Showing posts with label health care. Show all posts
Showing posts with label health care. Show all posts

Tuesday, September 23, 2014

A drunkard's walk amid silly people... Left and Right

Okay, this blog entry is going to be a bit rambling and angry... somewhat of a drunkard's walk, while ranting at the lamp posts! Hope it at least entertains. Here goes.

bullshit-asymmetry-brandoliniWe’ve all known this and said it for a long time. I laid it out in explicit detail in my Disputations Arenas. Still, it’s nice to see a cogent naming of the phenomenon -- Brandolini’s law - or, as Alberto Brandolini suggests, the Bullshit Asymmetry Principle:
"The amount of energy needed to refute bullshit is an order of magnitude bigger than to produce it."
== Heading for war? ==
On the left side of the spectrum, and in some places on the right, folks are asking whether "Obama is playing into Bush's bad policies. Now he's taking the U.S. back into Iraq with more bombing."
democrats-republicans-wage-warSorry, this is a wrongheaded reflex. Back in 2002 - 2003, the issue was never "should Saddam Hussein be toppled and replaced?" Nor was it "should the Taliban - who supported and helped bin Laden to attack us be toppled and replaced?" 

We needed to do both things. (Though in Saddam's case it deserved genuine policy debate and not a festival of Bushite lies.)
No, the real issue, re U.S. involvement/meddling over there, is and was "should it be done in the stupidest and most expensive ways possible? In a calamitous, gruesomely thuggish methodology that would cost us trillions, damn-near ruin our military and our reputations and leave only two winners: Iran and Haliburton?"
If you actually (astonishingly) think that there will be any resemblance between the coming Obama-led engagement and the Bushite quagmires, you really need to read about the diametrically opposite ways that Democrats and Republicans wage war.
==Decaying Infrastructure== 
And so the drunkard turns and veers in another direct, to rant that --

America's transportation infrastructure, once a continental engine of mobility, productivity and opportunity, has fallen into such disrepair that it's become an economic albatross. Consumers shell out billions of dollars for extra car repairs every year. Insufficient and poorly maintained roads mean costly bottlenecks for businesses, which discourage expansion and hobble American companies competing in the global economy. We all have heard of 60,000 bridges in desperate need of maintenance. Why is almost nothing being done?
BUDGET-DEFICITAt a time of steeply declining budget deficits (always true during democratic administrations and never true during GOP ones) it might seem simple to put middle class blokes back to work, stimulating the economy with high velocity cash while fixing the damaged streets and bridges and getting tons of benefits. One obstacle though. The do-nothing US House of Representatives… the laziest and least accomplished in the history of the republic… has refused to fund infrastructure repairs.
Moreover, several gopper congressfolk have openly admitted their reason — that the resulting improvements and economic boost might help democrats at the polls. It is the Hastert Rule. Never cooperate or negotiate in good faith with democrats, ever. (The last GOP leader who did negotiate - Newt Gingrich - managed to put together with Bill Clinton both the highly successful Welfare Reform Bill and the Budget Bill that led to several years of fiscal surpluses. But Gingrich was dumped and jettisoned for that very reason by Hastert, DeLay, Boehner and other leaders of the madness that has taken over today’s Republican Party.)
Anyone who continues to support this mutant betrayal of true conservatism/libertarianism is a rationalizing fool.

Let's see... any other lamp-posts to yell at?  Oh yes....
 ==War against Nerds==
Salon runs a fun article eviscerating how explicit has become the mad-right’s Assault on Nerds. It has got so clear and full-pitch that even William F. Buckley’s once-intellectual National Review has joined the War Against All Smartypants. Scientists and members of every knowledge caste have been driven out of today’s hijacked version of conservatism. God help us if this relentless campaign drives them all the way across -- past moderate liberalism -- all the way to the opposite madness on the far left.
sensible-problemsI doubt that will happen. All we want is a sensible society where adults negotiate with each other mixed-pragmatic solutions to problems, aiming for a future that will be vastly better than the past that nostalgic loonies (of both the far-left and the entire-right) yearn for. Is that too much to ask?
More evidence?  In late May, the Republicans in the House put an amendment in the Defense Spending Authorization Bill that forbids the Defense Department from spending any money preparing for the consequences of climate change. This article -- House Votes to Deny Climate Science and Ties Pentagon's Hands on Climate Change - on an admittedly liberal site - nevertheless lays this latest lunacy bare and lists an impressive array of serving and retired officers and military contractors who are deeply concerned.

 

The Bill is now in the Senate.
One of you in the community commented: “Our military wargames all kinds of scenarios. Preparedness is part of the job of our military planners, and having a plan prepared is the first step to winning a fight. I expect that somewhere the US military has a plan to deal with a threat from just about any conceivable direction. Oh, but not waves of hungry and thirsty refugees from all over the world, not that. We cannot plan for that contingency.”

denialismTo be clear, as we speak both the Canadian and US navies are struggling as fast as they can, to build capabilities to match the twelve  new military bases the Russians are building around the Arctic Sea, now that it is ice-free or navigable for much of the year. Denialism is a cult that borders on treason.

Ah... but now the drunkard does one of his patented veers... and aims some of his ire in the other direction!
==Divisive Politics==
HaidtSocial psychologist Jonathan Haidt and his colleagues have thrown another grenade. “Psychologists have demonstrated the value of diversity-particularly diversity of viewpoints-for enhancing creativity, discovery, and problem solving. But one key type of viewpoint diversity is lacking in academic psychology in general and social psychology in particular: political diversity.”
Read that between the lines.  It is an indictment of the political correctness that rules in several hundred university soft studies departments.  Along with San Francisco, Berkeley and Illinois, these are the places where you get to see the reason why moderate liberals are rightfully wary of their lefty allies.  And I will not be squelched in reminding you folks that there is danger there!  I remember campus lefty bullies.  I remember the Soviet evil empire (that was fought so effectively by George Soros.)  Just because the US right is currently more dangerous and crazy, that does not mean we can ignore warnings like the one issued by Haight.

But again... a few hundred university soft studies departments are a far cry from the worst danger to our republic and freedoms and planet. True, they hate and persecute science fiction!  That is one good reason to glance, askance at those allies of ours.
I am wary of that direction. But I am bloody furious at the New Confederates who are (at present) vastly more damaging and lethally dangerous to civilization.  For example...
==  Where are the Chicken Littles hiding, all of a sudden? ==

I predicted that, once the tepid and minimal “healthcare reform” called “Obamacare” kicked in, it would start applying market forces that would work fairly well, reducing both the ranks of the uninsured and the rates of increase of US medical costs… all of which is happening.  At which point (I also predicted) GOP pundits  - who had been proclaiming the sky would fall and America would collapse into the stone age - would simply DROP the subject, hoping that their viewers would forget their chicken little end-of-the-world ravings. (And given their viewership, that amnesia is pretty much guaranteed.)

 Indeed, I said that after using this “issue” to lock down and destroy all political processes in the United States of America, that suddenly GOP politicians would start pragmatically adapting to the ACA and even… claiming it as their own.

Which… they are somewhat justified to do!  Since “Obamacare” was cloned from “Romneycare” and “Gingrich-care” and the standard, Heritage-Foundation-designed Republican Healthcare proposal on every GOP platform for ten years.  Watch as that fact is suddenly remembered!  But do not let them forget the hell they put us through, the hysterics and frozen American political life.  The screeching.


== Ironies abound ==


sovereign-citizensMy sci fi author colleague John Shirley dissects “sovereign citizen”… a cult-like movement among those who take the anti-government wing of our widely shared Suspicion of Authority ethos to an extreme that denies any legitimacy of common bonds with three hundred million fellow Americans. 
While I agree with John, on many levels, I believe his approach is more left-versus-right than it needs to be, regarding this matter. (Indeed, while they are fewer - today - there ARE would be tyrants whose metaphors of outrage and hate come from (shall we say) the opposite direction. Surfaces can be misleading.)
In fact, it can be dissected very simply. Those who deny any validity to shared institutions that derive their legitimacy from the electoral political processes... institutions that in-turn reflect consensus of a great and educated nation ... are not simply asserting autonomy — (while hypocritically depending on that nation, utterly). They are either ignoring 6000 years of brutal feudal rule by armed thugs, or else deeply committed to becoming precisely those same armed thugs and feudal lords.
Civilization-FlashI attempted to portray this in The Postman, way back in the 1980s… and it is one part of the book that Kevin Costner translated to the film with utter accuracy! Especially Will Patton’s delightful General Bethlehem, who conveyed where all this would inevitably lead.
Indeed, I wrote The Postman specifically as a direct answer to these fellows. How average folks would not just cower before these would-be lords, but instead might (if properly inspired) rise up to restore that gracious consensus nation, once again.
Having tasted civilization, many of us will fight to the death, to keep it.
In an impromptu interview at a Portland restaurant, I gave a six minute run down of why I think the American political process has so broken down that we are effectively in phase eight of the U.S. Civil War. Not one of the factors that I mention has a scintilla to do with so-called “left-versus-right” or any of the matters that you are being told to hate-over.
==The Tea Party and the Confederacy==
And finally...

Not a Tea Party, a Confederate Party -- Here’s a somewhat too-radical but interesting essay about how the Confederacy lost phase four of the Civil War, in 1865, then won phase five with the collapse of Reconstruction and minority rights, in 1877. Indeed, things have swung back and forth, ever since, including the Civil Rights phase that was won by Blue America - finally crushing the vileness of segregation - but at a cost that resulted in the complete flip-reversal of the two U.S. political parties. In that light, today’s raging “culture war” is only the latest phase.
TAXES-REVOLTClearly the Tea Party is not heir to the 1776 Founders. Their romantic delusions about that Revolution are dissected elsewhere…
… but the crux is clear; instead of wearing three-cornered hats, our Tea Party neighbors should wear gray, for they are the neo-confederate party. In fact, more and more of them are realizing this. Their devotion to the rising, worldwide oligarchy is identical to the feudal loyalty that their forebears gave to plantation lords. (Yesss Massa Koch an' Marse Rupert.) The aim - to tear down the future-oriented, change-welcoming, scientific and pragmatic Blue America, in order to replace it with classic nostalgia and feudal hierarchy - is identical to that of the southern tories who rode with Cornwallis and Tarleton.
I trace out the phases of the Civil War, from 1776 to today, here.

PHASES-CIVIL-WARWhich phase was the most important?  My own, earlier take: The crucial phase of the Civil War, phase three, started in 1852, when waves of southern irregular cavalry began 8 years of violent raids into Northern states to enforce the Fugitive Slave Act. This was never the “war of northern aggression.” It was the diametric opposite. And it is time to re-learn the Battle Hymn of the Republic.


Picture the drunkard now, careening off into the dim night shadows, crashing into trash cans and - hoarsely - singing at the top of his lungs...


"... He hath trampled out the "newsroom" where the Fox of wrath has whored..."


Saturday, April 28, 2012

Credit where it's due...

In a brief return to political matters...  What won’t the candidates be discussing during this election season? Campaign finance, surveillance, patent reform…are among a few issues that candidates are sure to avoid. What else....?  This mini-slide show shows just a few. In fact, the matters discussed at sciencedebate.org are (in my opinion) more important -- and here you can vote for the top science issues facing America in 2012.

Put aside preconceptions. Give a read to this thoughtful interview from Rolling Stone to get a sense of where the President is coming from and how he thinks.  It's very insightful, whatever side you might be on.

Example: President Obama said a top priority was to get the US exporting again.  Since then, exports are up 34% and on target for his hoped-for doubling. Ford, GM and - yes - Chrysler are now selling top quality, world class products around the world at record-breaking profits. Companies that Obama’s opponent wanted to let go extinct.

But in fairness... let’s keep some balance here and give credit to the other side as well.  Presumptive Republican nominee Mitt Romney has a lot to be proud.  His one significant accomplishment as governor - the health care law that he shepherded into place in Massachusetts - after which President Obama modeled his national plan, appears to be working and is 67% popular in that state. Even conservative media admit progress. Way to go, Mitt.

(Though let’s give equal credit to Newt Gingrich, who largely crafted the Republican Alternative health care plan of 1995, on which Mitt modeled the Massachusetts plan and on which Obama... why is it that even when we reach consensus on a good idea, it can never be pleasant, or at the same time?)

== Is experience in government relevant? ==

Alas, there are other issues. For example, is experience in public service relevant in your qualifications to be president?  People used to think so. As recently as 2008, Republicans touted Senator John McCain’s long military record, followed by many productive years in Congress, as evidence that he grasped the elements of government from several directions and knew how to get things done.  Now watch as the murdochian meme of hating all government, all the time, reaches its fruition with Mitt Romney’s record of public service, the skimpiest in 100 years. One term as governor of a northeastern state... period.  That’s it.  Not even an additional day as mayor or dog catcher.

Now, Rachel Maddow has her own axes to grind. Hardly a detached nonpartisan, hereslf.  But the facts deserve a look. Only then recall what Maddow doesn’t mention.  That Romney got a lot done during that one term, creating a model for sensible health care reform for the entire nation. Come on. Rachel, try to be fair.

All right, I admit I was being a bit sardonic there.  Moreover, it is legitimate for Republicans to repudiate their own proposal of 20 years. “We’ve changed our minds” is a fair enough thing to say.

Still, the ironies come thick and rich and we citizens have a right to chuckle over them.  Picture this distillation offered by one member of my blogmunity: "The president was lambasted by his opponents for getting a congress (controlled by his party) to pass their (the other party's) version of a bill on an issue both parties had been debating for decades."

Okay, you can change your minds.  But why be so angry that the other side went ahead and passed your bill?  It’s the anger that’s dishonest.  Indeed, it is foul.

== Why We Need Whistleblowers ==

In his first television interview since he resigned from the National Security Agency over its domestic surveillance program, William Binney discusses the NSA’s massive power to spy on Americans and why the FBI raided his home after he became a whistleblower. Binney was a key source for investigative journalist James Bamford’s recent exposé in Wired Magazine about how the NSA is quietly building the largest spy center in the country in Bluffdale, Utah. The Utah spy center will contain near-bottomless databases to store all forms of communication collected by the agency, including private emails, cell phone calls, Google searches and other personal data.

Hey. Did I ever say the odds were in our favor?  Look at 6000 years of human history.  Our exceptional approach - dividing power so that we can sic mighty elites upon each other, so they won't prey on us - has always been a creaky, nervous bet. It mostly worked for the last two centuries, but only because people kept upping the ante on reciprocal accountability, the transparency and competitive processes that give us positive sum games.  It is what's worked and it might continue working...

...but to do that we must keep pushing hard, dynamically and vigorously, evading the traps.  (For example the meme spread by Fox that the uber-aristocracy and only the uber-rich are trustworthy, eliminating all other, competing elites.)

watchdog-wolfThere are many ways to let government see more (as the NSA will inevitably do) and yet keep a choke chain on the watch dog, so it never thinks that it's a wolf.  These methods would take some work and good will and a political process that's not frozen by culture war.

But it could still happen...

Thursday, December 17, 2009

Health Care. Again... Insure the kids first!

 What does it take to see the obvious?

 First, in today's weirdly reshaped political process we should not be wringing our hands over details in the Senate's version of Health Care legislation.  The current bill is warped by the need for perfect unanimity among members of the Democratic Party coalition. The Republicans’ strangely awe-worthy trait of utter party discipline, threatening filibusters instead of negotiating and deliberating as individuals, has put the independent senator from Hartford (capital of the insurance industry) in a powerful position to make certain that his industry gets what it wants.

In the current Senate version, that is.

But remember, all the Democrats need is to get some kind of bill out of the Senate.  It will then go into a reconciliation process with the version passed by the House.  The final bill that results from that blending will then be offered up for a straight vote in both chambers with no filibuster allowed.  This means that:

 1- liberals who are crying now about President Obama's "cave-in" concessions to Joe Lieberman ought to learn something about the process. And about patience.

 2- Since the final bill will only need 50 Senate votes to pass, Senators Lieberman, Lincoln, Landrieu, Nelson, Baucus and several other Democrats from more conservative states, will be able to posture and vote against it, for the sake of those at home, and still see it pass.

3- If the final version looks a lot more like the House Bill, and thus more liberal than anything the Senate might have passed, that will only be the Republicans' fault.  They could have negotiated and participated in a real process of deliberation, and hence had a real voice on the reconciliation committee.  (Democratic majorities have traditionally given the GOP Congressional leadership substantial voice in the reconciliation process -- that is, until the Republicans chose all-or-nothing political war. Total political war has its consequences)

 But I want to focus, briefly, on another matter-- one that I've raised many times before... that the Democrats have waged this struggle with the wrong emphasis, all along, in ways that are tone-deaf to both justice and the inclinations of the voters.

On several occasions I've pointed out the obvious, that Americans are inherently more "socialistic" toward children than toward adults.

When it comes to grownups, we retain, from Wild West Frontierland days, an attitude that people ought to stand on their own two feet.  Hence, our public still expresses relative puritanism over issues like welfare and insurance etc, compared to other industrial nations. (For all the FoxNews screeching about "Socialist Obama," the most radical version of health care reform that he ever proposed -- including the "public option"-- was positively right-wing by European standards.) 

But that puritan-cowboy-individualist reflex tends only to apply when the topic is adults.  The point I have been pushing is that we feel differently toward kids.

Just Go Ahead and Take Care of All Kids First!

It goes all the way back to Adam Smith, the so-called "father of capitalism" who nevertheless pushed for free public education.  The logic is simple.  Free enterprise works best from a level playing field, so that a maximum number of  individuals can participate in the competitive  process, delivering ever-improving goods and services  (Um, duh?  This is why any trend toward monopoly or oligarchy is the enemy of enterprise, whether that oligarchy is governmental or "private.")

Now, one can level the field by bringing the aristocracy down a notch. (Smith actually favored this, to a cautious and limited degree, at least by eliminating the secretive, collusive power of oligarchs to warp markets.) But a better way is to lift the bottom up. Again, carefully.  In the right ways.

If helping the poor has real capitalist-pragmatist justifications, certain types of help benefit long-range competition better than others. Conservatives are right to be suspicious toward lefty endeavors to "equalize outcomes."

On the other hand, certainly, the most justifiable kind of aid to the poor is also the most moral -- lifting up children.  Even rough-n-ready Americans know that.  And even George W. Bush felt compelled to push the State Children's Health Insurance Program (SCHIP), which - inefficiently and haphazardly - helped states with matching funds, to reduce the number of uninsured children.

My point is that Obama and the Democrats have been foolish to ignore this inherent double standard -- a willingness on the part of Americans to apply socialist methods to help kids.  Instead of trying to expand Medicare downward to include people between the ages of 55 and 65, they should have gone to the other end and presented a provision to simply cover all American children.   

I've been proposing this for a long time. First, it would - in a shot - take care of the most vulnerable citizens and those whose long range futures merit the greatest investment... offering the most profound return, on a simple cash-actuarial basis!

Second, a lot of the health care needs of kids offer great bang for the buck.  These include effective preventive care, or the rapid attending to brief-acute problems... exactly the areas where even Republicans admit that Canadian-style single payer systems work best.

Third, even if that left a lot of parents uncovered, at least those parents would get their worst fears lifted off their shoulders.  They could then negotiate their own policies with private insurers from a position of strength.  In fact, the insurance industry would know it had to play nice, or else "children" could be re-defined upward, from ages 21 to, say, 25... and so on.

Finally, this approach is politically powerful.  Because many who rage at "socialism" for lazy adults would not dare object to making sure that children get seen by a doctor and have their basic needs met. Putting opponents in a position of refusing care for babies... now that's political hardball.

Frankly, it worries me that this blatantly obvious option seems not to have occurred to Obama or the Democrats.  It reveals a tone-deaf lack of political savvy, as well as any clear-eyed notion of how to get the most accomplished, in a long and grinding process of incrementalism.

=====

Final note... go to GOODREADS.COM and look up your favorite author! But you can help by writing "reviews" of some or all of his books! It would be much appreciated and help a lot! Come on, do this for the guy! ;-)

Sunday, June 14, 2009

Yin vs Yang on Health Care: Conservatives make a few points

=== A contrarian view of health care ===

In case any of you have come to the false conclusion that I am a reflexive liberal democrat -- simply because I oppose the hijacked monstrosity that the Republican Party has become, let me make clear that I retain plenty of ways that I can exercise contrary orneriness toward the American left. There are times when even the Frankenstein, undead monster than conservatism has become can startle you, by uttering cogent and reasonable “Goldwater-style” objections, instead of the shrill mania pouring from the Murdoch-Limbaugh-Fox nexus.  We should be ready, whenever this happens, to heap on positive reinforcement rewards!  The biggest reward of all?  To actually listen.

One example is where decent conservatives point out genuine drawbacks to the state-run, “universal single payer” health care systems so widely touted in liberal circles.  As one who lived for extended periods in both Britain and France, I have to tell you that their systems have much we can learn from.. and also some serious flaws.  Without any doubt, they are vastly more fair than ours, and do a far better job at both preventive care and ensuring healthy lives for all kids -- which (as I said last time) should be the core goal of any system.

If we must make a zero-sum choice between Canadian and US health care, then by all means, let’s dump a horror story, in favor of dull, unimaginative and paternalistically meddlesome decency.  But I am always suspicious of zero-sum games. If we’re to improve, we should recognize what the current U.S. system does well.

Let’s start by giving conservatives their say. Here’s a quote from Dennis Gartman's eponymous newsletter. "Canada is a wonderful place to have a nasty gash on one's forehead stitched, or to break one's nose in a game of pickup baseball; but have cancer, or need eye surgery, or want an MRI, and the business of medicine in Canada and/or the UK breaks down badly in favor of medical care here in the US. For example... and we wish to thank The Investor's Business Daily for the data noted here this morning…

           "... here in the US men and women survived cancer at an average of just a bit better than 65%. In England only 46% survive. In the US, 93% of those diagnosed with diabetes receive treatment within six months; in Canada only 43% do, and in the UK only 15% do! For those seniors needing a hip replacement and getting one within six months, 15% get it done in the UK; 43% get it done in Canada ... and in the US 90% do! For those waiting to see a medical specialist, 23% of those in the US (fail to) get in within four weeks, while 57% in Canada have not yet done so, and in the UK 60% are still waiting after four weeks.  ......  When it comes to proper medical equipment, in the US there are 71 MRI or CT scanners available per million people. In Canada there are but 18, and in the UK there are only 14! Ah, but the best figure of all is this: 11.7% of those 'seniors' in the US with 'low incomes' say they are in excellent health, which in and of itself sounds rather low ... rather disconcerting ... and an indictment of the system itself, doesn't it? But in Canada only 5.8% do!


            "Yessiree bob, ya' jus' gotta' luv that collectivized, socialized medical care! Let's all go break a collective arm and enjoy the benefits of socialized medicine in the Commonwealth! (Canada) ... but heaven help you if you've got something really, really wrong. If that's the case, you'll be running south to the border faster than you can reach a specialist anywhere in Canada; of that we are certain."


Oh, sure, you can spot the use of cherry-picked statistics, right away. (See below.).  And you’ll note how Gartman airily dismisses the general preventive care that should be the heart and soul of any national system, especially aimed at kids, waving it away as stitching a “gash in the forehead.”  Also, I’d like to see comparison of his figures broken down by age group!  And, frankly, I’d like to smack his smug, dismissive face.  (He is not one of the of those “reasonable conservatives” I was talking about.)

HEALTH-CARE-REFORMNevertheless, putting aside his reactionary reflex and total lack of humility, after his side allowed the calamity of the Bush years, still, Gartman has a point. Because what people tend to ignore is that all health care systems practice rationing.  There is simply no way to avoid it, as we all would pay any price, for any chance of health.  Thus, there is very little market elasticity.  We’ll take our dying loved one to the best doctor, period, and screw the price and screw second best.  Capitalist principles are very dicey here.  So are paternalistic ones.

The chief difference between the US and the rest of the civilized world is that we let profit-driven insurance companies do the rationing, and they do it based solely on profit considerations and whatever they can get away with.  By exiling people who have health conditions, by eliminating the poor, by refusing service for the passive or meek or less influential or less-litigious.  On the other hand, those who can pay, and fiercely enforce their insurance contracts, can get their companies to cover vast and endless expenses for procedures aimed even at extending, futilely, the very last and most painful phases of life.  The phases that take up to a fourth of all medical expense, in the United States.

Europe etc are different.  There, socialist-oid state committees ration procedures, based on criteria that seem to make sense both to those committees and to generally accepted social consensus.  While it seems both logical and laudable that they prioritize children and young adults and illnesses that can likely be cured -- a proper role for paternalistic single-payer systems -- it still seems heartless and callous that they pay for this by telling old people, or those with chronic or “hopeless” conditions that little will be spent on them.  Indeed, this is why many of the elderly rich, all over the world, fly to America for treatment.

What is seldom mentioned is an added drawback to that system.  All the money that America spends (or grotesquely overspends) on unpleasantly difficult conditions - those with a poor prognosis - often results in improved science, treatment and success! In other words, the American system serves as the world’s medical R&D test bed.  This is why MRI machines were available here - for those who could pay out the nose - long before state commissions would buy them overseas.  (And boy, was I glad to get home and use one, back in 1992, even though it cost me $1,000!  Back in Europe, where I had lived, there simply weren’t any available.  At all.)

Is the rightwing wrong about Health Care?  Sure they are, as they have made a habit of being wrong about just about everything, ever since their movement and party drank Rupert Murdoch’s Koolaid and slid into mania, years ago.  The present US Health Care System is a travesty and outrage, period.  Nevertheless, the insistence of the Left upon simply adopting what they see overseas, without discussing the drawbacks, is both lazy and doctrinaire.  It is not worthy of a nation of innovators.

=== Start Down the Road Incrementally ===

Hence, let me return to something I said  before. We could derive the topmost benefit of European style health care if we start by simply providing health care to all kids!  Now, immediately.  Without any “insurance” rigmarole.   Take care of children.  Period. Right away.  Just do it!

One method that would take a one page piece of legislation?  Simply take Medicare and extend it to the other end of the spectrum, the other demographic group that is both helpless and deserving, by simple definition.  Or else, use the kids to experiment with single-payer.  Either way, the political opposition would be in a tough spot putting up much resistance!  Americans are inherently more socialistic when it comes to children than we feel toward adults (who, we think, almost instinctively, should stand on their own two feet.)  Moreover, it lets us act upon prevention and lifelong health investment in youth, by far the best use of medical care dollars.

Seriously, why isn’t this a no-brainer?  A win-win that would let Obama achieve wonders at a stroke, while keeping both cost and complexity down and achieving the greatest bang for the buck.  Poor parents would be relieved of their greatest fear and then be able to bargain better for their own, narrower coverage.  Can anyone explain why this isn’t even mentioned?

And then, with our future safeguarded and the very worst injustice solved, we can gather the best and most sensible people from all sides to compare apples, oranges, grapes and every possible plan for dealing with adult working Americans.

==A bit on Politics==

Lighting the political lamp...  Let’s start with evidence that something special is going on. Everybody, you must watch this. Get to know the guy.  And make your conservatives watch, too. 

Of course, if there are folks on the right who remain impervious to reality.  (As there are some on the left.)  Indeed, the more sensible and moderate and consually wise Obama seems, the more extreme the fantasies concocted by the crazies.  And the more imperative it becomes, for reasonable conservatives to choose the real world.

Speaking of which...

=== Some Conservatives Really Are Openminded ===

My friend, John Mauldin, the brilliant economic analyst, appears to have joined PIMCO’s Bill Gross and other “conservative realists” in breaking away from the standard right-wing doctrine about taxes.  Not in all ways or on all issues. But enough to declare independence form Rupert Murdoch’s party line.

For example, they are much more concerned about trillion dollar deficits than about the purported investment-stifling effects of somewhat higher taxes on the upper class.  Not only are they resigned (and imply some contentment) at seeing the Bush Era’s biggest set of “largesse” breaks for the wealthy expire, next year, they hint that a modest increase might be the least-bad way to reduce both those deficits and inequities in society.  You haven’t seen the punditocracy comment on this trend very much, on TV.  But it is a sea change among the brightest, reality-oriented conservatives and may represent the front of real change in republican circles, at least among those who see reason and patriotism and pragmatism as higher virtues than dogmatism.

And now... partly in order to honor those rational conservatives, and meet them partway, here’s something sure to rile a number of you.  A remise on last time’s topic of health care.  Only from an alternative perspective.

=== ADDENDA ===

“The Obama administration is warning lawmakers that the trust fund that pays for highway construction will go broke in August unless Congress approves an infusion of as much as $7 billion...  Sen. George Voinovich, R-Ohio, said it's clear that Congress must raise the federal gas tax, which is now 18.4 cents per gallon.”

Naturally, I agree with Voinovich.  Our gas taxes are among the lowest on the planet and have encouraged wastrel attitudes for two generations.  Still, I’d like to add one suggestion.  While the gas tax is being raised, also transform it from a flat rate to a PERCENTAGE of the cost at the pump.   That way, it can automatically be indexed to rise when consumption does, and some of that rise can be dedicated to filling strategic reserves and a rainy day fund, to kick in when hard times next return.

*  One of you said:
     “I sincerely hope that those who would mock Dr. Brin’s "10,000 McVeighs" prediction are paying some attention.The murder of Officer Johns at the Holocaust Museum, the murder of Dr. Tiller, the murder of five chilean students in Miramar Beach Florida by a man obsessed with "Illegals" , and now the murder of a nine year old girl and her father by the Minutemen.”   
 Alas. Folks, you ain’t seen nothing, yet.

And finally, oooog.  See why libertarianism is often its own worst enemy. What a shame.

Sunday, May 31, 2009

Solving the mess in Guantanamo

Keeping my number of political postings to a bare minimum, let’s just make a potpourri-pile of topical observations.

== Quoting Obama on Transparency ==

“And so, whenever we cannot release certain information to the public for valid national security reasons, I will insist that there is oversight of my actions - by Congress or by the courts.

“..... Because in our system of checks and balances, someone must always watch over the watchers - especially when it comes to sensitive information.

“Along those same lines, my Administration is also confronting challenges to what is known as the "State Secrets" privilege... while this principle is absolutely necessary to protect national security, I am concerned that it has been over-used. We must not protect information merely because it reveals the violation of a law or embarrasses the government. That is why my Administration is nearing completion of a thorough review of this practice.

“We plan to embrace several principles for reform. We will apply a stricter legal test to material that can be protected under the State Secrets privilege. We will not assert the privilege in court without first following a formal process, including review by a Justice Department committee and the personal approval of the Attorney General. Finally, each year we will voluntarily report to Congress when we have invoked the privilege and why, because there must be proper oversight of our actions.”
- Barack Obama

One of you commented upon how thoroughly this statement is  in tune with what I proposed in The Transparent Society, adding “Dr. Brin, are you writing his Speeches? ;)”

Ah... if only. Still, how nice to have an adult up there, for a change.


== And Solving Part of the Guantanamo Mess ==

The same commentor offered a suggestion that might help to get President Obama out of his bind regarding the Guantanamo detainees.  I think we can all agree that the Bushite doctrines there were dismal, loony, horrific and borderline insane.  Those so-called “pragmatists” only made matters far worse for our professional defenders, for example, by making torture legitimate for our enemies to use against our own troops.  Indeed, that alone offers probable cause to investigate charges of high treason.

On the other hand, what to do with the prisoners currently held in Guantanamo?  Or others we might capture amid a war without borders or fronts?  Many are genuinely bad or dangerous men and openly consider themselves to be enemies of the United States.  Others, to be sure, were hapless victims of circumstance, but, even after releasing those guys, President Obama seems caught between unpleasant options, when it comes to the really hard cases:

(1) bring some prisoners to America to face charges, which will be difficult to prove by civilian rules, and surely rile up any state where the trials take place,

(2) extend the duration of a somewhat gentler Guantanamo Prison, which will expose him to charges of hypocrisy and indecision,

(3) ship some of the worst off to home countries where they face likely torment and death... or else see them released to heroic welcomes and a return to plotting against our lives.

(4) Are those his only choices?   There does seem to be a fourth option, never mentioned.   It's pretty simple, as “Jester” pointed out, after a close reading of the four Geneva Conventions.

Those who have openly sworn allegiance to any entity that wages violent war against the US can legitimately be treated as Prisoners of War.

Yes, it sounds a lot like “enemy combatants.”  But that term was simply a Bushite excuse to drop every covenant that we had with decent or civilized behavior... a crazed raving offered by demagogues who tried to make us more afraid of a few hundred bozos with lice-ridden beards, than we ever were of a Soviet Union that bristled with 20,000 hydrogen bombs.  (And we let them do it, didn’t we?)

In contrast, “prisoner of war” has very clear definitions according to the Geneva conventions.  And yes, it can apply to irregular forces, even those that do not represent an official nation state.  (In any event, the Taliban government of Afghanistan was clearly an enemy state and it stood behind Al Qaeda. That regime’s continued existence in exile allows for an extended pretext.)

Calling the violent men in Guantanamo "POWs "does not mean they can be tortured.  In fact, the opposite. They must be treated according to Geneva protocols -- with red cross packages and everything else to make their existence far brighter than it was.  But it does mean they can be held indefinitely, in a military facility on American soil, so long as hostilities continue in a plausible state of war.  Moreover, there is no ticking clock to bring charges against them -- in fact, filing charges against such men might be illegal, if their actions were against even somewhat legitimate military targets.  Certainly there is no requirement to mix them with the regular population of a federal penitentiary.  In fact, that too violates Geneva.

True, this option does not apply to all of the current prisoners -- mostly those who have openly avowed that they consider themselves to be in a state of war against the US.  Moreover, they must be treated very different than they were in Guantanamo... e.g. they must be allowed to mingle with each other and garden and work and write home and appeal their conditions and all the things you see in movies like The Great Escape.  (Except for the tunneling part, we can hope!)

Still, consider how this option lets Obama & Co. off the hook!  He can end the Guantanamo travesty without letting them all go, or trying to press criminal charges that are inherently hard to stick, by civilian rules of jurisprudence.

Well, it's an idea…


==GM, Chrysler and Labor==

And... the bankruptcies of both GM and Chrysler seem to be pretty much following a path I suggested earlier (Offer a Fresh Deal to Labor and Management), sending them on a path where they’ll likely become largely employee-owned companies.  Ideally - and if they avoid repeating the (deliberately planned-in) mistakes that turned United Airlines sour - this should turn grumpy hourly workers into motivated owners, and allow American ingenuity to thrive.  It’s been a long time coming.  Both the far left and far right were nuts to oppose it for so long.

Of course, this assumes that the US government will eventually divest its huge stakes in these companies. Which raises an interesting point.

One recent rightwing talking (ranting) point is to yatter about “unprecedented socialism.”  This calumny deserves open derision.  First, because it's obvious who made our current mess, and who gave unbelievable gushers of “socialism for the rich” to their fat-cat friends -- the Bushite Gang.

Second, turning eyes toward the future, simply ask Limbaugh et al: ”What do you think Obama wants to do with all that GM stock?”

The answer is obvious, and so capitalistic it would make Adam Smith proud.  Buy low... and sell high!   Dare the ranters to take a bet.  If the federal government no longer owns these companies in 2012... and if the taxpayer by then has made a tidy profit out of buying and then selling the shares... um... is that still “socialism?”  Remember, the Limbaugh types are agile about redefining terms, focusing on the narrow moment... so ask this question now.  And nail down that wager.


=== Making a Mistake on Health Care? ===

On the other hand, I feel that President Obama’s approach to revising Health Care is not well thought-out.  Yes, we cannot take on the whole problem all at once, not in today’s economic and political environment.  But his people are urging that we continue down the road of adding layer after layer of complex insurance subsidies that will work through (and benefit) existing companies and involve a million twists and turns of bureaucracy and entitlement.  It will be maddening, inefficient and easy to ridicule.  Worse yet, it will not cut the Gordian Knot of today’s system at any level or at any point.

Elsewhere, I've offered a simple alternative. Let’s put off for another day any major reform for working-age adults.  If we have limited resources and attention, let’s not do a half-assed job across-the board, but rather take a targeted approach to solve one part of the mess, completely -- the most important part.  Let’s do an immediate and excellent job in the one area where rapid and major transformation could make the biggest immediate difference, where it matters to us all most.

Simply  provide health care to all kids.

One way to do this,, making the legislation incredibly short and simple?  Extend Medicare to the other end of the spectrum, the other demographic group that is inherently both helpless and deserving, by simple definition.  Or else, use the kids to experiment with single-payer.
 Either way, political opposition would be disarmed from the start. Americans are inherently more socialistic when it comes to children than adults (who, we think, instinctively, should stand on their own two feet.)  Moreover, this step would let us act immediately in the zones where socialized medicine inarguably works best -- prevention and lifelong health investment in youth, by far the best use of medical care dollars.

This approach then leaves for later the vexing areas where socialized medicine has inherent problems and where we might want to do some more careful thinking.  (More on this next time.)

Seriously, why isn’t this a no-brainer?  A win-win that would let Obama achieve wonders at a stroke, while keeping both cost and complexity down and achieving the greatest bang for the buck? Poor parents would be relieved of their greatest fear, for their kids. With that responsibility taken off their shoulders, they would then be better able to bargain for their own, narrower coverage.  Can anyone explain why this alternative isn’t even mentioned?


And that's enough for now.