Dr. Forbush Thinks

It drives me crazy every time I hear someone utter the factually incorrect statement that the US has the greatest healthcare in the world. I heard it again today on a radio talk show and the comment wasn’t even challenged. Of course this didn’t surprise me, because this assertion is never challenged.

Now, to be fair, there are certain ways that the USA could be ranked number one in health care. If by “best” we mean “most expensive,” then we might be in the running. However, if we would measure quality of health care as a function of healthy outcomes then the USA is not even close.

If we start by making the assumption that the goal of having a good health care system is to prolong life we might start by looking at the list of countries ranked by the number of deaths in a country per 1000 people living in the country. By looking at this list we see that the US is ranked about the center of the list ranked from highest to lowest -- 94th with a rate of about 8.1 deaths per 1000 out of over 200 countries. ( 2009 List by the CIA World Factbook) This does not tell us everything, but it does tell us that countries like Mexico have rates much lower than ours. Why?

There could be other problems just looking at this number, because some countries have younger populations than other countries. A younger country should have a lower death rate than an older country by the mere fact that everyone eventually dies. So, lets assume that the goal of health care is to allow people to live as long as possible. The measure of success then would be the life span  of the average citizen in the country. If we rank countries from the longest life span to the shortest, we find the US ends up at 50th out of over 200 countries with an expected life span of  78.11 years, while Japan finishes near the top of the list with 82.12, Australia has 81.63 and Canada 81.23. With these numbers how can anyone still argue that the US has the best health care in the World?

What exactly is a person thinking when they claim that the US has the “best” health care in the World? How do they measure best? It is true that within the borders of the USA there exists some very good health care. And, it is true that if someone has unlimited resources they would be able to have access to some of this very good health care. The problem is that many people in the US do not have access to this care. And, hence these people pull the average life expectancy of the US down.

So, if someone asserts that the US has the best health care in the World they must be asserting that their own health care is part of the elite few that have access to this advanced health care. They are also asserting that they really don’t care what happens to the population that does not have access to this elite care. Of course this is sad and selfish, but in the USA we do not have laws against being selfish and most people are numb to the suffering of others.

But, even the assertion that a person has access to the elite health care that exists in the USA is suspect. This is because many people are covered by insurance that they have only rarely used. This is because many people in the US never go to a doctor for a yearly physical. Insurance companies don’t see any benefit in having people see a doctor on a yearly basis, because it costs them money and they are in the business of collecting revenue and figuring out ways to avoid paying any money out. Insurance companies are in the business of making a profit, and any layout goes against the bottom line. It isn’t in the interest of the insurance company to care about the health of its customers. In fact, it is in their interest to see that their customers die in the cheapest way possible.

A person normally doesn’t learn the effectiveness of their insurance until the insurance is needed. And, when the insurance is needed its too late to change coverage. And, when the insurance is needed the trauma of the situation clouds ones vision of the financial picture. Many people with what they believed to be “good” insurance find themselves bankrupted and embarrassed by finding out how poor their coverage was when they needed it. This embarrassment prevents them from sharing this with their family and friends.

The silent killer in the US health care system is the fact that health care costs have been rising over the last 20 years. People may have had favorable experiences with their insurance companies over the years, but their current situation may have changed over the years. Many procedures and drugs are no longer covered under some plans. Employers are buying cheaper coverage that covers less with higher deductibles and co-payment options. This means that more money comes out of your pocket before the insurance company pays anything.

Eighteen years ago the US was already a very expensive health care system. I know this from personal experience. My daughter was born in Germany in a private hospital. I was working for a US company and therefore my US insurance would cover the hospital and delivery costs in Germany. I just needed to get the bill and send it to the insurance company. As my wife went through prenatal care and through the birth of my daughter I submitted the bills to my health insurance company. The total at the end of the process was completely covered by my health insurance. And, the company could not believe that I had submitted all of the bills in total because the cost of my wife spending an additional three days in the hospital “should cost much more” as the insurance company wrote to tell me. The German bill noted each procedure and expense in meticulous detail -- even to the extent of pointing out that I was being charged an inflated cost because we were covered by private insurance.

The question we should be asking is -- Why was there such a disparity in cost between the US system costs and services and the German system? I would assert that it must be greed in the US system. I would also assert that greed itself is not illegal, but it preys on people when they are in very vulnerable situations. Greed in health care pushes suppliers to encourage patients to over spend. The emotional situation urges the loved ones of the ill to “do whatever is possible.” There is no natural limitation to this spending except the bottom of each person’s money supply.

I know that this greed is real from another personal experience. I was involved in a project to develop one of the first MRI (magnetic resonance imaging) machines. At that time we called it NMR (nuclear magnetic resonance), because the technique actually causes the atomic nuclei to resonate. When we talked with doctors they told us many quite interesting things that gave me insight into the health care industry.

The first thing they told us was that the word nuclear needed to be dropped, because nuclear was a scary word and people would not want to subject themselves to a machine that used nuclear anything. Of course, MRI is one of the safest forms of imaging, applying a magnetic field and  electric field and measuring the magnitude of the resonance signal of particular nuclei in order to map the density of water in the body for example. This is much less dangerous than using X-rays that can cause mutations when they hit the DNA in a cell.

The next thing they told us was that the MRI pictures were three dimensional and multi colored. The colors did not look like the colors in the body, so it would be much better if we could make them look more like X-ray pictures. Obviously the doctors could not recognize the advantage of the new technology and they would prefer that the new technology was only slightly better than the older technology so that the doctors would be more likely to adopt the new technology. Obviously this is something to keep in mind whenever one takes a trip to the doctor.

And the most frightening revelation of all was that the doctors told us that they were happy that the new technology was cheaper to operate than the previous technology. But, it was new technology, therefore they could charge more for it. The most important implication was that the profit margin would be larger with the new technology.

The summary of this is that the doctors were willing to make the technology less effective, they were willing to lie to the patients by changing the name of the machine and they wanted a higher profit margin. I have to tell you that I have had a very skeptical view of all doctors because of this experience. I think that we should all be more skeptical.

When I was in Germany I noticed that the doctors were much more friendly and willing to share what they didn’t understand as well as what they did understand. I felt more connected with the process. I felt like my questions were listened too and thought about. In the US this is much less frequently the case.

Anyway, I am still very confused at the assertion that the US has the best health care in the World. If anyone knows of any evidence that supports this I would love to read it. Please tell me what you know I am all ears.





Cross Posted @ <a href="http://www.teambio.org/">Bring It On</a>, <a href="http://drforbush.tblog.com/">tblog</a>, <a href="http://drforbush.blogspot.com/">Blogger</a> and <a href="http://drforbush.blogspirit.com/">BlogSpirit</a>

<br>
<a href="http://technorati.com/tag/Reflection" rel="tag">Reflection</a>

It drives me crazy every time I hear someone utter the factually incorrect statement that the US has the greatest healthcare in the world. I heard it again today on a radio talk show and the comment wasn’t even challenged. Of course this didn’t surprise me, because this assertion is never challenged.

Now, to be fair, there are certain ways that the USA could be ranked number one in health care. If by “best” we mean “most expensive,” then we might be in the running. However, if we would measure quality of health care as a function of healthy outcomes then the USA is not even close.

If we start by making the assumption that the goal of having a good health care system is to prolong life we might start by looking at the list of countries ranked by the number of deaths in a country per 1000 people living in the country. By looking at this list we see that the US is ranked about the center of the list ranked from highest to lowest -- 94th with a rate of about 8.1 deaths per 1000 out of over 200 countries. ( 2009 List by the CIA World Factbook) This does not tell us everything, but it does tell us that countries like Mexico have rates much lower than ours. Why?

There could be other problems just looking at this number, because some countries have younger populations than other countries. A younger country should have a lower death rate than an older country by the mere fact that everyone eventually dies. So, lets assume that the goal of health care is to allow people to live as long as possible. The measure of success then would be the life span  of the average citizen in the country. If we rank countries from the longest life span to the shortest, we find the US ends up at 50th out of over 200 countries with an expected life span of  78.11 years, while Japan finishes near the top of the list with 82.12, Australia has 81.63 and Canada 81.23. With these numbers how can anyone still argue that the US has the best health care in the World?

What exactly is a person thinking when they claim that the US has the “best” health care in the World? How do they measure best? It is true that within the borders of the USA there exists some very good health care. And, it is true that if someone has unlimited resources they would be able to have access to some of this very good health care. The problem is that many people in the US do not have access to this care. And, hence these people pull the average life expectancy of the US down.

So, if someone asserts that the US has the best health care in the World they must be asserting that their own health care is part of the elite few that have access to this advanced health care. They are also asserting that they really don’t care what happens to the population that does not have access to this elite care. Of course this is sad and selfish, but in the USA we do not have laws against being selfish and most people are numb to the suffering of others.

But, even the assertion that a person has access to the elite health care that exists in the USA is suspect. This is because many people are covered by insurance that they have only rarely used. This is because many people in the US never go to a doctor for a yearly physical. Insurance companies don’t see any benefit in having people see a doctor on a yearly basis, because it costs them money and they are in the business of collecting revenue and figuring out ways to avoid paying any money out. Insurance companies are in the business of making a profit, and any layout goes against the bottom line. It isn’t in the interest of the insurance company to care about the health of its customers. In fact, it is in their interest to see that their customers die in the cheapest way possible.

A person normally doesn’t learn the effectiveness of their insurance until the insurance is needed. And, when the insurance is needed its too late to change coverage. And, when the insurance is needed the trauma of the situation clouds ones vision of the financial picture. Many people with what they believed to be “good” insurance find themselves bankrupted and embarrassed by finding out how poor their coverage was when they needed it. This embarrassment prevents them from sharing this with their family and friends.

The silent killer in the US health care system is the fact that health care costs have been rising over the last 20 years. People may have had favorable experiences with their insurance companies over the years, but their current situation may have changed over the years. Many procedures and drugs are no longer covered under some plans. Employers are buying cheaper coverage that covers less with higher deductibles and co-payment options. This means that more money comes out of your pocket before the insurance company pays anything.

Eighteen years ago the US was already a very expensive health care system. I know this from personal experience. My daughter was born in Germany in a private hospital. I was working for a US company and therefore my US insurance would cover the hospital and delivery costs in Germany. I just needed to get the bill and send it to the insurance company. As my wife went through prenatal care and through the birth of my daughter I submitted the bills to my health insurance company. The total at the end of the process was completely covered by my health insurance. And, the company could not believe that I had submitted all of the bills in total because the cost of my wife spending an additional three days in the hospital “should cost much more” as the insurance company wrote to tell me. The German bill noted each procedure and expense in meticulous detail -- even to the extent of pointing out that I was being charged an inflated cost because we were covered by private insurance.

The question we should be asking is -- Why was there such a disparity in cost between the US system costs and services and the German system? I would assert that it must be greed in the US system. I would also assert that greed itself is not illegal, but it preys on people when they are in very vulnerable situations. Greed in health care pushes suppliers to encourage patients to over spend. The emotional situation urges the loved ones of the ill to “do whatever is possible.” There is no natural limitation to this spending except the bottom of each person’s money supply.

I know that this greed is real from another personal experience. I was involved in a project to develop one of the first MRI (magnetic resonance imaging) machines. At that time we called it NMR (nuclear magnetic resonance), because the technique actually causes the atomic nuclei to resonate. When we talked with doctors they told us many quite interesting things that gave me insight into the health care industry.

The first thing they told us was that the word nuclear needed to be dropped, because nuclear was a scary word and people would not want to subject themselves to a machine that used nuclear anything. Of course, MRI is one of the safest forms of imaging, applying a magnetic field and  electric field and measuring the magnitude of the resonance signal of particular nuclei in order to map the density of water in the body for example. This is much less dangerous than using X-rays that can cause mutations when they hit the DNA in a cell.

The next thing they told us was that the MRI pictures were three dimensional and multi colored. The colors did not look like the colors in the body, so it would be much better if we could make them look more like X-ray pictures. Obviously the doctors could not recognize the advantage of the new technology and they would prefer that the new technology was only slightly better than the older technology so that the doctors would be more likely to adopt the new technology. Obviously this is something to keep in mind whenever one takes a trip to the doctor.

And the most frightening revelation of all was that the doctors told us that they were happy that the new technology was cheaper to operate than the previous technology. But, it was new technology, therefore they could charge more for it. The most important implication was that the profit margin would be larger with the new technology.

The summary of this is that the doctors were willing to make the technology less effective, they were willing to lie to the patients by changing the name of the machine and they wanted a higher profit margin. I have to tell you that I have had a very skeptical view of all doctors because of this experience. I think that we should all be more skeptical.

When I was in Germany I noticed that the doctors were much more friendly and willing to share what they didn’t understand as well as what they did understand. I felt more connected with the process. I felt like my questions were listened too and thought about. In the US this is much less frequently the case.

Anyway, I am still very confused at the assertion that the US has the best health care in the World. If anyone knows of any evidence that supports this I would love to read it. Please tell me what you know I am all ears.





Cross Posted @ <a href="http://www.teambio.org/">Bring It On</a>, <a href="http://drforbush.tblog.com/">tblog</a>, <a href="http://drforbush.blogspot.com/">Blogger</a> and <a href="http://drforbush.blogspirit.com/">BlogSpirit</a>

<br>
<a href="http://technorati.com/tag/Reflection" rel="tag">Reflection</a>

One of the fundamental differences between English Law and American Law is the presumption of innocence until proven guilty. The Bush administration has fought continuously over the last seven years to erode this fundamental right.

The Bush crew has used fear to gradually work the American public into accepting the idea that the government knows better who is guilty and who is innocent. You would think that people on the right who fear that the government might take their weapons away would also fear this new threat. However, the conservatives’ self-righteousness has been able mask this fear. Conservatives tell themselves that they are above the law because they are good patriotic Americans. Obviously they should not fear that a government might choose to arrest them and hold them indefinitely.

Progressives know this fear a bit more personally. This is because progressives and conservatives don’t always show their opposition to the government in the same way. Progressives most notably tend to gather great numbers of people to stand outside events where the opposition is gathering. Progressives like Amy Goodman who is a reporter for a “real” left wing media program “Democracy Now - The War and Peace Report” have experienced guilt by association directly. She was reporting in the left wing protests at the Republican convention during August and she was beaten and thrown into jail with some of the protesters. She was with the protesters, therefore she must be one was the attitude of the police. This was a sad day in American history, and it got very little coverage in the mainstream media. How liberal is this media?

Any American from the left or right should shudder at the telling of this story. Eventually she was freed and not considered a terrorist. That may have been because she was palling around with liberal protesters and not a former 1960’s radical. Obviously there is some standard for this guilt by association that I really don’t understand. Are you guilty if you aid and abet a person who bombs abortion clinics, the Atlanta Olympics and then hide in the woods for a number of years? Are you guilty if you meet with a man that had been found guilty of a felony, served his time, changed his life and has become a force for good in his community? In the first case many pro-life supporters helped a wanted fugitive hide from the authorities while in the second case people are urged to question a presidential candidate’s ulterior motives.

Guilt by association works both ways so it makes sense that this form of slander should not be assumed to only work against your enemy. If we also consider the six degrees of separation that suggests that we are separated by as few as six contacts from any person in the country or perhaps the world we have a further need to worry about this dangerous concept of guilt by association. Where does it end? If someone you know has “palled around with terrorists” does that make them a terrorist by association. If they are a terrorist then doesn’t that make you one too?

In Biblical times guilt by association was one of the rules. People believed that they were punished directly for their sins. For example when we read about the man who was blind from birth Jesus is asked what sin he or his parents had committed. Isn’t this another form of guilt by association? Today’s Christians should remember that not only did Jesus heal this man, but he also pointed out that this man was not born blind as a punishment for either his sin or his parent’s sin.

And, what types of groups do we consider a danger to our national security? For example, a group that seeks secede portions of the country threatens the very makeup of our country. These groups exist around the country with various motivations and ideologies. Some of these groups lament the fall of the Confederacy and would like nothing better than for a new South to rise again. It would be hard to argue that a group that seeks to tear the fabric of the country apart would not be a terrorist group. After all, the main motivation behind this group is the destruction of the country, our country -- The USA.

A similar group exists in Alaska where a group would like to make Alaska an independent country. And interesting point here is that Sarah Palin, governor of the state of Alaska and current Republican Vice Presidential candidate has a husband that not only pals around with this group of secessionists but he is an active member. Perhaps we should not condemn Sarah Palin as a member of this group for merely associating with her husband. However, we should also consider the fact that Mrs. Palin does not just pal around with these people, but she also supports their cause as evidenced by her address to the secessionist party’s convention. Shouldn’t question Sarah Palin’s terrorist connections to these people?

The point of this diatribe today is to point out that it doesn’t matter if you talk to a liar, it does not make you a liar by association. If you share a meal with a thief as Jesus did, it does not make you a thief by association. If you have a business meeting with a former radical that has repented and served his punishment it does not make you a radical. The only way to prove that you are guilty of a crime is to prove it with the evidence -- Like a speech in front of radicals supporting their cause.






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Don't forget what Stephen Colbert said, "Reality has a well-known liberal bias."


Cross Posted @ Bring It On, tblog, Blogger and BlogSpirit



Reflection

It’s not what you have, but what you believe you can have that drives the American economy.

We should all understand that Republican fiscal ideology is focused on benefits for the wealthy. It costs the wealthy too much to help out those down on their luck, so we shouldn’t do it is the Republican mantra. However, in marketing this to the common man the Republicans normally drop “the wealthy” modifier and change “down on their luck” to “welfare cheating scum buckets” or some other derogatory adjective.

As Senator Phil Gram, the former Texas A&M economics professor, tells us that the economy is not as bad as we are imagining. Senator Gram said, “We have sort of become a nation of whiners. You just hear this constant whining, complaining about a loss of competitiveness, America in decline despite a major export boom that is the primary reason that growth continues in the economy.” Now, Senator Gram is pulling a Republican fast one on us here. What is more important to the average man, being able to feed his family or Apple being able to make a huge profit selling more iPods? If the man is an executive at Apple then the question is one and the same, but if he isn’t there will be layers of a complex economy clouding the issue.

If your paycheck has been constant over the last few years, and the price of gasoline and food have gone up, then you will be feeling the pinch. If your pay check has gone up by more than the cost of gasoline and food over the last few years, then I would venture to guess that you aren’t hurting so bad. So, I’ll ask - is Senator Gram right when he says, “the constant drubbing of the media on the economy's problems is one reason people have lost confidence.” Maybe it is one reason, but I’m guessing that to those on the lower end of the economic scale will be feeling more than what they are told by the media.

In America, though, we have some expectations when it comes to economic status. Expectations may be good, and they may be bad. Either way we need to remember that they are expectations and not reality. In fact success in America is measured by certain expectations. If a person meets or exceeds those expectations we have celebrations and fan fare. And, when those expectations are not met, then a person’s fiscal failings are kept in the shadows, something that we would rather not talk about. Fiscal failings are considered a source of embarrassment for the man down on his luck. But, if this information is kept hidden and not spoken about, then no one really knows if the expectations are even reasonable.

In America people have accepted that they should be better off in every proceeding year from the last. A small cost of living raise serves as an illusion to this expectation, while it shows a rising wage, it doesn’t always even match inflation. When a company is doing well they will often compensate the employees, but these compensations aren’t always justified in their distributions. Truth be told, fiscal failings behind common expectations are the rule rather than the exception. Americans have discovered how to continue the illusion in the face of this failure to meet expectations. Americans have taken to borrowing money in order to appear that they have exceeded expectations.

American expectations plaque the American economy in many ways.

The entire mortgage crisis that has recently burst the housing market bubble was caused by people meaning to appear to meet the expectations of the American dream. People bought into the idea that things were going to be better further down the road. They deluded themselves into believing that five years down the road they would be able to pay the mortgage when the payment jumped in their sub-prime loan.

Let me take the example of our neighbors, who confided recently that they will be moving out of their house. Five years ago when they bought the house they were able to do so by borrowing the money at a low interest rate. Even with that low interest rate they still had to make a $3000 per month mortgage payment. I don’t really know what they were thinking when they were told that in five years the payment would jump to $6000 per month. They were able to make the $3000 per month payments by having several families live in the same house and pool their resources. In addition one of the women in the house opened a day care in the house to take care of the children a raise a bit of extra cash. I could imagine that they might have been thinking that they could increase the number of children that they took in to significantly defray the cost when the payment jumped. They could have been thinking that they would all be making double their wages in five years and hence have the additional money needed when the payment jumped. Maybe they were thinking that they could double the number of occupants in the house over the next five years so that they could make the payment when it doubled. I don’t know what they were thinking, but whatever it was they were not able to make it happen; so they will be moving out of their house shortly.

The whole story above was forced into play by unreasonable expectations. The people moved into that house because they had expectations that they should be living in this house that was beyond their means. But, in America we have expectations that anyone should be able to “make it” if they work hard. They people living in this house accepted those expectations and proceeded the best way they knew. They set up an illegal day care and tried to make some extra cash. They work extra long hours putting in as many as they could, leaving in the morning before sunrise and getting home long after sunset. The main obstacle was not motivation or ingenuity. Their main obstacle was the expectation.

Expecting success often delivers success. A person is often motivated to work hard just believing that success will find a way. Many people, myself included, have operated under this premise. The ugly truth, however, is that many people also fail to meet these expectations following these same principles. Success or failure is not conditioned on how much work is put into an endeavor. Success or failure happens for many unforeseen reasons. And, because the reasons are unforeseen each individual that succeeds succeeds mainly because of luck. And, the entire concept of success is nestled in the expectations for the endeavor itself.

So, American entrepreneurial spirit is based on expectations. Entrepreneurs expect to invest time, energy and resources into a risky venture and succeed in producing something new and novel. This type of expectation is good for America and infects the American society with the can-do rags-to-riches mentality. But, if everyone in the country comes to expect that they to can become wealthy by selling shlock that no one wants or needs to the next guy, then that entrepreneurial spirit has changed from a net positive to a net negative for American society as a whole. And, the only real thing that has changed in this equation is the expectation. People once believed that innovation was a key to make a new product worthwhile has been changed into the belief that slick marketing can sell any old crap to anyone and make the seller wealthy. People won’t by crap was once the counter to this argument. But the real life counter example to that argument is how many people bought Windows computers and operating systems instead of much better alternatives such as Unix. The legacy lives on unfortunately. Marketing outmaneuvers substance.

Marketing after all is all about expectations. Marketing starts out by telling you what you should expect, then it claims to fill that expectation with the perfect product. Since America is the capital of the capitalist world we shouldn’t expect anything different than the marketing of many unfulfilled expectations and products that can’t fill them.

Since the Great Depression and FDR calling for Americans to expect a chicken in every pot our expectations have continued to grow with American marketing machine. Chickens in our pots, Cars in our garages, houses on our golf courses and yachts on our rivers and lakes we finally expect that we should control the world itself. Obviously we can always create expectations that are higher than we can realistically achieve and we most likely will continue to do so. And, when we do so how will we be able to know which expectations are reasonable and which ones are not?

Well, perhaps Senator Gram has an answer for that as well. When he lashes out and calls us a nation of whiners, then perhaps we will know that our expectations are a bit too high. Or, perhaps his expectations are too low?



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Don't forget what Stephen Colbert said, "Reality has a well-known liberal bias."


Cross Posted @ Bring It On, tblog, Blogger and BlogSpirit



Reflection

Today Paul Krugman once again points out that the Republican party has only two solutions to problems - Tax cuts and deregulation or ignoring the problem hoping that it will go away.

Of course ignoring a problem and hoping that it will go away is not a solution. But if you can convince enough voters to ignore the problem along with you then at least you can win elections, control the government and eventually control the information going out to the public.

The Bush administration does this every day with the news from Iraq. How many pictures of coffins do we see coming out of the bellies of the planes coming back from Iraq? None! The reason for this is the simple party line - “its bad news, so ignore it until we have good news.”

The whole surge issue started with an increase in the numbers of deaths and injuries, both to Americans and Iraqi civilians. But, the administration did the best to ignore it, and at best admitted it saying that things would get better when the surge started to “work.”

Well, it’s a year later and the surge is supposed to be finished. The troops are supposed to be drawn down and the Iraqi government is supposed to step up and take over. Well, the reality is that “the enemy” went into hiatus and simply waited until the Americans finished their silly surge. And, now that it is ending those who are against America’s puppet government are slowly waking up and beginning where they left off before the surge began. If the US spent a little more time working with all the political forces in the country, instead of using force to make Iraq do what America believes is best maybe things would be different. But, the current administration doesn’t want you to see that. They continue to be in denial about what the solution must be. They don’t want to even admit to ant wrong doing when the whole situation could have been prevented in the first place.

But the administration is in denial about so many other things as well. Mainly it seems to be a fact that the Bush government is a faith based government. You are supposed to put faith in your government or else you are not being patriotic. Too many people bought into this in 2004 and re-elected George W Bush. Unfortunately we are stuck with this idiot for a few more months. But, if we work together to point out what the Republicans continue to deny then we may have enough people to vote to end this ridiculous ostrich policy.

Paul points out that the health care system is falling apart as we sit here and type. They believe that a market system will fix everything. But, there is a slight problem with markets. Markets react to what the average person is willing to pay for a service. So, I ask you one simple question, how much is your health worth to you? Are you willing to pay your entire family estate to make yourself live a few years longer - given there is a cure. So, given the fact that most people are willing to give up all of their money to live longer, then the price of health care will rise until all of our wealth is spent and health care providers possess all of the wealth. What other possible limiting factor is there? Why would people pay less than they have and decide to die sooner? The average cost of health care will always rise to mean wealth of the country. Health care providers will end up being the only people able to afford health care. If you disagree, then please tell me what will limit the cost of health care in a free market.

The only solution is to limit the market in some way. We can provide less health care, then people would not be able to purchase health care when they need it, thereby conserving wealth. We could allow everyone to become a health care provider and competition would tend to limit the price. Basically we would learn to take care of ourselves. Or, we could mandate maximum prices that health care providers would be able to charge for services. This would limit expenditure and reserve cash for other purposes.

The bottom line is that a free market health care system rations health care to those who can afford it, until they spend all of their money and whatever that they are allowed to borrow until they are forced out of the health care system surrendering that spot to the next guy in line. We could ration health care to the wealthy, or we could ration health care to the sickest, or we could ration health care to the most deserving. In the end health care is limited by the supply. If we maximize the supply and ration to the deserving we end up with the fairest system. Anything else is inherently unfair.






-----------------------------------------------------





Don't forget what Stephen Colbert said, "Reality has a well-known liberal bias."


Cross Posted @ Bring It On, tblog, Blogger and BlogSpirit



Reflection

Last week I ventured on a business trip to the middle of the country. St. Louis is a major American city based on the fact that it offers major league sports teams. However, when you compare the city of St. Louis to many other American cities it seems to be a little more “laid back.” When I suggested this idea to a friend he asked, “By laid back do you mean - nothing is going on?” I actually believe that something is going on, it is just going on a bit slower than in other areas of the country.

Missouri is the “Show Me” state. Basically this self-assigned reputation suggests that people in Missouri are born skeptics. However, I don’t believe that Missourians are skeptics in all areas at all. Instead, as a casual observer it seems more likely that people from this state tend to be set in their ways until they are show to do things another way. Now, stereotypes are generally frowned upon by those who are politically correct, but when you walk into a new place and everyone is behaving in such a strange and universal way it is hard to not believe in stereotypes to some extent. In fact, the idea that people from certain places behaving in certain ways would be strongly supported by the cultural influence in an area effects the population. People who move from these areas take their culture with them as well as their genetic pool.

Missouri is also one of those states that will most likely play a significant role in the 2008 election. Missouri is also a state with a history of racial issues. For example, the Dred Scott case was argued in St. Louis. Therefore it tends to be important to understand how the people in this “compromise state” might feel toward the possibility of Barack Obama being elected to the highest office in the land.

The first Missourian I asked about Barack Obama laughed at me. Of course this fresh graduate from Mizzou was extremely drink and would laugh at just about anything she did have a serious disbelief in the possibility of a person of color being elected president. As I proceeded to ask her if she had heard any of his speeches, or knew what he stood for she drew a blank. She was aware that there was no possible way that any of her friends would vote for him. At that point I was happy to learn that she was not registered to vote.

Well, I didn’t feel very encouraged after listening to this (what do you call a person from Mizzou?) person tell me “the facts of life” in Missouri.

The next person that I questioned about the 2008 election wasn’t exactly from Missouri. And, since this was an informal survey that actually means nothing I will tell you what he said anyway. I began by suggesting that of course he must have voted for Barrack in the primary election, and he laughed in my face again. (I guess this is bound to happen when one spends time in the bar.) When he collected himself he asked me “In the month after 9/11 back in 2001 could you have ever imagined that we would have a black Muslim running for President of the United States?”

Well, what other answer could I have for this obviously misinformed question than, “Of course, I expected that would be the next step in our political culture.”

When this man was caught off guard by my response he said, “Hey, you aren’t being honest with me!”

Then I was able to say, “Well, that’s because you weren’t being honest with me. Barrack Obama is not a Muslim. In fact, the problem that he is currently having pertains to his membership in a Baptist church. And, last I knew the Baptist religion is a Christian denomination.”

Of course arguing with a drunk is never likely to be productive. But it does tend to bring to the surface one of the problems that our country still needs to solve. Clear lies and misinformation will continue to plague this election. Whispered innuendo will be a major force that will continue to work against what would be best for our country.

Of course the person I was arguing with was a working class person that would benefit economically from the election of Barack Obama more than the election of either of the other two candidates. However, the economic interest of the upper class is being served by the prejudice of the lower class. This tends to be a convenient circumstance for the upper class, because they would never dare to bring it up and expose their advantage. And, when people have been raised in a culture of racism then that racism is an undercurrent that seems to be acceptable within that culture.

My daughter recently returned from a trip to Texas. Being raised in California and having friends from many different racial groups she found her experience shocking. She was in the process of visiting different schools in an effort to choose a university to attend after graduation. Most likely just because her parents graduated from Texas A&M she felt an obligation to tour this campus. The non-diversity of that school was shocking, and she announced that it was highly unlikely that she would be able to attend that school. Her host, somewhat surprised, said, “Why? You’re white and you’re not a lesbian, so you would fit in just fine.” My daughter couldn’t even grasp the comment. She must have told us this story twenty times just trying to understand where these people were coming from.

But, the rest of the country might be a bit more like the center of the country rather than the coasts. And, because of this we are in need of a major national discussion on racism. And, I offer these points as just another effort to push this conversation forward.




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Don't forget what Stephen Colbert said, "Reality has a well-known liberal bias."


Cross Posted @ Bring It On, tblog, Blogger and BlogSpirit



Reflection

What should America’s foreign policy be?

I just finished “reading” “Charlie Wilson’s War.” I actually listened to the audio version of it on my way back and forth to work over the last week. I highly recommend it to anyone who wonders how our government works. The book details quite a few examples of why politicians do what they do as opposed to what they say in public.

The story of our involvement in Afghanistan and the historical context around it brings up a very interesting question. If America really hated communism or socialism, why were the Republicans so dead set on the Nicaragua War and the Democrats so dead set against it? And why was the converse true of the Afghanistan War?

People who haven’t seen the movie or read the book might be surprised to discover that Charlie Wilson was a Democrat from Texas. He was actually known as the “Liberal from Lufkin.” So, why did Charlie find the Afghan cause so important and the Contra effort such a lost cause?

The answer lies in the true nature of these two different wars and in the basic ideology of the Democrats and Republicans.

The Nicaragua War began when Somaza the dictator of Nicaragua, from a merger of wealthy coffee plantation family and other wealthy families was overthrown by a group of people who organized because of the abuse they suffered under this government. The overthrow could have been viewed as a liberation of the people from the oppression of the upper class. But, because the wealthy in America fear the common people they were eager to restore this wealthy family back to power. In order to do this they hired soldiers of fortune - the Contra to fight against the new Sandinista government.

The Afghan War began when the Soviet Union marched into Afghanistan and took over the government. The country was poor and not ruled by anyone possessing huge wealth. The Soviet Union mainly wanted territory and eventually access to a port on the Indian Ocean. But, in Afghanistan the Afghan people rose up en masse to fight the occupation of this land. These people didn’t need to be paid to fight, because they would gladly give their lives to fight the Soviet Union to the death.

These wars began roughly the same time in 1979, but the Republicans quickly backed the Nicaragua Contras while Charlie Wilson, the Democrat in Congress, sought to back the Afghanis. By looking at how those two wars started it is quite clear why one party backed one war while the other party backed the other. What does justice mean? Is justice protecting your ill-gotten gains or is it protecting your freedom? Obviously each political party here in the United States has its own interpretation. One war was to restore a wealthy family to power while the other war was to win freedom for a country that was overthrown by our direct cold war enemy - the Soviets. Which war was the more noble war? Which war was a war for freedom? Which war was for the people?

It is funny (or maybe sad) to think about how the Republicans have somehow inherited the caricature of the party that is willing to fight for freedom and liberty to defend our country, when they actually don’t act that way at all. A war for freedom and liberty isn’t really worth the fight in the minds of the Republican party. But, when real assets are involved, then the Republicans jump on the band wagon waving their pitchforks shouting “kill the beast.” In reality Democrats seem to act to protect our country in a more reasonable and rational way most of the time. When they are swayed to jump into the fight it seems to be when the plight of the people is in danger. Charlie Wilson went to bat for the Afghanis when no one else cared about them. He saw a noble people fighting to free themselves from oppression. This is the same fight that many working class Americans battle day to day because they have no choice; they need to feed their families. Hopefully, as these stories are retold and the truth bubbles to the surface we will see the true colors of the American political parties when it comes to defending our country.

When we put the Iraq War in the light of these two wars fought at roughly the same time we see how a Republican congress and a Republican President used their power to manipulate the facts to present their case for war. Their motives seem to be quite clear in this light. The Iraq War has nothing to do with winning freedom from the oppression of Saddam Hussein as many Republicans would have you believe. It is obviously for the control of Iraqi oil. Well, Ok I already knew that years ago, but it is always comforting to see additional evidence backing a theory. Although evidence mounts some people will never believe that whoever they support could ever do anything wrong.

Like a said above, this book is a must read. It goes into the nuance details of how this politician with a noble goal in mind could not realize when his war was beginning to go wrong. And, by wrong I mean that the CIA support against the Soviets turned into fuel for internal conflict in Afghanistan. The result put the Taliban in power and created terrorist camps. Charlie Wilson and the CIA remained blinded by the perception of the nobility of those they supported although the extremism that beat the Soviets was slowly being turned against the United States. They believed that if they were able to bring down one super power, they could surely bring down the other, because “God is the only superpower!”

When I start hearing words tied to actions like that I begin to worry. The mind of the person who says these things is convinced not only that God is all powerful. That part I am OK with. But they also imply a second part that says I am doing Gods will. The flaw is that the person acting believes that they know what God’s will is. This frightening thought process is not only a part of the Islamic religious ideology. It is a part of fundamentalist religious ideology. Not all Muslims are fundamentalists. Just like not all Christians are fundamentalists. But, all fundamentalists have this belief that they are doing God’s will and therefore nothing can stop them from doing it. And that’s why George W Bush’s claim that he is doing God’s will in the Middle East is so frightening. Eight more months!




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Don't forget what Stephen Colbert said, "Reality has a well-known liberal bias."


Cross Posted @ Bring It On, tblog, Blogger and BlogSpirit



Reflection

I have written before that in general conservatives operate on fear while liberals operate out of necessity.

Let me briefly review this idea. In general conservatives are the successful wealthy business people who fear losing what they have - money. Or, conservatives are the morally upright religious zealots who fear that society could go down the toilet at any moment. These two groups represent the majority of conservatives. Progressives however, feel that the world has already caved in all around them. Progress is anything that can help them dig out of this mess. Progressives are willing to try almost anything to fix the problems in society, while conservatives fear that anything new will lead to the downfall of everything they have come to love.

Since the people who are happy with the way things currently are is usually a smaller number than those who believe that they are up to their necks in shit conservatives needed to craft a way to convince those in need to vote to change things to the way they have been. The idea that change back to the “old ways” was a progressive change was championed by the Reagan revolution. Fear and progressive change have been the guiding principles of American politics for a long time.

Well, it actually turns out that the majority of people actually reside somewhere in the middle. These moderates fear change that is too rapid, but they want some change to help them out of the doldrums. For these people “fear” and “change” are words that can move them to support a candidate. Reagan used “change” to move these people to his side. George W Bush used “fear” to keep them there in 2004.

The truth of the matter is that we should worry a bit about change. But, we should also recognize that change can happen for the better.

It is easy for people to become fearful of terrorism. Obviously seeing 3000 people killed in one day in an orchestrated terrorist effort is scary. I don’t need to say this, but we all know that death is a bad thing. But, death does not only come from terrorist attacks. Death comes in many preventable ways. And, progress happens when we can reduce unnecessary death no matter where it comes from.

But, how can we know which efforts to defeat unnecessary death should be taken on, and which efforts should not? We have limited resources and we can only do so much. This is known as risk. We can calculate risk by what we observe. For example, we can count the number of people killed by terrorist attacks and divide by the number of years that we examine. We can quickly see that even before the security measures taken on by the government we have had relatively few people die in terrorist attacks per year. We can compare this to automobile accidents and we quickly realize that driving our cars is much riskier than going back to our old level of security before 9/11/2001.

But, fear rules and conservatives are controlled by their fear. Our conservative government has told us to be afraid and to do whatever we can no matter what the cost in order to protect ourselves from terrorism. We have spent billions of dollars in Iraq fighting a war out of the fear that terrorist will attack us again. We have spent billions of dollars trying to prevent terrorist attacks that rarely happen. We could calculate how many lives have been saved by counting the number of deaths due to terrorism occurring in the seven years leading up to 9/11 and compare that to the number of lives lost in the prevention of terrorism since 9/11. We can include the amount of money spent and we will quickly come to the realization that we have lost more lives and spent more money based on irrational fear than before 9/11. The risk of terrorism was small and it is still small. We have lost more lives. It is almost as if we are paying terrorists to kill our soldiers. If we used a balance sheet that would be the conclusion.

But, the sad and frustrating part of this wasted effort is that the money could have gone to save lives instead. One example is our health care system. It turns out that roughly 18,000 people die each year because of lack of health care. That is equivalent to six 9/11s per year. Many of these people could have been saved if they had the health care that a civilized country like the United States has available to every citizen. With preventative care and regular checkups many lives could be saved or enhanced. The billions of dollars that we are wasting in Iraq to bring that country up to the twenty-first century could have been used to bring our poor and needy up to this century instead.

The foes of open borders continue to complain that immigrants too easily have access to services provided by our country. However, we freely give this same aid to Iraqis in an effort to appease them so that they will not join the insurgents. This may be working, but if we weren’t their in the first place it wouldn’t have even been an issue. And, if we had assessed to risks in a proper way we would never have gone into Iraq anyway.

Fear can be tempered by considering the risk involved. Fear of driving to and from work is almost zero for most commuters. The risk of this drive is far greater than to probability of being attacked by a terrorist. Roads could be made safer, but fear has persuaded the hand of government to spend more money on the terrorist “threat” and less on our roads.

The biggest problem that we face is not terrorism, or roads, or even health care. The biggest problem that we face is the education of our children. It turns out that we could make very good decisions based on the calculation of risk. However, our education system has cheated so many people in our society from having a useful education that politicians, if they actually can think, are able to persuade the public to fear risks that are as tiny as the threat of another terrorist attack. If we don’t educate our society to think, we will surely become a society where the wealthy and well-to-do minority will be able to control the rest of us through our ignorance. The erosion of our education system will ensure that any progress that we have made over the last 50-some years will erode as well.











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Don't forget what Stephen Colbert said, "Reality has a well-known liberal bias."


Cross Posted @ Bring It On, tblog, Blogger and BlogSpirit



Reflection

Tomorrow I get to vote. I actually get to vote in an election that actually may effect the outcome of the American political process.

Twenty-some years ago I was in college when Harold Washington won the Democrat mayoral primary to become mayor of Chicago. Well, at least that’s what I was told as many exuberant Chicagoans ran through the dorms announcing that the first African-American had become mayor of Chicago.

I began to think about this recently as we are on the brink of such a similar historic event. I lived in a Cleveland, Ohio suburb when people like Dennis Kucinich and Carl Stokes were mayors of that town. At the time Harold Washington’s coronation as King of Chicago didn’t seem like such a big deal to me, an outsider to the windy city. When I finally read the news and discovered that his winning of the primary was only the first step - he had to win the general election I continued to be confused about this thing they called Chicago politics.

Politics is a funny thing. People think that they understand the way politics works until it doesn’t work like that any more. Hillary Clinton was able to pull off a surprising victory over Barack Obama in the New Hampshire primary by simply shedding a tear. On the other hand four years ago Howard Dean won the New Hampshire primary and lost that nomination on the same night with his historic scream of exuberance. Confidence is a good thing but overconfidence soon becomes arrogance. And excitement soon becomes perceived as lunacy.

Perception influences more votes than any other aspect of a candidate. Perception is a powerful tool that can be used to lead a nation. In a perfect world there is a correlation between perception and reality. However, we don’t live in a perfect world. George W Bush and Karl Rove taught us that, if we didn’t know it before.

Harold Washington was an inspiration to many people who admired the struggle against adversity to achieve political power. However, Harold Washington also died of a heart attack that was most likely induced by the cocaine that was found in his bloodstream at the time of his death. People can be both an inspiration and a poor role model. Thomas Jefferson and George Washington advocated freedom and liberty while they were both slave owners. Being perfect is a very high ideal.

When we look for our next leader, and as I said I must cast my vote tomorrow, we can only know what we perceive a candidate to be. We are always short of the total picture of any candidate. The Chicagoans that voted for Harold Washington never knew that he had a cocaine habit. Instead, the perception that elected Mayor Washington was the perception that he understood the voters and he would fix the problems that the voters needed to be fixed. Because he was an African-American it was assumed that he had lived a life that a typical African American had lived, whether that was true or not. And, some people who where not African American feared that anyone who had experienced these inequalities in society was bound to take advantage of the power of the office of mayor to take retribution. Obviously this is a sad state of affairs when one group believes that there was a group of people that had been mistreated and a representative of that group might use power to seek retribution. Both the knowledge of mistreatment and the assumption of retribution are sad commentaries on our society.

Slowly our society is learning that people don’t necessarily take retribution when they win power. And, we are also learning that people we once thought that we could trust not to abuse political power surprising do abuse their power, like the current administration. How can we protect ourselves from people that would abuse their power? After all, this is the aspect that most of us fear the most about our government. We look for hints when we see these politicians up close and in person. We suspect politicians when they manipulate the facts on the campaign trail, because this type of manipulation makes us wonder what else they might manipulate.

So, I have determined that I will cast my vote for Barack Obama tomorrow. When I see Hillary shedding a tear the day before a vote and miraculously winning the New Hampshire primary it seems a bit too manipulative. When I see her do the same thing this weekend right before the big Super Tuesday primary it seems just a bit too unlikely to not be planned. But, this is not the sole incidence of Hillary’s continued perception of manipulation. I saw her take the easy way out when she voted to attack Iraq back in 2003. I saw her craft her presentation in such a way that she carefully doesn’t commit to anything in an effort not to lose any potential voters. She mirrors the same manipulative behaviour that I have despised in the Bush administration from the beginning. She may be on the left side of the political aisle, but she seems to be on the same side of the obfuscation partition. I really don’t want to have another deceptive presidency. I don’t think that any of us do.

Of course it really is hard to know if Barack is just better at hiding his manipulation. After all, many people still believe that George W Bush is as honest as the day is long. Currently that number of people might be down to 17% of the population. But, 17% of 300 million is still a lot of people - 51 million. And 51 million people can still influence a lot of power in this country, especially if there are dollars attached to those people. So, regardless of whether Barack is able to manipulate me as a voter I am willing to cast my vote his way and hope. I hope that we will finally have a president that believes what he says and will bring America together to create a more perfect union and move us forward.




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Don't forget what Stephen Colbert said, "Reality has a well-known liberal bias."


Cross Posted @ Bring It On, tblog, Blogger and BlogSpirit



Reflection

Ronald Reagan had a vision. You might not agree with his vision. You might not even agree with the premises of his vision but you can not say that he did not have a vision. His vision was based on the propaganda that he voiced through out World War II. His propaganda ignored the reality that many Americans faced every day. Ronald Reagan’s vision could not see the homeless sitting on the grates trying to warm themselves. Ronald Reagan’s vision did not see a struggling poor person, he saw a lazy fat-ass welfare mom trying to cheat the taxpayers out of their money. Ronald Reagan certainly had a vision.

When George HW Bush won election in 1988, the part of the country that accepted Ronald Reagan’s vision thought that his Vice President had seen the same vision. They wanted to be told that they had a right to be wealthy and ignore the rest of the country. The poor were all the suckers and losers; if you had money you had a divine right to it. But George HW Bush hadn’t heard the train whistle. He didn’t have a vision to share with the American people. The working class who had suffered for 12 years under the Reagan vision and never saw any of it come true were ready to latch onto a new vision. Bill Clinton had a vision that was different from Ronald Reagan’s vision. But, the people wanted a leader with a vision as opposed to someone without one. So, George HW Bush lost the election because of that “vision thing.”

Every good leader needs to have a vision. It isn’t about what that vision is, it is about what the country could become. We do these things as a nation so that we can become a better nation. The vision is what we might become.

In the past many elections have been a competition between visions. The potential leaders tell us what their visions are, and we choose where we want to go. But, in recent years the reverse has become the trend. The leaders no longer tell us what their visions are for a future with them in the leadership role. Instead, they tell us to fear the vision of their opponent in that same leadership role. The electorate becomes entangled in trying to pick the least bad vision of the future. And, when a real visionary emerges he is shot down by his opponents who tell us how impossible and unrealistic his vision is. The message is that we can’t trust a leader with such outlandish and impossibly unrealistic ideas. He certainly must be hallucinating in order to have such wild visions.

Apparently the Bush family is the antithesis of vision, because George W Bush lacks vision just like his father. Occasionally he announces a new vision, but he lacks the skill to convince us that it really is his vision. It is more likely that he has an advisor that suggests to him that it is about time to tell the American people that he has a plan. These plans don’t fit into a bigger picture. Instead they are plans announced with the hopes that we can conjure up our own vision of what he is telling us. He announced a new space objective to land a man on Mars a few years back. Those who like and study science may still be imagining this amazing journey. Most of the rest of us have long forgotten this. Was this part of a larger vision for this country? Actually it doesn’t really fit into the rhetoric of a president who doesn’t trust science.

Even the George W Bush vision of spreading Democracy around the world has lost its luminosity. In the last seven years we have invaded two countries under this premise. But, a larger vision would include diplomatic and political efforts to free many more countries from the oppressive rule of tyrants and military governments. We are never reminded that General Musharraf Pervez is a military dictator who overthrew or sabotaged several democratically elected governments. General Musharraf Pervez has gone against democracy by arresting opposition leaders and even a Supreme Court Judge. A true vision of democracy can not coexist with embracing leaders like this.

It is actually more likely that George W Bush has a personal agenda, rather than a vision. He is in the White House to weld power for his friends, family and loyalists. His actions demonstrate this louder than any words that he has spoken. The appointment of incompetent loyalists to positions to which they were not qualified has lead to many disasters - where Katrina is at the top of the list. The appointment of the unethical Alberto Gonzales is another on this long list. The reasons or intentions of these appointments don’t fit into any vision for America. Instead these appointments fit into a personal agenda for George W Bush. America is only beginning to see this, because George W Bush never shares this vision with the American people.
Now, as we think back to 2000 we might ask ourselves if Al Gore would have had a vision for America. And, because you don’t need to be president in order to share your vision with the world we can say that Al Gore certainly has a vision for America. He has spent the last few years telling us about the “Inconvenient Truth.”

Al Gore’s vision is to make America better, by putting and end to global warming.

We could argue that terrorism might be a bigger problem. But, if you actually look at the risks and probability Global Warming is actually a bigger problem. Global Warming will effect our food production, our coast lines, and our infrastructure. Terrorists may occasionally destroy a building and show the results on TV in order to terrorize us. Global Warming will work 24 hours a day seven days a week gradually damaging our country piece by piece. But, because the destruction is a hurricane here, a flood there, a drought over there we don’t see this as clearly. And, therefore we are fooled into thinking that the terror problem is worth a larger effort than the Global Warming problem.

And, it turns out that Al Gore’s vision, without even being president, is making a bigger impression than George W Bush has on almost anything except his debacle in Iraq. It just goes to show that you don’t need to be president to make an impression and get your vision out there. Of course, if Al Gore were president he would certainly have more power to make an even bigger impression. Of course, its really important to have that vision thing.



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Don't forget what Stephen Colbert said, "Reality has a well-known liberal bias."


Cross Posted @ Bring It On, tblog, Blogger and BlogSpirit



Reflection