality exists between different racial groups.[citation needed]

Various Supreme Court rulings have restricted some types of affirmative action, on the grounds that they descriminate against the majority white population and non-underrepresented minorities.

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Issues
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Torture and abuse
Certain practices of the United States military, civilian agencies such as the CIA, and private contractors are widely criticized, with some practices allegedly amounting to torture. It should be noted that fierce debate regarding non-standard and enhanced interrogation techniques exists within the US civilian and military intelligence community, with no general consensus as to what practices under what conditions are acceptable. These practices include: extended forced maintenance of "stress positions" such as standing or squatting; psychological tricks and "mind games"; sensory deprivation; exposure to loud music and noises; extended exposure to flashing lights; prolonged solitary confinement; denigration of religion; withholding of food, drink, or medical care; withholding of hygienic care or toilet facilities; prolonged hooding; forced injections of unknown substances; sleep deprivation; magneto-cranial stimulation resulting in mental confusion; threats of bodily harm; threats of rendition to torture-friendly states or Guantánamo; threats of rape or sodomy; threats of harm to family members; threats of imminent execution; prolonged constraint in contorted positions (including strappado, or "Palestinian hanging"); facial smearing of real or simulated feces, urine, menstrual blood, or semen; sexual humiliation; beatings, often requiring surgery or resulting in permanent physical or mental disability; release or threat of release to attack dogs, both muzzled or un-muzzled; near-suffocation or asphyxiation via multiple detainment hoods, plastic bags, water-soaked towels or blankets, duct tape, or ligatures; gassing and chemical spraying resulting in unconsciousness; confinement in small chambers too small to fully stand or recline; prolonged underwater immersion just short of drowning (i.e. dunking); and extended exposure to extreme temperatures below freezing or above 120 °F (48 °C). These practices have resulted in a number of deaths. According to Human Rights First, as many as 46 detainees have been murdered or tortured to death in U.S. custody in Iraq and Afghanistan. [5]

Torture and abuse is strictly illegal and punishable within US territorial bounds. The legality of abuse occurring on foreign soil, outside of usual US territorial jurisdiction, is however somewhat murky. Accordingly, the United States Administration creates an ad-hoc category called unlawful combatants, that have no basis in U. S. or international law, to deprive such persons of protection under the Geneva Convention as prisoners of war, and are keep and interrogated them on foreign soil. Both United States citizens and foreign nationals are occasionally captured outside of the United States and transferred to secret US administered detention facilities, sometimes being held incommunicado for periods of months or years. Overseas detention facilities are known to be or to have been maintained at least in Thailand, the Philippines, Pakistan, Afghanistan, Uzbekistan, Azerbaijan, Jordan, Egypt, Iraq, Kuwait, UAE, Saudi Arabia, Morocco, Cyprus, Cuba, Diego Garcia, and unspecified South Pacific island nation(s). In addition, individuals are suspected to be or to have been held in temporary or permanent US controlled facilities in Indonesia, El Salvador, Nigeria, Equatorial Guinea, Libya, Israel, Denmark, Poland, Romania, Bulgaria, Albania, Hungary, Germany, and Scotland. There are also allegations that persons categorized as prisoners of war have been tortured, abused or humiliated; or otherwise have had their rights afforded by the Geneva Convention violated. In 2004 photos showing humiliation and abuse of prisoners leaked from Abu Ghraib prison, causing a political and media scandal in the US.

The detention camps at the US Naval base of Guantánamo Bay, hosting over 500 detainees, have gained notoriety in recent years. Some detainees have been held for up to four years without charge or trial. Detainees have included American citizens and children as young as 11 year old. Though often criticized for being denied due process, all detainees have received review before Combatant Status Review Tribunals subsequent to US Supreme Court rulings.[citation needed]

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Freedom of expression
Main article: Freedom of speech in the United States
In the United States, like other liberal democracies, freedom of expression (including speech, media, and public assembly) is seen as an important right and is given special protection. According to Supreme Court precedent, the federal and lower governments may not apply prior restraint to expression. There is no law punishing insults against the government, ethnic groups, or religious groups. Symbols of the government or its officials may be destroyed in protest, including the American flag. Significant legal limits on expression per se include:

Crimes involving sexual obscenity, solicitation, fraud, specific threats of violence, or disclosure of classified information
Civil offenses involving defamation, fraud, or workplace harassment
Federal Communications Commission rules governing the use of broadcast media
Ordinances requiring mass demonstrations on public property to register in advance, and sometimes to use specific venues (see free speech zone)
Some laws remain controversial due to concerns that they infringe on freedom of expression. These include the Digital Millennium Copyright Act and the Bipartisan Campaign Reform Act. Such laws can be brought before the federal courts to determine their constitutionality, but the expense and time required is often prohibitive. Other recent issues include military censorship of blogs written by military personnel in Iraq.

In two high profile cases, grand juries have decided that Time magazine reporter Matthew Cooper and New York Times reporter Judith Miller must reveal their sources in cases involving CIA leaks. Time magazine cooperated with authorities after exhausting its legal appeals, and Mr. Cooper eventually agreed to testify. Ms. Miller was jailed for 85 days before cooperating. U.S. District Chief Judge Thomas F. Hogan ruled that the First Amendment does not insulate Time magazine reporters from a requirement to testify before a criminal grand jury that's conducting the investigation into the possible illegal disclosure of classified information.

Other journalists who've been legally pressured to provide information to investigators include Tim Russert, who moderates NBC's "Meet the Press," Washington Post reporter Walter Pincus, and syndicated columnist Robert D. Novak.

Several foreign journalists including British reporter Elena Lappin who arrived in the USA without an I-visa have been jailed and deported since the 2001 terrorists attacks. Citizens of many Western countries are exempt from a U.S. visa requirement intended mainly for tourists. However, they must declare that they are not representing the "foreign information media." This requirement is outside the norms of other democratic countries, and many journalists entering the USA were not aware of it. In 2005, the United States territory was ranked 44th in the annual Worldwide Press Freedom Index by Reporters Without Borders.

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Death penalty
The United States, Japan, South Korea, and Singapore are the only developed nations to use capital punishment in practice. This practice is controversial. Death penalty opponents regard the death penalty as inhumane and criticize it for its irreversibility and claim that it lacks a deterrent effect. Further, opponents often point to overrepresentation of blacks on death row as evidence of the unequal racial application of the death penalty (2003 [6]). It is the official policy of the European Union and of a number of non-EU nations to achieve global abolition of the death penalty. For this reason the EU is vocal in its criticism of the death penalty in the US and has submitted amicus curiae briefs in a number of important US court cases related to capital punishment. While criticism of the death penalty within the United States is strong among activist groups, public support varies regionally. The death penalty has been largely abolished in the Northeast, while the South and West continue to conduct executions. Texas overwhelmingly leads the United States in executions, with 359 executions from 1976 to 2006. The second-highest ranking state is Virginia, with 94. A 2002 Houston Chronicle poll of Texans found that when asked "Do you support the death penalty?" 69.1% responded that they did, 21.9% did not support and 9.1% were not sure or gave no answer.[citation needed]

A ruling on March 1, 2005 by the United States Supreme Court prohibits the execution of people who committed their crimes when they were under the age of 18. Between 1990 and 2005, Amnesty International recorded 19 executions in the United States for crime committed by a juvenile.

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See also
Capital punishment in the United States
Capital punishment in Texas
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National security exceptions
The United States government has on several occasions claimed exceptions to guaranteed rights on grounds of protecting national security. It typically invokes exceptions in wartime or during international conflicts short of war (such as the Cold War). In some instances the federal courts have allowed these exceptions, while in others the courts have decided that the national security interest was insufficient.

Sedition laws have sometimes placed restrictions on freedom of expression. The Alien and Sedition Acts, passed by President John Adams during an undeclared naval conflict with France, allowed the government to punish "false" statements about the government and to deport "dangerous" immigrants. The Federalist Party used these acts to harass supporters of the Democratic-Republican Party. Congress passed another broad sedition law during World War I. Its provisions were so strict that the government imprisoned one Hollywood director for making a film about the American Revolution because it depicted the British unfavorably. These laws lapsed or became inactive at the end of the conflict.

Presidents have claimed the power to imprison summarily, under military jurisdiction, those suspected of being combatants for states or groups at war against the United States. Abraham Lincoln invoked this power in the American Civil War to imprison Maryland secessionists. In that case, the Supreme Court concluded that only Congress could suspend the right of habeas corpus, and the government released the detainees. During World War II, the United States interned thousands of Japanese-Americans on fears that Japan might use them as saboteurs. In the recent campaign against terrorist groups, the government has detained suspected al Qaeda affiliates like Yaser Esam Hamdi, who also had his citizenship revoked.[citation needed]

The Fourth Amendment of the United States Constitution forbids unreasonable search and seizure without a warrant, but some administrations have claimed exceptions to this rule to investigate alleged conspiracies against the government. During the Cold War, the FBI established COINTELPRO to infiltrate and disrupt left-wing organizations, including those that supported the rights of black Americans. More recently the USA PATRIOT Act has been attacked as eroding Fourth Amendment protections.

National security, as well as other concerns like unemployment, has sometimes led the United States to toughen its generally liberal immigration policy. The Chinese Exclusion Act of 1882 all but banned Chinese immigrants, who were accused of crowding out American workers. Today foreign nationals can be detained or deported for minor infractions, although deportation is uncommon. The government is sometimes accused of skirting the required legal procedures. Tracking of immigrants has also increased as part of the anti-terrorism campaign, so that foreigners arriving by air are now subject to mandatory fingerprinting and photography. Since 2002, male adults from any of two dozen countries, most of them Muslim, have been subject to Special Registration. The United States is sometimes criticized for the effects of its border control efforts; for instance, between 1998 and 2004, 1,954 persons are officially reported to have died along the U.S.-Mexico border.

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Prison
As of 2004 the United States had the highest percentage of people in prison of any nation. At a rate of incarceration of 726 inmates per 100,000, the United States has the highest reported rate in the world, well ahead of the Russian rate of 532 per 100,000. In 2004, more than 2.1 million Americans, or roughly 1 out of every 138, were in prisons or jails, a figure which represented one third of the world's prison population. To illustrate these figures, if the United States had the same rate of incarceration as Japan or China, only about 100,000 people would be in jail. [7]

Because the legal system has imposed liability upon employers for negligence in hiring ex-convicts and in supervising them, many employers now make background checks a mandatory part of the hiring process. As a result, prisoners who are released often have difficulty finding jobs and often return to crime to support themselves.

According to Human Rights Watch, "black men [in 2000] were eight times more likely to be in prison than white men". [8] According to the Federal Bureau of Prisons, approximately 40.2% of the prison population is black, while 32.1% of the population is Hispanic, [9] with several enquiries and critics commenting negatively on the use of racial profiling and the overrepresentation of minorities in American prisons.

Sexual abuse in United States prisons is believed by many to be widespread. It has been fought against by organizations such as Stop Prisoner Rape, some of whom allege that some wardens use sexual abuse as a control tool in the prisons.

The United States also has "supermax prisons", where the most dangerous prisoners are kept in soundproofed solitary confinement for 23 hours a day with almost no human contact. They are often defended as appropriate for mass murderers, but there have been reports that some nonviolent prisoners have been sent to supermaxes.[citation needed]

In many states, those convicted of felony offenses are banned from voting. These laws have a much greater effect on minorities, especially African Americans, as they are more likely to be convicted of felonies. In some United States cities, for example, half of all black men cannot vote, and in states such as Florida and Alabama, as many as a third of black men cannot vote. For this reason, the constitutionality of this practice is likely to be tested in the United States Supreme Court in due course. (see Count Every Vote Act)

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Health and the family
In recent years several human rights issues regarding health and the family have been widely debated across the United States. The first is the question of whether a woman has a right to terminate a pregnancy or, as it is cast by opponents of abortion, whether the unborn child has a right to life. Although a Supreme Court decision (Roe v. Wade) established that most laws against abortion violate a constitutional right to privacy - it should be noted that this "right" appears nowhere in the Constitution - opponents of that decision have been pressing for the appointment of judges who might reverse that ruling.

At the other end of life, are the questions of whether a terminally-ill person has the right to decide the time of death (euthanasia) and whether the families of patients who have permanently lost all brain activity can end medical care or stop feeding. Both questions have been hotly contested and families are sometimes forced to endure lengthy court battles.

Unlike many other industrialized countries, the United States does not treat health care as a fundamental human right and provides publicly funded medicine only to people falling into certain limited categories. This has resulted in a wide gap in the quality of treatment between those who can afford health insurance, or who have it provided as an employee benefit, and those who do not. On the other hand, some have alleged that the US federal government pays more for health care than some other national governments, in part because the uninsured tend to seek care only once conditions become serious, and to use emergency rooms (which are required by law to serve even those who cannot pay) as primary-care facilities for conditions such as ear infections. (See Health care in the United States and Canadian and American health care systems compared for more details.)

A major reason for this is the ascendancy of the Republican Party (especially in 1980 and 1994), which strongly opposes universal health care as "socialized medicine" and "big government". Another reason is the opposition from powerful insurance lobbyists, who worked in concert with the Republicans to defeat the health care reforms proposed in 1994 by then-President Bill Clinton and First Lady Hillary Clinton. The Republican Party and insurance industry has promulgated stories (many unverified) of substandard care and waiting lists in Canada, the United Kingdom and other countries as reasons for the United States to not adopt universal health care.

While some countries such as Canada and Spain have recognized same-sex marriage, the issue remains hotly contested in the United States. There has recently been talk of defining marriage as one man and one woman by directly writing it into of the U.S. Constitution; which would rule out all homosexual marriages. As of 2005, same-sex marriage has official status only in the Commonwealth of Massachusetts, though some states offer similar privileges to same-sex couples. (See Same-sex marriage in the United States).

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Assessments of human rights organizations
Amnesty International states for the year 2000:

Police brutality, disputed shootings and ill-treatment in prisons and jails were reported. In May the U.N. Committee against Torture considered the initial report of the USA on implementation of the U.N. Convention against Torture. Eighty-five prisoners were executed in 14 states bringing to 683 the total number of people executed since 1976. Those executed included individuals who were children under 18 at the time of their crimes, and the mentally impaired.
In 2005 the organization expressed alarm at the erosion in civil liberties since the 9/11 attacks. According to Amnesty:

The Guantánamo Bay detention camp has become a symbol of the United States administration’s refusal to put human rights and the rule of law at the heart of its response to the atrocities of 11 September 2001. It has become synonymous with the United States executive’s pursuit of unfettered power, and has become firmly associated with the systematic denial of human dignity and resort to cruel, inhuman or degrading treatment that has marked the USA’s detentions and interrogations in the "war on terror".[10]
Amnesty also condemned the Guantánamo facility as "the gulag of our times," which raised heated conversation in the United States. The purported legal status of "unlawful combatants" in those nations currently holding detainees under that name has been the subject of criticism by other nations and international human rights institutions including Human Rights Watch and the International Committee of the Red Cross. The ICRC, in response to the US-led military campaign in Afghanistan, published a paper on the subject The legal situation of unlawful/unprivileged combatants (IRRC March 2003 Vol.85 No 849). See Unlawful combatant. China has criticized racial discrimination in its annual China's Human Rights Record of the United States. HRW cites two sergeants and a captain accusing U.S. troops of torturing prisoners in Iraq and Afghanistan. [11]

http://en.wikipedia.org/wiki/Human_rights_in_the_United_States
 

Jersay

House Member
Dec 1, 2005
4,837
2
38
Independent Palestine
And America is a nation that only has 66% of its people registered for health care of some kind. And we have heard stories of elderly residents of America who have to eat dog food or cat food because their pills are so expensive.

American health care is provided by a diverse array of entities. "Ambulatory care" refers to health care outside the hospital; most health care in the United States occurs in the outpatient setting.

Private sector outpatient medical care is provided by personal primary care physicians (specialists in internal medicine, family medicine, and pediatric medicine), subspecialty physicians (gastroenterologists, cardiologists, or pediatric endocrinologists are examples) or non-physicians (including nurse practitioners and physician assistants). Hospital emergency departments and urgent care centers are sources of sporadic problem-focused care. Clinics for wound care, physical therapy, rehabilitation and "surgicenters" are examples of specialty clinics. "Home health care services" are generally nursing enterprises, but are usually ordered by physicians. Hospice services for the terminally ill who are expected to live six months or less are most commonly subsidized by charities and government. Churches and other charitable organizations may supplement private health care by helping with medication costs.

There are various public outpatient facilities. In certain areas, Medicare patients and veterans may be able to avail themselves to earned public ambulatory care. Prenatal, family planning, and "dysplasia" clinics are government-funded obstetric and gynecologic specialty clinics respectively, and are usually staffed by nurse practitioners. However, most public outpatient care (Medicare and Medicaid) is in a private physician's office where it is reimbursed at reduced rates by state and federal governments.

Some elderly or severely handicapped persons who require daily nursing care live in nursing homes which are funded privately, by charitable institutions, and government. Their medical needs are supervised by nurses under the direction of physicians.

Hospitals provide some outpatient care in their emergency rooms and specialty clinics, but primarily they exist to provide inpatient care. There are nonprofit hospitals, which may be operated by county governments, state governments, religious orders, or independent nonprofit organizations. There are for-profit hospitals, which are usually operated by large private corporations.

Much of the cost of outpatient medical supplies and durable medical equipment is borne by state and federal goverments in the form of Medicare and Medicaid, but some is financed by health care insurers or other private sources.

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Who covers it
The default legal situation has always been that the patient must pay out-of-pocket in full for all services rendered, as with any other service industry; this business model is known as "fee-for-service." But today, fee-for-service applies only to the minority of Americans who are not covered by any kind of insurance, a situation further discussed below.

Most Americans are covered by some kind of cost-spreading mechanism (i.e., insurance) which distributes the risk of illness and the cost of health care among a group of people. This means that each individual or their employer pays predictable monthly premiums, so that when any given individual needs health care, they will have to pay up-front one of the following: (1) nothing (increasingly rare), (2) a minimum part of the total cost (a deductible), or (3) a small part of the cost of every single procedure (a co-payment).

The entity that provides the health care is usually not the same entity that does the task of spreading the cost of it. The exceptions are health maintenance organizations like Kaiser Permanente which run their own hospital and clinic networks to control costs, and a few employers which employ an in-house physician (e.g., Google) or even operate their own outpatient clinics.

Instead, most Americans receive their health insurance coverage through benefits programs provided by employers. Many of the remainder are covered by government insurance programs like Medicare and Medicaid, and various state and local programs for the poor.

Either way, health care providers must bill a patient's insurer for the cost of services rendered. The billing process is considered by critics, to be inefficient, if not wasteful, for the following reasons:

The lack of a national identity card forces insurers to impose many bureaucratic procedures like pre-authorization of non-emergency procedures upon both providers and patients to guard against fraud;
The insurers have a financial interest in denying coverage for any reason, and providers and patients have a financial interest in fighting denials of coverage, and both end up wasting time and money in the process;
The extreme fragmentation of the entire industry forces all entities to waste a lot of time learning about each other's bureaucratic procedures, because of the low probability that any pair of provider and insurer will regularly encounter each other; and
Much of the health care industry still operates on inefficient paper documents, because no entity outside the federal government has the market power to impose a single standard for digital transmission of health care information, and the federal government has been unable to create such a standard as of 2005.
The process of selecting the appropriate billing code for each procedure completed has become so intricate that there is an entire industry of clerks devoted to it (complete with its own professional association, the American Academy of Professional Coders).

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The coverage gap
Enrollment rules result in millions of Americans going without health care coverage, including children. The most recent data available from the U.S. Census Bureau indicates that 45.8 million Americans (about 15% of the total population) had no health insurance coverage during 2004.[1] This constituted a rise of about 850,000 from the previous year.

Most uninsured Americans are working-class persons between the ages of 2 and 65 whose employers do not provide health insurance, and who earn too much money to qualify for one of the local or state insurance programs for the poor, but do not earn enough to cover the cost of enrollment in a health insurance plan designed for individuals. Some states (like California) do offer limited insurance coverage for working-class children, but not for adults; other states do not offer such coverage at all, and so, both parent and child are caught in the notorious coverage "gap."

Since 1986, a controversial federal law, EMTALA [2], has required all American emergency rooms which bill federal healthcare programs to stabilize all incoming patients without regard to their ability to pay. This law was created as an unfunded mandate; the federal government and the state governments have never fully compensated both public and private hospitals for the full cost of such emergency charity care. The hospitals do attempt to bill uninsured patients directly under the fee-for-service model, but most such people cannot pay their hospital fees, and escape into bankruptcy when hospitals seek legal process against them. Meanwhile, some uninsured people use the emergency rooms as primary-care providers for illnesses such as ear infections and strep throat that could be more cheaply treated elsewhere, and arguably are not emergencies.

As a result, innumerable private hospitals have gone out of business since 1986. Others have raised prices on those that can pay to avoid going out of business. Some physicians have vociferously questioned the ability of the remaining emergency rooms, particularly in smaller cities, to respond to very large-scale disasters like 9/11.

Although it certainly keeps alive many working-class people who are badly injured, another problem is that the 1986 law neither requires the provision of preventive or rehabilitative care, nor subsidizes such care, and it certainly does nothing about the difficulties in the American mental health system.

In turn, in many American cities, it is common for mentally ill homeless people to "cycle" through emergency rooms. When admitted, such patients can be suffering from numerous diseases and malnutrition; hospitals clean them up and nurse them back to health, then discharge them to the street at the first legally justifiable opportunity; and then the same patients are back in the ER in three to six months after becoming critically ill again. The hospital sometimes ends up absorbing the full cost of care, since some homeless people are convicted drug addicts, which makes them ineligible for almost all federal and state assistance programs for the poor.

In the end, hospitals spread the cost to the patients who can pay (by raising prices on everything), which only further increases the total cost of health care for everyone. This increase in total cost may also cause additional people to become uninsured as insurance companies pass on the cost.

Finally, the unavailability of free preventive care and the sometimes high cost of paying out-of-pocket means that many working-class persons delay visiting a doctor or an emergency room as long as possible. In turn, such persons are more vulnerable to catastrophic diseases that could have been much more easily treated if identified early through regular checkups (like cancer and heart disease). The financial cost of treating those diseases at a late stage is also much higher.

[edit]
Major issues
[edit]
Prescription drug coverage
Since the 1990s, the price of prescription drugs became a major issue in American politics as the prices of many new life-saving drugs has increased exponentially and many citizens discovered that neither the government nor their insurer would cover the cost of such drugs.

Although some people argue that the U.S. should regulate drug prices like nearly all other countries, the U.S. government has taken the position (through the Office of the United States Trade Representative) that U.S. drug prices are rising because U.S. consumers are effectively subsidizing costs which drug companies cannot recover from consumers anywhere else (because so many other countries regulate drug prices). This is essentially an instance of the free rider problem in economics. The U.S. position is that the governments of those countries should either deregulate their markets or directly remit the difference (between what the companies would earn in an open market versus what they are earning now) to drug companies or to the U.S. government. In turn, those companies would be able to lower prices for U.S. consumers.

The counterargument is that the corporations commonly known as Big Pharma are among the most profitable in the world, and their executives and shareholders are already earning astronomical returns; the standard rebuttal is that those corporations and their investors take enormous financial risks in developing any given drug, and as with any capitalist enterprise, they should be allowed to capture enormous profit in exchange for accepting the risk of enormous losses. Less than 1 in 10 make it through the full approval process, and if a drug is proven to be unsafe later, then the manufacturer can be subject to massive legal liability (e.g., fen-phen).

Many also feel that because the US government pays for large amounts of research in the form of grants and subsidies that it has a right to expect that research to be used for the greater good.

[edit]
Universal health care
As for remedying the problem of the lack of coverage, some physicians and analysts support the concept of tax-payer subsidies for the health care system as has been done in most industrialized countries. However, such proposals have fell flat, largely due to opposition from other physicians and analysts, libertarians, conservatives, and the corporations who manufacture most drugs and run most hospitals.

A major problem with tax-payer subsidies is that the quality of American physicians at present appears to be partially dependent on their salaries, which compensate them for their working hours, education and training (approximately 10 years from when they make the decision as a college undergraduate), and education debt.

In contrast, in nearly all other major industrialized countries, higher education institutions are tax-payer subsidized and thus their physicians do not have to obtain loans to finance their educations. However, physicians in such countries have lower maximum income potential, due to the subsidization by tax-payers of healthcare systems. During the SARS crisis, some American healthcare analysts argued that the inadequate responses of several foreign healthcare systems (especially Canada) was partially caused by the tendency of the best and brightest students in such countries to be attracted to higher-paying fields like business or law. Similar comparative analyses have been performed on various other public health disasters.

It remains to be seen whether industrialized nations will follow the U.S. system of requiring the fees for services rendered to be paid by those receiving such services, or whether the U.S. will follow those counties in the rest of the world which have chosen tax-payer subsidized healthcare.

There have also been occasional reports of incidents in which illegal immigrants from various countries (including the United Kingdom and Mexico) deliberately enter the United States to seek treatment of extremely severe or rare illnesses. When Immigration and Customs Enforcement sought to deport such persons for illegal entry or for overstaying their visas, the immigrants would throw themselves on the mercy of the American people. The argument is that deportation to their home countries would be a death sentence, because their home countries' healthcare systems are either incompetent or underfunded. In early 2005, one highly publicized case involved a young girl named Rachel Andrews, whose parents fought deportation to the U.K. on the grounds that U.K. doctors did not know how to treat her rare sleep disorders properly and that the life-saving drug she needed (Provigil) was not approved for pediatric use in the U.K.

Some see the current system as a compromise: it guarantees excellent care for the 100 million who have money to pay for good insurance, reasonable care for the 150 million who have average insurance or government insurance, and emergency care for the 40 million who don't have any insurance[citation needed].

[edit]
Health disparities
In the United States, health disparities are well documented in minority populations such as African Americans, Native Americans, Asian Americans, and Hispanics[citation needed]. When compared to whites, these minority groups have higher incidence of chronic diseases, higher mortality, and poorer health outcomes. Among the disease-specific examples of racial and ethnic disparities in the United States is the cancer incidence rate among African Americans, which is 10 % higher than among whites[citation needed]. In addition, adult blacks and Hispanics have approximately twice the risk as whites of developing diabetes. Minorities also have higher rates of cardiovascular disease, HIV/AIDS, and infant mortality than whites[citation needed].

http://en.wikipedia.org/wiki/Health_care_in_the_United_States#The_coverage_gap
 

Jersay

House Member
Dec 1, 2005
4,837
2
38
Independent Palestine
So to recap;

A spotty Human rights record in its far distance past and recent controversies and incidents in between.

37 million people in poverty, and to put that into dimensions, that is bigger than Canada's population.

And only 66% covered by medicare, social security going down the drains and elderly residents having to pay huge costs for medication.

And it makes 13 trillion dollars a year. The nation of the U.S of A does.

Now this is not an attack on America because there are only a few nations ahead of it in these areas and a ton behind it. But a nation that everyone preceives as perfect, no faults at all, seems to have problems.
 

Daz_Hockey

Council Member
Nov 21, 2005
1,927
7
38
RE: What Makes America Pe

crikey, are you sure Blackleaf doesnt have split personalities?

lol
 

HonestAbe

New Member
May 5, 2006
33
0
6
Illinois
Um...man did you write a lot there buddy. Sorry, but I didn't read it all. However, I don't think people think America is perfect, I think they think that America is just cooler than a bunch of other countries.

You see. The U.S. is not like any other country in the world. As such, it is way cooler than all countries. Like Canada, you guys are pretty similar to England, I've heard. I mean, don't you have a picture of Queen Elizabeth on your money? What's that about? Also, China isn't cool, because they are into that whole communism thing, and Russia is into that whole Child Pornography thing. The USA though, we are just that cool. I mean, what other country is as cool as America.

In short, U.S.A. = Cool 8) Other Countries = not cool :(
 

selfactivated

Time Out
Apr 11, 2006
4,276
42
48
60
Richmond, Virginia
I think not said:
What Makes America Perfect??

Nothing.

It's a dumb question.

There is no such thing as a dumb question! Ive been reading a bit around here and theres a real stong sense of ego! It is so nice to have an ADULT conversation WITHOUT calling names. Is that possible? Cause I tell ya every single board I see doesnt seem to get the fact people need a kinder take on life for a conversation to get anywhere! My 2 cents worth.
 

Daz_Hockey

Council Member
Nov 21, 2005
1,927
7
38
HonestAbe said:
Um...man did you write a lot there buddy. Sorry, but I didn't read it all. However, I don't think people think America is perfect, I think they think that America is just cooler than a bunch of other countries.

You see. The U.S. is not like any other country in the world. As such, it is way cooler than all countries. Like Canada, you guys are pretty similar to England, I've heard. I mean, don't you have a picture of Queen Elizabeth on your money? What's that about? Also, China isn't cool, because they are into that whole communism thing, and Russia is into that whole Child Pornography thing. The USA though, we are just that cool. I mean, what other country is as cool as America.

In short, U.S.A. = Cool 8) Other Countries = not cool :(

HonestAbe, why does Canada have the queen's face on their money?, coat of arms, british parliment system?...it's about loyalty, honesty, not buying into a whim....helping a man when he's down (check the napoleon war dates), helping other people....you would also have the queen's head on your money too...people easily forget where they come from....the US has as much history with the UK as canada, so why do you forget this?...because some English American Colonial decided to throw his toys out the pram cus we didnt want him in our army? come on man, I think America is different because:

1. It's SO Bloody big, the open spaces, you just dont find anywhere else, except Russia, Mongolia and Australia(they so have the queen on their money u know!!!!!)

2. Attitudes are different to the rest of the world, price of Gas, Geography, international relations these are all foreign to the US
 

jimmoyer

jimmoyer
Apr 3, 2005
5,101
22
38
68
Winchester Virginia
www.contactcorp.net
Jersay, you take a very traditional and un-analytical
view of POVERTY.

I'll either start a new POVERTY thread or find an
old one to get all of us to look at ALL the angles on
POVERTY.

I know of no system devised by mankind to eradicate
it.

Do you ?

Has ANY plan worked ?

That doesn't mean we ignore it, but we are certainly
failing at every system ever devised, haven't we ?
 

cortezzz

Electoral Member
Apr 8, 2006
663
0
16
i say cancel the war on terror
cancel the war against drugs
cancel the war against crime
and declare

a war against poverty----

---as a side effect the above problems will be attenuated by 80%

a war against poverty---

hummm---- why is it i just cant picture the ---fill in the blank-----declaring that one.....
 

the caracal kid

the clan of the claw
Nov 28, 2005
1,947
2
38
www.kdm.ca
Re: RE: What Makes America Perfect??

cortezzz said:
i say cancel the war on terror
cancel the war against drugs
cancel the war against crime
and declare

a war against poverty----

---as a side effect the above problems will be attenuated by 80%

a war against poverty---

hummm---- why is it i just cant picture the ---fill in the blank-----declaring that one.....
The US has a "war against drugs" to advance its own industries.
The US has a "war against crime" to advance its own industries.
The US has a "war against terror" to advance its own industries.

A war against poverty will only happen when it would advance the interests of the US "elite". In a world of finite resources, more to the poor means less to those with the power so don't hold your breath for this one. (Disclaimer: as with all US "war on...", a propaganda war selling the masses on what is called a "war on..." may well occur.)
 

cortezzz

Electoral Member
Apr 8, 2006
663
0
16
Re: RE: What Makes America Perfect??

the caracal kid said:
cortezzz said:
i say cancel the war on terror
cancel the war against drugs
cancel the war against crime
and declare

a war against poverty----

---as a side effect the above problems will be attenuated by 80%

a war against poverty---

hummm---- why is it i just cant picture the ---fill in the blank-----declaring that one.....
The US has a "war against drugs" to advance its own industries.
The US has a "war against crime" to advance its own industries.
The US has a "war against terror" to advance its own industries.

A war against poverty will only happen when it would advance the interests of the US "elite". In a world of finite resources, more to the poor means less to those with the power so don't hold your breath for this one. (Disclaimer: as with all US "war on...", a propaganda war selling the masses on what is called a "war on..." may well occur.)

then its clear
declare a war on the elites
we come full circle
 

cortezzz

Electoral Member
Apr 8, 2006
663
0
16
Re: RE: What Makes America Perfect??

jimmoyer said:
Hey Caracal kid !!!

How would you fight a war on poverty ??

jim ---
no importa que estas hablando a caracal
si yo estoy aqui
tengo que decir--otra vez---
de utilizar la lengua de dios