Archive for February 2010

Dark Before Dawn?

February 21, 2010

This past week there was renewed talk of passing a health care reform bill. Trial balloons were released which said the “public option” could be reconsidered, and that Republicans ideas (like malpractice curbs or buying health insurance across State lines) were still possible. While a more comprehensive combination of reforms would represent a step forward and might even slow the yearly increase in health care costs, all of these reforms do not strike at the heart of the problem, “where do these costs come from”?

If one looks dispassionately at this, health care costs begin with “us”, the users. If we didn’t go to doctors or hospitals or consume drugs, there would be no health care costs at all. Since that is not possible, it is clearly then (1) how much health care service we use, and (2) how much that service costs.

Health care insurance is really just a red herring. It should be obvious, however, that insurance companies are enablers to yearly health care cost increases because there is no value in it for them to try and control costs. Profits come first.

A portion of the health care cost does originate from insurers from their the profit and their designed administrative inefficiency.  You can determine that by comparing the difference in health care premiums (private insurers and Medicare) and how much is actually paid to health care providers (about 20% for private insurers and 5% for Medicare).

So, the place to begin looking for why health care costs so much and why it is increasing each year 2-3 times the rate of inflation is (1) us, and (2) doctors, hospitals, and drug companies.

So what role would some combination of health care reforms currently being considered by Congress make? At the worst, the resurrected health care reforms would include far more Americans with coverage, and in most combinations, would require more Americans to buy coverage. This would force more Americans to confront the cost issue even when they were young and healthy. In our society, most Americans believe in the power of the consumer to naturally regulate costs.  If that is true, this should help.

At the best, reforms could include a public option, which in turn would represent a direct threat to the profitability of private insurers. All health care players know that today, in Europe, Canada, and Japan, there is health care coverage that is open to all residents, provides high quality care (equal or better than the US), and costs 1/2 to 2/3rds of what we are forced to pay. As private health care companies begin to experience declining profits (from competition with a public options), they will break ranks with their secret covenant with doctors, hospitals, and drug companies.

Today, too few Americans know that excellent health care does not have to cost so much. Too few Americans know that as close as Canada is, there exists better coverage for less money. Too few Americans know that Japan, France and Germany all offer better care at much lower costs. Once this message is driven home, real reforms will be demanded by Americans.

Here’s a word of caution. All health care systems, in one way or another, ration health care. In the US we use the ability to pay. If you are employed or wealthy, no problem. If you are not, big problems.

In the US, health care for the wealthy or employed is available for even those people who had opted out of insurance pools when young or healthy (therefore raising the rates to everyone else) as well as to people who have lead risky life styles and simply have not taken care of themselves (who have consumed more health care services than they would have needed to otherwise). The rest of the modern world rations health care using set fee schedules (limits how much doctors, hospitals and drug companies can make from each patient), emphasize preventive and diagnostic services (catch illnesses early and cure them less expensively), and promote healthy life habits (nutrition, exercise, and work/life balance that lead to good health).

For many libertarian thinkers the notion of rationing health care as the rest of the world  will be seen as un-American. Just remember, the rest of the world has excellent care, on average live longer than Americans, and pay less for their health care.

I wonder whether the darkness in Washington is just a sign of the dawn about to come?

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Poor Judgement

February 20, 2010

The Justice Department has released its findings in the investigation of the “torture memos”. And the answer, please. The authors used “poor judgement”.

This is certainly a testimonial to clear thinking. All Americans should rest easier knowing that their Justice Department professionals can determine that the “torture memos” and those that created them used poor judgement.

What other words might have been used? Were these memos “insightful”? Were these memos “brilliantly conceived”? Were these memos “extensions of previous precedents”? The answer, of course, is no.   Not any of those possibilities could be used to describe the memos.

John Yoo was recruited to his position in the George W Bush Justice Department largely because he was bright, ambitious,very conservative, and, as a bonus, sympathetic to the view that the chief executive is the more equal of the three equal branches of Government. He was just the type of lawyer Dick Cheney was looking for. Yoo listened to what was wanted (justification to use enhanced interrogation techniques) and went to work on developing memorandum that provided legal cover to those who would subsequently violate US Law, the Geneva Convention, and common sense.

Yoo and his former boss, Jay Bybee failed the test of professional ethics and did their clients (President George W Bush as well as Dick the chicken hawk Cheney) a huge disservice by issuing the torture memos.

It is hard to explain the whitewashing that the Obama Administration Justice Department has given in its final conclusions (if you read the report, the facts would lead most people to a much harsher conclusion). One explanation is that one lawyer is just trying to protect another. More likely, however, is the desire not to open Pandora’s box. Had Bybee and Yoo been charged with “misconduct” and disbarment proceedings were to begin, the trail would quickly lead to former Vice President Cheney and ultimately to former President Bush. It seems our leaders do not have the stomach for opening this wrenching examination.

Instead Americans are left with facts that support a much stronger conclusion but findings that simply do not go far enough. No wonder Americans do not trust the Government or lawyers.

Disturbed and Disturbers

February 19, 2010

Yesterday a very disturbed man flew his plane into an IRS Building in Austin, Texas. In addition to taking his own life, he took at least two other innocent people’s lives. Why do people do things like this?

Reports indicate that the pilot was extremely upset with the IRS, and was also in debt and didn’t know how to get out of it. The Government was the enemy and the IRS was its face. In his mind, he was the brave patriot fighting back against the tyranny of our Government. Why do people think that way?

For sure, this soul could simply have been insane and incapable of making sane decisions. Certainly flying his plane into the building was an act of insanity but why did this person cross over the line into an unreal world? I suggest we look for “disturbers”.

The IRS does not have rules for just one person (unless they are legislated tax breaks and then the IRS did not make the rule, Congress did). The “disturbers” I have in mind are those groups that play with the weak minds of others. Sometimes these “disturbers” are called Tea-baggers, or right wing conservatives, or pro-lifers, or religious fundamentalists. They come in all colors but have one thing in common, they distort facts and always create false black/white choices. Free enterprise is good, government is bad.

Yesterday there was also a meeting of conservatives in Washington. Mitt Romney addressed the group and declared the Obama Presidency was a failed presidency. (It is amazing to say the least that after one year Mitt can conclude this, especially when the ink is not dried on the review of the George W Bush years where the evidence of failure is written in words like Iraq, Abu Ghraib, Katrina, Guantanamo, waterboarding, and NSA spying on Americans.) Other speakers, including former Vice President Cheney heaped one more criticism after another on to President Obama. Absent of course was any explanation on facts or what the speaker would have done differently and why.

It should not be such a surprise that we have Americans who go off the deep end with all this negative and vitriolic rhetoric that bombards us each day. Shooting a doctor in a church because he performed legal abortions or flying a plane into a building with hundreds of innocent people are acts of mentally unstable and horribly misguided people.

I hope that the press puts as much coverage onto the “disturbers” as they are likely to put upon this “disturbed” pilot.

Means Do Count

February 18, 2010

Last weekend, the New York Times printed a story on the Congressional Black Caucus and more specifically the huge amount of money it is raising from Corporate America. Yesterday on a radio talk show, a guest analyzed the situation and said (in effect), “there is nothing illegal about these donations, white members of Congress do this all the time and this is being made an issue because it involves blacks, and frankly this is how business is done in Washington.

This defense is probably all correct but it totally misses the point. Buying Congressional favor (and there is no other way to read this) is wrong and a disservice to all Americans. (It is wrong because the quid pro quo intentional favors someone over another with no regard to the commonwealth. The amazing aspect of this is the blatant personal ethics lapse each member of the caucus has made. (Why should these Congress members trade their votes for contributions that in turn favor selected groups over the whole? Ends justify the means?)

The common justifications are the usual two, (1) it does not influence my vote, and (2) the foundation does good things. If the “things” that are done are good (and they probably are), why do they not receive support from direct donations? Also, if it does not influence your vote, why do you think these corporations donated to Black Caucus and not directly to the cause?

We all saw in the George W Bush Administration the out of control use of “ends justify the means” thinking (for example, invasion of Iraq, Abu Ghraib, Guantanamo, NSA spying on Americans, and the abrogation of the Geneva Convention all presumably occurred in the name of safeguarding Americans). Ends are important but the means should be selected carefully in pursuit of the goal.

Giving money to Congress members (for campaigns or charities) is highly suspect unless done in some totally blind or nominal manner. Otherwise it is “if I give you this, will you give me that?”

If you do not buy my personal ethics argument, then I ask you to consider efficacy.  Look at the performance of Congress. Is this the best representation money can buy?

Selling US Short (us too)

February 17, 2010

The Obama Administration is said to be reconsidering its trail of and not holding it in New York City. While there is something to be said about a trial costing an estimated $1 billion due to heavy security costs associated with downtown Manhattan, cooler heads need to keep control of this process. Move it maybe, but don’t move it back to military commissions.

Senator Lindsay Graham, a former Judge Advocate officer (a military lawyer), has added his pint of fuel to the political blaze on handling terrorists. Lindsay wants President Obama’s counter terrorism advisor to be fired. The reason most recently cited is the decision to try the Detroit “underwear bomber” in civil court rather than by a military commission. Surely Senator Graham has better uses of his time.

Anti-American values music is growing in volume and the tune is simply shameful. The tune says President Obama is soft on terrorism, or at least poorly advised, harsh interrogation is good, and indefinite confinement is wise. What are these people really thinking when they propose tactics that would make the founding fathers blanch in disgust?

The intended message, however, is different. They mean to say that Republicans are tough on terrorists and only they will protect Americans. The obvious question they present, “which do you want”?

Once again Republicans are selling both us and the US short. This is a false choice. America can retains its values and protect itself from terrorists.

With military commissions, Republicans are tearing down the judicial system (one of the three co-equal branches of government) implying that it can not render justice. With the already high distrust of Congress, Americans are now being told that the Judicial system is faulty and can not be trusted. What are they thinking?

The embedded “fear message” is easier to understand. Scare the hell out of Americans and reap the benefits at the polls. The question I ask is how many times can they cry wolf?

Military commissions have not tried any significant detainee. Far worse, these commissions would be able to use “hearsay evidence” and allow judges to prevent the detainee from seeing evidence marked confidential that would be used against them. Think about both of these. Who is a sane mind will consider any guilty judgement a fair judgement? (If you have trouble with this notion, substitute “american tourist” arrested in Russia or China, denied counsel, and sentence to hard labor based upon information kept secret.)

I do not know whether John Brennan is a good advisor or not. What I do know is that the decision on his advisors is solely President Obama. I also know, form experience, that Senator Graham has offered some pretty poor advice during the “W” years.

President Obama needs to stand firm and support the long term view of American justice. Habeas corpus, the right to know your accuser, a speedy trial by ones peers, and safety from cruel and unusual treatment are tenets of our civil and criminal law. As Americans, we need to see through the Republican fear mongering political tactics and support justice the American way.

Fly Paper

February 15, 2010

What is worse than fly paper and just won’t go away? If your guess is former Vice President Cheney, that is a good one but not the one I am thinking of. It is none other than Johnny Bolton, former UN Ambassador, former “W” Administration aide, and former signer of PNAC (Project for the new American Century). Johnny must not be pension eligible because he keeps showing up in the “opinion pages of the Wall Street Journal.

On last Friday, Mr Bolton (he continually referred to President Obama as Mr. Obama), spoke out on the need to militarily strike Iran in order to “eliminate” the potential that Iran would develop nuclear weapons. This is an old saw for Bolton and other neoconservatives – shoot first, think second. He mixes the sound to arms with the need for tougher diplomatic language or his favorite, tougher sanctions. When not saying what the Obama Administration should do, he revels in listing what President Obama is doing wrong.

The blue print for Bolton’s amazing insight can be found in the PNAC document. With fellow signators such Dick Cheney, Paul Wolfowitz, Richard Pearle, Scooter Libby, and Douglas Feith, I should not have to say more. This document preached the self appointed role for the US in the 21st century to operate as the world’s policeman.  Implicit in their pronouncements is that it is all achievable.

You would think that after 8 failed years with “W” where this craziness ruled government thinking, Bolton would have moved on in his thinking. He has not.

Iran poses a threat to everyone, not just the US. Already Islamic extremists target parts of Russia and China, and terrorism knows no borders.  Somewhat surprisingly, both Russia and China are reluctant to follow Bolton’s advice.  European countries also do not see the Iranian threat the same way as does Bolton, or even the Obama Administration. They see some low level or narrowly defined level of sanctions are necessary but we should not expect them to do more than irritate.  In the meantime Europe, Russia, and China are enjoying some level of profitable trade with Iran. Hmmm.

Military action (even if done by Israel), on the other hand, is simply incredible to propose. Iraq and Afghanistan should be lessons enough.  Just a bombing (and not invasion) would be the same as pulling the plug on open unpredictable hostilities in the Middle East and most certainly worldwide. Iran would become the poster child for global jihad.

Bolton and all the other chicken hawk neoconservatives do all Americans a disservice with their brand of rhetoric and frankly are worse that fly paper, they are dangerous if we listen to them.

Go America

February 12, 2010

The winter Olympics begin this weekend. For sports fans this is a wonderful time of the year, or should I say, a wonderful time every four years. While all the athletes compete every year for something, the Olympic champion somehow is considered the best. It is simply too bad we must watch this on American TV.

I do not mean just American TV sets. I mean the Olympics presented by an American TV network. This year the winner is NBC but the abuse of viewer intelligence could just as easily be committed by ABC or CBS. The issue, I think, is fighting to occupy the lowest rung on the ladder of common sense.

NBC, I am sure, does not think it is fighting for banality, but is committed to satisfying its viewers in hopes there will be many. Like so much that is going on in the news business, telling the listener or viewer what they want to hear is very compelling. Advertisers pay for an audience and reasonably speaking do not care what gets the audience.

Following from this is the great epoch of the snow board “tube”. NBC thinks that snow boarding is the, or at least one of the most important winter Olympic events. Imagine all the former alpine and nordic skiers who are turning over in their graves.  Why would NBC do this?

It seems inescapable that NBC is searching for something America can win and vicariously, make Americans in their homes feel warm and happy, and tune into another night of Olympic coverage. If NBC does this for the Olympics, which means absolutely nothing in the great scheme of things, what do you think they are doing with “nightly news”?