Tuesday, October 22, 2019

Elite or ...


“ I’m just an ordinary man,”[i] The political turbulence of the last few years, created an eddy about the idea that educated people who live in large metropolitan areas, or near the coasts are elites and elitists, and that that is a bad thing. I don’t understand why they became a pejorative. In a vain attempt at full disclosure, I did grow up in the East, although 120 miles from any saltwater, went to a great high school, and got a college degree. I’ve also worked in two large metropolitan areas in the last forty years; brace yourself, one of them was on the left coast. Still, I don’t consider myself elite or an elitist; just a regular guy.

America is experiencing rapid change, technologically, socially and morally. Advancements in artificial intelligence reduce the need for low-skill jobs. When manufacturing leaves the smaller towns and cities because the product is no longer needed, productive people are replaced by robots, or the jobs moved to the large city or another country, certain desperation sets in. Without jobs, life becomes a  struggle, stores close, the population dwindles and division begins.

Those who cause disruption tend to be well-educated technocrats who use high-skill abilities to create new products and services. Long-standing industries become obsolete – think taxies, small hotels, or assembly lines. Change has brewed for a few decades but is now in a fast boil. Our national DNA is steeped in a them-vs.- us divide. Those who don’t have the opportunity or the will to keep up need someone to tag with the blame for their lot in life; perfectly understandable.

One of the things I learned early on when I was a teacher was that a lot of “smart” kids were smart because we told them they were because we treated them as if they were and set higher expectations for them. Children from poorer families were not grouped with the elites; race made a difference too, social standing made a difference, and behavior made a difference. The problem was that those kids were smart too but we treated them as if they weren’t. The self-fulfilling-prophesy was at work. G. B. Shaw was right.[ii] He still is.

America rid itself of royalty at its founding but kept its elites: Washington, Jefferson, the Adam’s, the Lowell’s, Cabot’s and Lodge’s[iii], the Roosevelt’s, Kennedy’s, Bushes and other politicians. We have a pantheon of corporate moguls: Carnegie, Stanford, Hearst, Ford, Mellon, Gates, Jobs, Buffet, and Ellison. In a meritocracy, we will always have those who, through family position, luck, or pluck, will rise above others.  

What do most people do as they accumulate success and excess money? They move to neighborhoods that reflect their view of themselves, associate with others like themselves, buy bigger toys, vacation homes, join organizations with similar folks, and go from there. They seek out the best schools for their kids, foster competitiveness, push academics, and urge them on to independence with the best of intentions. Why is that bad? That is the American dream, isn’t it?

Some say that we need just plain people running our nation because the elites have not done so well by us. I am not sure I agree. Contemplate our country governed by poorly educated people, with diplomats who lack a basic understanding of the forces of hegemony, the value of alliances, with leaders who disdain expertise and experience, or lack social graces. Think of schools led without a passion for learning. There seems to be something happening that does not like education, which does not believe science, does not like the traditional definitions of success, that can’t cope with the sea change flooding our lives.

We live in a global economy whether we like it or not. That means we compete with people from countries that place a high value on educating their elite students: those who can pass the entrance exams and move from one level to another. India has 260 million high-school students, China has about 300 million, and the US only 11 million. Let’s put that in perspective; The top 10% of high school students in India or China are larger than the entire high school population of the US. Their elites will be kicking our butts in a few years.

So, who are these elites that have everyone up in arms? They are mostly people who went to college, and let’s face it, went to elite schools like Harvard and Stanford. All of the current Supreme Court Justices, for example, went to Harvard Law School or Yale Law School. (RBG transferred from Harvard Law to Columbia Law School.) They excelled and they succeeded. Most Fortune 100 CEOs have graduate degrees from highly rated schools. Highly educated and skilled individuals lead most major non-profits. They are all members of the elite class. That seems like a good bargain for the nation. Yet, as no good deed goes unpunished, the elites are blamed for the economic disparity in the nation, the educational disparity, and the social class disparity. They may deserve it, too. But … but!

Too few of the elite class own too much. We have too few willing to share the spoils of success with those who helped them rise to the top. Worker wages really haven’t gone up much in the last twenty years while the very rich are even richer by many folds. This creates a natural dislike for the haves by the have-nots. The divide showed its power in the 2016 election when a conservative nationalist game-show host with no governing experience was sent to the White House because many people were willing to vote for anyone other than more of the same. The elites do rule the country at local, state and national levels; they always have. Most have no concept of life in mid-America or the problems it faces. So, they focus on the needs of the people in the cities, on issues of no concern to the mid-west or the northern plains. They forget that 80% of the Senate represents only fifty percent of the population and their states have the same percentage of the Electoral College.

I am comfortable with highly educated up-to-date visionaries leading the country, up to a point. The wealth of the nation needs to be better distributed. We need to ensure that every American has access to good healthcare at an affordable price. We need to insist on schools that educate and train people for the jobs of the future, not the last century. We need those jobs in this country even if it cost a little more. We need a company’s value measured by more than its stock price.

We have been through these cycles before; the agricultural society suffered through the industrial revolution, we endured a half-century or more of wars, lived through a postindustrial world, and are now working our way along a technological road to the next disruption. The elites led all the movements and recoveries, though with restraints by the masses. That’s where we are today: pulling the reins on a runaway, unregulated economic system that encourages greed and oligarchy. The pendulum will swing back, led by a new batch of elites. If we don’t let them become elitists, we’ll be fine.






[i] Lerner & Loewe – My Fair Lady – 1957 – I’m an Ordinary Man
I’m an ordinary man
Who desires nothing more than just an ordinary chance
To live exactly as he likes and do precisely what he wants
An average man am I, of no eccentric whim
Who likes to live his life free of strife
Doing whatever he thinks is best for him
Well, just an ordinary man
[ii] George Bernard Shaw – Pygmalion – 1913
A play on which My Fair Lady is based
[iii] A well-known toast to the city of Boston  – 1910 - “Here’s to the beans and the cods, where the Lowell’s speak only to the Cabot’s and the Cabot’s speak only to God. The Lowells never get a look in.”


Tuesday, October 8, 2019

Article II, Section 4



The President, Vice President and all civil officers of the United States shall be removed from office on impeachment for, and conviction of, treason, bribery, or other high crimes and misdemeanors.

You do not want to impeach a sitting president - unless you have to! It can take weeks, months, or years. When it starts everything else stops; government grinds to a halt, factions on each side of the question coalesce, the nation divides. Alexander Hamilton told us this happens:

 The prosecution … will seldom fail to agitate the passions of the whole community, and to divide it into parties more or less friendly or inimical to the accused….it will  enlist all their animosities, partialities, influence, and interest on one side or on the other; … there will always be the greatest danger that the decision will be regulated more by the comparative strength of parties, than by the real demonstrations of innocence or guilt.”[i] 

And, so it begins!

On June 17, 2015, Donald J. Trump, accompanied by his wife Melania rode the long escalator to the lobby of Trump Tower in New York City and announced that he was running for the Republican nomination for President; he would make America great again. The pundits laughed.

During the Republican debates, he outwitted his opponents with name-calling, innuendo, sarcasm, and bizarre comments and a lack of fact-checking. The talking heads guffawed. They were aghast. How long could this go on? It would all be over in a few weeks.

It wasn’t. Donald J. Trump held all the cards he needed. He played them well. He had the money, he had a private jet, and he had the audacity. He won the nomination. The coastal elites were perplexed and the heartland ebullient.

Nominee Trump understood how to use the plight of those left behind, those without jobs, the not-so-well educated folks of the fly-over states to his advantage. They wanted change because the left-of-center pendulum had swung too far and needed to be righted. He promised jobs, regulatory erasure, conservative judges, fewer taxes, border security, and gun rights, pretty much what had been bothering a lot of people for a long time.

Elections have consequences. The winners, most of them anyway, promise a lot on the campaign trail but once elected, forget the reason they ran for office. Not Trump. He promised to appoint highly conservative judges, and he did it. He promised to deregulate environmental laws and workplace laws, and he did it. I don’t like his judicial appointments, but he won. I don’t like his efforts to deregulate environmental efforts to save the planet, but my favorite candidate lost. I don’t like his general lack of interest in the history of the presidency or the nation. He is not terribly well educated or doesn’t care and neither does most of his base. Joblessness is at an all-time low, wages are up, and the markets at all-time highs. Why would a nation impeach a leader with these accomplishments? Why now?  

Impeachment is about behavior as much as it is about crimes. High crimes and misdemeanors are about abuse of power more than anything else. It’s using the office to profit oneself. It’s about not being “presidential.” It’s also; let’s not forget, about politics.

Several committees in the House are conducting investigations into the President’s behavior, his actions, his friends, and other activities. They have the trying job of separating fact from “Trump being Trump.” Each committee issues subpoenas for information from the executive branch and they are stonewalled. Department heads refuse to answer phone calls. So the Fourth Estate is forced to up their game to find the truth. They do it rather well. After months of House investigations and public testimonies, smoking guns were still in their holsters. Citizens were and are conflicted about impeachment. Those who listen to Fox News or MSNBC heard two different views of the news. Then one day a couple of weeks ago, the dam broke and everything changed overnight. The White House released the transcript of the President’s conversation with the President of Ukraine. Many saw what looked like the President seeking a quid pro quo for the release of weapons needed to stave off  Russia’s invasion of Ukraine. Others saw no such thing.

Whistleblowers are expressing concerns about administration behavior, Special Envoys are resigning, and Ambassadors are recalled. Personal lawyers are in the fray and presidents of foreign governments are resisting involvement in the process. Have we reached a breaking point? Recent polls say maybe.[iii]

Impeachment is always the decision of the Speaker of the House. Speaker Pelosi shied away from that decision for over two years, pleading with her caucus not to push too far too quickly. Impeachment requires not only proof positive of high crimes and misdemeanors but also the consent of the people. She held off a formal impeachment investigation until she could not. The pressure was too much.

The whistleblower had sent a strongly worded letter to the Inspector General of the National Security Advisors office, which found it credible and urgent. The Acting Director of National Intelligence (DNI), Joseph Maguire delayed delivering the letter to Congress as required by law. It also sent the charges to the FBI so that they could investigate the claims. The CIA also announced that it also had sent credible evidence to the FBI for investigation. The former Special Envoy to Ukraine was summoned for a closed-door nine-hour hearing with Congressional committees. It seems we have reached a state of statis est statis.

Some consider the transcript of the President’s call to the President of Ukraine all that is needed to convict him. Others view the same transcript and say there is no evidence of a quid pro quo. Similar evidence continues to unfold daily, to be viewed differently by each party. It’s going to be a news-filled few months. Buckle up!

[i] Alexander Hamilton - The Federalist #65 – October 1887-April 1888
[iii] Steven Shepard - Politico – October 2, 2019,



Wednesday, September 25, 2019

Under no obligation ...


It’s come to this! The President’s former campaign manager testifies before Congress. The questions are simple. The lawyer asked Corey Lewandowski if the testimony he had given to a Special Prosecutor was true or if the statement he made on CNN was true since they differed.

“I have no obligation to be honest to the media,” was the reply. In other words, he lied, and that was no big deal because he was under no obligation …! This man is considering his own run for the Senate in 2020.

I am a bit old-fashion about this stuff. It may have to do with the way I was fashioned. My folks wouldn’t put up with lying, and the nuns at school certainly wouldn’t. I took an oath almost every week at scout meetings, for several years, to be trustworthy and I try to live up to that promise.

Mr. Lewandowski appeared before the House Judiciary Committee to answer questions about his relationship with the President, and some actions he might have taken on behalf of the President. The White House advised him not to tell the committee anything. The Committee knew this and didn’t expect very many complete answers to their questions.

Lying to a committee of Congress is a crime. For most of the day, Mr. Lewandowski read a statement, prepared by the White House Counselor’s office. The stalemate between the Legislative branch and the executive branch of government continued pour tout le monde a voir.[i] A constitutional crisis unfolds before us each day and no one seems to care.

This isn’t about left or right, conservative or liberal, democrat or republican, or even about politics, but about the ethical degradation of our nation’s governance. Benjamin Franklin said, “You have a republic if you can keep it.” Ours is a unique form of government: three equal branches working with each other and checking on each other. It works best when each trusts the other to do the honorable thing. When that trust is broken, the government grinds to a standstill.

The House brought three articles of impeachment against Richard Nixon in 1974: 1) obstruction of justice, 2) abuse of power and 3) contempt of Congress. The obstruction and abuse of power were so anathema to Americans at that time that Nixon quickly resigned from office. Contempt of Congress, something devoutly to be avoided, occurs when one ignores a call to testify or defies a subpoena to testify. Obstruction of justice occurs when one lies to Congress or to Justice Department investigators. Mr. Lewandowski was instructed to do both, and stone walled the hearing. The White House directed two others to be MIA at the hearing. I’m no lawyer, but …

Branch intramural contests aren’t really the issue. Faith and trust in our government is worthy of our focus. Our nation is divided right down the political middle. Folks on either side of the red or blue line don’t trust those on the other side, won’t have dinner with “them,” won’t date “them,” and don’t want to be around “them.” At all levels of polity, we have state-of-the-art models of non-cooperation in all things government. That’s no way to run a government.

In just the last few weeks, we have heard and read about Air Force crews bedding down at expensive digs in Scotland, our Vice President camping out at a luxury hotel 300 miles from his meetings in Dublin, and the Secretary of Transportation taking her father with her to a meeting to discuss shipping policies that would favor his business. The President, of course, owns the fancy hotels. Our constitution is very specific in its disdain for a President making a profit on his or her business because of his/her office. Yet, foreign dignitaries are encouraged to stay at his hotel in the District of Columbia and other cities around the world, with total disregard for tradition, for law, for policy, or for our Founder’s intent.

Shakespeare laid it out for us, but we don’t have to go back as far as Hamlet or Richard II to see the rot of self-preservation and exercise of personal power from within. We see the corruption in our time, and recent years: a Vice President forced from office because of corruption, a President chased from office for defying Congress; governors spending time in jail for taking bribes, and other major offenses. Today’s corruption in the highest levels of government is at a level not seen since Tea Pot Dome days; it is blatant. Rather than being shocked and awed by the audacity of it, we treat it as if it was only the scandal-of-the-day. Not to worry it will get worse.

Mr. Lewandowski does have an obligation to be honest with the media and the American people. It’s a moral obligation, if not a legal one. Those called to testify before Congress have an obligation to appear and be honest. The White House has an obligation to encourage those under subpoena to show up and be honest.

I do not smell of self-righteousness to ask all of us to try to be honest in our dealings. The stench is with those who don’t feel an obligation to be trustworthy, who consider it OK to lie to the press, to Congress, or to suppress any investigation into those who may have lied to the Congress. Frankly, it stinks to the high heavens.

America is not easy and democracy is not easy. It is even harder when you have a republic. Historians consider it a bit of a cliché to equate our current state of affairs to those of a declining Western Roman Empire. Invasion by the Huns, the spread of a new state religion, and the vastness of the territory all contributed to its fall. Most agree, however, that the rule of strong- willed despots, an economy controlled by oligarchs, and less than competent leaders contributed to its decline. Corruption abounded across the empire in plain view. The Senate, its legislative branch, did little to correct a worsening situation. People stopped listening, stopped being proud of their inheritance and lost trust in their leadership. Romans, proudly proclaiming “Civis romanus sum”[ii] became a boast from the past.

We have a republic. Can we keep it?




[i] For all the world to see
[ii] I am a Roman Citizen, for those of you who forgot your Latin I. The story is often told that a Roman citizen could walk anywhere in the empire without fear, because an attack on one Roman was an attack on all Romans. They were proud to be Roman and felt safe because they were romanus.

Tuesday, September 10, 2019

Ubuntu?


The Headmaster of the high school from which I was graduated wrote his Start-of-School letter a couple of weeks ago, addressed to students, parents, town folks, alumni and alumnae. UBUNTU, he explained, will be the motto for this school year; Ubuntu!  Founded in 1842, the school’s traditional motto is Semper Discens. This year’s motto sets a tone for the students and faculty of a learning community striving to build people of character and integrity. Ubuntu! Have you ever heard that word before? Me neither! It is a Bantu word. It is most often translated as “I am because we are.”   

Ubuntu stuck with me because of its simple but very deep message. It resonates a bit like “It takes a village.” If you grew up as I did, in small-town America, the village helped your parents shape you. Your parents drove the first stakes, but the local police walking the beat downstreet helped keep you out of trouble. The scout troop taught you skills to survive in the woods and in life, the teachers on the playground kept the bullies at bay and the games moving. Local service clubs sponsored an elementary school basketball league and provided the town with a swimming pool, a gathering place for teenagers on summer afternoons; a fraternal order provided an annual Christmas movie matinee with Santa Clause, and a bag of fruit from Florida. The churches, on every corner it seemed, created a certain ethos, a way to live and treat each other. There were cultural norms. There was an Are.

Job growth today is in cities where technology reigns. Middle-class jobs are disappearing, replaced by robots. A college degree is the new 8th-grade diploma. As our slow-moving diasporas creep toward the two coasts and the big cities, small village stores close, schools consolidate, and people move. If the small towns shut down, what will be the We Are?  

Morris Massey, a professor at the University of Colorado postulated that You Are What You Were When. His believed that a person is influenced greatly by their teenage environment and experiences. We are because of who we were.  

Much evidence, a lot of it anecdotal, argues for Massey’s theory, and generations of plausible explanations exist for Ubuntu. At three or four score years, people tend to reminisce about their upbringing, almost always referring to teen years, pointing out how school “wasn’t that way when I was a kid,” and  listing the most grievous offenses that got them in trouble; starting with comments about chewing gum in class. The early teen years formed us. They were our When, our Are.

So, does any of this have relevance today? I think of the young teenagers brought up in neighborhoods well below the poverty line, living on streets where random shootings occur on a regular basis, where most qualify for free breakfast and lunch at school and at the library in the summer. I think of neighborhoods, villages really, where there are no service clubs to provide basketball leagues, swimming lessons, no books at home to read or to read others. I think of kids growing up in villages where unemployment is high, where parents see their children losing opportunities to improve their lot in life. Too many have no There. Twenty or thirty years from now, today’s kids will say, “We are what we were when.” Is today the When we want for them? Many will remember Ubuntu, “I am because we are.” Is today the Are we want for them?

The choice of Ubuntu for this year’s school motto encourages us to asks questions: about why we are letting our world behave the way it does, about our nation’s leadership, about how we contribute to the divide in the nation, about how we treat each other each day. We must ask if homelessness and hunger are what we want for our children, our community. We must ask if are making our villages a better Are.

When the next generation says, “I am because we are” …?



Tuesday, August 27, 2019

Julia's Advise!


Some of you remember Julia Child, whose TV cooking show changed the way Americans eat. The health-conscious criticized her for using too much butter. Her acerbic retort was that she was cooking for four people, and a stick of butter wasn’t too much. “Everything in moderation," she told us, "including moderation.” 

I was reminded of Julia recently while reading newspaper accounts of our leader’s tweets. They and those who respond on Twitter and other social media seem to have never met Julia. The insults come like heightened metabolism, the hyperbole races to a rant, and the general tenor of conversations stretch the definition of politeness. We could all tolerate a bit more moderation. They could be civil.

Talking heads on cable TV dull our senses. They say horrible things about our leaders, slant the news to their advantage for one hour each day, and then turn the microphone over to someone else with a rapid heartbeat. These folks are paid to be rude, to support one political party over another. One channel exists to praise Trump, the other to bury him. Yet, we lend them our ears! Civility vanquished?

How did we lose it? The unprincipled commentators are only one ingredient of the messy stew we’ve become. Vast numbers of people don’t watch cable news, millions of others don’t read newspapers, and still more don’t listen to current events on the radio. Those who do watch, listen and follow just abet them, encourage them, and are complicit with them. I do, and I am, I admit it.

Something changed in the last three or four decades. Civility is something you learned at home at an early age. You learned how to speak when spoken to, how to treat people well, how to call your elders Mr. or Mrs. or Miss, or Sir and Ma’am. No parent intentionally raises kids to be uncivil. No school intentionally teaches kids to be uncivil. Yet it happens. Maybe it starts when we don’t correct incivility when we experience it. Everyone is their own snowflake, you know. Let’s not stifle their creativity. Those who haven’t been taught politeness don’t recognize impoliteness when they see it. In the end, we elect national leaders who are on daily marathons of incivility, trying to reach 10,000 steps of crassness. If our leaders and the talking heads speak that way, why should I worry? Some moderation, please.

Everyone has the power to express their opinion on social media, with no need to be polite about it, or factual for that matter. Unimpeded free speech is a great freedom. We can speak our minds without fear of retribution from the government or those we dislike. We can be as uncivil as we want knowing there is no recourse, and we can start most arguments with IMO. But, should we? Can’t we do it in moderation?

If we can assume that 90%[i] or more of us are reasonably civil toward each other, why do we allow the other 10% to drag down our society, to let it wallow in presidential hubris? Two years from now, or six years from now will a new leader be able to turn us back to a nation that treats science with respect, that doesn’t lead by calling people names or calling them the enemy? Perhaps we could convince people, in the meantime, to be uncivil with a bit more moderation. Maybe we can take that first step in the journey back to civility among ourselves, with and from our leaders,

I’ve seen civility, I’ve experienced it, I witness it from time to time in the present, and aspire it for ourselves in times ahead. St. Francis supposedly told his followers to spread the Gospel to all they met and to use words if they must. Can we spread the good news of civil society by being civil ourselves? Think of it as the butter of life; not too much moderation.                                                                                                                                                                              





[i] A number I picked out of the air, but which I believe to be true with no data to back it up, and you know where this is going ….

Tuesday, August 13, 2019

Healthcare for All? Really? (part 1)


Most Americans believe that we have the best healthcare system in the world. It is a myth!

“My doctor said I needed the operation, but he didn’t know if my insurance would approve the payment. He sent in the paperwork last week. We still haven’t heard back.” Sound familiar?
                   
Ten years ago, the notion that healthcare was a human right was novel, if not a revolutionary idea. A recent Reuter’s survey, however, found that 70 percent of Americans now support a universal single-payer health insurance program and a Gallup poll reported that 71 percent believe healthcare is in a state of crisis.[i]

So, what is good healthcare? A person has good healthcare when they can see a doctor of their choice when they are sick, when they can go to the hospital when they need to and get the procedures they need when they need them, when they can get other professional help when they need it. Not everyone has that kind of healthcare today.

Let’s look at the data. America has highly trained doctors, nurses, and other medical professionals. Our hospitals are first rate. We do amazing research that discovers cures for diseases and improves lives. Yet, our very expensive healthcare doesn’t deliver world-class outcomes.

The US spends 17.8 percent of its gross domestic product on health care, while other countries spend 9.6-12.4 percent, with better outcomes.[ii] Our life expectancy is the lowest of 11 comparable countries, and going down each year. Our infant mortality rate is among the highest in the developed world. We go to the doctor less often and spend less time in hospitals than those in other industrialized countries. Our prescription drugs cost twice as much as other countries. Our administrative costs are the highest in the industrialized world, 8% vs. 1-3%.[iii] Two-thirds of all ER visits are avoidable, at an average cost of nearly $30 billion per year.[iv] In other words, we pay twice as much as other countries for lesser outcomes. Why?

Our processes or systems for delivering high quality medical outcomes are antiquated and inefficient, including how we pay for it. Nearly half of our doctors are in private practice. How 1850s is that? A medical office with ten doctors is small according to the AMA. Most doctors in private practice don’t know what they will be paid for a patient’s visit because it depends on the type of insurance involved – HMO, PPO or EPO, the age, and gender of the patient, and the way the doctor codes the procedures. Most insurance plans require that we use doctors and hospitals in their network. None of those networks crosses state lines. Patients are at the mercy of the insurance companies, who contract different fees for each procedure, with the hospital and with the doctors.

Medicare, one of the largest customers for drugs, is prohibited from negotiating prices.[v] The US doesn’t regulate drug prices as the rest of the world does. Manufacturers doubled the price of insulin from 2012-2016, with four percent annual increases since. Why? Because they could. The current administration is trying to implement a plan that allows drug stores and hospitals to import drugs from Canada where the price is much lower, but still the second-highest in the world. Would it surprise you to know that Big-pharma is fighting the idea?

In March 2010, Congress passed the Affordable Care Act (ACA), an attempt to provide better healthcare options for those who had no insurance, and to set new standards for all healthcare practices. People seem to forget what medical insurance was like before ACA: no coverage for pre-existing conditions like high blood pressure, coverage for preventative care, no coverage after a $1million in expenses, no coverage for children after age 19, and it goes on. The bill was a compromise, so it didn’t address all the issues. It was a start.

A key provision of the Act required everyone in the country to have medical insurance. It also required insurance companies to offer comparable policies with roughly the same premiums. So much of the plan’s provisions are burned into our way of thinking about healthcare now, that we would not tolerate them being taken away. One political party has tried, from day one, to eliminate the plan. It was a key provision of their platform in 2016. In the 2018 mid-terms, it lost them the majority in the House.

Large insurance companies, Big-pharma, medical device companies, and hospitals don’t want to change the current system, because it will impact their bottom line. Large trade groups contribute millions of dollars to campaign war chests, $23 million in the first quarter of 2019, large companies, and hospitals that spend millions lobbying Congress As recently as this month a bill passed the California Assembly that would eliminate “surprise bills” resulting from hospital stays. It was pulled before the Senate could vote on it, right after a huge inflow of money from hospitals, anesthesiologist, and other medical groups.[vi] Most of the discussion isn’t about healthcare; it’s about politics and money. So, what are we to do?

Let’s study how other countries provide healthcare to their citizens. They will surely be able to teach us what works and doesn’t, demonstrate advantages and disadvantages to different processes, and help us with the cultural issues. We are different from those other countries, so we shouldn’t implement their plans wholesale. We need plans that meet our cultural needs and our traditions. We also need healthcare we can afford.

This is an election year, so those to the right of moderate will label any proposed change as socialism. It is an effective tactic because so many people don’t know what socialism is and so many older people can remember what it was in the Soviet Union and East Germany. President Trump, in a State of the Union address said that we would not allow socialism to get a foothold in our country. I agree with him. I’m a big fan of capitalism, knowing it has to be reined in from time to time. Harry Truman said, “Socialism is a scareword they hurled at every advance the people have made in the last 20 years. Socialism is what they called public power (TVA)…social security …farm price support … bank deposit insurance … labor organizations… anything that helps all the people.”[vii] 

While we don’t want a socialistic economic system for our country, we already have many examples of socialized medicine, where the government owns the hospitals and clinics and employs the doctors and nurses. The Veterans Administration is a good example. Many large cities and counties own and operate hospitals and clinics, and employ doctors, nurses, and other medical professionals. The government manages many other insurance plans, which are not socialized medicine.

 Forty-four million people already have Medicare, a single-payer insurance program. It pays hospital and doctor bills for nearly everyone over the age of 65.[viii] Medicaid is another single-payer insurance plan for people with low incomes that insures 72 million people, 40% of whom are children.[ix] Fifteen million people have military insurance and about 22 million people have ACA insurance. Put another way, 153 million Americans, 44% of the population, already have a single-payer medical insurance plan managed by the government. Medicare works and it is less expensive than private insurance.

Nearly 155 million people under the age of 65 have insurance plans through their employers or that they purchased themselves. It is very expensive and often limits the care one can receive. Examples abound of insurance companies denying coverage for needed procedures, or Pharmacy Management Companies denying cancer medicines to patients.[x] Most private insurance plans require that members choose doctors and hospitals in their network of contracted providers, with options for deductibles and co-pays.

I’m leaning very much toward the idea of a universal single-payer health plan. Think about it. Everyone in the country is in the same health plan, which is available in every state, not just limited area networks. Everyone keeps their favorite doctor because there is only one insurance plan to which all doctors must belong. Companies that provide insurance for their employees would continue to pay in some form because they can’t afford to lose good workers. One million workers change jobs each month and must hunt for new doctors, and use expensive COBRA plans. Millions more stay in jobs they do not like because they can’t be without insurance.  

“They” say that major cultural changes take upwards of twenty years to take hold. The idea of a universal single-payer insurance plan has been working its way through our national debates for about ten years now. It may take another ten years to implement single-payer in some form, but when seventy percent of the people agree on an issue, the die is cast. Change is in the wind. “The past is over.”[xi] We will cross the Rubicon.
Part #2, Can we pay for it?


[i] CNBC article in late 2017, quoting both Reuters and Gallup polls.
[ii] Karen Feldscher – What’s behind high U.S. health care costs – The Harvard Gazette – March 13, 2018
[iii] Ibid
[iv] UnitedHealth Group –  Study of patient costs – Reported by Axios July 22, 2019
[v] Medicare Modernization Act of 2003
[vi] Axios – July 28, 2019
[vii] President Harry S. Truman – October 10, 1952
[viii] Peter Ubel – Forbes Magazine – November 21, 2018
[ix] Medicaid.gov – April 2019
[x] Sacramento Bee – July 10, 2019
[xi] George Bush -2000 Campaign speech



Monday, August 5, 2019

POP, POP, POP, POP

Another mass shooting! No, wait, another one! What, another one? Wait!

Gilroy, El Paso and Dayton had mass shootings in the last few days. We are numb; twenty-nine mass shootings so far this year. It is, as one commentator said, “It’s the new common, but it’s not normal.” I spent last weekend in Yosemite National Park without wifi and spotty reception on the phone. Truth be told, we shouldn’t take phones and tablets to a place so majestic. It was a lesson in how attached we have become to those little computers and how connected we are to the rest of the world.

We only had a hint of what was happening outside the forest. It was uncomfortable not knowing the details. The beauty of nature should be our normal, should be our tranquilizer, and should be our common. But, it isn’t, is it?

Mass shootings, one after another, bring out all usual suspects to cure our ills. We know them by heart: guns don’t kill, people do; we have to get the guns off the street; we need to keep guns out of the hands of the mentally ill; we need better background checks. This time, we heard some new ones: it’s the video games, it’s the culture of hate, it’s the white supremacists. Sunday news programs showed appropriate amounts of hand wringing, as usual. It will all be for naught, until the next mass shooting, in the next few days, when we will start all over again.

The President called for an end of hate in America, and lots of prayers.

Nothing changes, because we love our guns, for some valid reasons but most not so valid. We have more guns in the US than we have people. Actually, I don’t have a problem with that, if people have guns for the right reason. If someone wants to go hunting, fine, own a hunting gun. If a rancher needs to protect his or her livestock, fine. If a person likes to shoot competitively, skeet shoot whenever. But let’s be honest about it, hunters don’t need AK47’s to kill Bambi’s father. Guns of war have no place except on the battlefield. Automatic and semi-automatic weapons have no place in the home or on the street, and arguing about the precise definition of each is wasted energy. Most countries outlaw handgun ownership. We don’t need them either. Some people want them to protect their home and families, or for self-defense; they buy into a huge myth. There is no valid evidence that guns are effective protection, except as intimidation.

When someone wants to buy a gun, they submit to a not very thorough computerized background check of their criminal history. It only takes a few minutes. In other countries, the background check is a real background check that can take three to six months. It includes an interview with the local police, certifications from doctors, as well as statements from neighbors and friends about the applicant’s behavior and suitability to have a gun. Guns and ammunition are sold only to people who have a license. Some states don’t even require a background check. Most gun shows exempt people from background checks. None of these background checks, it seems to me, fly in the face of the Second Amendment.

There is too much hatred. Leadership at the top cannot escape complicity with the White Nationalist and Nativists when it doesn’t condemn anti-immigrant riots in the streets, saying there are good people on both sides of the argument.

Our President didn’t pull any triggers this weekend, and he said there was no place for hatred. However, a couple of weeks earlier, he basked in the limelight of a crowd of MAGAs shouting, “Send her back,” referring to a duly elected member of Congress. That rally may go down as one of the most racist’s events in the history of our country; it gave permission for every immigrant hater to come out of the woodwork with guns at the ready.

We rely on our leaders to help us find our better angels, not to point us in the opposite direction. We rely on our leaders to look at the facts and understand that there is a culture of hatred; a toxic brew is how one pundit described it, growing across the land and much of Europe. We need them to lead us to be better than we are, to help us curb the hatred that leads to these killings. We need them to get weapons of war off the streets, out of our schools, and out of our stores.

There were nearly one-hundred-thousand people in the seven-mile-long valley this weekend. There was little noise except when the rangers fired beanbags to convince a bear to leave the campground, or the helicopter helping with a search and rescue. The solitude, the politeness of the people, the diversity of the visitors from all over the world, and the opportunity to be free of distractions should be the new normal, the common. If we need to be shocked, one view of any of the domes of Yosemite will give us all the awe we crave.

 Returning to reality will not be an easy transition.