Friday, September 18, 2009

The government can't do anything right?

With all the fuss about the evils of government in the news lately, I thought this piece I found online was interesting:

This morning I was awoken by my radio alarm clock powered by electricity generated by the public power monopoly regulated by the U.S. Department of Energy. I heard the news without interference from another source on a frequency regulated by the FCC.

I then took a shower in the clean water provided by a municipal water utility.

After that, I turned on the TV to one of the FCC-regulated channels to see what the National Weather Service of the National Oceanographic and Atmospheric Administration determined the weather was going to be like, using satellites designed, built, and launched by the National Aeronautics and Space Administration.

I watched this while eating my breakfast of U.S. Department of Agriculture-inspected food and taking the drugs which have been determined as safe by the U.S. Food and Drug Administration.

At the appropriate time, as regulated by the U.S. Congress and kept accurate by the National Institute of Standards and Technology and the U.S. Naval Observatory, I get into my National Highway Traffic Safety Administration-approved automobile and set out to work on the roads build by the local, state, and federal Departments of Transportation (for over 15 years I set out to work by walking on sidewalks built by local government to take a train or bus run by government to my office, or close to it, on a fairly timely basis), possibly stopping to purchase additional fuel of a quality level determined by the Environmental Protection Agency, using legal tender issued by the Federal Reserve Bank.

On the way out the door I deposit any mail I have to be sent out via the U.S. Postal Service and wait with the kids for the bus to take them to the public school.

After spending another day not being maimed or killed at work thanks to the workplace regulations imposed by the Department of Labor and the Occupational Safety and Health administration, enjoying another two meals which again do not kill me because of the USDA, I drive my NHTSA car back home on the DOT roads, to my house which has not burned down in my absence because of the state and local building codes and Fire Marshal's inspection, and which has not been plundered of all its valuables thanks to the local police department.

And then I log on to the internet -- which was developed by the Defense Advanced Research Projects Administration -- and post on forums about how SOCIALISM in medicine is BAD because the government can't do anything right.

Wednesday, September 16, 2009

Wishful thinking by the GOP?

Not even 9 months complete, some political handicappers consider President Obama's presidency to be such a failure that right now is not "will Republicans make gains at the midterm elections?" but "how large will those gains be?" I don't know about that. While the party in power almost always loses seats in midterm elections, a lot has to happen or not happen before next November for big changes. However, ignoring that incumbents tend to win in a very high percentage and that a number of somewhat moderate Republicans who could probably attract Obama supporters, have already announced they are not running again next year, the GOP has a bigger problem -- their leadership gap. In 1994 the GOP had Newt who, while out there, was somewhat rationale. He had a 10 point Contract for America plan and some of it made sense to Clinton supporters. Also, the purge of moderates that Reagan democrats could vote for hadn't begun yet. I don't see that with the GOP today. While there are those who do have good ideas they are being shouted out by the crazies whose main goal is just to obstruct. But even so, the GOP has other problems.

Just because they choose to highlight their celebration of ignorance and their passion for stupidity does not mean the rest of the country is going to follow that path. They point to the teabaggers as their new base but, if that is the case, why were the teabaggers not out demonstrating against the Medicare drug benefit, the Sarbanes-Oxley bill, and all the other pork-barrel spending that President Bush refused to veto -- much of which was passed when the Republicans held both houses of Congress? Are we seeing a real grass roots movement or just a bunch of Republican hacks in disbelief that they have been exiled from their seats of power?

If this movement was a majority, we would have seen rioting in the streets months ago. Instead we seem to have a few thousand hard-core individuals intent on destroying and undermining the man that a majority of Americans elected without any proposals of what they would do, aside from not doing what the President wants to try. That is not a grassroots uprising; that is a communication strategy, same as the ability of a very few people to mess it up for everybody because they can.

Instead of growing their base, they are appeasing their worst by chasing away Latinos, who Bush, in theory, was going to bring into the party as natural Catholic conservatives, at the same time their demographics continue to increase. Their embrace of the birthers who think the state of Hawaii was part of Kenya for a brief time in the early 1960s, and other crazy theories is also chasing away voters. Add in that many in what is left of the middle class may have finally come to the realization that the GOP doesn't always have their best interests in mind and it may be hard as sooner or later more will realize that they spent the Bush years working more hours for less dollars, at least until their jobs were outsourced so CEOs could enjoy the additional profits that their tax cuts failed to provide. Their only real hope is that President Obama continues to show the lackadaisical leadership lately that has helped to lead his poll numbers down. If the President stops speaking softly and starts using his big stick then that might be it.

Who do the GOP have now on the national scene? Rush Limburg? Glenn Beck? Sarah Palin? Screaming "you lie" is not leadership. Instead of grooming new leadership they have concentrated on chasing away all but the pure, who will just follow without question. The GOP's supporters may be loud but they are fewer in number then they were 16 years ago and coverage of some of their antics feels more like filler news because there is not much else interesting going on.

The GOP may gain some midterm seats, many if the healthcare war ends badly, or the auto and bank bailouts turn out to not have helped the economy and unemployment remains high. But unless they get the crazies out, like the Dems did over the last 25 years or so (with Kennedy gone are there any real liberals left?) they're going to set themselves up for a bigger disaster in 2012.

Sunday, September 13, 2009

Justice, justice shalt thou pursue

Andrew Sullivan, author of the blog, The Daily Dish, among the most popular on the Web, was recently busted for smoking a joint on a federally owned beach on Cape Cod. Recently Sullivan, who is a British national, was to appear before a judge for disposition of his case. However, unlike three other defendants in front of the judge for the same crime, prosecutors chose not to pursue Sullivan's case in the interests of justice. This irked the judge who was upset that Sullivan was not standing equal in front of the law with his co-defendants (as if that never happens like, for instance, when someone with money is found not guilty of murder while a street kid, without the money to afford a good offense -- er I mean defense, is convicted despite being not guilty) but that he had no power to order prosecutors to pursue the case.

The judge's problem, and I generally agree with him that it should be either all get off or all face prosecution, is that Sullivan got special treatment. However sometimes there is a good reason why other people under similar circumstances are being prosecuted while one is being let off the hook. In this case a conviction of Sullivan could potentially lead to a deportation.Deportation for smoking a joint? Apparently the prosecutor thought that was a little draconian and in the interests of justice dropped the case.

But again, what really peeves the judge is that he can't legally do anything about this. Hogwash. There is plenty he can do. If the judge doesn't like the prosecutor's actions, he can get himself appointed federal prosecutor and prosecute. Or, if he feels that it is unfair that one man gets off while the other
defendants are convicted, he can dismiss the charges against the other three in the interest of justice so all could be equal once again. He could even do something about our silly drug laws that could lead to deportation for something so trivial. Finally, the judge could get out of the law all together -- he seems like he'd be an excellent school principal who would sit on his brain and expel a first grader for bringing a butter knife or aspirin to school because the "law requires" him to do so and not to bother to consider whether the expulsion was true justice and/or it accomplished anything. What he can't do is over rule the prosecutor because he thinks that defendant should stand before him so the judge can convict him.

It is the prosecutor's role to determine what cases to pursue. It is the judge's role to rule on the facts of the case. If the prosecutor decides that in the interests of justice, whatever the reason outside a bribe or something illegal, not to pursue criminal charges, then that should be that. If the judge wants to both prosecutor and convictor, he could apply to be a principal in one of those school districts that punish children for possession of illegal drugs because they bought an aspirin into the school without appreciating the consequences because they are 12 and 12 year olds are not always known for their logical thinking patterns, without looking at the individual facts, such as this, for a legitimate reason to treat someone differently.

Prosecutors make decisions like this all the time. In this case it sounds like the prosecutor looked at the totality of the situation and realized that a conviction in a misdemeanor offense possibly leading to deportation was not in the interests of overall justice. The punishment for Sullivan could have been far greater than for you (assuming you are a legal US citizen) or me. Unlike some who like the safety of hiding behind rules so that every decision is made for them, some still have the courage to do what is right. The judge's inability to see this, that the penalty for Mr. Sullivan would potentially be far greater than that of his fellow defendants, is what has led to his complaint. I guess I shouldn't be surprised. It is a mentality like the judge's that has led us to be a country with vindictive laws where the punishment far outweighs the crime. We've become a nation afraid to use our minds to figure out the proper solution to the individual situation, instead preferring to be a martinet and hide behind firm rules and laws.

We've long had a justice system that is supposed to weigh the specifics of a case charge and make sure the punishment isn't overly oppressive for the crime. It is only recently that we've become a bunch of nipple heads afraid to do what is right. And, going back to the specifics of this case, as shown by the different penalties for crack cocaine, which is generally an urban problem, and for cocaine, which is generally a suburban problem, the war on drugs has had a double standard when it comes to prosecution for many decades.

Justice is not served by the enforcement of unjust laws. There is a long history in this country of citizens refusing to comply with unjust laws, and also of other citizens refusing to find them guilty for the violation of unjust laws. These actions are often the impetus for the work needed to change the laws in the face of an unwilling political establishment. Blindly complying with the demands of authority has little to do with the concept of justice.

Thursday, September 10, 2009

The emotional illogic of yelling liar at the President

The Congressman who yelled liar at President Obama during his speech last night has already apologized but it may already be too late as donations to his opponent for Congress next year rose sharply overnight as he capitalized on raising money to run against "the man who yelled liar at Obama." However, no matter how impolite that shout was, the Congressman did raise a valid point when he yelled liar after the President noted illegal aliens will not be covered under his plan. What happens to illegal aliens if they can't get coverage?

Under EMTALA
, emergency rooms must stabilize any patient that walks in the door regardless of coverage or citizenship. Does this mean illegal aliens will no longer be able to go into an ER and get care that is more expensive than it should be because they couldn’t get preventive care? If so, who will pay for their care? Us with that hidden tax mentioned that we already pay to cover the un-insured or is the plan just to let them die in the street?

I think the President mistakenly got caught up in the emotions running through this country that is anti anything good for illegal aliens. That is not looking at the big picture. If the President really wants to lower medical costs the illegal aliens must be covered. Call me a bleeding heart liberal instead of a fiscal conservative but I'd rather spend an extra $1 a month in taxes to cover their preventive care than pay an extra $10 a month in insurance premiums to pay for their emergency care.

This has been been the big problem with the health care debate. We are letting emotions get in the way of fiscal common sense. Too many concentrate on how we can not let the government be involved at all while ignoring the possibility that reform with a public option may save us money. And maybe that is what the President should focus on. Get away from the emotions of government death panels (in lieu of insurance company death panels) pulling the plug on Grandma (or worse, fat panels) and concentrate on the cool, fiscal logic of Spock.

I read an article that noted that a huge percentage of medical costs is due to doctors’ offices wrestling with the different paperwork of over a 1,000 different health care plans. Maybe in lieu of a forced public option for insurance there should be a forced public form option where all companies are forced to use the same forms. Maybe make them an automated form a little later, just fill in the different insurance company and have all their information populate the form instantly, including possible specialists etc. and move on from there.

If private insurance is so much better they should be able to compete with a public option. We already have that in our mail and package delivery system. The USPS is a perfect example of private industry doing better than the government and yet shows there is still the need for a public option. Fed Ex & UPS picked off the lucrative package business and email killed their private letter business model. Yet, while a private entity may be able to deliver 1st class mail to urban areas for 44 cents a letter they would never do that for rural areas so you still need to provide a public option for the crud no one else wants to deliver.

Meanwhile, if you're illegal, poor, and have diabetes, you'll still die a miserable death due to lack of care. However, fortunately for you, the emergency room will cut your leg off when it gets really bad, ensuring you become a dependent of the state for the rest of your days. We're still civilized enough for that at least.

Thursday, September 3, 2009

A civilzed medical debate?

On Facebook today, there has been an update string stating, more or less "No one should die because they cannot afford health care, and no one should go broke because they get sick. If you agree, please post this as your status for the rest of the day." There have been a few variations such as "No one should die because drug companies need to suck up to politicians, rather than develop new drugs for the free market. No one should die because an official panel decides you're too old to be worth treating. If you agree, please post this as your status for the next 24 hours" from free-market type people or "No one should die because they cannot afford a Big Mac, and no one should go broke because they want fries with it. If you agree, please post this as your status for the rest of the day" or "No one should go dry because they cannot afford beer, and no one should go broke because they drink. If you agree, please post this as your status for the rest of the day" from people with a sense of humor, but the first post has been the main variation.

Of course, Facebook being Facebook, people are commenting on the status of those who post the first status update. However, as everyone reading and writing the comments is a friend of the status poster (or a friend of a friend) the debate has been fairly polite, even when posters are blasting each other's position. One person opinioned that no one is going to die because they cannot afford health coverage as all states already have a "welfare" system in place for those that can't afford it, and under EMTALA, emergency rooms must stabilize any patient that walks in the door regardless of coverage or citizenship. It was then pointed out that we the insured already pay for the uninsured through higher taxes to cover the uninsured and/or through higher costs we pay in insurance premiums and medical bills. If you ever get sick and look at your hospital bill and see you have been charged a small fortune for a band-aid (I wish I had my mother's last hospital bill handy) you will see we (through higher payments to our insurance companies) are already paying for the welfare for the uninsured. Another thread focused on how how some people have trouble paying whatever deductible they must pay before insurance kicks in and are forced to the emergency room for health care which is a pretty expensive way to go. Under my current plan, I go to the doctor and pay my somewhat reasonable co-pay and that is it, whether it is the first time I'm seeing him or the tenth (easy to do with kids). Now I can afford to pay the $75-100 (or whatever the cost of the office visit is) if I had to pay $X before insurance kicked in, but some can not. Those are the ones who can't afford health care. And I'm not talking about people with Dish TV, I'm talking about people who decide between heat or eat in winter.

Another person essayed "the problem is none of us (unless we're over 65) really have insurance. We are just led to believe we do. ... Let's imagine, despite exercising and eating right, you got cancer. No problem - you have insurance through your employer. Except you get too sick to continue working, and have to go on disability. You no longer have insurance through your employer and you are out on the open market. Except you have a pre-existing condition. You can get coverage, except not for what is making you sick, or you can pay astronomically for it. And remember - you are no longer able to work. What do you do next?"

Other posts were more touching. I had one uninsured friend remind me when he had to go to the hospital with a bad pain in his side a few weeks ago it cost almost $6,000 out of pocket. And of course I had my mother who had insurance (good insurance at as she was a retired teacher) and still had a medical bankruptcy at age 65. She lost her home and would have been in a nursing home a decade earlier than she went if she didn't have children who could help her out and pay for assisted living.

It's a mess all over and I'm not sure government can fix it. But what we have now is just a house of cards slowly collapsing on all of us one card at a time. I'm more of a fiscal conservative than a liberal and think the current situation is pretty lousy financially. I really don't care if an illegal immigrant, for example, gets free medical care for a dollar of my tax money if it means I don't have to pay $10 in extra insurance premiums to cover their ER visits due to EMTALA. However, while I don't trust the insurance companies to put health before profit, I don't think government is the complete answer either (I have sneaking suspicion there will be a bureaucratic nightmare when some entity tries to determine who does and does not have insurance and needs to pay a "fine").
Personally, I just want whatever is more efficient and costs less. If that is the government, then the private insurers can match. If it is the private insurers, after some streamlining and whatever else that they need to do to bring down costs and meet whatever minimal standards are set up, then they can do it. We are fortunate that we live in a time and in a country rich enough that can do this, if we want to. One thing I am pretty sure of though -- I'm not retiring to California.