Sunday, September 6, 2009

On "Storm Coming" essay attributed to David Kaiser

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"Storm Coming or History Unfolding" Essay       

First of all this is a fraud, and was not written by the scholar David Kaiser, as the real individual confirms here on his personal blog.

But there are those who continue to spread this kind of venom, perhaps under their own name, or a pseudonym, or simply attaching it to a respected scholar as this was done. And with enough of a deluge of these distortions, it starts to stick.

As a moderate,  I have many objections to the actions of our current President, Barack Obama, but they are always based on the actual facts and my own evaluation of them.

Since this is not the first, or the last of such emails, let's do some examination of the content:

A few details show that this is not the work of a scholar, or even someone with a casual respect for the truth, as demonstrated from this quote from the essay:

When Winston Churchill pointed out the obvious in the late 1930s while seated in the House of Lords in England (he was not yet Prime Minister),

Winston Churchill was not a member of the House of Lords in the 30s (and other than a symbolic seat to retired Prime Ministers, never served on this body), Based on the above quote  found on this link.  he actually fought against the power of that institution. 

This is also from the essay

(Surely you have heard him speak about his idea to create and fund a mandatory civilian defense force stronger than our military for use inside our borders? No?

This has been a distortion that is widely repeated.

It is appropriate for serious essays to link sources when one makes an accusation out of respect for the reader who may want to verify the facts  and then do his or her own interpretation.

The words candidate Obama used were "civilian national security" force equal to the military.  He never said or implied that this would be mandatory or armed.  Here is the link to the actual speech

The implication among the right wing extremists, supported by a slight change of wording, is something more pernicious, which is a personal military force.  From the context of the actual speech, which anyone who assumes the worse has an obligation to listen to, he was referring to public service such as Americacorp or The Peace Corp.

These are divisive times, and it's easy to take vague remarks and distort them into a pattern of Obama's attempt to become a dictator, something with no evidential support. 

This kind of fraudulent distortion harms our country in many ways.   In a two party system, both parties must be reasonable enough that productive dialog can take place.  When absurd accusations replace rational conversation we are all in trouble.

There is another mid term election in 14 months, when we all get to vote on who controls congress.   And two years after that we vote for president. Those who prefer the Republicans can support their candidates and vote for them. 

Those who pass on fraudulent essays that claim are from actual scholars are attempting to bestow legitimacy on the worst kind of deceitful fear mongering.   They are spreading hate that  just could trigger an act of violence that will lead our country into chaos. 

This would be a tragedy for all us, no matter what party we identify with.

Tuesday, July 28, 2009

Misleading Petition From AARP on Health Care

As Congressional committees are cobbling together what they are calling "Health Reform," AARP, which has become the de facto "official" lobbying group for retirees just sent out a massive mailing to all its members.

It was signed by Addison Barry Rand, CEO of AARP, requesting special funds to lobby for Health Care Reform. His letter covers many issues, some that benefit AARPs constituency, older Americans, while others actually work against our group interests.

The paragraph of the main letter that is headed, Health Care Must Be More Affordable and Accessible defines a generalized benefit, medical care for all, but ignores certain harsh realities.

The program being developed will increase the demand for health services, while doing little to increase the capacity of the system to satisfy this demand. Actually, in the absence of price controls, when this occurs, prices of services invariably rise, which would negate the effectiveness of this entire reform effort.

This Washington Post article describes the problem:
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Saturday, June 20, 2009

As the debate on overhauling the nation's health-care system exploded into partisan squabbling this week, virtually everyone still agreed on one point: There are not enough primary-care doctors to meet current needs, and providing health insurance to 46 million more people would threaten to overwhelm the system.

Fixing the problem will require fundamental changes in medical education and compensation to lure more doctors into primary-care offices, which already receive 215 million visits each year.

The American Academy of Family Physicians predicts that, if current trends continue, the shortage of family doctors will reach 40,000 in a little more than 10 years, as medical schools send about half the needed number of graduates into primary medicine.

"You're talking about an eight-to-12-year period to fix the problem," said Robert L. Phillips Jr., director of the Robert Graham Center for Policy Studies in Family Medicine and Primary Care, part of the American Academy of Family Physicians.

Evidence that demand already exceeds the supply of primary-care doctors ripples through the system as patients increasingly have trouble finding a new doctor, then wait weeks or months for an appointment, spend more time in the waiting room than in the examining room, encounter physicians who refuse to take any form of insurance, and discover emergency rooms packed with sick people who cannot find a doctor anywhere else.


There is one thing that is certain, that Health Care Reform no matter what its details will help AARP, specifically it's wholly owned for-profit division that is mainly in the business of selling of insurance. Excerpts from this A.P. article, Lobbyists the silver lining in health care storm?, lays out the situation:

WASHINGTON — A strong force, perhaps as powerful in Congress as President Barack Obama, is keeping the drive for health care going even as lawmakers seem hopelessly at odds. (this is special interest) Lobbyists.
The drug industry, the American Medical Association, hospital groups and the insurance lobby are all saying Congress must make major changes this year. Television ads paid for by drug companies and insurers continued to emphasize the benefits of a health care overhaul — not the groups' objections to some of the proposals.
"My gut is telling me that something major can pass because all the people who could kill it are still at the table," said Ken Thorpe, chairman of health policy at Emory University in Atlanta. "Everybody has issues with bits and pieces of it, but all these groups want to get something done this year."............
(snip) This time, the health care industry groups see a strategic opportunity. As lawmakers squabble, the groups are focused on how to come out ahead in the end game.
"We're still optimistic that we can get health care reform accomplished," said Robert Zirkelbach, spokesman for America's Health Insurance Plans, the main insurance industry trade group. There is strong support from policymakers and from across the health care sector. "
(snip)
......... Meanwhile, government programs have been expanding — and they've gotten increasingly friendly to private insurance companies. Insurers now play major roles as middlemen in Medicare, Medicaid and the children's insurance program.
And if the government requires everybody to get coverage — just what the overhaul legislation calls for — it could guarantee a steady stream of customers subsidized by taxpayers not only for insurers, but for all medical providers.


AARP is now behaving exactly like those in this article, The drug industry, the American Medical Association, hospital groups and the insurance lobby are all saying Congress must make major changes this year. Just as these industries have always put their own financial interests first, so in this case, is AARP.

Public Option


It is also telling that Mr. Rand does not include a demand that this reform bill include what is called a public option, a type of government run program that will realize considerable saving since it will be non-profit, run by government officials rather than CEOs like himself.

Among those who have seriously looked at America's health care system, the major source of savings is only to be found in a system that eliminates private insurers for the majority of people, while allowing such insurance, as in the case of private schools, as the exception for the very wealthy, rather than the rule.

In spite of AARP's ignoring this, the Public Option in some form may well be included, and on this subject he ignores an essential aspect of it that has already been approved by the House of Representatives without any objection from AARP.

I'll quote from the description of the bill from this N.Y. Times article.

Under the bill, the public plan would be run by the Department of Health and Human Services and would offer three or four policies, with different levels of benefits. The plan would initially use Medicare fee schedules, paying most doctors and at Medicare rates, plus about 5 percent. After three years, the health secretary could negotiate with doctors and hospitals.


This Public Option, whether being something that is really a small limited program for those otherwise uninsurable, or a larger nucleus for a major tax based service for the bulk of Americans, will have one effect. By paying doctors more than those on traditional Medicare, its clients will be put ahead of the line in securing medical care.

So, not only will this bill increase the demand on medical resources by some fifteen percent, largely by taxpayer contribution, it will also put part of this new group ahead of Medicare patients, those of us who have been contributing to this fund for our entire working lives.

The mass mailing from AARP is a one way communication, with no Email address to raise the issues that I am raising here. They want a bill passed NOW, asking us not to sweat the details. Any bill that is passed is certain to increase their insurance revenues, but unless there is resistance by members, it is also certain to lessen the ability of Medicare to provide prompt high quality medical care.

Those of us on Medicare have don't have an unlimited time horizon . We must not accept a bill where we are a political football, whose current excellent health insurance will be subordinated to new government programs. I believe in the Pubic Option, but with a concomitant increase in care providers to accommodate these new demands as they are implemented.

Reforming our health care system is an important issue, not only for us, but for those still in the work force, and for generations to come. Every group, from Doctors, to Hospitals, to major pharmaceutical companies are fighting for their own interests. We, as seniors, who care deeply for meaningful improvement in our nation's health care, also have a right to have our interests aggressively represented.

This current mailing, (while sent to all members, is not on their web site) and AARP's actions on this bill so far, indicate we are not getting the representation that we deserve. This organization, "our" organization, claiming to represent the interests of tens of millions of retirees, is not doing so. It is now promoting immediate approval of a bill that, as it now stands, will enrich private health insurance corporations, while subordinating the well being of seniors.

It is a clear conflict of interest, that at the very least gives us poor representation, and at the worst is a monumental betrayal of trust.



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Notes:
Wikipedia Article on Criticisms of AARP
Bloomberg News on inherent conflicts caused by Insurance Profits

Monday, July 27, 2009

Six Politicians Control Health Care Reform Bill

Or maybe its more than those described here, perhaps it's the heads of the various house and senate committees, or we add the speaker and majority leader, and of course we add the President.

What do all of these people have in common? The need to get elected, and then re-elected. And for this they need campaign funds, lots of it, so they can run those short ads on television that are so effective in convincing the voters that they are the good guys.

I've noticed a troubling statistic on Health Care Diaries on this site, the more complex, the more serious, the lower the readership. Here's one by andiamo of dailykos.com, Unsustainable, rising costs doom Democratic..... that wasn't even too long, kind of snappy but with a profound message.

His conclusion, and mine, is that the entire enterprise of what I'll call "Obamacare" is so flawed that it should be scrapped, voted down, abandoned. And in homage to Andiamo, I will quote his diary for the reason:

America needs affordable healthcare desperately, but American families are not prepared for the costs if America is expected to continue down the "health insurance reform" path we are following now and purchase the Democrats inadequate "incremental" health reform based on private insurance, (with or without a public option).

Why? Because it fails to reign in rapidly rising costs and relies too strongly on a private insurance system that was already unaffordable for 3/5 of us in 2005 and is even more so now.

Both Democratic and Republican plans for health reform are futile if the costs proposed are not possible for most American families to bear without crowding out most other spending or preventing their purchase of essentials like food or housing.

Simply proposing that people buy insurance and then making it mandatory, without cutting healthcare costs drastically, and eliminating the additional ONE THIRD burden of the insurance profit margin, cannot work.

However you put it, Americans are living beyond their means, or their wages are too low, relative to their cost of living. (The rising cost of health care has a LOT to do with that.)

"Whatever..." as they say..

It doesn't matter. By any measure of affordability, they CAN'T afford it.


To make an omelet you must break eggs

President Obama does not accept this truism, so the greatest omelet ever conceived, a workable, affordable Health Care system for 300 million Americans is something he wants to achieve without breaking the eggs of existing systems that are in place. He is thinking like a politician, not a revolutionary, as he proposes a task, the remaking of one sixth of the American economy, that would be, that must be, the essence of a revolution.

A revolution means changing ingrained relationships and power structures. There was no way to eliminate the power of the Aristocracy in Russia in 1917 by negotiation. There was no way in mid nineteenth century America to reach a compromise with those who wanted to continue the institution of slavery; or to complete the process of actual de jure equality of the descendants of slavery a hundred years later.

This task of Health Care reform has been assigned to politicians, when that is the absolute wrong profession, the wrong mindset, to lead a revolution. A politician is someone who works the existing power structure, who is a facilitator of compromises without upsetting the underlying distribution of power. That's how they rose to office, and that's what they are trained to do. It is a high art, and when done right is an admirable profession, but it has its limits.

Politicians may pretend to be revolutionaries, to be for change; but they don't have the least intention to do any such thing that would disrupt the existing cultural economic norms; actually they have no idea how to do it, and if they did, they don't have the makeup for it. To be a revolutionary means you perceive your cause to be so valuable, that like the signers of our Declaration of Independence your are ready to risk "Lives, fortunes and Sacred Honor."

The blueprints for real change are out there in abundance. I could throw out a few links, but why bother. They all require the breaking of eggs, powerful entrenched eggs that have the ability to control the levers of power, and have no intention of relinquishing them unless forced to do so. It's Insurers, Doctors, Pharmaceutical Companies, The owners of Medical facilities, all of the groups that have amassed power and wealth over the last century or so in the Health Care business.

What if a variation of the Health Care Reform is passed?

We could very well have a grand signing of "The Health Care Reform Act of 2009" and actually it would be a happy event. It will be happy for all of those who believe that they will now have the best Health Care, just like the U.S Senators have. It will be a happy day for the Democratic Party, who will be able to bask in their great success. It will be a happy day for the health care-insurance complex, who will have gotten away with maintaining the status quo under the guise of "reform."

It will be especially good for doctors since they will have many more customers which will allow them to raise prices, rather than deliver more services, since they are maxed out right now.

And the private Health Insurers will have pulled off the coup of the century. They will have higher revenue from more customers, but unlike say fire or auto insurance, there will be nothing like a proportional increase in outlays. Primary physicians are at maximum capacity, and cannot see more patients in many areas. Health Insurance companies only pay for actual visits to doctors, not sickness followed by long delays for appointments, as is already the norm. More money in, same money out. No wonder they are thrilled that this program seems to be passing as described in this article)

An alternative approach

And if you think this is simply a pessimistic diary, you're wrong, it's a realistic one. Here's a serious analysis of why aggregate medical cost will continue to bankrupt individuals and the country, unless there is breaking the proverbial eggs, and then describes what must be done. It's from the web site appropriately called Fresh-thinking.org from JAMA, the American Medical Association, The Perfect Storm of Over-utilization.

Lowering cost substantially will not occur through computerization or preventive care. It would taking control of much of the for profit medical-facility industry, confiscating much of their wealth, a revolutionary act that would require at the least a constitutional amendment. It will also mean radically restricting the freedom of physicians to maximize their income as they are now used to doing.

It's probably not possible; so the Democratic leadership is pretending that they can cut costs and provide universal care with no pain, no rationing, and no disruption even of individuals personal relationship with their doctors or insurance companies.

George W. Bush said we could turn the Islamic Middle east into a haven of democracy, and do it without any real cost; "they will pay for it out of their oil" and be indebted to us forever. It was a silly dream, that got him elected twice, but then brought down his party.

President Obama is saying that we can have all the good things we now have in our medical care, and give the best care to every citizen of the united states no matter how poor; all this without increasing the deficit or raising taxes on any but the top one percent, and then only a little bit.

Those who seriously study this say it's impossible; yet he continues to repeat it, with more and more sincerity. He describes those who are suffering because they presently can't get care as if this is an argument that his proposal, his pain free proposal, will actually work. And any objection is portrayed as simply partisan attacks that are not to be taken seriously.

I don't want an omnibus thousand page bill that purports to reform health care in one swoop. I actually believe it will do the opposite, and be a boon to the industry that is represented by the six senators of both parties that seem to have the ball right now.

If there are many good ideas in this omnibus bill, we can have many individual bills that can be understood, debated and refined by the public whom it will affect. We are not really ready for a revolution, so lets deal with one issue at a time.

For any of this to be possible we must get out of campaign mode, where promises can be divorced from realistic expectation. The American public must be treated like adults, who understand that sacrifice can sometimes be required for the common good.

It would be a fresh approach, that just could work.