MEDICAL AND DENTAL FRAUD

A booth at the state fair carried a large label that read “Fraud Prevention”. As I walk by a woman standing behind the counter of that booth directed her remark to me; “If someone tries to defraud you let us know.” She said what she said in a way that suggested she expect an answer. Consequently, I answered her question with a question, “Do you mean other than being cheated on by the medical community.” The look on her face was precious but fleeting. In the fraction of a second, it went from the triumph of finding someone who was being defrauded to assuming an attitude of doesn't bother telling me something we already know. I went to a dentist, with a toothache. The two-hour wait and two-minute diagnosis was gum disease, and treatment was a week on antibiotics. The bill was $140. Of course, there was a follow-up appointment. During that appointment, a periodontist cleaned my teeth and gave me an estimate for dental work he said I needed. The bill was $150 for that visit, but his estimate was $1194.00. My judgment was that I would have that work done, which I did which took two more appointments. After that was finished, and I paid for the work, there was another appointment with a dental hygienist. A very nice woman cleaned my teeth again, and a DDS, Doctor of Dental Science entered the examine room and proceed to do an examination. The bill was $150 and this time the estimate was $2000.00 for work I needed to have done. One single solitary tooth already had a crown on it. As one might expect, the decayed area was near the nerve. The dentist carefully explained he would have to remove the crown, do a root canal, fix the decay, and then make a new crown, which fits remarkably close to what all dentist charge for this kind of work. In my mind, this amounts to price fixing and is so excessive it amounts to fraud. I went to a physician because I was losing hearing. I explained to the nurse and then to the doctor that all I wanted was to check if I had water or wax plugging my ear canals or something other than age-related diminished hearing. The nurse handed the otoscope to the doctor. The physician then looked, glanced was a more accurate description of what she did, handed the otoscope to the nurse, and said I was OK; that is all she said. She started for the examine room door. I stopped her and explained again that I wanted to know if there was any wax, water, or inflammation or reason my hearing was diminishing. She said, “No”. She said she would walk me to the appointment desk, the same desk where I had just pre-paid $30. From experience, I knew my insurance company would receive a bill for $126.00 of which they would pay $96. If you care to do the math, $96 plus $30 equal $126. You can imagine my surprise when the physician said to the clerk, “Make a follow up appoint for him, in three months”. My response was follow up for what. Because of the way I am, I told the physician the two clerks and the nurse and anyone else listening in a normal tone of voice that I considered what they were doing as a fraud. I asked them to remove my name from all of their records. I told my daughter in law about that experience, and she casually said, “Oh yes, I know because that kind of thing happens to me all the time.” Is medical and dental fraud so common that we just accept it without question? Is this just good business? Like the attitude of the woman in the fair booth said, don’t bother to tell us with what we already know. URL: firetreepub.blogspot.com Comments Invited and not moderated

PRIMARY PURPOSE OF INSTITUTIONS IS LOST

A tendency in modern society seems to be a diversion from the primary purpose of our institutions. People organize into religious, educational, social organizations. Although we may not agree with the purpose of this or that organization, in a general sense we recognize the primary purpose of the organizations we form. Until recently, I have been critical of what is taking place in many of the organization but have not stopped to think of what is happening as trend or tendency. Now, knowing what I now know from a long life dealing with human behavior, I think perhaps the tendency is inevitable or innate. For examples, what is the primary purpose of a church, a university, a public school, or out of the medical profession, or what the purpose is of a political party? No one stumbles on that question. However, when we examine what is happening within these “organizations” we see something entirely different from what we all know is the primary purpose. I could go to some widely different organizations; however, I will start with medical care as an example. My hearing started to wane, so as a first step to resolving my problem, I went to a Physical to check out my ears before going to a hearing aid specialist. I know that the cost of hearing aids is ridiculously exorbitant so want to be sure I need that kind of device. At the doctor’s office, a nurse asked me step on a scale and then took by blood pressure. The doctor, a female, entered the room. She introduced herself as the wife of the physician, but asked no questions, took an otoscope and glanced at my ears for less than 10 seconds per ear. Her pronouncement was that there is nothing wrong with my ears. She next turned to the nurse and said; “Set him up for a follow-up appointment in two months.” She was moving toward the door of the room when I stopped her by asking if she was an MD. She seemed insulted but emphatically responded, “Yes.” Then I asked her, “Follow up for what?” She shrugged her shoulders. I angrily said to them to cancel all future visits and remove my name from their client list. Similar nonsense is what had happened on previous visits; one for a visit for taking a blood sample and the next to tell me everything was normal in my blood. In addition to the several hundred dollars cost of the laboratory, the cost for each visit was $30 co-pay and $126 for the visit. The follow-up was to be in six months. I should have asked why a follow-up visit if everything was normal but didn’t. The pattern of visits just did not make sense if the primary purpose of the medical profession is to deliver health care, but it made much sense in terms of making money for the practice. What is the primary purpose of a university? The answer is obvious. Of course, it is education. I worked for years as a professor at two different universities. Over a period of thirty plus year, I watched these universities deteriorate from being teaching institution to research institutions. They grew buildings and faculty to the point where they have many more professors than students and many more laboratories than they have classrooms. I could go into a discussion of politics and political parties as a further example. It should be obvious that the purpose of government is to govern. In stark contrast, the platform of the Republican Party is simple and straight forward, get rid of government; get rid of regulations; and get rid of taxes. I could go on with the purpose of the religion of love and respect, as another example, but run into the Muslim-Christian conflict; kill, kill, kill, and hate, hate, hate. URL: firetreepub.blogspot.com Comments Invited and not moderated

AMERICA NEEDS GOVERNMENT

It is difficult for most American people to understand why there are an unprecedented number of Republican candidates for president all saying the same thing. Their message has not changed since Teddy Roosevelt split the Party with his progressive ideas left Taft and the classic conservatives isolated. Calvin Coolidge reduced the basic conservative pattern while president ending in 1929, which is to destroy government by starving it. Need I point out that after every conservative president starting with Coolidge; we have had an economic downturn in spite of their yelling at the top of their voices that cutting taxes on the rich creates jobs. In an honest election, they would not have a chance based on this history. Voter suppression, gerrymandering, unlimited campaign contributions, bribery of congressional representatives, and other results of nefarious management of the Republican Party by the rich has led this maneuvering of our democracy. It is what will elect them not that they stand for good government. Of course, there are a few among us who live in the conservative fantasyland; American be great without a government—no it can’t. This morning on a TV newscast, I heard a brief clip of an interview with Donald Trump. He was attacking Obamacare with the same tired old Coolidge rhetoric, destroy it, and replace it with something much better. The difference is that Coolidge focused on destroying organized labor. The reason conservatives want to destroy government is their classic, and redundant justification, which is Obamacare is a government program. It is the same reason they want to destroy the IRS, Social Security, Medicare, and Aid to Dependent Children, public education, food stamps, and an arm lengths list of others. In each case, they will replace it with “something better”, which is the classic Republican response to everything “we the people” or the government does. Everyone knows they will never define what that “something better” is because they have no idea what would be better. They define “something better” as anything that is not a government program. We have to decide for ourselves what they mean by that, which is easy. Start with government regulations of any kind. They want to get rid of all government regulation from speed limits to capital regulation on banks that are too big to fail. Each motorist and the bank can decide what is most advantageous for him or her. Think about the IRS. How much taxes would you pay is you could decide how much your tax bill would be to support the government? How much capital would a bank hold if their objective were to maximize profits on loans? The classic conservative wants to preserve the good thing our of the past but they never think about the fact that Adam Smith, the father of the ideas of the societal benefits of individual pursuit of their self-interest, died in 1790, 225 years ago. Ayn Rand more accurately and recently defined the wonderful benefits of greed. Of course, we have to ignore what the effect is on those who do not benefit from the greed of other individuals. This morning Trump made it clear, his solution is to create a situation where everyone has an equal opportunity to buy insurance. That sure sounds like an all-American idea all Republican can back; however, what is missing is the fact they many, many people cannot afford to buy insurance. They cannot afford to buy insurance because the work two jobs at starvation wages paid by greed adherents of Adam Smith’s philosophy. The problem is not that insurance is not available to buy. Nonetheless, Trump went on at length this morning about how with his program would see that hospitals would make they treated all sick people because insurance was available to everyone, like in Canada. Can anyone question why I think the man is an idiot, a greedy conservative idiot? By the way, I learned to call people names from Trump. URL: firetreepub.blogspot.com Comments Invited and not moderated

JEB BUSH AND COMPASSIONATE CONSERVATISM

As the presidential candidate hopefuls line up and give speeches, we hear more and more oxymorons. So far, the master of that game is Jeb Bush. His announcement speech was one contradiction after another. He took a page out of his brother’s playbook when he declared himself a compassionate conservative. Every thinking person knows there is no such thing. I often reference the ultimate conservative, Ayn Rand, in articles I write. She has become an icon of conservative ideology flattered by imitation. When Jeb Bush labels himself as a compassionate conservative, he labels himself as a follower of Ayn Rand, an imitator. Although we can easily identify the promoters of her political philosopher, there is reluctance on their part to admit an association. Congressional representatives Paul Ryan and Ron Johnson from Wisconsin, the now deposed Eric Cantor, the financiers of political campaigns, the Koch brothers are prime examples. She bases her entire philosophy on one idea, which is individualized greed; if I have mine, to hell with you. You cannot a compassionate conservative because there is no such thing. If you are not a productive member of society, you should not benefit in any way from society, which is Darwinian! As Herbert Spencer, a Darwin contemporary philosopher, summed up his ideas, “it is survival of the fittest”. Greed is core to conservative political philosophy. A majority of people knows and hates greed. Even conservatives do not want to identify themselves as being greedy, so they lie by calling themselves compassionate conservatives. Don’t they know it is a contradictory expression? They are admitting their shame. Using an oxymoron in not the only way they cover their shame. Conservatives completely avoid the subject of welfare in their rhetoric, or it comes up in a stilted way. Conservatives, those who can afford to pay for their health care, call for Congress to repeal and replaced universal health care or Obamacare, which by definition requires government intervention to pay the cost for those who cannot afford it. I defy anyone to tell me what would replace it. Their answer to that question is so obvious; they would replace it with free enterprise medicine. As Ayn Rand says, it is simple, if you cannot afford the medical care you need you should not have that medical care; you die; so what—you don’t count. As a society, conservatives and liberals alike know this; however, conservatives don’t care. In contrast, liberals saw this, which is why we have Obamacare. Nothing in biology makes sense without understanding evolution and Darwin’s contribution to the subject. Also, that understanding has to include how in many ways out humanization is causing us to turn our backs on the survival of the fittest. As parents, we feed and care for our children but also we feel an obligation to feed and care for those adults who are not capable of doing so, the injured, the mentally retarded, and old, etc. Humans know what leads to suffering and know the consequences of suffering, and act to prevent it. Conservatives, in a universal voice call to destroy social security when they know that program ended old age poverty; so why do they want to destroy it. There is only one answer; if you are too old to work, you no longer count. Of course, emotions are a guide to survival; however, conservatives, like “survival of the fittest”, know no misery or cruelty. If a person for any reason, including old age, cannot feed him or herself, they starve to death—que sera, sera. URL: firetreepub.blogspot.com Comments Invited and not moderated

UNDERSTANDING THE EBOLA DEBATE

The science-political conflict about Ebola should be obvious. From the scientific point of view there is absolutely no chance that a person who is not symptomatic can spread the disease. The medical profession base this assessment on the fact that provable information. A person cannot spread the virus unless they are asymptomatic because to be symptomatic means they have the virus in the body fluids. This is not only logical but is provable and scientists have proved this reputably.

Scientific study has unequivocally established that a consistent 21-day period between exposure to the virus and when symptoms first appear. Medical professional established this in spite of a couple of big unknown—things that cannot be known—which is, does the person exposed actually have the virus and is the person expose susceptible to infection. They know people who have been infected and recovered are not susceptible again. Another factor, one that is also known, is the size of the infecting dose does not change this 21-day incubation period; nevertheless, the size of the infecting dose may be influence the outcome of the disease. For example, a woman in stillbirth in Liberia may have massively exposed the patient who died in Texas. This is in contrast to the physicians who came back to the United States and later developed symptoms as well as the two resident nurses who developed symptoms but survived. In each case, the doctors and nurses appear to have exposed themselves by breeches in personal protective devices, implying the infecting dose was very, very small. A political split between science and politics hinged on this point; those who felt they could take advantage of it chose not to consider the size of the infecting dose instead invoked a different treatment based on race as the cause; the person who died was black while the doctors and two nurses were white.

Of additional importance, is the fact that in this disease there is not carrier state, meaning that once a person is infect, he or she will not spread the virus after recovery. To spread the disease, a person must have symptoms. The first symptom is an obvious increase in body temperature reflecting the death of cells infected with the virus. The virus infects a cell, and using the cell mechanisms, reproduces to the point it kills the infected cell; this takes 21 days. Although, I have not seen data to this effect, apparently, the cells infected are in the intestines, kidneys, and testis. Obviously, once the infected cell dies, it can no longer produce more viruses. With time, the infected body produces more and more antibody, which binds the virus, which prevents it from infecting more cells. Outside the body, the Ebola virus is an RNA virus, which is not stable outside living cells. It will become non-infective after a short time outside living cells. In addition, common disinfectants kill the virus on contact.    

This pathophysiology indicates Ebola is highly infectious, is often lethal, but also is a self-limiting disease. This should be obvious from data collected in those regions in the world where the virus runs unchecked. In addition, the data shows properly administered symptomatic treatment “usually” works; nutritional and massive fluid therapy. Again, the political–scientific split occurs in the way the medical community verses the media handle this information. The medical communities (epidemiologist and clinicians, etc) study the data and made scientific recommendations, which include the idea we all should know about; overall, the best way to stop the spread of the disease is to send medical professionals to fight the disease in Africa and stop it there.

In contrast to the medical community, the popular media, urged on by politics, has worked hard to induce panic; while not deliberately lying, they make it sound as bad as they possibly can—for instance; the initial published numbers of sick and dying is always greater than the actually number. As a direct result of all of this, I heard a physician, who should have known better, speaking in support of the restrictions imposed on the people by the governors of States of Maine, New Jersey, and New York in a manner that would curtail medical professionals from going to Africa to stop the Ebola epidemic. The governors were responding to the media induced panic. The physician said 80% of people believe in the United States are frighten they will be exposed to the virus. That is “justification enough” for the governors to “fight” Ebola in their states at our ports of entry to the Untied States by quarantining “all people” who have been in certain countries in Africa; hence, according to the media; are potentially infected, hence die of Ebola. This of course is beyond stupid.

What was unusually disgusting this morning was +Joe Scarborough on his program (MSNBC). He viciously attacked president +Obama. He aimed his attack at Obama’s “hiding under the covers” speech he gave in strong support of the medical (scientific) community. Once again, Scarborough demonstrated that he is not above appearing stupid by catering to the panic the media induced in the public. The media, by crating and spreading misinformation, created the 80% and now they are taking advantage of it for ratings. Obviously, President Obama, in the manner of a true leader, is working hard to do the right thing and dispel the idiocy in initially dispensed by a few right wing science deniers. Joe Scarborough reminds me of “the guy with the rope” in lynch mob; that is it is OK to aid and abet murder as long as it calls attention to ones self.    

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EBOLA OVERSIGHT COMMITTEE FARSE

Last Fridays meeting of the +Oversight and Government Reform Committee chaired by Darrell Edward Issa, who is the Republican U.S. Representative for California's 49th congressional district, should stand as one of the most if not the most egregious example of failed government in our nation’s congressional history. It was grounded in total ignorance. Unlike most of my peers, I enjoy watching congressional hearings more than I like watching sports events meaning I have watched many hearings down through the years. +Darrell Issa is a well-know and often despised on both sides of the aisles for his extreme partisanship. In previous hearings, he conducted committee business as a dictator; he made news by openly refusing to allow members of the Democratic Party to speak; thus, eschewing the normal “democratic” ways of conducting business. However, his “no compromise” conduct of committee business is typical of Republican committee chairs although we as liberals may not accept it we expect it. Yesterday, Issa outdid himself in addition, he and his fellow Republicans committee members displayed unbelievable ignorance of the issue at hand, which was the Government handling of the Ebola epidemic in Africa. Issa even distorted the purpose of the hearing. Childlike, Issa stumbled and bumbled over the name of the disease and the country involved. He referred to Ebola as “ecoli” and then as “Eboli” as found in “Guyana” and not “Guinea”. Of course, the name of the disease is Ebola; we see and hear the name repeatedly, in every news media outlet; thus, for the chair of a committee with the awesome responsibility for government over site of that specific topic not to know that name is inexcusable. In addition, not to know that +Guyana is in South America and +Guinea is a country in Africa demonstrates extreme carelessness, which is reminiscent of +Sarah Palin referring to people who come “from Ebola” as if the name of the disease was a country or referring to +Africa as if it were a country and not a continent.

The issue that took center stage at the hearing in question was President Obama’s timely appointment of and experienced government manager. Typical of the Republican mindset is to call for the naming of a “czar”, specifically using that term, and then criticize the president for appointing someone to oversee the Administration’s response to Ebola by saying he was appointing a czar dictator. The public outcry over the disease has been greatly exaggerated by the right wing press and talk radio. Issa was trying desperately to take advantage of this in terms of his being in front of cameras. In addition, he wanted to justify the hearing by proclaiming that there were government missteps at the level of the president of the Untied States in handling the treatment of +Thomas Eric Duncan in Dallas when there was clearly an understandable mishandling his case by a nurse and physician in a local hospital.

As the involved physicians in that hospital said, medical schools train them in to look for horses and not zebras when they hear hoof beats. Hindsight is and will always be 20/20. The committee’s objective was not oversight, but was to ridicule government efforts for publicity purposes and have the committee serve as a “pseudo” grand jury to indict someone for something. The chair and his fellow Republican committee members made this evident in course of the hearing. Early in the hearing, Issa said:

"Sadly, in my opinion, (+Klain's appointment) shows the administration has on one hand recognized the missteps (in handling the Ebola crisis), and on the other hand is not prepared to put a known leader in charge or, in fact, a medical professional in charge,"

Everyone involved, including the media knew that the President was following the advice of multiple experts in infectious diseases and in epidemiology. These expert range from those in the CDC and in charge of state and worldwide health organizations including the World Health Organization and MSF (acronym for French rendition of the name Doctors without Boarders) who where on site in +West Africa. All the actions of the president, hence the government was based on medical experts, who are readily available to President. This fact alone should make the +Issa hearings a farce; the Congress and state politicians refuse to believe the medical experts yet he has the temerity to question why the president did not “name a medical professional’ to be in charge. Like climate change deniers, the Ebola crisis is clearly another instance of “science denying” for political gain. Hot head committee member +Rep. Trey Gowdy, R-S.C., summed up these feelings when he asked why Obama had to appoint a "dadgum lawyer" rather than a doctor to be the Ebola czar. In addition, he tried to use the cheap trick of playing off jelousy by asking +Nicole Lurie, a physician and assistant secretary of the Health and Human Services Department, why Obama didn't pick her instead.

However, their denying of experts didn’t stop there. They even deny what +Maj. Gen. James Lariviere, deputy director of political-military affairs in Africa for the Defense Department told them about how the military are protecting our troops in west Africa. The justification for the question was +Rep. Tim Walberg, R-Mich., who said, using words intended to induce panic, military families are worried that soldiers face a "potential death sentence being sent in to combat a virus."

Sadly, the objective of this Republican committee, like all Republicans in congress, was the same old thing, which is to continue to undermine government function at any cost. This phenomenon of denying science by Republican lawmakers has become so common in modern Washington that the saying, “I am not a scientist” is common political parlance. I was shock at the crudeness of hearing one committee member embarrass himself by openly and illogically calling a medical expert a lair for saying you cannot get Ebola on public transportation from someone who is not showing symptoms. He emphasized his point by saying you could get could get Ebola “on a bus if someone vomited in your lap on a bus”.

When the voters elect a Republican, they assume the wisdom of all those who elected him or her. Much in the same manner as Republicans have a propensity to run committees as dictators, they also seem to believe that once people elect them that make the professionals who do not have to consult anyone: physicians, climatologists, generals, or whatever. Not only that they ridicule those who do consult experts, such as our current President. 

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CRUSE SHIP IN BELIZE AND EBOLA CREATES COMEDY OF ERRORS.

A worty way to pass time is to try to figure out how Republicans think; how they approach probe solving. This morning on +Morning Joe (MSNBC) gave us a clear illustration of his approach; it is either yes or no, it is black or white with nothing in between. On reflection, this seems the approach used by many people but Republicans in particular.  Scanning over topics, think about the well-known propensity for Republicans not to compromise on anything. Isn’t that clearly a direct reflection of black and white logic.  Think of +John McCain and his propensity to bomb everyone he doesn’t agree with, isn’t that a clear indication that he feels he is right enough in his judgment to start killing people. Look at arming rebel groups in Syria and Iraq, in the Republican mind-set, they are either with us or against us, whom we know from experience in the region, they are not. The same applies to Muslims; they are all evil or they are not even though we have learned from Hitler that this type of thinking in its self can be pure evil.

This morning the subject was +Ebola as it is on every radio and TV station these days, specifically as infectious diseases relates to travel. Republicans including Joe Scarborough wants a travel ban. Their thinking seems to be a simple “black and white approach”; if we do not allow travel, we can stop the spread—simple. In contrast, it appears every medical advisor believes that a travel ban would hinder and not help the fight to curtail the spread of this virus; however, I am sure that Republicans will find one MD that will support their view, just as they can find one climate change denier among scientists. Our +President Obama will take the intellectual approach and follow the advice of his advisors. The Republican controlled congress, with a significant number of Democrats, probably will take the Texas cowboy or knee jerk response, ban travel, and make things worse. Obama will have to figure out a way to correct their foolishness, which he will do against a barrage of accusations that he did not do the right thing if the disease spreads. Of course, if it doesn’t his critic will withhold credit.

I look at my country of +Belize for an example. A cruise ship showed up with say 3,000 passengers, one of whom was a nurse that handled samples from Mr. Duncan, the man who died from +Ebola in Texas. The United States government requested permission of the Belize government, to move those passengers back to the United States from Belize through their major airport as opposed to telling them they were going to do it.
Aside from that, this is a clearly a comedy of errors on the part of everyone involved. The nurse in question was not showing signs of disease, which means she is not infecting other people; medial science knows this. First, the U.S. government panicked by believing they had to act. Second, they included the entire passenger list, which includes people who were not in close enough contact with her body fluids. Third, they foolishly chose to fly them back to the Untied States, presumably returning each one to their homes; they came from all over the United States. The alternative, the disease has a 21 day incubation period so if they did not return them to their homes, they would have to house them in one place for that long in a concentration camp like environment. There is actually no danger in shipping them “all” home for the reasons I have already mentioned but they are proposing action because, in their black and white way all or nothing way, they think there is danger, so what they proposed to do is clearly counter to what they claim to believe. In addition, flying that many people from an airport would exponentially expand those exposed.

I could go on and on but there is not purpose in doing so. My point is simple, The Joe Scarborough black and white approach, what I label as the Republican approach because of the pending action of +U.S. congress, the +U.S. Government approach to the cruise ship as well as the +Belize Government approach to the same ship would be devastating from every point of view; medical, economic, and human rights. It should not be surprising to read what people, including my Belize friends, are posting on +Facebook and in the media; they are congratulating their governments for acting stupidly. It is worth noting that the right wing media is viciously attacking +Obama for not acting, when in truth, Obama and his medical advisors are the only ones who are acting responsible. One time during the Gore Bush campaign, +Bill O’Rielly said that “we don’t want a Rhodes Scholar as president we want Bush”. It hurts me to say it but Bill O’Rielly was right in judging what the American people want, but it certainly is not what we need; we need men or women like Obama for president.   

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CONGRESS REACTS TO EBOLA

CONGRESS REACTS TO EBOLAPanic in Congress! Against the advice of medical experts, Republican congress representatives are going to restrict travel from places where Ebola exists: Sierra Lion, Liberia, Guinea, and Dallas, Texas. Talk about stupid! Of course, when criticized for what they do, they are prepared to respond that the reaction is bipartisan because they have one Democrat that is joining them, which by some twist of logic, makes it not stupid.  

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EBOLA; A CASE FOR A SOCIALIZED HOSPITAL SYSTEM

The Ebola crisis has once again pointed out that privatization of certain things in society has the potential for a disaster. This has been a theme of this blog site since it started. I repeat, the government is there to do for us what we cannot do for ourselves through the means of wealth distribution meaning taxes and salaries. I will use several major areas as obvious examples of things that society needs done but must not be done for profit, which include education, health care, and prisons and then move to the more universally recognized areas of police and militaries, and mail delivery. Privatize, privatize, privatize is the cry of the Republican Party. Toward that end, they label privatization as ‘socialism’, which it is, or use the more poignant invective, ‘communism’, which it is not. The radical right wing media in their diatribes refer to those who support my view (privatization is wrong for some things) as ‘liberal’, using both labels, ‘liberal’ and ‘socialism’, as dirty words.

The question at issue here is, has privatization of health care, specifically hospitals, hurt or helped efforts of the medical community to control the potential Ebola out break in the United States. Perhaps, the current discussion of Affordable Health Care (ACA) overshadows this issue. Of course, the ACA is aimed at individuals but was enacted by Congress and President Obama as an awkward hybridized version of privatization of health cares in response to the privatization issue; allow insurance companies to make money and poor people can have health care insurance even if they cannot afford it. The ACA effected hospital income secondarily. Greedy hospital administrators had learned how to shovel taxpayer dollars into there profit column thought exaggerated charges for emergency room care—charging thousands of dollars per hour etc. They blamed the federal law that says emergency room medical staff must treat everyone who presents to an emergency room and most people did not have insurance because they could not afford it. We all know medical costs were spiraling upward essentially out of control. ACA dramatically shifted this burden to insurance companies because all individuals should have affordable health insurance while spectacularly lowering the rate of increase of health care costs. This whole picture affords a stark example of what happens when we privatize of emergency room care.

More to the point, people are calling for every hospital to have top-notch isolation facilities and personal protective devices and protective clothing for all staff in anticipation of receiving suspected Ebola patients; this is ridiculous yet we need such hospital regionally. Most hospital administrators “candidly” refuse to do that because of great costs, which would cut into profits but will not admit to their greed based actions. In contrast, all health care works demand protective clothing, protocols, etc. Nursing unions do this where Republicans have not destroyed such unions. Hospital administrators who would comply rightfully expect the government to pay them with tax dollars. To have a system of government hospitals would be out and out socialisms in the eyes of Republicans; the only place socialism is acceptable to Republicans is the Veterans Administration; then “liberals” cannot give them enough money and support.  

In summary, it is foolish to expect “every” hospital to pay for such things. We need a government hospital system nationwide like the Veterans Administration but for everyone. That much needed system will never happen with a Republican controlled government. It obviously would save taxpayers great amounts of money and provide peace of mind across the nation, especially during this era of resurgence of childhood disease, AIDS epidemic, and Ebola crisis, but has a down side, which is the greed of individually owned and privately held hospital corporations; they would have competition. The Republican House of Representatives, as part of their campaign to destroy the government, has underfunded the CDC among many, many other things they have underfunded so who or what is there to do what “we can not do for ourselves”. In health care, it is to identify infectious disease cases, control treatments, and management, in addition to identifying and controlling movement of travelers from suspected “hot spots”. Should we bother to mention educate our children (now in crisis) and hold prisoners, police our neighborhoods, and protect our shores?

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MARCIA BLACKBURN APPEARS IRRATIONAL

Some prefer to look at political beliefs as being on a line with the extremes at one end or the other with most of us hovering somewhere in the middle. My mother, who was a consummate debater of all things political, often referred to what she called a ‘political circle’. Her point was simply that if you go to one extreme or the other it makes no difference, you are extreme or more meaningfully, you are irrational. This morning Steve Kornacki’s on his show UP (MSNBC) had a politician as a guest, which was usual. What was a bit unusual was the circumstances; there was breaking news, there was the second confirmed case of EBOLA in Dallas, Texas. The guests, a congressional representative from Tennessee with no special credentials in health matters that I could see, commented on the occurrence of the “first” infection in the United States and make the comments she did. Every responsible person was going out of his or her way to avoid inducing panic in the United State. To be frank, for me, her comments were classic examples of what is wrong with politics in the United States.

The magic of democracy is that if what is decided “by everyone” is, by definition, not extreme, which is what makes democracy, as a form of government, much more rational than dictators, royalties, or caliphates. We assume the same thinking applies to election of our leaders, including heads of political parties, presidents, senators and other congressional representatives, which is what the guest was. We have numerous examples of failed states around the world in addition to having the success of our own 238-year long history to prove the general accuracy of that thinking—stating as the somewhat trite “shinning light on the hill”. This morning, Steve Kornacki’s guest proved the system is fallible; there are imperfections. Virtually every one of her many utterances appeared carefully calculated to instill panic over EBOLA in the American People—I am left confused in trying to figure out what her objective in doing this might be. Instead of a rational representative of reason, she sounded the same as a newly graduated journalist looking to build a reputation, as Sarah Palin who in her ignorance thinks EBOLA is a country, or as a Fox News commentator motivated by hate.

For examples of the nature of her remarks, when asked to comment on the case in Dallas, she responded, “We have 8,000 cases and 4,000 deaths”. Clearly, she was citing worldwide statistics but pointedly use the pronoun “we” in the context of Texas with the obvious intent of making it sound as if these cases and deaths were taking in the U.S. The truth is there was only one death in the United States (Eric Duncan) and not 8,000 with 4,000 deaths. She claimed that the man who died from EBOLA virus in Dallas lied and because of his lie, the health officials in Liberia allowed him to enter the United States. Clearly, she was implying the screening procedures had failed, meaning we are at high risk of an EBOLA epidemic. He did say he had no exposure to EBOLA patients. Much to his credit, he had helped a woman, who was in the throes of going though stillbirth, travel from hospital to hospital looking for medical assistance. She died of EBOLA but he did not know that at boarding time for his flight to the U.S.—as far as he knew, he told the truth.

Marcia Blackburn (R-Tennessee) clear is an extremist speaking as a “medial” authority because of her elected position with the intention of inciting panic. Her political party affiliation has little to do with this extreme position. Only she will know the inter workings of her devious mind; thus, explain why she feels inducing panic in America over EBOLA virus. As an experienced politician, she should know that panic leads to dangerous and irrational decisions. The book, Shock Doctrine; The Rise of Disaster Capitalism (2007) by Naomi Klein is well known, clearly associates the use of disasters, either natural or created, for political gain, which boils down to economic gain—just plain greed! If that was what she was doing on UP this morning—creating a shocking event—I have no idea of what she will gain or how she will gain, what ever it is she is seeking. It is easier for me to think that she is simply so far right she appears irrational—not making sense to anyone even other extremists in either political party; she has gone the full circle.  

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EBOLA CALLS ATTENTION TO SEA CHANGE IN MEDICINE

Something about this Ebola case in Texas that caught my eye. A nurse took the patient’s history during his first hospital visit. The history included a statement saying the patient mentioned that he had recently traveled from Africa. In retrospect, that statement became super important. I heard several people, medically trained as well as layperson newscasters, state unequivocally that had a “doctor” heard that, he or she would have known the patient had Ebola virus, which may be true but no necessarily so. Let me explain something about medical education that I have been arguing for years.

In a recent exchange of letters with a Dean of a college, I pointed out that this dean had bowed to social pressures to change the curriculum in his college. After years of bureaucratic nonsense of collecting opinions, taking surveys, and forming committees to study this or that, the curriculum was changed; in my opinion, the college (the Dean) changed the curriculum in a disastrous way. The Dean was the only person who could have prevented it from happening, but didn’t. Admittedly, the social pressure on the Dean from students, college professors, the medical community as a whole, and from society was intense. In this case, the Dean not only approved the change but also promoted it.

The totality of “medical knowledge” that has accumulated over time is breath taking. It is not only massive and sweeping but also expanding at an accelerated rate. It is much more than anyone person can know or even groups of persons can know. Thus, college administrators divide the massive task of medical education into manageable subunits: undergraduate, professional school, and postgraduate education. Educators have further divide postgraduate education into PhD for bench researchers and residencies for specialties and clinical research. In addition, administrators integrate nursing, and technical education as part of medical education, which are a big part of the overall picture. Thus, administrators have divided the technical and professional curricula into two huge areas. The nomenclature that has developed surrounding this division is awkward; of course, nurses are professional; nevertheless, the term ‘professional’ applies to the medical doctor or the veterinarian, while the term technical applies to all who the public charge with the responsibility of helping to carry out the overall objective, which is health care.

Most people seem to have a grasp of the concept of ‘professional’ verses ‘technical’ knowledge over the doctor nurse divide. Jokingly we hear people say things like, “nurses can do everything but doctors know everything”. However, the sad truth is that students of medicine seem to have not applied that conceptual difference to their education. Medical students see themselves as highly respected individuals in white coats or surgical scrubs with stethoscope casually slung around the neck practicing medicine—doing things—as they have seen in hospitals and doctors officers. They want to achieve that status as quickly and effortlessly as possible. They have led themselves to believe that practicing medicine is doing these things. It is not; practicing medicine has to do with what is going on in their heads; nursing is doing things. Of course, there is tremendous over lap.

Students do not see setting in lecture after lecture as learning about exotic diseases and circumstances that rarely happen as well as the everyday things that can and do go wrong. In their minds, the clinic is where they learn medicine not the classroom. Consequently, they push for their college administrators and professors to eliminate lectures or at least cut them to a minimum and to expand clinic exposure time. The history of medical education is the story of a shift from apprenticeship programs to academic program; students want to reverse that trend.

The patient suffering from Ebola entered the hospital. More and more physicians are trained, as one doctor said during a recent interview, they are trained to look for horses if they hear hoof beats and not to worry about zebras. Every nurse in that hospital can diagnose common colds, mild and severe flue, allergic reactions; everyday stuff but there is only one who sat through boring lecture after boring lecture where some professor described zebra. Diseases that they could never learn through an apprenticeship program that is by personal experience. The signs and symptoms and the distribution of dengue, falciparum malaria, sleeping sickness, Ebola, etc, etc; one boring disease after another, disease the nurses have never heard of or have the slightest idea of how to make a diagnosis.

That nurse should not be expected to be able to diagnose exotic diseases but the physical should have because that is his or her job. However, the failure to diagnose the Ebola patient in the first hospital may not have happened even if the nurse had told the doctor the patient came from Africa especially if he or she was a young doctor recently graduated from a medical school where the students had undue influenced over the curriculum turning medical education back into an apprenticeship program. It is extremely unlikely under ordinary circumstance that the nurse or even the doctors in that hospital would have recognized the signs and symptoms of Ebola and referred the patient to an exotic disease specialist if the popular press did not have the Ebola epidemic in the headlines. I think the medical community acted in an exemplary way in Dallas. The question remains unanswered; are our physicians now “highly trained nurses” and are our medical specialist becoming what physicians used to be. If this is the case, it represents a sea change in medical education made in response to the exponentially expanding knowledge and we should recognize it as such.      

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MEDIA INTENTIONALLY INDUCES EBOLA PANIC

Public health officials should investigate the way the media is handling the news about the Ebola case in Dallas Texas. Obviously, the objective would be not to stifle news coverage but to see where the health industry could have done better with news releases and interviews with medical personnel. I listen to “talking head” after “talking head” try to make their coverage more exciting than the next person. The result is a great distortion of the facts. For example, the number of people exposed to the individual ranged from the low teens to hundreds. My interpretation is that some of the “news people’ deliberately misread the new releases from the medical community by saying that all of the people “confined to the tight space on the planes” he was on “for long times” with “recycled air”, etc. The most egregious lie was making the intentional panic inducing statements by saying he exposed “four” children; hence, the entire student body in the schools they go to; hence, exposed thousands of children to the Ebola virus—usually couching what they say in terms like “death inducting virus” or, “deadly infection”. Then, to make things worse, they stick a microphone in the faces of some parent and ask, “Do you think this is the thing to do?”, or something equally asinine.

The medical facts seem to be that the virus is spread by direct contact with body fluids; tears, saliva, urine, feces, and semen but only if the fluid touches the mucous membrane or open wound after the patients are sick. They do not seem to understand what a 21 day, non infectious incubation period means. The man in the Dallas hospital was not sick. He did not have a temperature increase, he was not vomiting, nor was he peeing on people feet, especially those with broken blister on their big toe, certainly ridiculous. People respond to this talking heads as if they believe what they hear—panic sets in and then it is too late to prevent them from doing ridiculous things—for example, not traveling, which caused them to sell off airline stocks. Oh, and we cannot forget, their news show ratings go up which is what the news media wants but also it may mean people want to be panicked. Can you, in your wildest imagination, think that anyone on any of those planes, even the person in the seat next to the patient was infected?   

Although not as headline grabbing, they are doing the same thing with the enterovirus infections. I have no idea of what the “true facts” surrounding the infectivity of this virus really is or the consequences of being infected. There is something fundamentally wrong in the chain of understanding between the people, the medical community, and the media.   

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OBAMACARE EXPOSES MASSIVE FRUAD

I said it before and I will say it again; Obamacare has exposed one of the greatest corporate frauds perpetuated on the American people known. WHY THIS IS NOT HEADLINE NEWS ACROSS THE NATION, I DO NOT KNOW. Collectively, the health insurance companies were selling fraudulent polices wholesale. They attracted buyers of these policies by the simple expedient of charging a low price. Of course, these cheap policies could not pay the policyholder’s medical needs and make a profit. The policies included many small print exclusions and inclusion written in legalese and upheld by the courts: excluding paying for preexisting condition to the point of being ridiculous, for example, being a woman is a preexisting condition for pregnancy. In addition, policy lifetime maximums were far too low, deductable far too high and company profits were ridiculously high to name but a few of many, many things. Paying for a health insurance policy meant nothing; if you got seriously ill, you went bankrupt.

As is the case with “all” insurance policies, no one outside the industry knows how much coverage they actually need; they do not nor cannot know the future but neither can the insurance companies. They only know when it is too late. What companies do is spend millions of dollars compiling actuary tables that tell what the future might hold from the past and based on that they formulate the cost of a policy. Our government is there to do what we cannot do for ourselves and Obamacare is a case in point. A legislative committee struggled through data and compiled an actuary table of their own that indicated policies health insurance companies were selling, industry wide, were far below being adequate; of course, they were the most sought after “cheap ones”.

Insurance company lobbyist on Capital Hill denied this was the case saying if it were so, it would be rare; thus, the health insurance industry lies set the stage for what turned out to be a small disaster for the president. Using the information they gathered, the committee set minimum standards for health insurance policies; we do not want the government paying for sub standard policies that are inadequate—really, cheap but fraudulent policies that do no one any good. The committee was acting in the best interest of the taxpayers. Obama believed the committee, who in turn believed the lobbyists, when they said it would be a small number of policies thus he made the now  famous statement that “if you like your health insurance policy you can keep it”.

As it turned out the industry was defrauding thousands upon thousands of people, far more than anyone expected; selling policies that made billions in profits but did no on any good. When the truth made it clear that these polices were no good, the insurance companies sent out notices canceling thousands of them; the  truth is that Obamacare exposed their fraud and the had to withdraw those polices. The industry cleverly mounted a huge campaign to blamed Obama for lying; when actually, he was saying he believes in American industry and did not believe big business was massively defrauding the American people.  He found out the truth, the hard way!

There is a big message in this story; some big industries have become more and more corrupt with time; the immorality of the MBA thesis of “profit first”, which is running unchecked in our country; the holding of profit above everything:  motherhood, baseball, and apple pie. Democrats should hold congressional hearings of big company executives and ask them if they need more government regulations? If they answer no, then investigate them. We now know they do. Why do I say Democrat should hold hearings? Can you imagine that happening if Republicans control both houses of government? Remember once you vote in November you cannot get your vote back.    

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WARNING TO CUSTOMERS OF BIG BUSINESSES

A Republican “dirty tricks” ad that really bothers me says that Obama blatantly lied to the America People. The ad states, “They knew Obama's ‘you can keep your health insurance’ promise was a lie. But they forced ObamaCare on YOU anyway.” Because the ad reflects on what is so fundamentally wrong with American business may attention was called to it. Of course, the ad is disingenuous. Obama did say, “If you like your insurance policy you can keep it”, which to everyone surprise turned out not to be true.

To evaluate what happened, let me first explain why what he said turned out not to be true. The Affordable Care Act has a provision that honors all existing health insurance policies, with the proviso that they are genuine health care policies.  We all know there are insurance companies that sell policies at a low premium but the policies do not provide even minimum coverage they are fraudulent policies. Of course, any responsible government program would not pay for such policies. What was unexpected was the massive number of those policies on the American market but also, that the companies selling those polices were so well respected. Every swindle has clever aspect; the policies were cheap, were sold by reputable companies, and those who bought the policies were told they were good policies; the purchasers thought they had found a good deal. The affordable care act specified minimum provisions for a policy to qualify to be covered under the affordable care act. In other words, the government was policing the industry, which is something businesses, like bank robbers, do no want because the prime job of the government is to protects the consumer from their fraudulent practices of the rich and powerful. The authors of the Affordable Care Act, but especially our president, had no idea they would uncover such a widespread practice, thousands and thousands of fraudulent policies. In addition, the companies realized the game was up so they started cancelling polices they knew were inadequate. Like magic, it was suddenly not company fraud but was the fault of the Affordable Care Act that policies were being cancelled. People liked their health care polices because they had been told they were good polices and they were cheap. However, it is not like car you use everyday, health care insurance is use only when you try to use it do you find out it is fraudulent. After you are bankrupt, by a medical need, it is too late. The premium you paid for many years disappears into the bowel of the insurance company to be lost forever.

The Affordable Care Act uncovered many other deceptive and downright fraudulent practices as well. Including but not limited to failure to pay for preexisting conditions, hidden deductibles, and policy maximum written in “legalese” the small print. We all know the drill; it was written correctly in the policy by a very expensive attorney right there in the policy that you read and signed, and a judge tells you it all “honest” and “legal” as he evicts you from your home to be sold to pay your medical bills—don’t worry the insurance company already got theirs.      

To see legitimate business people advancing this ad calling Obama liar should be a warning to their customers, even if they do not practice such practices in their own stores, manufacturing industries, and other businesses, they condone them. Keep you guard up; just because they are big does not mean they can be trusted. Lust for profit does strange thing to the human mind.  

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UNFOLDING THE SCIENCE OF AGING

Real scientists often express their dismay with scientific storytellers. The truth of the matter is that the most important “storytellers” are most often scientist themselves but with journalistic talents who write full-length books and not journalists who publish articles in local newspapers and popular magazines. Some of these books have well over 1,000 references, which in turn reference thousands more, compared to an article that originated from the summary of one or two scientific papers. Any one who has struggled to read and understand a scientific paper describing original research can appreciate what it takes to read and comprehend 1,000 of them in a coherent way. The bottom line is that writers comb the scientific literature for coherent gems of wisdom that they can weave into a readable story to publish in the popular press. I am talking only about those who write to inform the lay public of what is new and revealing hidden in the back rooms of science laboratories  or scientific journals available to those who pay high subscription fees. In one sense, these authors are like some veterinarians and physicians professors who do the same thing and then tell their students to apply that information to clinical treatments. Professors should be closer to the "test tube banging" scientist than even medical specialists are closer than general practitioners are. This is a process that takes years.

The danger is that journalists sometimes tend to exaggerate the results or do not understand the limits and restriction of the findings. The most dramatic examples deal with desperate people and their loved ones grasping at straws by rushing to use scientific  results without the necessary winnowing of time: terminal cancer patients are a prime example. Right now, genetics in cancer are huge in the newspapers but few understand the meaning of the results; however, aging has been a “hot” topic of interest perhaps since man learned he could die. The problem is that there is not enough information in a short article to understand how to interpret, what they are reading; scientific books help to fill in that information gap.

In the fall of 1994, I retired and was in the process of cleaning out my office when the last issue of Clinical Chemistry arrived in my mailbox. Out of habit, I glanced through it and found the managing editor was beseeching his readers to pay special attention to an article in that edition; it had to do with red wine and a compound called “resveratrol”, a relatively simple compound, which sounded like the same old thing; eat this or that and you will live longer. The editor said the article published in that issue should be believed because he and his staff thought that the numbers were too good to be true so they check and verified the techniques used; red wine prolonged life and “resveratrol” in that wine appeared to be the responsible compound. Up until that time, the only thing that prolonged life had been restriction of caloric intake. Of course, this discovery launched a flurry of research most of it buried in had to read and interpret scientific papers. In addition, a flood of “over the counter” resveratrol containing products were produced and sold with all kinds of unproven claims. This was reminiscent of the Vitamin C products that flooded markets some years earlier with the ill-advised recommendations of the marketers to take massive doses, which people did. Vitamin C or ascorbic acid is an antioxidant understood as a chemical that protects the body from the damaging effects of free radicals of which ozone is one. It sounds good and logical but it is not.

I recently read, finished it yesterday, a book by Nick Lane, Life Ascending: The Ten Inventions of Evolution. This talented science writer has a PhD in chemistry with a long research history in that field. In one section of his book, he condensed the work of a number of scientists into his book in the form of the complicated and unfolding story of “resveratrol”. In the process, he made a number of interesting points that were well worth reading. Apparently, it is one of a number of compounds, many of them that belong to a large family of signal molecules we call insulin, and their matching cell surface receptors that activate two different aging related genes. Of course, “insulin” is more of a popularized concept in the minds of most people related to sugar metabolism and reduced to a single compound and specific compound just as the disease diabetes mellitus we reduced to Type I and Type II, when in truth is not that simple: it is an extremely complicated disease complex. Basically, lack of insulin means cells starve for lack of internalization of glucose or lack of nutrition thus tying insulin to life prolonging restriction of nutrition. I would have never dreamed of such a convoluted connection between red wine and life involving genes and evolution had I not read it in Dr. Lanes book. Even though scientists have unequivocally prolonged life significantly in primitive life forms with resveratrol, it is just plain disingenuous to simplify all that science by saying “red wine” or resveratrol prolongs life, which would be equivalent to saying food or specifically sugar prolongs life or that there are just two types of diabetes

What I found exciting was the ability of scientists to compound-by-compound further unfolding the story of something as ill defined as the mechanisms associated with the length of life across all species, which is a story no single scientific paper could tell. Can critics criticize Nick Lane for inaccuracies or misinterpretations: of course, they can and will but in doing so they miss the big message. The story of “insulin” simplified to Type I and type II diabetes tells the story of that disease the same as an ancient scholar told the story of aging with the tale of a head  bowed, drooling, badly withered120 year old man who was granted a wish for prolonged life but did not have the wisdom to ask for prolonged good health.   

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VA AND SHINSEKI TRAGEDY

There seems to be a message for high-level government agency appointees revealed in the so-called Veterans Administration “scandal”. General Eric Shinseki now resigned as secretary of Veterans Affairs, became aware of some job malfeasance in his agency and ordered an investigation. Acting as an efficient administrator, which he is, he ordered an investigation, which confirmed his worst fears; budget considerations caught certain administrators in an administrative squeeze and they started to “cook the books’ to make themselves look good. The truth is that the Republican controlled congress shorted his budget in keeping with their philosophy to destroy the government; they want to force the government to get out of your lives. The VA hospitals did not have the number of physicians they needed to fill the need for appointments, especially following the tremendous impact that the Bush war that bloated tremendously the veteran’s ranks—much greater than the measly budget increase. The books showed those responsible were falsifying the appointment waiting time records but not the waiting times. This is simply a manifestation of innate self-preservation.

Shinseki being a thoughtful administration, as opposed to a knee jerk boss, was in the process of proving the allegations before firing those involved and had fired a few of them before the D.C. media got wind of the problem. The Republican establishment went wild; they could condemn the government for “mistreating veterans”; the only segment in society that both parties hold in reverence, which are veterans. If they cared too, news people could look across the spectrum and could find other example in society where socialism is acceptable across the entire political spectrum. Social security is the most prominent for example. The GOP attack makes a mockery of their objection as a party to “socialized health care”, which is what the massive veterans health program is: hospitals clinic physicians, nurses, physical therapy: everything. Much more sweeping and socialistic than Obamacare ever was or ever will be. Of course, Shinseki would have fired the responsible employees had the Republicans not forced him to resign before he could prove who they were. It was a victory for irresponsible administration. It was a great victory for shifting the emphasis of a huge government agency from caring about people, which veterans are, to caring about the economic elite, a huge step toward destroying the Veterans Administration. We can now add the VA to their moves to destroy environmental protection agency, consumer protection, public schools, social security, and privatize health care of all kinds.   

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VETERANS HEALTH CARE IS A CONSTITUIONAL RIGHT

When a conservative is right it is worth taking notice. This morning on #Steve Kornacki show, Up (MSNBC) guest #Col. Jack Jacobs, while taking about the so-called Veteran Administration Scandal, made an obvious point. The government should fold the Veterans Administration health care, which is a parallel government run health care system, into the current Medicare, Medicaid, and Affordable Health Care Act. I would agree with that sentiment, as would most Americans; however, predictably, the radical conservative right minority would freak out if congress moved in that direction. Conservatives consider all things “Pentagon” is their “to have, to hold, and to cherish for ever and ever” and that include military veterans. The conflict for “the hate the government at every turn” Tea Party Types, should be obvious, even to the most political naïve; such legislation would immediately expand government control of the entire health care system. There would be few things in America hated more by right-wing conservatives than the government regulating anything but especially “things” military.

In my mind, this conflict is beyond reason to the point of being insane. Republicans in general and Tea Party types specifically are flag waving patriots. Brave men (not women) in uniform with shouldered bayoneted rifles on their shoulders, marching to martial music—the flag, fife, and drum thing—with the people watching their heroes pass those the helpless on the curbs, waving wildly, and throwing flowers while holding their hands over their hearts and women looking at them with loving, admiring eyes. That is all part of some sort of right wing moral order.

In the halls of congress, these same types see them selves as protecting Americans freedoms, which is where the conflict with the Constitutional mandated “we the people” enter the picture. They are not talking about defending all American freedoms in those constitutional terms; it is their personal freedom, not the freedom of all of the people. It seems the Tea Party defines “personal” more narrowly in their minds than in the minds of a liberal. Some of the more blatant examples of this conflict deal with voter suppression in North Carolina or  the plantation South, for example; if you are black or brown your not part of their group—royalty or economic elite, which is how they look at themselves; as the ruling class; restated they are the only ones fit to rule. My critics object to referring to the South this way; they claim it is not “just the south” but is universal. Of course, they are right in sentiment but not degree when it comes to skin color. However, the example serves to outline a general perception—us verses them—reduced to a problem of personalized rights.

Extend the same sentiment to immigration reform where the entangled worker/race conflict is currently at a boiling point. We are an immigrant Nations; conservatives know this and are proud of the fact but also their stance on this issue points out the fallacy of their arguments. Right wing types want to restrict immigration to Western European but realize that western Europeans are not there in the needed numbers willing to work in agriculture. They want the Latino workers but do not want them to have the vote. Our history, as Nation, if filled with examples of legislation aimed at doing this sentiment starting with the Constitution. Certain people wanted to count the numbers of slaves to increase their representation in the population based House of Representatives but did not want “them” to have power; thus, the founding fathers concocted the asinine 3/5 of a man counting system. There were a number of preferred immigration laws as well; excluding Asians and Africans; and in the time of political and natural disaster, those from Haiti. Can you imagine the internal conflict there is over this issue in the minds of people like Senators Rubio and Cruz, both first generation Cubans. Ayn Rand was a Russian immigrant who saw the divide as producers or white collars on those that count verse others, which in her mind were workers or blue collars who “threw off their chains”.

The conflict is between the people who work for a living and those who are conservative by nature. Apparently, they hate themselves so much they vote against their own interests. They vote in support of Reaganomics, cry about all the money being at the top, and vote against raising taxes to support social programs, such as health care and vote in favor of the Veterans Administration health care.  

Of course, there is the raw political divide; there are free marketers and communist often described as capitalist verses communists—communists are inferior people, which bring us full circle back to blue collars workers or those who want unions. The more radically right ones political philosophy, the more it extends to include socialism until the Tea Party declares people who vote for Democrats are socialists; thus close to being communist. It is difficult to reconcile this sentiment with our Constitution, which the founding fathers based on “we the people”. The objective of government—“we the people”—is to do for the people what they cannot do for themselves. The concept of a labor union is the same: a labor union can do for the workers what they cannot do for themselves. Right wing Tea Party types hate labor unions just as they hate government—people working together in any manner is socialism, which is next to communism except, of course, if they are Republicans working together. This is individualism in a crowded world, which in modern society is logically ridiculous as well as practically impossible: a hermit living downtown New York.

I am reminded of the time when a loud mouth conservatives talking about how union hating hard working individual farmers, were bragging about being part of the huge “tracker ride” on Washington.

“…the American Agriculture Movement decided to take their demands and their tractors to Washington. They demanded revision of the 1977 Farm Bill. They argued that the bill encouraged large-scale production, but did not guarantee of high enough prices to keep small farms in business. The AAM emphasized rallies and protests against the political system. “

It seemed beyond their ability to understand that was what a union is and does. Strange, how easy it is to shed the “honored” mantel of individualism when it serves a personal purpose. Of course, everyone can remember the Fox News rallying cry when Rancher Clevin Bundy when the entire gun toting “union hating” conservative group “worked together” against the government.   

Tragically, four veterans died in Phoenix because the VA health care system failed them. Is there any doubt that hundreds and hundreds of people die every day because of inadequate health care in the United States? What is the difference? Conservatives assume they can drag the dead bodies of those four veteran deaths through the halls congress—four of their voters—to destroy more of the socialistic government guaranteed by the constitution. The conflict is that they are forming a union of radical conservatives to rally against a socialistic program. OMG For centuries, fundamentalists cry, the words health care are not written in the constitution; as a liberal let me tell you those words are there when that document says “we the people”.

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VA HEALTH CARE IS UNFAIR

The scandal in the Veterans Administration caused me to ask a bigger question. As a liberal, I find that I am against the Veteran Administration Hospital program for one reason; it is ONLY for all veterans. Because of the all-inclusive nature of the program, some consider health care for veterans to be a liberal program but they are wrong because it is not. It is just the opposite; the weak and infirm cannot serve in the military because their physical condition excludes them from serving; therefore, the people in society who need health care the most are excluded from the VA health care system. Thus, VA health care is certainly a form of socialized medicine but it is a grossly unfair system. It is the Ayn Rand system; the ones who have get more. The government has singled out a segment of society for special treatment. For the people to considered socialized programs of any kind, above all else the program must treat everyone equally.

There is no argument that people who suffered because they served their country deserve every consideration. If they sustained life long injuries while in uniform such as from brain trauma, Agent Orange, radiation injury, or asbestos they deserve life long care—no question about it. There always will be arguments about what caused someone’s cancer, for example, but individual cases could be resolvable in a way I would expect that favored veteran. Nevertheless, when I look at my own case, I see a problem. I am a naval “combat” veteran along with 317 other sailors on the same ship. We were the target of North Korea guns that actually shot at us but failing to hit us; the point is that we were in a war zone along with dozens and perhaps hundreds of other ships; therefore, I assume all veterans on those ships were eligible for admission to veteran’s health care—why? Does everyone of the thousands of us all deserve life long health care because we were on a ship in a war zone? Worse yet, do those deserve health care because they were in uniform but not in a war zone. Should we all be so grateful to a Republican or Democrat politician for “taking care of us veterans" that we will vote for them for that reason? Of course, there were severely injured service men and women that deserve lifelong health care but, by far, most of us do not.

I am sick of hearing some politician tell me our veterans need the best of everything because we “bravely served our country”. I had the best experience in my life for four years, had the privilege of serving my county, and was proud to do so. I should add, I do not feel any ill will toward those who take advantage of the Veteran Administration Health Care system even though they do not really deserve it. It is just that I feel I have already received more from the government than I deserved in compensation. The Navy trained me in electronics and I went to college on the GI bill after serving something I could not have done without that help. The GI bill, like the VA program, is a social program that allows young people to go to college or advanced training that leads to productive lives. I avoid going to the VA for healthcare because I do not have to. As a liberal, I believe that as citizens of the richest country in the world, everyone, veteran or not, should have health care if they need it just as everyone should have free K-PhD education—if they have the desire and ability—that in my mind is only fair! It is simply unfair to pay all that tax money for political expediency.      

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OBAMACARE MAY BE REPEALED

There is a force unleashed that may be placated; however, how that happens may surprise you.

The aim of the Affordable Care Act (ACA) was three fold; number one, was to insure the uninsured; number two, was to get rid of bogus insurance policies; and number three, the biggest aim of all was to clean up the mess our free enterprise system has made of the health care.

The principle headlines have always been that the ACA would increase the number of people with health insurance, which it has done with tremendous success. Yes, there is more work to be done but so far, it looks as if we as a country are on the right road. Bankruptcies caused by not having health insurance will approach zero. Emergency rooms in hospitals around the country will no longer be filled with young accident victims, who can afford insurance but do not have it, looking for “free” health care; of course, as always, free means paid for by tax payers.

The second aim, which the government kept out of the headlines, was to stop insurance companies from cheating people by selling them useless health insurance polices. President Obama famously said, “If you have health insurance, you like; you like you can keep it”. What opened him up to insurance company directed attacks was that he didn’t say “unless it was a junk insurance policy”.  I think even the authors of the ACA had no idea of how pervasive insurance company fraud was when they wrote the legislation. People looking for cheap health insurance dumped billion of dollars into millions of fraudulent insurance policies that most of the companies were more than willing to provide. Of course, when they were exposed by the ACA, they counter attacked in dirty trick fashion; that is with the Karl “Rove-sque” fashion. The president lied! The president lied! No he didn’t he caught the insurance companies lying—big time.

The third aim of the ACA was to expose the depth of the disaster the free enterprise system created for health care in the Untied States. Almost no one but the very, very rich could actually afford health care. Sky rocketing costs cause even those people with insurance to titter on disaster. Expenses were adversely affecting or GDP: medical equipment, education, drugs, and office visits were out of control. To top it off, the insurance companies were corrupting the industry in the name of outlandish profits. It was a crisis equivalent to the worst ones Naomi Klein wrote about in her book, The Shock Doctrine.

Even though there was a Democratic congressional majority and a crisis at hand, the people had to challenge capitalism by attacking a principle industry in our capitalistic society. Our social-capitalistic society favors capitalism, which is the way our elected representatives vote, of course, supported by the insurance companies spending millions to lobby against “government interference in their business”. Even with the radical right wing screaming, they “hate Obama and his communist administration” the “blue dogs” had to vote to favor the people. To get the votes needed to pass the legislation, greed, graft, and corruption had to be exposed.

Our politicians had the entire world to look at; they saw countries were there was no health care because they were poor and countries that had socialized medicine. It was obvious that socialize medicine was working. The result was the ACA; a compromise, just as the social security act of 1935 was a compromise. However, just like the Social Security Act, it will never go away. With a Republican President and a Republican Legislature, ACA opponents my repeal “Obamacare” but they will repeal it in name only—give it a name they can claim as their own— with a few sops to insurance companies. The health care system in the Great United States has been reformed and Obama did it. 

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KATHLEEN SEBELIUS, HERO

The TV talking heads across the nation are shaking with excitement; HHS #Selelius resigns. #Rachael Maddow explained it best when she explained that was shocked that such a thing could happen, in her words, “the White house is snatching defeat out of the jaws of victory.” She is sure the right wing will attack mercilessly, as they are prone to do, to anything—and I mean anything—that occurs in #President Obama’s administration but especially to the hated Obamacare. She is right; they will attack; it will just take a few days for the hate machine to gear up because they have not been able to wound her; there is no blood in the water so they have to create some—that takes time.  

Secretary Kathleen Sebelius was responsible for planting the flag on top of the huge, out of control health care problem in the Untied States of America. I look at what she did as heroic and deserving of the respect of all Americans. Our congress created a policy to solve a festering problem created by the free market system in what we claim is the most advanced society in the world. Capitalism is great and an absolute requirement for countries to excel. What is great in our nation is that we recognize that there are things that the people must do without an uncontrolled profit motive: educations, national defense, prisons, and among other things, healthcare. Congress compromised and allowed the government to control the healthcare market by insurance reform; the best way would have been a direct-payer system; however, that wasn’t to be. Once Congress formed the policy, the president turned the responsibility for implementing it was turned over the Sebelius.

Congratulations Kathleen Sebelius! You did it. She charged up the side of that mountain and planted the American flag on top where is will proudly wave for along long time. What she did made me think of mount Seribachi on Iwo Jima. She did not do it alone; she had a group of supports; a team. Caves and “Fox” holes covered the mountainside filled with people who were willing to die, and let others die, rather than see the government interfere in private enterprise.

In 1945, when Iwo Jima happened, a terrible controversy surrounded the raising of that flag and over the years it was replace time after time but it was still there. When I was there in 1953, eight years later, I could not see the flag from my ship but I knew it had been there even if I could not see it; actually, the flag is no longer there. Japan took control over the island in 1968. What was there will remain in the hearts and minds of the American people. Nothing can change that because it was the right thing to do. Thank you Congress for the policy and thank you President Obama for caring for the “all” of the American people but especially think you Secretary Kathleen Sebelius; you are truly a veteran of a hard fought but on going war.   

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