Ready for Disruption!

I went to the grocery store the other day. They make it easy to shop. Each item has a shelf tag that shows the price of the item. I like that!

Grocery stores have low gross margins, so they need to lure customers with good prices, good selections, and good service. Most stores put a flyer in newspapers on Wednesday listing their specials. You can compare one store’s prices to the other’s, and decide if it’s worth the gas to drive four more blocks to save a few cents.

Car dealers place price stickers on the window of their cars, fueling stations post the price for each grade of gas on big signs. Department stores have price tags on most items. Restaurants have menus that tell you the ingredients of each dish and its cost.

Most hospitals, doctors, and other medical providers don’t list prices. I don’t like that!

What does your local hospital charge for a knee replacement? How much is an X-ray? How about a night in the hospital? How much does your doctor charge for a physical? What does the Lab charge for a blood test? Why aren’t prices posted in the lobby of clinics and hospitals? Then you could decide if it’s worth driving a few extra blocks to save hundreds of dollars.

 A well-respected regional hospital in the Northeast, with which I’m familiar, has this on its website:

            Healthcare billing and insurance issues can be complicated.

Professional fees are not included on your hospital bill. You will be billed separately by your attending physician, anesthesiologists, radiologist, pathologist, and other specialties.

A hospital serving The Villages of Florida, a huge retirement enclave, posted this on its website:

… we understand how overwhelming it can be to deal with health issues and billing issues on top of that. We know that your medical bill and insurance details can get confusing. It is our goal to make the process as easy as possible for you.

A hospital chain in Sacramento has this on its website:

Please note that you may receive more than one bill for services received at the Medical Center. Physician charges, may include bills for Radiologists, Anesthesiologists, Cardiologist and Pathologists, and will be billed separately. Physicians are independent of the hospital and bill for their services separately.

If grocery stores took the same approach as your local hospital, they might post this on their website:

We understand that grocery billing is complicated and can be overwhelming. Most fees are not included when you check out. The farmers, fertilizer companies, meat packers, box companies, food-testing agencies and other specialties, will bill you separately.

The U.S. has some of the best-trained doctors in the world. It has great research facilities, it has the latest technologically advanced equipment and highly skilled nursing and other patient care professionals.

Best of everything, however, doesn’t deliver the best results across a broad range of measures. The U.S. spends double the percent of Gross Domestic Product (GDP) on health care as other developed countries but ranks last in nearly every category of efficiency and effectiveness.

We don’t get much bang for our buck because healthcare isn’t an integrated, holistic system. Our science is first-class but our systems and processes are from medieval times. Doctors are in “private practice.” Medical specialties have their silos. Hospitals allocate their operating rooms to the surgeons with the most business. Big Pharma works in its silo. A hospital’s billing practices sometimes infer that they are hotels. with medically related room service.

When we compare the U.S. to eleven other developed nations,[i] we come up short: our access to medical care ranks last, in large part, because we don’t have universal healthcare. We rank last in information flow between primary care and specialist because of the dearth of integrated systems; we have the highest rate of mortality amenable to health care, and our life expectancy dropped each of the last three years.

We have one of the highest infant mortality rates in the world.

The administrative costs account for as much as 31% of total hospital expenses.[ii] One study found that administration cost is about 0.67% per doctor in large medical groups.[iii] The lack of a national approach to healthcare delivery results in unsustainable expenses with poor results; management systems and processes are antiquated, payment systems are outdated and pricing processes are decades behind the business world. Our great doctors and nurses in a dark-ages medical world that reduces quality outcomes. Healthcare is ripe for major disruption.

We see disruptions today unimaginable ten years ago: Airbnb is the largest hotel chain in the world, Uber and Lyft compete to be the largest taxi company in the world, Ma Bell isn’t in the telephone business anymore, and Bitcoin is chasing real money. We are only a few years away from driverless cars, making car ownership obsolete.

We face two gigantic challenges: how to lower healthcare costs dramatically and how to bring medical outcomes up to world standards, and then surpass them. Systemic change usually takes twenty years; however, modern disruption strategies take five to ten years or less. Amazon’s purchase of Pill Pak is a good example. Most drug stores could go out of business in ten years. Amazon will deliver pills to your home in individual doses with date and time to take them, at very low prices. They won’t have the cost of middleman distributors and prescription management companies who eat up rebates and pay pharmacies. The entire drug distribution system is ready for a major disruption.

The current model of doctors in private practice is unsustainable because of its inefficient delivery model. It too is ready for disruption. In addition, Artificial Intelligence (AI) is set to take over most of the diagnostic challenges doctors face every day and the methods to remedy ailments. We see that already in many kinds of personalized cancer treatment protocols. Universal healthcare will provide primary care to everyone, reduce illness, improve delivery systems, and reduce costs. A single-payer system would reduce costs even more.

What does a highly efficient and effective healthcare delivery system look like? The healthcare system to which I belong has over 4.3 million members in Northern California; it operates 21 hospitals, 242 medical offices, and outpatient facilities. It has 8,900 doctors and 23,000 nurses on its payroll.[iv] It has great management systems. Admittedly, scale helps this kind of system. An easy, but not necessarily accurate, way to describe the system is that the insurance company and the medical practices are one system. Because of the organization and management systems, it is able to control costs and provide outstanding customer service.

Doctor clinics, labs, radiology, outpatient surgery, pharmacies, physical therapy and more are integrated into one efficient operation. On-line services are outstanding; making doctor appointments, ordering meds, email, and doctor consultations are all available on a smartphone or computer. It’s obvious that they understand Lean Management and Six Sigma quality measurement. I like that!

Medical systems across the country are slowly moving to the single provider model, with the hospital as a focal point. It will take a massive disruption to effect significant reductions in health care costs and improvements in healthcare outcomes. Not only is the pharmacy industry about to see a major makeover, but the day of the private practice-doctor has less than twenty years before it disappears. Integrated medical practices, processes, systems, and administration have the potential to lower medical costs by 20% out of the bag. We know this because we can compare our costs with those of other countries.[v]  

Ask your doctor what he charges for a regular visit, for a physical, or how much per day your hospital charges per day. Don’t let the blank stares scare you.

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[i] Mirror, Mirror 2017 – International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care – The Commonwealth Fund

[ii] Becker Hospital Review – CFO - 2009

[iii] Health Affairs - 2011

[iv] https://share.kaiserpermanente.org/article/northern-california-fast-facts/

[v] Mirror, Mirror 2017 ibid

There is a time!

“To everything there is a season … a time to plant and a time to pluck up …[i]

It was time for pluck but had I known the level of frustration involved, I might have lived with the current state of affairs a little longer.

 It wasn’t earth-shattering, mind you, but the annoyance level was high. I wouldn’t want to do it more than once every ten years.

It was increasingly hard to get through a conversation on the oldest phone. Our carrier dropped off the face of the earth in mid-sentence. Even with a personal cell tower in our house, service was intermittent. The second phone was serviceable enough. The tablet, almost an original, was nearly useless. By all indications, technology had passed us by. Kids and grandkids rolling their eyes were the norms.

Staying with our current carrier was an acceptable option only if we could be satisfied with updated equipment but poor service. It was time for a change. Off we went to the large competitive carrier looking for the simplest solution to our dilemma.

Phone number one was too old to work on their system or qualify for a rebate. The second phone wasn’t compatible with their system either but qualified for a modest rebate. The tablet engendered a broad smile or was it a sneer.

 A simple opportunity to upgrade some equipment resulted in three hours of in-store discussion, and information exchange between one device to another,  and further hours on the phone with the corporate “customer loyalty” department to erase the activation fee they charge customers for each phone and tablet. They want to charge new customers to do business with them. Really?

I bought my first mobile phone in 1991. That was back in the day when it was a phone. I could make calls on it and I could receive calls. I upgraded to something better every year or so.

In 1994, I installed a phone in the car. Very modern and up-to-date. It required a microphone above the sun visor, a speaker behind the seat, and a big flip phone in a cradle that was atop a flexible post between the front seats. We removed the antenna on the back window to go through the car wash.

Flying back and forth to the mid-west and east cost required making a phone call when you landed so that the phone knew where you were.

When traveling from The City to the East Bay, I would wait until I had gone through the Caldecott Tunnel before calling home because it saved on roaming charges and long distance charges.

When we started using our new phones we discovered that, yes, most of the data transferred, but not all of the passwords for the apps. Almost all of the apps needed updating and reinstallation. That wasn’t too hard.

I started with the Weather Channel, then Facebook, Starbucks, Google, Amazon, Wells Fargo, Translate, Solitaire, Cribbage, KDFC, Pandora, Linkedin, Uber, Kindle, Amazon Alexa, SacBee, MLB at Bat, Kaiser Permanente, Netflix, OpenTable, Park Mobile, Golfshot Plus, Sky Guide and of course, My Verizon.

It turned out that many of the apps could be downloaded from the cloud, which should have been easy since it was such a cloudy day, but as you might suspect, it wasn’t. Going from a joint account to separate accounts requires new usernames, new passwords, new processes, and who knows what.

When I went to high school, I used an Underwood typewriter that my mother’s father had used. It was simple. The basic keyboard was the same layout – asdfg hjkl; - it lasted for generations. The sales clerk told me that phones and tablets are really meant to be replaced every couple of years. Really? Why do phones require such frequent upgrading? Aren’t they constructed well? The answer is simple. They are not phones after all.

We walk around with computer platforms that have a phone app on them, along with the choice of a million other apps. The phones are well made I suspect, but the technology moves too fast for the platforms to keep up. I wonder if we could get along ok without all those apps?

Maybe we could. But if we didn’t have them, how would we reserve a space in the parking garage at the Kings game or get a 20-minute warning that the parking meter is running out of time without Park Mobile? How would we make a reservation at a restaurant without Open Table? How would I know the distance to the flag on the golf course without Golfshot Plus, or be able to identify the stars and planets at night without Sky Guide? How would I make appointments with doctors and get lab results without the Kaiser Permanente app? How would I get a ride without Uber, read a book without Kindle, or listen to music without Pandora? How would I deposit a check from home without my Wells Fargo app? How would I buy from Amazon without their app?

It was really an inconvenience to set up all those conveniences. Well, anyway, we should be good for another ten years, at least. Or, maybe two?

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[i] Ecclesiastes 3: 1-8

… even the President says so …

There is an epidemic in our country: people calling the police on other people, especially those of color or minorities, who are doing nothing wrong. Its individuals walking up to strangers, mostly people of color, and telling them to leave the country or stay out of their neighborhoods. Is it a reflection of the fear so many experiences on a daily basis, or is it pure racism?

A video on You Tube[i] went viral last week. It raised racism to new heights. The dustup occurred in the LA area when a woman yelled at and harangued a 27-year-old Latino who was working in a customer’s yard.

“Go back to Mexico,” she yelled as she crossed the street to shout epitaphs at the man and his mother. 

Mr. Guzman, it turns out, is a citizen of the US, a college graduate with a steady professional job, and a homeowner. His mother cleans houses and yards for her customers. He helps her on weekends.

 Mr. Guzman confronted the woman. “Why do you hate us?  

 “Because you’re Mexican,” she said.

 “We are honest people right here.”

 “Ha-ha… Yeah... Rapists and animals!” The accusations went on to include drug users and gang membership.

“Do you believe what you are saying?” Mr. Guzman asked the woman.

“Of course, because I heard it on the news.”

“Do you believe everything you hear on the news?”

“Yes… even the President says so.”

I believe that she really does believe that Mexicans particularly and Hispanics, in general, are thieves, rapists, drug users and any other accusations you want to pile on. She believes it because even the President says so.

Between talk radio and cable news outlets, and agenda-driven newspapers, we are reliving a world punctuated by Yellow Journalism. The late 1800s saw Yellow Journalism flourish between two competitive New York City newspapers. Their owners, Joseph Pulitzer and William Randolph Hearst preferred sensationalism to facts. Both had agendas and both reported in ways that supported their agendas.

Cable TV and talk radio, The Huffington Post, Red State and other newspapers are today’s equivalent of Yellow Journalism, more concerned with sensationalism than fact. The lack of journalistic integrity is a major reason why hate and distrust permeate our land, why our social fabric is fraying, why our value systems are called into question almost daily, and why our politics is so polarized that Congress is in a perpetual stalemate.

An old adage says that what comes out of your mouth is a reflection of what is in your heart. Donald Trump tweets what is in his heart, and that makes him partially to blame for our current state of affairs. A large minority of the people support his vision for the country. Another large group dislikes his vision and direction. So be it! That is what happens in a democracy.

Trump’s approach, however, is different from other presidents, and in the end, is a disservice to the nation. His tweets and general comments are usually negative, debasing, and impolite, to say nothing of the overwhelming narcissism. He does not show respect for the office he holds.

A casual review of the President’s tweets for May and June 2018 shows comment after comment, day after day, that debase people, that call them names, that mock them, and that invigorate his base.[ii] A deeper review of the President’s tweets displays falsehood after falsehood. Extreme right-wing radio, TV, blogs, and newspapers pick up the falsehoods and publish them as truths. Sensationalism triumphs again, and legitimate journalism is called fake news.

The President’s tweets and his public comments resounded with his followers and echoed his sentiments. Almost overnight, it became legitimate, again, to call people names, to ban immigrants because of their religion, to be derogatory to minorities, to ask citizens of color to go back home and to separate children from their families.

 We have to find a way to survive this assault on our way of life. Where do we start?

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[i] https://www.youtube.com/watch?v=9JmcRHIBmZM

[ii] http://www.trumptwitterarchive.com/archive

Who gets to eat out?

I don’t especially want to have dinner with Sarah Huckabee Sanders. You know, be at the same table in a restaurant. She strongly supports political policies with which I disagree. Her ejection from a restaurant in Virginia last weekend, however, is way beyond acceptable norms of behavior. Is her ejection a barometer of the wave of populism that is changing American culture?

Mrs. Sanders is the Press Secretary for the Trump administration. We see her on television almost daily, reporting on the events at the White House, explaining the president’s policies and sometimes trying to explain the president himself or his tweets. It’s a difficult job that requires her to varnish the truth from time to time. Everyone knows it and goes along with the game. It’s too bad that press secretaries have to do that. She directs most of her pronouncements at the 30 percent of the population that form the Trump base of voters. I disagree with most of the things that energize them. But, that’s not the point!

Mrs. Sanders, accompanied by her husband and friends went to a small restaurant for dinner last weekend. The Red Hen has about 12 tables. When the wait-staff noticed that Mrs. Sanders was in the room, they, totally flummoxed, called the owner at home, to see what they should do about it. The owner came to her restaurant, asked Mrs. Sanders to go to the patio where they could talk privately. She asked Mrs. Sanders to leave. The restaurant owner did not want to serve anyone who worked for Trump. The rest of the dinner party left with her. The firestorm on social media was quick and ferocious, with about equal numbers of supporters and detractors.

Mrs. Sanders should not have been asked to leave. We must ask ourselves what has become of our country. Politics, always a blood sport, operated within certain rules of behavior. It is not acceptable to refuse service to someone because of who employs them. Disagree with their politics all you want, but they have the right to go out to dinner, expect a degree of privacy and expect good service. Regrettably, the owner of the restaurant did not extend that courtesy to Mrs. Sanders, and we, as a nation, are the worse for it.

The political divide in the country is severe; people no longer understand the idea of freedom of speech, expression, religion, or politics. Our values demand that we respect other people’s opinions, politics, or religion. Our ethos tells us not to discriminate against people for who they are, what they believe, or whom they worship. Yet, the nation is split down the middle on these core values.  People won’t invite members of the opposite party into their homes, associate with them socially, or eat dinner in a restaurant with them.

We have seen balkanization too often in our history and the rest of the world. It never turns out ok. It leads to populism, and that never turns out ok. The issues that divide the nation are so great that few have real ideas for fixing them. We might start by letting families go to the restaurant of their choice. We might start by trying to be nicer to our fellow citizens. We might start by being more polite to those with whom we disagree politically. We might try staying calm.

Will Durant summarized one of Aristotle’s famous works this way: “we are what we repeatedly do. Excellence then is not an act but a habit.” Isn’t it time for us to be, repeatedly, a tolerant people, not a divisive people, to be a people willing, repeatedly, to consider other points of view, to be a people repeatedly willing to let even our political opposites enjoy an evening meal with friends?  

What will you tell your grandchildren and great-grandchildren?

We are a nation of immigrants, yet too many of us are anti-immigration. Once our ancestors settled in and the third generation became the norm, many of us discourage others from coming.

People immigrated to the US because of intolerable situations in their homelands: religious persecutions in England, famine in Ireland, the extermination of Jews in Germany, oppression in Russia, civil unrest in Central America, lack of living wages in Mexico, or killing rampages after the Vietnam War. Hundreds of thousands of people came through Ellis Island in the East, and Angel Island in the West. They came for a better life for their families or simple survival. My ancestors came from France, Ireland, and Hungary.

Once here, all was never as expected. Those who were already here feared the loss of jobs, they feared possible changes in norms and culture, and they feared fear itself. Irish-need-not –apply signs were prominently placed on factory walls and store windows. The KKK burned crosses on church lawns. Racial segregation was enforced. National and ethnic segregation was the norm in much of the country. We beckoned people to come and then treated them in unwelcoming ways.

The nation’s immigration policies of the last three or four decades resulted in millions of people coming into the country illegally. Some, in fact many, have lived in the US for over ten years; they got jobs, bought homes, educated their kids in public schools, and sent them to college. The parents are illegal but most of the kids are citizens or dream of citizenship in the only country they know.

Our history has its warts, to be sure. From the early days, starting with Jefferson, our national belief in Manifest Destiny was our excuse for taking over large swaths of the continent, starting with the Louisiana Purchase, going to war with Mexico to gain control of California and the Southwest, and attempts to annex large parts of the Oregon Territory claimed by the English. President Polk, in 1844, ran on a ticket of “54/40 or fight.” Our history is replete with government actions to displace people from their lands. We cannot be proud of how we treated Native Americans, many religious groups, and minorities in general. We have had several periods in our history when immigration was discouraged when immigrants were abused, and when we treated people badly. Today we are witnessing a new level of disdain with which we are not comfortable.

Our current government administration is enforcing a zero tolerance level of immigration that we have not seen in modern times. They do it arbitrarily and without compassion. Our government does not distinguish between refugees seeking asylum and those just crossing the border for personal advantage. All are treated as criminals. Instead of caring for families until their cases are adjudicated, children are yanked from their parents and then sent to detention facilities. Thousands of children, even babies who were breastfeeding, are sent to warehouse facilities run by Homeland Security. Even in our dark days when we sent Japanese citizens to internment camps in WWII, we did not separate children from their parents.

News organizations publish pictures of thousands of children incarcerated in chain-link fence cages, pictures of others sent to the heat of Arizona to live in tents, pictures of kids living on energy bars, and pictures of toddlers bewildered by their situation. We see pictures of small children in diapers in those cages with other children too young to care for them. Even with all the published pictures and the anecdotal stories that grow every day, the Director of Homeland Security denies the existence of a policy of family separation. The president says it’s a law created by the opposition party, denies the Department of Justice’s policy of zero tolerance; both are lies.

Is this the nation we want to be? Is this the nation we have become? The outrage is growing. People of principle are outraged. Religious leaders of all faiths are outraged. Former First Ladies are outraged. The general population is outraged. The United Nations Human Rights Council has decried our outrageous policies as inhumane.

Newspaper articles tell riveting stories of mothers deported without their children, of parents arrested while mowing the lawn in front of their homes, of children sent back to countries they do not know or to which they no longer have any connections.

Countries have a right and a duty to protect their borders, but they must do it humanely. Our country and its leadership, the executive branch and the legislative branch are shameful in their pursuit of these family-separation policies. It is time to stop this inhumane treatment of people. It is time to raise the cry for change. It may be a time to take to the streets in protest. We are sickened by the behavior of our government, and by the election fears of Congress who are complicit in these inhuman actions.

What will we tell our grandchildren and great-grandchildren that we did while our country tore children from their mothers and put them in concentration camps?

Startling Primary Results

California will have a Democrat and a Republican running for Governor in the general election in November. Can you believe that? What is the big deal, you ask?

If you do not live in California, you may not understand our surprise. Pundits and talking heads had predicted we would have two Democrats running against each other in the race for Governor. Remember, this is California. We do things a little differently.

In our primaries, all candidates for each office are on the same ballot, regardless of party affiliation. Correct! There isn’t a separate ballot for Republican candidates and another ballot for Democratic candidates. All the candidates are on the same ballot. The top two winners go at each other in November, regardless of party. Go figure.

The race for governor will feature Gavin Newsom, a Democrat, and John Cox, a Republican. The race for Lieutenant Governor will be between two Democrats. In the race for US Senator, Feinstein, an 84-year-old Democrat garnered 1.7 million votes, and Kevin De Leon, a 51-year-old Democrat received 441 thousand votes. All the Republicans running for the Senate seat received fewer votes so they won’t be on the ballot in November. (Shades of Reagan’s debate with Mondale: “I will not make age an issue of this campaign. I am not going to exploit, for political purposes, my opponent's youth and inexperience.") The six Republican Candidates split 1.1 million votes. One wonders if the results would be different if the GOP had united behind one candidate.

There are 53 congressional districts in the state, most represented by Democrats. An independent commission was established a number of years ago to design the congressional districts. It reduces the influence of one party over the other and avoids the gerrymandering that results when the legislatures design the districts. They do a pretty good job. Democrats polled well in most of the heavy Republican congressional districts. Republicans did well enough to get on the ballot in most heavy Democratic districts. This resulted in candidates from two parties in most district elections in November. Go figure.

Several counties in California use a vote-by-mail only system for this primary. Sacramento County, as an example, is reporting a 40% voter turnout, a historic high for a mid-term election in the last few decades. If these numbers hold, it bodes well for the turnout in the 2020 elections when the whole state will vote by mail.

I like the new vote-by-mail system and I like the top-two system for primaries. I do not know, yet, if either is better than the old systems, but they are more convenient and will change campaign dynamics in the years to come.

If most people are voting by mail, the campaign is really over a few weeks before Election Day. If that discourages candidates from mailing tons of printed material or reduces the number of TV ads, that would really be plus for the trees and us.

The Vote-By-Mail Primary

Tomorrow, June 5, 2018, is the last day to submit a ballot for the California primaries. I voted on May 15, 2018. I filled in the circles on the ballots, I inserted the ballots into pink envelopes, I sealed the envelopes, and then I signed the envelopes. I dropped it off at City Hall on May 16, 2018. Done!

I haven’t voted at a polling place in years, but this time was different. Every registered voter in our county, about 740,000 of us, received their ballots in the mail last month. We will all vote by mail in future elections as well. This may seem strange to folks in some states that seem to limit voter registration and voting itself.

The governor signed a bill in 2016 that allows 14 counties to hold mail-only elections in 2018. The rest of the counties will follow in 2020. It makes sense. By 2016, over 51% of voters in California voted by mail anyway. Conducting elections is expensive. It requires large staffs at each of the hundreds of voter precincts in each county. Vote-by-mail only requires 53 drop-off points in Sacramento County. If one feels the need, a few voting centers opened for a few days ago, where one can actually vote in person.

We used to stand in line to vote. The clerk checked off our names, verified our address, and we signed our name next to our printed name in the Registrar’s book. Then we went to a booth to fill out the ballot. We put the completed ballot in a locked box with the slit in the top. We stood in line, we did our civic duty, and we felt good about it.  

I remember voting on a large mechanical voting machine a few times that let you push one lever to cast all your votes for one party. They called it voting the party line. Does the party mean all that much anymore? The local paper just reported that there are more people in California registered as no party preference than there are registered Republicans. The county estimates that the vote-by-mail system will save about four million dollars for this primary alone, about nine dollars per registered voter. The whole idea is to make voting easier, make it more convenient, and to encourage more people to vote. We have come a long way.

When I cast my first vote, I was required to have paid my poll tax, a levy on every citizen of the state who was over 21 years old. I think it was $10 or $12, but still … In the South, the poll tax was a way to keep non-whites from voting.  The courts ruled it unconstitutional a couple of years later. 

Voting is still a state function. If you are an 18-year-old US citizen, you should be able to register to vote with no barriers to the process. If you have an address in the county and state in which you want to vote, you should be able to register to vote with no barriers. If you are a registered voter and have a government-issued photo ID, you should be able to vote with no barriers. Proclamations that requiring a government photo ID to register to vote, or to actually vote, is a deterrent to actually registering or voting is pure tommyrot.

The least we should require at the voting station is an ID to match the registration. Some say the poor cannot afford an ID. If they don’t have an ID, they can’t sign up for Social Security benefits, food stamps, they can't drive or open a bank account; why not to vote. Getting an acceptable ID is pretty easy and cheap and in many states, free.

Registering to vote should be easy. In our state and some others, you are automatically registered to vote when you apply for a driver’s license or state ID, (you can decline if you want) or you can register online. In fact, in California, you can register in any of ten languages.[i] People in many parts of the country may find that odd, but in Florida, you can register in Creole.[ii] In California, about 800,000 people speak Tagalog as a first language at home, more than the population of some states. Nearly 100,000 people speak Khmer at home. In some parts of the state, over 70% of the people speak Spanish. In LA there are 244 recognized languages used on the streets every day. I’m a bit torn about this. I think people should vote in English.

To become a US citizen, a person must sit through an interview and take a civics test in English, unless they have been in the country for a long time and are over 55 years of age. I don’t think 55 years old is very old, anymore! Generally, registration forms and ballots are printed in English in most states.

I find it a bit disconcerting that in California, the home of modern technology, we can’t vote on our phones, tablets, or computers. Then again, the Russians might like that. Just maybe a vote-by-mail paper ballot, in a sealed pink envelope, is the way to go.

I like the vote-by-mail system. You can read about the candidate’s biography if he or she paid to have it included. You don’t need a “sample ballot” to take into the voting booth with you because you can’t remember for whom you wanted to vote. You can discuss proposition pros and cons before you vote. Mostly I like it because it is easy, it lets me vote when I want to and Mr. Putin will never know which circle I filled in.

Tomorrow we will know who won the primaries, and that’s another story!

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[i] English, Spanish, Chinese, Hindi, Japanese, Khmer, Korean, Tagalog, Thai, and Vietnamese,

[ii] Miamidadecounty.gov