The Health Care Aftermath 醫保餘波

醫保餘波

幾經擾攘，參眾兩院醫保折衷議案，終於以簡單多數票，在眾議院投票獲得通過。這又是清一色民主黨的投票取向，共和黨無一人投贊成票，當然還有不少害怕在本年11月中期選舉失利，從此不能返回國會的民主黨政客，在陣前倒戈，跟從共和黨人，投下反對票。

共和國黨人為反對這喻為“奧巴馬醫保”法案的通過，進行垂死掙紮，無所不用其極。包括在投票討論前，停止一切委員會就不同的議題而進行的公聽會。在參議院討論醫保折衷議案時，加進不少無稽的修訂案。在民間，極端份子向民主黨議員地區辦事處，投擲附有恐嚇字條的磚塊，打恐嚇電話，寄恐嚇信及白色粉末。當議員步入國會山莊時，示威者向黑人議員吐唾液、用種族歧視字眼進行辱罵，這些都是有新聞錄影為證。

面對在煽動下兼幾近失控的民憤，共和黨頭號人物不得不站出來，假惺惺譴責這些暴力行為，呼籲黨員把憤怒放在選票上。可是，共和黨第二把手卻在“賊喊捉賊”，說民主黨公開恐嚇電話及恐嚇信的內容，只會引發更多暴力，這種言論實是倒果為因，目的是搏取政治得分。代表麻州眾議員班尼法蘭克說﹕共和國黨人不譴責施暴者，反而攻擊受害人，這是本末倒置，無助竭止暴力。

在共和黨負面宣傳下，多個民調均顯示，醫保只得少於半數的支持者。自從奧巴馬簽署醫保法後，支持者已逐漸反超前，加上奧巴馬親自四出解釋法律的內容，強調超過3千2百萬現時沒有醫保的人會受惠，從此保險公司不能拒絕已有病歷的兒童投保，而成年人可依附在父母親的醫保直到26歲，奧巴馬特別選擇在大學校園演講，博得更多年青人的掌聲，這些都是未來民主黨的票源。加上，共和黨人無論在國會辯論或在傳媒鏡頭中，都是惡形惡相，失分甚多。結果，在國會通過醫保後，有百份之96國民認為這是代表“希望”。

從電視訪談節目中所看，愈來愈覺得部份共和黨人的政治言論，不但向極右的方向轉，更與茶葉黨及武裝民兵組織的看法相似，如反墮胎、白種人至尚、排外、反移民、反對政府任何干予、反聯邦政府稅收、支持擁有進攻性來福槍等。假若共和黨人為爭取憤怒選票，投其所好，採取這些極右政綱，把美國民主議政傳統，推向極端主義及暴力邊緣，若共和黨無法兌現這些極右主張，倒頭來會燒到自己的頭上。現時美國大概有1700個武裝民兵組織，他們並不是散兵遊勇，而是受過高度的軍事訓練，並擁有大量攻擊性武器，這股力量是不容忽視的。

麻州唯一的共和黨參議員史葛布朗，因投票贊成奧巴馬的刺激就業法案，立即被茶葉黨人炮轟。共和黨有意推翻醫改法，有15州共和黨檢察長進行聯合訴訟，控告聯邦政府違憲，這種徒勞無功的做法，除了浪費納稅人的金錢外，並無實質的作用。前副總統候選人莎拉佩璉更在籌款網頁上，鼓勵人推翻醫改法外，更聲稱要“再上滿子彈膛”。

奧巴馬的醫保方案是建基於麻州的強醫保法，並加進了200多項共和國黨人的建議。4年前，當麻州推行強制醫療保健法，是當時的共和黨麻州州長朗尼大力提出的，現在，反對奧巴馬的醫保法的，也是這個朗尼。在2008年，朗尼參加總統競選，而在共和黨初選出線中，敗給麥凱恩。如共和黨朗尼繼續利用反對醫保，作為競選政綱的話，在辯論時，必然會是啞口無言，不能自圓其說的。

其實，由現在到11月的中期選舉，還有半年多，更有很多變數。奧巴馬的刺激就業法初見成效。以麻州為例，經濟不但走出谷底，開始有所增長，失業人數減少，廠商逐漸增加招聘工人。如共和黨人繼續追隨如“霍士新聞”的右派言論導向，便會失去大部份的中間選票及遊離票，也會失去保守但反對暴力的宗教人士選票。現時奧巴馬受到前所未有的攻擊，已遷怒少數族裔選民，在參眾兩院的黑人政團，只有一位除外，已全體投票支持奧巴馬醫保改革，從這一點看來，他們已開始進行全面反擊了。

在醫保改革後，隨之而來的國內問題，都是連場硬仗，如移民改革、修改軍中同性戀“不問不講”政策、金融改革、就業與經濟愎甦等，是在考驗奧巴馬在壓力下，運籌帷幄的魄力。在籃球比賽場上的術語有謂﹕進攻是最佳的防守，對籃球有一定認識的奧巴馬，又怎會不知道呢！

Letter from the President 總統來函

pkchanboston,

I'm writing to you on a great day for America.

This morning, I gathered with members of Congress, my administration, and hardworking volunteers from every part of the country to sign comprehensive health care reform into law. Thanks to the immeasurable efforts of so many, the dream of reform is now a reality.

The bill I just signed puts Americans in charge of our own health care by enacting three key changes:

It establishes the toughest patient protections in history.

It guarantees all Americans affordable health insurance options, extending coverage to 32 million who are currently uninsured.

And it reduces the cost of care -- cutting over 1 trillion dollars from the federal deficit over the next two decades.

To ensure a successful, stable transition, many of these changes will phase into full effect over the next several years.

But for millions of Americans, many of the benefits of reform will begin this year -- some even taking effect this afternoon. Here are just a few examples:

Small businesses will receive significant tax cuts, this year, to help them afford health coverage for all their employees.

Seniors will receive a rebate to reduce drug costs not yet covered under Medicare.

Young people will be allowed coverage under their parents' plan until the age of 26.

Early retirees will receive help to reduce premium costs.

Children will be protected against discrimination on the basis of medical history.

Uninsured Americans with pre-existing conditions can join a special high-risk pool to get the coverage they need, starting in just 90 days.

Insured Americans will be protected from seeing their insurance revoked when they get sick, or facing restrictive annual limits on the care they receive.

All Americans will benefit from significant new investments to train primary care doctors, nurses, and public health professionals, and the creation of state-level consumer assistance programs to help all patients understand and defend our new rights.

As I've said many times, and as I know to be true, this astounding victory could not have been achieved without your tireless efforts.

So as we celebrate this great day, I want to invite you to add your name where it belongs: alongside mine as a co-signer of this historic legislation. Organizing for America will record the names of co-signers as a permanent commemoration of those who came together to make this moment possible -- all of you who refused to give up until the dream of many generations for affordable, quality care for all Americans was finally fulfilled.

So, if you haven't yet, please add your name as a proud health care reform co-signer today:

http://my.barackobama.com/cosigner

Please accept my thanks for your voice, for your courage, and for your indispensable partnership in the great work of creating change.

History, and I, are in your debt.

President Barack Obama

Health Care Reform 世紀醫改

世紀醫改

在上星期六，美國東部節省陽光時間剛過了晚上11時30分，在國會中長達一年多的醫保改革爭論，終於結束了，並進入最後投票階段，結果正如預料，參議院原議案及參眾兩院折衷議案，在眾議院均以超過所需的216些微多數票通過，投票取向而且是壁壘分明。傳媒一致稱之為歷史性的醫療改革法案，但要說這是世紀醫改，一點也不為過。在本星期二，已由奧巴馬總統簽署，成為法律，而兩院折衷議案，仍會在參議院有所爭持。

就全民保健，已說了近一百年。早在1912年，老羅斯福在競選時，已呼籲要推行全民醫保。到了在1935年，羅斯福總統簽署了社安法案，由於美國醫學會反對，結果剔除了全民醫保的部份。4年後，羅斯福總統再推全民醫保，又遭共和黨及南部民主黨反對。在1943年，部份僱主為吸引勞工，開始向僱員提供醫療福利。從此使醫保私人化，有工作便有保健。

在1945 及1949年，杜魯門總統提出全民保健，更被當時的共和黨指為是共產主義，與奧巴馬在目前所面對的情況相似。到1962年甘乃迪年代，曾提出給社安受惠者醫保，經醫療業遊說後，便從此束之高閣。3年後，為實現杜魯門總統的宏願，詹森總統在1965年簽訂醫療補助法，為65歲及貧窮與殘障人士提供全面醫保。

當愛德華甘乃迪在1966年，首度進入參議院時，已念念不忘要為全民保健立法，可是，到他在2009年臨終時，全民醫保仍未有落實。其間在1993年，克林頓總統曾任命第一夫人希拉莉推動全面醫保，亦受到醫保產業反對，而以失敗告終。在2003年，布殊總統給予醫療補助受惠者處方醫藥。好如美國這樣的已發展先進國家，竟沒有全民保健，實在是難以想像的。

自奧巴馬上任以來，共和黨既得利益階層，並不甘心失敗，藉著在鎮堂會議的醫療改革論壇，四處煽風點火，受醫保產業背後支持的茶葉黨，加緊制造憤怒情緒，說醫保計劃的目的是“處理老人家的後事”、“由政府接收醫保”、“實行社會主義”等，利用不明事理的人們的恐懼心理，實行危言聳聽。議員、政客更擔心在11月的國會中期選舉，失去席位而投其所好。因此，醫保法案能夠在眾議院通過，是得來不易。在民主社會，有超過半數的人贊成，有少於半數的人反對，這是選舉投票生活的一部份，是十分正常的。

醫保事業是佔美國經濟總產值的6份之1，當然不能等閑視之。在未來10年來，醫保改革叫價9400億。在首10年，會減少財赤1430億，並為現時沒有醫保3千2百萬人提供保障。對自僱而無醫保人士、小企業僱主、甚至州政府提供資助。看來這個全民受惠的改革，怎樣還會有人反對。

雖然，共和黨及保守派政客在眾議院中投票失敗，會轉移陣地，在參議院繼續進行垂死掙紮，所採取的策略就是不斷提出修訂案，務求推翻原議。當然更會鼓動群眾，在國會山莊示威及叫喧。當議員步入國會時，有人多次用種族語言，辱罵黑人眾議員，而麻州同性戀議員班尼法蘭奇亦遭侮辱。更在投票前，當反墮胎民主黨議員在發言時，德州共和黨眾議員在席上高呼，指責他是“殺嬰者”。如此種種醜行，已令人到了反感的地步。

史葛布朗在麻州補選的勝利，共和黨政客是高估了，認為這是共和黨人，在中期選舉翻天的進軍號角，而沒有正視一個事實，單憑憤怒的獨立選民，對目前經濟困境而且產生的不滿情緒，作為投票的取向是不可靠的。共和黨史葛布朗在民主黨老巢、票倉當選，只不過是對手太弱而已。

民主黨議員在醫保改革投票中猶豫不決，舉棋不定，除了被茶葉黨虛張聲勢的集會嚇怕了之外，也低估了奧巴馬個人的魅力。從奧巴馬在國情咨文中說醫保改革還未壽終正寢後，在短短3個月，便讓醫保起死回生了，由弱勢總統轉為強勢，前後出席各州多個鎮堂會議，替民主黨候選人站台，民情已經轉向，亦暴露了共和黨不得人心的技倆。不錯，中期選舉是一場硬杖，夾著醫保的勝勢，民主黨人鼓其餘勇，在參眾兩院繼續保持優勢的局面，是絕對有可能的。

Boston Chinatown Gateway Park 波士頓華埠牌樓公園

華埠花園角

經過近20小時的旅程，包括轉機、清關及時差，一家四口已經是十分疲累了。住在波士頓外郊丹佛市的外伯父，駕駛著美國名牌卡杜力巨型豪華房車，從勞根機場接走了這個香港移民家庭，穿過波士頓海港隧道，走上向南的93州際公路，進入地下行車出口，直達唐人街京都酒家，時間大概是下午3時多。

在1984年，一個和風拂臉的10月，正是金秋時節，典雅的波士頓顯得格外怡人。中午飯茶市已過，華埠行人稀落，當然不能與九龍旺角相比。與伯父共嚼洗塵茶點後，接過老華僑長輩給移民新客的利是，步出酒家，抬頭一望，嚇然見到華埠牌樓，上面就是國父孫中山先生的名訓“天下為公”4個大字，加上筆者祖籍中山，倍感親切。面向華埠內街的一面，刻有 “禮義廉恥” ，國之四維是也。這個牌樓是台灣國民政府，在美國立國200週年，送給波士頓的禮物。

與華埠中式牌樓相映成趣的，是一幅用幾何圖形拼湊而成的壁畫，上面有明月、帆船及長城，大概在說華僑拋洋過海，在月圓之夜，對故鄉思念之意。高牆內是麻州公路的抽風系統，清新空氣進口的地方。牆下就是小小的華埠牌樓公園，台山老華僑多叫這公園為“花園角”或“公園仔”。這個公園不但是波士頓唐人街的地標，每逢新移民抵埠時，與家人或親朋戚友，多在這公園拍一張合家歡、團圓照。

為紀念在第二次世界大戰，為美國捐軀的黃金國先生，在牌樓下的“花園角”對開的空地，便命名為“黃金國廣場”。大凡有華埠城中名人仙遊，在華埠酒家設解慰酒後，多在這花園角燃燒寶燭，或在這裏“擺路祭”，這些都是華人的傳統習俗。最近，市府更有計劃把華埠牌樓公園，改為司徒麗英紀念公園，為這位一向關心華埠治安問題的女士、華埠鄰區議員，表揚她生前熱心為華人僑胞的服務事工。

由於地點開揚、適中，在80年代的社會運動、示威集會，都以“公園仔”為集合出發點或終站。華人餐館工人黃龍光先生，被警察無理毆打，引起公憤，社區發起示威遊行，就以“花園角”出發。為紀念89 北京民主運動，由當時華埠社區市長聯絡員李健遠先生大力推動下，在牌樓公園安放64紀念碑，悼念為民主獻身的青年學生。每逢6月4日或有民主人士到訪波城，都會舉行獻花及默哀儀式。

這些悼念及示威活動，已成了華僑生活與追思的一部份，均無礙公園遊客與家人，在那裏拍照、閑坐、耍太極，甚至練氣功。連月來，有人藉重新修建司徒麗英紀念公園，主張拆毀天安門紀念碑，為何在家鄉狹隘的思想偏見，竟一起移植到波城華埠呢！這與美國多元、包容社會核心價值相違背。在波士頓大大小小公園，都會各種各樣的紀念碑、人物銅像，每尊都具濃厚政治色彩，以去政治化為藉口，搬走天安門紀念碑，無論如何總說不過去。

華埠作為一個社區整體，蘊含著不同的文化背景、風俗鄉音及政治取向。越棉寮三方多百年的愛恨情仇，華僑可以組成互助團體組織。國共兩黨你死我活的爭鬥，大可以一笑泯恩仇，在波城只研究書法、曲藝。韓日水火不容，在餐桌上有共同菜單品味，以廣招睞顧客。而一塊佔地不到4平方英尺的紀念碑石，竟穿越不過細小的心眼，是目光如豆，還是心胸狹窄，這確實是態度的問題。

64慘案，公道自在人心。有人說坦克鎮壓，政府不仁，也有人說學生示威，要求民主該死。如要為被疾駛輾斃的老婦哀鳴，為一頭墮河遇溺的小貓而惋惜，為什麼可以對千百為民主而犧牲的民眾，而全無怵惕惻隱之心呢。無怪乎波士頓華埠牌坊上，除了“天下為公”外，還要有“禮義廉恥”的橫匾，是對為政者有更高的道德要求，並對做人處事和價值取向，需要有更多的包容，加以警醒。

Tiananmen Memorial 波士頓六四紀念碑

In Chinatown, politics of old country still spark
Small and secluded, a memorial to Tiananmen’s fallen is causing ripples as residents debate its place in a redesigned park
By Meghan E. Irons, Globe Staff | March 10, 2010

Boston’s Chinatown memorial to the Tiananmen Square massacre sits at the shaded edge of a children’s sandpit in Mary Soo Hoo Park, a fenced gathering place just outside the neighborhood’s famous gateway.

When it was installed more than 20 years ago, the small granite marker was meant as a historic tribute to the massive Beijing uprising of 1989, put down with deadly force by the Chinese military.

But the memorial is now at the epicenter of a controversy that erupted in Chinatown after some residents asked that it be removed as part of city plans to renovate the park. It touched off a crossfire of accusations and exposed deep-rooted tensions over the role Chinese politics should play in everyday life in Chinatown.

E-mail campaigns to save the memorial were launched, heated exchanges marked a public meeting, and the issue has appeared in neighborhood blogs and Chinese-language newspapers. It is seen by some as so divisive that they did not want to be quoted as taking a side, fearing they would antagonize neighbors.

“I don’t think that everyone feels comfortable that the monument is going to stay,’’ said Jill Zick, a landscape architect at the Boston Redevelopment Authority who is spearheading a series of neighborhood meetings. “There is confusion about what the intention is [for the marker]. Will the monument stay or will it go?’’

Zick said the marker is likely to stay in the park, though it could be moved. But the controversy continues, in part because of the intense feelings it evokes. The marker, and the park where it rests, has long been a rallying point for activists protesting policies of the Chinese government, and many in the neighborhood of more than 6,000 see it as a symbol of rare resistance to the authoritarian government in their homeland.

“This monument is meant to educate the people about freedom and Democracy and the fact that we should value it,’’ said Chungchi Che, an activist in Chinatown.

But other residents say the stone memorial is a grim reminder of a dark past and that the park should be a place of repose, where adults can relax and children can play without the intrusion of politics. They point to followers of the spiritual movement Falun Gong who use the park on Sundays, practicing their breathing and posting large and graphic displays of the Chinese crackdown of their movement.

“A group that moves families out of their park is something that should not happen,’’ said Bill Moy, a co-moderator of the community organization Chinatown Neighborhood Council. “The Falun Gong do have a permit to be there, but on Sundays that excludes the families.’’

Moy had requested that the memorial be taken down so the park will be more inviting to children and the elderly who practice Tai Chi. He has since softened his tone, saying that the redesigned park would have enough space for both the monument and families.

First dedicated during the administration of Mayor Raymond L. Flynn in fall 1989, the Tiananmen Memorial stands chest-high at Beach and Hudson streets, a bustling hub at a tip of Chinatown that features markets, restaurants, and other businesses. The monument is unremarkable by itself, largely unnoticed by the men who play chess, the tourists who snap pictures on the adjoining greenway, and market clerks who hawk their wares.

In bold, black letters in English and Chinese reads the inscription: “Tiananmen Memorial. This park is dedicated in honor of the democracy movement in China and in the memory of those who died in the struggle for freedom in Tiananmen Square in June 1989.’’

It honors thousands of students who filled Beijing’s Tiananmen Square that year to demand freedom and democratic reform. After tanks and armored personnel carriers rolled through the square to disperse the crowd, thousands of bodies remained.

The issue of the monument first flared during a BRA redesign planning session in December, when a few residents suggested that it should go.

The meeting was held to gather community ideas for improvements in the park. About 60 residents were given blue stickers and sticky notes to rank their preferences.

Among the top suggestions: No political gatherings and “reform/transform/relocate Tiananmen Square Memorial.’’

Chinatown activists who had not heard of the first meeting flocked to a second session last month, peppering BRA officials with questions about whether the monument should be moved. The subject came up repeatedly as city designers urged residents to choose one of three proposed park redesigns, none of which showed a space for the monument.

Zick said she was “a little surprised’’ by the alarm from residents over the monument, which she said will either be relocated to a quiet corner, rebuilt, or reintegrated into the park’s new design. A third meeting is set for March 25.

“We were looking at different ways to keep the sense of the memorial,’’ she said, “but at the same time providing a location for it that is in tuned with the narrative of a memorial, something more contemplative.’’

Meghan Irons can be reached at mirons@globe.com.