What caused the debt? That sounds like an easy question. Could that be the problem?

One would hope that our “leaders” could get their arms around a simple question. Well, apparently we never learn.

The short-bus riders on The Hill are pretending to deal with what to do about the debt. It seems logical to ask the question in the title of this article before addressing any possible solutions. Knowing how you got here might be helpful in finding your way back.

Back to the initial debt question.

Even conservative economists acknowledge the role the tax cuts of the early aughts played in eliminating the surplus and creating a major portion of the debt. No rocket science required. No dispute, except among those who prefer playing politics and maintaining “Their” seat in Congress.

Rule of thumb: If a politician considers his career more important than the well-being of the people or the country, he/she does not belong in any public office.

Should American corporations enjoy loopholes that let them snub their noses at our country? Other countries aren’t so considerate. They use our government’s protection, services, infrastructure, airports, ports, education of their employees and enjoy other benefits of being and operating in our country.

Over two-thirds of the largest paid no corporate tax. They are freeloaders. They are parasites. And, many still get subsidies. Even some foreign corporations have discovered how to do the same. That means that you are paying their way. It means you are subsidizing them to send our jobs overseas and pay taxes to other countries. It’s difficult to fully appreciate your generosity.

Our glorious new Secretary of Wars is visiting our money in Iraq and Afghanistan. He tells us that we are close to defeating al-Qaeda. After only 10 years and we are close to defeating them? All 24 of them? Why not throw in another couple of hundred thousand and finish them within this decade?

They tell us they are drawing down a couple of squads this year from the 100,000-plus US troops over there. Why didn’t they mention our mercenary forces? They actually outnumber our troops. Whatever, I have been told in the utmost of secrecy that those military operations added somewhat to our present debt.

The oil industry needs subsidies? Enough said.

There have been various other expenses. We average consuming 170 pounds of sugar every year for every man, woman, child in this country. Aren’t we sweet? But, that just isn’t enough. Somehow, that industry just can’t survive without my pocket change. Ooops! They do survive without it. They get some of that Chinese money that puts us in debt.

If it were only the sweet guys. But, no. You either don’t have enough fingers and toes to count those struggling to get by on corporate welfare, or you belong in Ripley’s Believe It Or Not Museum.

Luckily, I already had 3 years of Chinese language courses in grad school. I can beg in their native tongue.

Cargill, Archer-Daniels-Midland (ADM), Land O’Lakes, Monsanto, Dole, Chiquita, Perdue Farms. These are needy family farmers that can’t afford to increase their fleets of corporate jets as much as they would like unless you go deeper into debt. Please, consider helping your neighborhood agricorp.

One more biggie; the drug lords. Medicare Part D. That needn’t cost the government any money, except they agreed to refrain from negotiating with the pushers and pay whatever their asking price is. Medicare is much larger than the Veterans’ Administration. They could have a lot more bargaining weight than the VA, which pays half as much as Medicare.

So, where do we cut?

That’s easy. First you cut Medicare and Social Security. Why? Because old geezers don’t need no stinking private jets, or sufficient and decent food (cat food is cheap and convenient), or full doses of their meds. They can move in with their kids. If those kids are unemployed they can squeeze out a little to help with the mortgage.

Neither Medicare (except Part D) nor Social Security has added a single nickel (or yuán 元) to the national debt. They are paid completely from taxpayer contributions via the payroll tax. Both are, and have been, running large surpluses. Those surpluses are projected to disappear in the future; Medicare, in about 12 years, or so. Social Security in several decades. Whatever, neither has contributed to our present debt problem.

We can save a few farthings by cutting the funding to such frills as air traffic control, highway maintenance, matching funds to states and local governments for practically everything they do (cops on the beat, firemen on pumpers, education, etc.), courts, passports, parks, prisons, paychecks for the troops we claim to support, the FBI, airport security, medical research, subsidies to hospitals and too many more to list.

The President says the Social Security checks may not go out on time next month. I might get upset if they decide not to send my Social Security checks. The IRS charges penalties if my taxes are late. Does anyone have any ideas about what size of a penalty I should impose?

Are our “leaders” serious? Are they planning and preparing for any of those doomsday scenarios that  are no longer unthinkable? Since it has never happened before, we really can only guess at what we will face. No. They are not planning and preparing. No. They are not serious.

Pay Up.

That first item I mentioned as playing a major role in creating our present mess needs revisiting. We have the lowest income tax rates in more than 60 years. Low taxes means the creation of jobs, so we are told. Then why are we creating the fewest jobs of the last 6 decades in the decade since the latest tax cuts? Because that old saw is a lie. With all of the misinformation, ideological nonsense and other lies getting the attention of the media, it’s time to cut through the BS and look at the realities.

For real? That’s the top marginal rates for the wealthiest taxpayers? Actually, not. That fails to take into consideration two fairly important factors. The wealthy have more deductions than those seniors without a private jet (by the way, those jets are deductible). They have so many it pays them to compensate CPAs and tax attorneys very well to make sure they don’t miss any.

The other factor is that most of the wealthiest don’t work for most of their income. They let their money work for them. That’s called capital gains. That little scam is taxed at less than working for a living. The capital gains tax rate is only 15%. Money gets a nice little benefit when it works. You don’t when you work.

You might be interested in a couple of further points about the other countries listed on these graphs. First, surveys have shown that the citizens of each of those countries are significantly happier with their lives than are Americans. Second, the overwhelming majority in each of those countries prefer their health care system to the American system. Are we missing something?

But, Mitch McConnell just repeated on the tube, with 9.2% unemployment, it isn’t the time to raise taxes, particularly on those poor benighted job creators. Well, have I got news for you. All of those other countries in the graph above that have much higher taxes, are all also doing better with employment. Look for yourself.

Note: Since this graph was constructed US unemployment has increased .5%. The others are the same or lower.

Social Security and Medicare are entitlements. We are entitled because we pay for them and were promised, by law, that we would receive them.

So, our “leaders” decide to make those who are entitled to be paid bear the burden while those who are not entitled cavort in their private jets and enjoy unconscionable incomes and subsidies. The 400 wealthiest are worth as much as 150,000,000 Americans on the other end. Yet, many pay no income tax.

We partied on a credit card for the past 30 years and the loudest voices scream for more tax cuts. I’m getting just a mite upset with some of my fellow Americans for wanting more tax cuts so we can consume our way out of debt, while damning everyone but themselves for the debt and proclaiming their patriotism. The new American motto seems to be, “No pain, just gain.”

I was not totally into the celebrations of this 4^th of July. I am not quite in the mood to lead everyone in a chorus of, I’m Proud to Be an American.

Will our honorable representatives treat us fairly? Surely, you jest. I’m inclined to agree with Jay Leno, “If God had wanted us to vote, he would have given us candidates.”

. .

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In her gentle and succinct manner, Cheryl took me to task for my last post. To quote, “Who are you and what have you done with Crawford.”

I did respond in the comment area but felt the need to explain more fully. Her objection didn’t specify one aspect, so I intend to address each of the matters in its own, separate post.

There were four points: Afghanistan, healthcare reform, the economy and a strategy to get from the present sorry state to solving these problems. First, let’s explain the problem of Afghanistan.

Just what outcome do we want in Afghanistan? No. Be realistic. There is a better chance of Michelle Bachmann making a rational statement than of establishing a functioning, stable, Western-style democracy in that relic of the 14^th Century.

However much we are disgusted by the inhumane tenets and actions of the Taliban, they didn’t attack the Twin Towers. True, they cheered those who did it but they never attacked anyone outside of their own territory, at least until we drove them into Pakistan. We may want to eliminate such barbarians but that is neither our prerogative nor our responsibility.

The justification for our attacking Afghanistan was to strike back at al-Qaeda and deny them a base of operations. They now have bases in Pakistan, Somalia, Iraq and a few other places where they don’t have to compete with Club Med. We need to change the definition of success.

I subscribe to the tenets of the Powell Doctrine as I understand it. We should commit our troops only when our vital interests are at stake. We should have clearly defined and limited objectives. We should employ overwhelming force. We should have an exit strategy. None of those criteria were met when we militarily engaged in Afghanistan.

According to the Army’s own book, the metrics for fighting an asymmetrical war in that country require a force of at least 500,000. That would call for a major, politically and economically unattainable increase in the size of our army.

So, with 68,000 troops in country, how did our military leadership come up with the stated need for 40,000 additional troops? First, they wrote off about half the country. It would not be defended. Also, certain necessary, according to the book, operations would be eliminated. That helped get the required number down to 200,000. That still leaves a slight, unaccounted discrepancy.

That means we don’t have and never will have the force required to permit the government of Afghanistan to establish viability. And just what is needed from that government?

They need a stable government. They need the support of the people. They need stable conditions; reasonable safety for their citizens, infrastructure and economy. They need to substantially eliminate corruption. They need well-trained and reliable military and police forces. That’s what is needed. What do they have?

The brother of the President is a, if not the, major drug trafficker in the country. The “government” is an unruly conglomeration of tribal warlords. The President should more accurately be called the Mayor of Kabul. He retained that lofty position by a universally acknowledged corruption of the electoral process. There is no reliable or well-trained military or police presence. Whatever support the government has depends on continuing the rental payments. None of that bodes well for a viable national government.

In the previous post I gave the possible length of time our services would be needed as 400 or, possibly, 700 years. That obviously was said with less than full seriousness. When juxtaposing the present state of affairs against the stated requirements demanded by the Army’s own policies, it appears that the actual time would be somewhat in excess of infinity.

Now, taking all of that into consideration, how many troops should we commit and for how long? If there is no expectation of success, the killing of more of our young people is unconscionable.

Employment of military force is supposed to be the last, unavoidable option; not the first. Military leaders are imbued with the desire to win. That is what we expect and desire. Once we are involved in a conflict, military leaders generally are the last ones wanting to stop short of victory. If victory is definitely not in the cards, our need for their advice is limited to how to accomplish an orderly disengagement. They are not the ones to determine national policy.

National policy is the purview of our political leadership. We have many important, indeed vital, interests as a nation. Afghanistan is not one of them. It detracts from more important issues. It diverts resources from those other interests.

Will a decision to do what needs to be done represent a political liability? Yes, but it is unavoidable, except at great and unnecessary costs to our military, both institutionally and individually to many young fathers, mothers, sons, daughters and other kith and kin.

As a personal aside on a lighter note, the graphic of a spanking brought to mind my days at a military prep school. The football coach also had to teach a few classes. He was known as Man Mountain. He had been a star lineman at the local college, back when you played both offense and defense. He sat on the bench of the New York Giants for two years. He was far ahead of his time in size.

One time he caught two brothers and their cousin cheating. He made each stand to one side of his cleared desk resting on their elbows. Each malefactor received one blow from his paddle. He used only wrist action. The result in each case was a cadet sprawled on the floor on the other side of his desk. Oh, those wonderful memories of childhood.

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Who’s in charge? Here is an article from the New York Times illuminating the real role that al-PhARMA is playing and how the administration is prostituting itself, unnecessarily.

Be prepared to be sickened. Understanding what they are doing and how they are doing it spotlights just who is in control and why the final result of “reform” will end up costing far, far more than needs be.

August 6, 2009
White House Affirms Deal on Drug Cost
By DAVID D. KIRKPATRICK

WASHINGTON — Pressed by industry lobbyists, White House officials on Wednesday assured drug makers that the administration stood by a behind-the-scenes deal (emphasis added) to block any Congressional effort to extract cost savings from them beyond an agreed-upon $80 billion.

They are assuring the drug dealers of their intent to keep their promises. This while caving on their promises to those who elected them. Obama pretends that he is standing back and letting the Congress develop the plans but, as that sentence says, he is prepared to interfere with the Congress by blocking their efforts – not that Congress is doing us many favors.

It is important to understand the $80 billion concession the drug dealers have promised. First, that is over 10 years. The bulk of it is directed at the Medicare Part D donut hole. When seniors reach $2,700 (composed of their premiums, deductibles and co-pays plus what the insurance company has paid) the donut hole appears. The senior pays 100% while in the hole. To get out of the hole $4,350 must be reached. This upper level is composed of only the seniors’ expenditures, so a senior must pay much more than the $1,650 you get by subtracting the first number from the second. The seniors still must pay their premiums while the insurance company is paying nothing. Few get out of the hole.

The drug dealers have agreed to only charge 50% of retail to seniors while they are stuck in the hole. But, this applies only to their brand names. They will continue to make obscene profits at that reduced rate and hope to entice seniors to stay on brand names rather than purchase generics.

Drug industry lobbyists reacted with alarm this week to a House health care overhaul measure that would allow the government to negotiate drug prices and demand additional rebates from drug manufacturers.

This is the key. al-PhARMA wrote the Part D bill. They included the prohibition on Medicare negotiating any pricing. The Veteran Administration has been negotiating all along. They pay about half of what Medicare pays. Since Medicare is by far the largest purchaser of medical goods and services, you might imagine keeping that provision is worth far, far more than $8 billion a year. Individual companies have paid fines in the neighborhood of $1 billion for fraud against the government. While we think that is a lot of money, they consider it the cost of doing business, pocket change.

In response, the industry successfully demanded that the White House explicitly acknowledge for the first time that it had committed to protect drug makers from bearing further costs in the overhaul. The Obama administration had never spelled out the details of the agreement.

Notice that they feel they can demand the administration do their bidding. They are willing to make the “behind-the-scenes deal” public in order to hold Obama’s feet to the fire. Have you ever tried to demand that the president follow your demands?

“We were assured: ‘We need somebody to come in first. If you come in first, you will have a rock-solid deal,’ ” Billy Tauzin, the former Republican House member from Louisiana who now leads the pharmaceutical trade group, said Wednesday. “Who is ever going to go into a deal with the White House again if they don’t keep their word? You are just going to duke it out instead.”

Billy Tausin was the one responsible for shepherding the Part D bill through Congress. He then left Congress to become president of al-PhARMA, at a salary of $2 million per year.

A deputy White House chief of staff, Jim Messina, confirmed Mr. Tauzin’s account of the deal in an e-mail message on Wednesday night.

“The president encouraged this approach,” Mr. Messina wrote. “He wanted to bring all the parties to the table to discuss health insurance reform.”

Why anyone would want to bring the enemy, those who created the mess, to the table for planning the strategy of the battle is beyond comprehension, beyond the realm of sanity.

The new attention to the agreement could prove embarrassing to the White House, which has sought to keep lobbyists at a distance, including by refusing to hire them to work in the administration.

Is there any doubt that they deserve to be embarrassed?

The White House commitment to the deal with the drug industry may also irk some of the administration’s Congressional allies who have an eye on drug companies’ profits as they search for ways to pay for the $1 trillion cost of the health legislation.

But failing to publicly confirm Mr. Tauzin’s descriptions of the deal risked alienating a powerful industry ally currently helping to bankroll millions in television commercials in favor of Mr. Obama’s reforms.

Go ahead. Alienate them. Requiring negotiations and a few more easy changes could pay for at least half of that $1 trillion, a number that is artificially and unnecessarily high anyway. Their power will become more of a nuisance than a threat.

The pressure from Mr. Tauzin to affirm the deal offers a window on the secretive and potentially risky game the Obama administration has played as it tries to line up support from industry groups typically hostile to government health care initiatives, even as their lobbyists pushed to influence the health measure for their benefit.

Are the drug dealers really on Obama’s side? Do you think that the largest, most powerful lobbying machine is sitting on its hands. Before this reform issue came to the fore, al-PhARMA had 638 lobbyists on Capitol Hill. They outnumbered the 435 Representatives and 100 Senators. They are angling for more. Universal care gives them more customers. You’ve heard that 47 million have no coverage. That figure is old. The latest number is 52 million and growing daily as more jobs are lost.

In an interview on Wednesday, Representative Raul M. Grijalva, the Arizona Democrat who is co-chairman of the House progressive caucus, called Mr. Tauzin’s comments “disturbing.”

“We have all been focused on the debate in Congress, but perhaps the deal has already been cut,” Mr. Grijalva said. “That would put us in the untenable position of trying to scuttle it.”

He added: “It is a pivotal issue not just about health care. Are industry groups going to be the ones at the table who get the first big piece of the pie and we just fight over the crust?”

Congress needs  to wake up.

The Obama administration has hailed its agreements with health care groups as evidence of broad support for the overhaul among industry “stakeholders,” including doctors, hospitals and insurers as well as drug companies.

Everyone is at the table but the people. They are not working on healthcare reform. They are modifying insurance coverage.

But as the debate has heated up over the last two weeks, Mr. Obama and Congressional Democrats have signaled that they value some of its industry enemies-turned-friends more than others. Drug makers have been elevated to a seat of honor at the negotiating table, while insurers have been pushed away.

“To their credit, the pharmaceutical companies have already agreed to put up $80 billion” in pledged cost reductions, Mr. Obama reminded his listeners at a recent town-hall-style meeting in Bristol, Va. But the health insurance companies “need to be held accountable,” he said.

“We have a system that works well for the insurance industry, but it doesn’t always work for its customers,” he added, repeating a new refrain.

He needs to realize that it works even better for the far more profitable drug industry. Prescription drugs, taken as prescribed, are the 4^th leading cause of death in this country.

Administration officials and Democratic lawmakers say the growing divergence in tone toward the two groups reflects a combination of policy priorities and political calculus.

With polls showing that public doubts about the overhaul are mounting, Democrats are pointedly reminding voters what they may not like about their existing health coverage to help convince skeptics that they have something to gain.

“You don’t need a poll to tell you that people are paying more and more out of pocket and, if they have some serious illness, more than they can afford,” said David Axelrod, Mr. Obama’s senior adviser.

The insurers, however, have also stopped short of the drug makers in their willingness to cut a firm deal. The health insurers shook hands with Mr. Obama at the White House in March over their own package of concessions, including ending the exclusion of coverage for pre-existing ailments.

This is just one of their broken promises to Congress in 1993.

But unlike the drug companies, the insurers have not pledged specific cost cuts. And insurers have also steadfastly vowed to block Mr. Obama’s proposed government-sponsored insurance plan — the biggest sticking point in the Congressional negotiations.

The drug industry trade group, the Pharmaceutical Research and Manufacturers of America, also opposes a public insurance plan. But its lobbyists acknowledge privately that they have no intention of fighting it, in part because their agreement with the White House provides them other safeguards.

Mr. Tauzin said the administration had approached him to negotiate. “They wanted a big player to come in and set the bar for everybody else,” he said. He said the White House had directed him to negotiate with Senator Max Baucus, the business-friendly Montana Democrat who leads the Senate Finance Committee.

Mr. Tauzin said the White House had tracked the negotiations throughout, assenting to decisions to move away from ideas like the government negotiation of prices or the importation of cheaper drugs from Canada. The $80 billion in savings would be over a 10-year period. “80 billion is the max, no more or less,” he said. “Adding other stuff changes the deal.”

They don’t need to be in a position of making demands. They need to be the target of demands.

After reaching an agreement with Mr. Baucus, Mr. Tauzin said, he met twice at the White House with Rahm Emanuel, the White House chief of staff; Mr. Messina, his deputy; and Nancy-Ann DeParle, the aide overseeing the health care overhaul, to confirm the administration’s support for the terms.

How many people mentioned in that paragraph represent your interests? The answer is zero.

“They blessed the deal,” Mr. Tauzin said. Speaker Nancy Pelosi said the House was not bound by any industry deals with the Senate or the White House.

But, Mr. Tauzin said, “as far we are concerned, that is a done deal.” He said, “It’s up to the White House and Senator Baucus to follow through.”

As for the administration’s recent break with the insurance industry, Mr. Tauzin said, “The insurers never made any deal.”

- 30-

So, we have deals in the back rooms and under the table. We have a primary culprit in creating our healthcare mess making demands and threats. The President is going to force Congress to its will (ironic when they are showing no backbone) as a part of his bipartisanship, I’m guessing.

I am disheartened. I am sick. We are no longer citizens. We are subjects. Plutocracy rules.

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No servant can serve two masters: for either he will hate the one, and love the other; or else he will hold to the one, and despise the other.

The Biblical citation is also found, excepting one word, in Matthew 6:24. Matthew substitutes man for servant. Since the subject is public servants, I lean toward Luke.

In my last two posts I mentioned my challenge to Bart Gordon, Blue Dog extraordinaire, to debate me on healthcare reform. I made a mistake.

I wanted to debate the representative of my congressional district, which includes the counties of Sumner, Rutherford, Wilson, Robertson, Macon, Trousdale, Clay, Jackson, Smith, Overton, Putnam, Dekalb, Cannon, Bedford and Marshall. It appears that this district is unrepresented. Perhaps it’s time to break out the old rallying cry of “No taxation without representation.” It certainly applies.

It seems that Representative Gordon’s district includes Blue Cross, Cigna, Aetna and the other members of AHIP, as well as the American Hospital Association, al-PhARMA and AARP. The challenge stands, however. Otherwise I would have to find some other representative to debate.

I was just ruminating about the Blue Dogs and thought that their constituents must have a very weak case if it costs so many millions to get their side out. Another thought was that they are always attacking the ephemeral “public option.”

Their version of the public option is socialistic, government-run, rationed care, expensive, denial of choice, et cetera, ad nauseum. We are always on the defensive. Someone asked, what’s so good about the private plans. Let’s go there.

Private plans are far more expensive. Not only do they average close to 30% more in administrative costs than Medicare, they have to charge enough to make a profit. Cigna’s CEO makes $12.2 million a year, plus stock options and a $73 million golden parachute. You pay for that. I don’t think any government employees make quite that much. Oh, and they have to buy all of those congressmen and spend all of that money defending lawsuits and paying multi-million dollar fines for fraud.

Private plans ration care. Several months ago a 19-year old girl was told a liver transplant was “experimental.” Tell that to Steve Jobs. National publicity caused the insurance company to reverse itself, the day before she died. Waits for most types of transplants are longer in the U.S. than most European countries and elsewhere.

Private plans also ration care by canceling customers, limiting total expenditures and denying preexisting conditions. Between 1995 and 2008 the percentage of small and medium businesses providing health insurance to employees dropped from 67% to 38%. That’s called rationing by price.

A former New York Times health reporter says that at any given time 65% of us have a prescription drug in our home. Since the health industry has access to pharmacy records (oh, you didn’t know?) they can easily find a “preexisting condition” to use for denying you coverage. Do you take a birth control pill? That means you have the preexisting condition of potentially bearing a child. Did a psychiatrist prescribe an SSRI to help you when a parent, child or spouse died?

Since most private plans are through employers, a pink slip means you just lost your coverage. The stimulus package included some money to help a little with the temporary Cobra plan. That could still run you $700 a month or more. That’s alright though. You can cover that from your unemployment check.

The largest contingent of people filing for bankruptcy are those forced to do so because of medical bills. The majority of these people had private health insurance. I have not found a single case of anyone forced into bankruptcy because of Medicare.

Private plans frequently limit your choice of providers, physicians and hospitals. I have had 32 or 33 doctors in the past 4 years while covered by Medicare. I always ask for referrals from those I already see. I have not had a single problem and, Nashville being one of the major hubs for hospitals and medical care, many of my doctors have national or regional reputations.

Private plans resemble a Keystone Cops version of the Mafia. Consider this. You own a retail shop and the Mafia comes in and asks the value of your inventory. You answer $100,000. They offer protection for 30% of that. You can be certain no one will touch that merchandise, as long as you pay up.

Private plans want 30% or so for their administrative costs plus all of the other costs I mentioned above. So now you are covered. Right? Well, maybe, maybe not. Remember those 14,000 losing their private plan every day? Remember those “experimental procedures?” And, lest we forget, the price will change. It will likely double again in the next six years. The Mafia are bleeding hearts by comparison.

Private plans are socialistic. Hey, I caught you off guard with that one, didn’t I? It’s true. Private insurance plans, as well as hospitals, drug companies, et alia, get direct subsidies. They get indirect subsidies. They get tremendous tax breaks. In fact, without those subsidies and tax breaks it is difficult to see how they could possibly operate. The numbers are interesting.

Private plans put bureaucrats between you and your provider. Yeah, I know how they yell and scream that it will happen with a public option. I also know that no bureaucrat from Medicare has ever gotten between me and any of my providers. But, it happens constantly with private plans.

The private firms actually have layers of bureaucrats. Bureaucrats working for the private plans are often given goals of how many procedures will be turned down. One may also want to ingratiate himself with the boss, or just try to protect his job. They don’t have civil service protection.

Private insurance companies lie, to anyone and everyone. They are now telling Congress they will quit denying people with preexisting conditions and work for universal coverage. If you would like to check, you will find that they made the exact same promises in 1993, in their successful effort to stop any reform.

And speaking of lying, the health industry has formed and funded several “grass roots” nonprofits to help you “get the facts” about our healthcare system. You know the one, the best in the world, that provides a shorter life expectancy for men than Mexico; a higher infant mortality than Cuba.

Those congressmen might find a way to represent us mere citizens, if they were familiar with the Bible.

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Few aspects of our society need more correction than the corrections system.

For anyone unfamiliar with how I spend some of my recreational time, I do volunteer work in prisons with those suffering from mental illness. After a decade of such involvement I flatter myself that I have a better understanding of what goes on therein than John Q. Public or Joe the Plumber.

For anyone who jumps to the conclusion that I am a typical bleeding heart, let me say that I am atypical. I am a former commissioner of police. An astute visitor who has suffered through even just a few of my posts might have guessed that I am no more content with what obtains in the correctional system than I am in any other area.

We are apparently a nation of outlaws. One of every four prisoners in the world are in American prisons. We have the longest average sentences in the world. We have the highest recidivism rate in the world. Someone needs to slap our hands.

Our correctional system has no idea of what its role is or should be. Why? Because we have no idea what we want it to do. More precisely, we have too many ideas. Confusion.

Do we want it to keep them locked up so as to protect us? How about revenge? Perhaps we want the prisoners to be punished. Could it be rehabilitation? Actually, we change our minds. We want one combination now, another later. There is no consensus. If we were to ever reach a consensus it would change before we realized that we had reached one. There can be no reform unless and until we decide what we want.

Follow me now. This may not seem to make sense. One suicidal prisoner I was dealing with was given two weeks of solitary. He had to wait a couple of weeks for an opening. The prison put two people in every solitary cell. See what I meant? Can you say overcrowding?

One of the biggest problems is that politicians never lose votes by being seen as tough on crime. If they feel a need to shore up their support, they concoct a new way of toughening the laws. They have focused primarily on two areas.

The first is the issue of mandatory sentences. To me this a violation of the intent of the Constitution. It is a case of the legislative branch overstepping their authority. They are impinging on the prerogatives of the judicial branch. They are taking away the right of judges to judge.

The entire thrust of our legal system is based on our being treated as individuals. The circumstances in different commissions of a crime can be different. The motives and other factors of different individuals can be different. Over the centuries of the development of English Common Law, and our continued efforts to refine those traditions in this country, we relied on judges to look at the crime, the circumstances and individual involved to decide the appropriate punishment.

By putting mandatory sentences on the books, the legislatures are usurping the very job of the judge. They are denying your individuality and mine. They are corrupting 800 years of progress in assuring fair and equitable treatment of the citizenry. And they do this merely for votes.

The above ties in neatly with the draconian laws legislatures have enacted directed at whatever offends them or one of their constituents.

New York State has been considering lately ridding itself of some of what are known as the Rockefeller Laws. These are laws enacted in 1973, during Nelson Rockefeller’s time as governor. They focused on the use and abuse of drugs.

The law imposed a mandatory sentence of 15 years to life for selling two ounces or  possessing 4 ounces. Ounces of what? Well, it could be heroin or cocaine or opium or morphine or even marijuana. That matches the penalty for 2^nd-degree murder. That seems a bit much, but maybe that’s just me.

Has the State of New York acquired a sense of equity or empathy? No, not really. They are looking for ways of reducing the prison population. Apparently they have decided that saving money trumps the safety of their citizens, revenge, et al. Cracking down on drugs combined with harsh mandatory minimum sentences worked to violate the sanctity of the Commandment to Reduce Taxes. They don’t seem to appreciate that this action is a tacit acknowledgment of the error and excessive taxation of the past 36 years.

So, they want to reduce expenditures. Reversing the Rockefeller Laws is one way of doing that, at least it appears to do so. Another way to reduce costs is to reduce the already inadequate funds for helping those released to adjust to life on the outside.

The problem is that targeting these two areas for budget reductions is insane. Or, maybe the real problem is that legislators think this makes sense.

The economy is worse than simply bad. It is a basket case. Just at this time they intend to shove hundreds of thousands of people unwanted by employers into the job market. They want to top this off with reduced resources to prepare them for gainful employment. Aren’t you glad they are saving your tax dollars?

Just a side note: many jurisdictions are making budget cuts that include reductions in law enforcement personnel.

Do you think it’s possible that there may be unintended, however obvious, consequences? Would you like to try to tally up the increased costs of such stupidity? Rest assured, there will be costs, both financial and social. Welcome to Alice’s world in Through The Looking Glass.

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You’ve heard all the good news coming out of Washington.

al-PhARMA has generously offered to cut their theft by $80 billion over the next 10 years.

The health insurance industry is promising to reduce their greed by 1.5% for the next 10 years.

HCA and other the poor hospital corporations (ignore all of those construction cranes) are offering to forgo a fraction of their annual increases.

What more could we possibly ask for? How about a bit of honesty and some serious savings?

We should note that with universal healthcare, or something approaching it, there will be more patients for the hospitals and more customers for drugs. The insurance companies are expecting more clients as well. The pie will be bigger and they all want a private system to ensure they can continue to leech off of the misery and misfortune of their fellow Americans.

The insurance companies have signed up one-fourth of those eligible for Medicare for a scam. The companies get the Medicare monies plus an additional $11 billion a year subsidy. They promised it would result in better outcomes. It hasn’t. There’s an attractive saving.

If I say let’s rid ourselves of the prime culprits who created the current mess, some will scream that all of those poor, unnecessary insurance company employees will be out of work. Actually, a single-payer system will create far more jobs than it eliminates. It also gives these people something to do which will benefit rather than harm the rest of us. Savings and more jobs.

The savings would even pay for their retraining. The executives would have to adjust to a significant pay cut. I recommend they begin a savings account now. They might even consider selling 3 or 4 of their mansions and trading down a couple of their private jets.

Hospitals may complain about the government requiring them to behave in a socially responsible manner but most are adequately subsidized. There are numerous areas of possible savings for the government vis-a-vis hospitals. Some are obvious, some not.

Without an autopsy many fatalities are ascribed to auto accidents. Was the driver made drowsy by medication? Did a mixture of drugs prove toxic? Hospitals were required to autopsy 20% of the deaths they handled. They failed to do so. So, once again the government relented to the lawbreakers. We are left with less information about causes of death than we could use. This costs lives and wastes money.

Medicare pays for an autopsy when anyone over 65 dies. They pay for it. The hospitals take the payment. They don’t perform the autopsies. The hospitals don’t want their mistakes known. The same with physicians.

The White House is giving major play today to an announcement that the hospitals are offering a savings of $155 billion over the years. That seems too specific a number when one sees the how vague and lacking in detail the “deal” actually is. Don’t get too excited about it yet.

The drug companies don’t want you to be reminded that prescription drugs, taken as prescribed, are the 4^th leading cause of death. The information gained from knowing the real cause of death in many cases contributes to the saving of lives and money.

Prescribing a drug for something not approved by the FDA is known as prescribing off-label. It is against the law for drug companies to even suggest it. Surprise, they do it anyway. One drug, Neurontin, earned over $9 billion from off-label uses. That is over 90% of its total earnings. Not a single scientific study showed it to be efficacious for any of these off-label problems.

Neurontin was approved for epileptic seizures. It was almost useless, even for that. It was to be used as a second drug to aid a primary drug if it wasn’t doing the job. The company trained their sales force to break the law by recommending it for essentially everything: ADD, manic-depression, sexual dysfunction, hiccups, any neurological disorders they could think of, tremors, Lou Gehrig’s disease, peripheral neuropathy, migraines and a host of other maladies.

John Ford, a senior marketing executive, told a meeting of salespeople, “That’s where we need to be, holding their hand and whispering in their ear. Neurontin for pain, Neurontin for monotherapy, Neurontin for bipolar, Neurontin for everything.” He also stated, “I don’t want to hear that safety crap either. Have you tried Neurontin? Everyone of you should take one just to see there is nothing. It’s a great drug.” This was in response to a question of tripling the approved dosage.

At least $9 billion was wasted on off-label and the remaining billion dollars was spent on something that barely worked in the studies the company itself conducted. Those studies, by the way, were definitely not scientific. They ignored such niceties as randomization, double blinds and placebo-controlled protocols.

Such cavalier behavior, in defiance of the law, is not limited to one drug, or one company. It is rampant. It is costly. There needs to be penalties for physicians prescribing off-label. The government could save billions by refusing to pay for such prescriptions.

They will claim that it is sometimes advantageous. Create a waiver office. Require a waiver in advance if it is to be covered. Records could be kept to see which drugs and which prescribers show up too frequently, prompting an audit. Major savings and fewer lives lost to untested medications.

Presently, the overwhelming majority of research and advertising money spent by the drug companies is aimed at “me-to” drugs. When a competitor has a major success they copy the drug but slightly modify a molecule for the purpose of obtaining a patent. Patents should be given out only one to a class of drugs. Coverage should be for generics only, once they are available. This would provide enormous savings.

The government has no interest in promoting or paying for lifestyle drugs. Yeah, you know what I’m referring to: Viagra, et al. Here is a bit more of a savings.

The members of al-PhARMA are subsidized by the government in many ways. This come through tax advantages that other industries don’t enjoy. It comes through both direct and indirect subsidies.

Some of the biggest breakthroughs in the field came from government labs or academic labs supported by tax monies. The drug lords get to claim credit and profits for these. Why should we taxpayers pay the drug companies to advertise, market and profit from these drugs? Once again, significant savings.

There is no earthly reason for advertising drugs to the public. Only the US and New Zealand permit it. Does the patient know about a drug that was advertised on TV while his physician is unaware of a treatment for the patient’s problem?

Which drugs receive the most airtime and ink? The ones that are the most expensive, the least effective and share the market with the most “me-to” competitors. The savings to the drug companies from not advertising could be passed along. Although probably not, if properly monitored it could be a sizable savings.

Drug companies do not violate the law. The executives do. All legal judgments should be borne by the people who perpetrate the violations. At least tens of thousands of people have died in this country from the illegal actions of pharmaceutical executives. Why have none been imprisoned? Why have none been fined? Why have none been charged?

Eliminate all payments and other considerations of value to physicians from the drug companies. This costs the drug companies and, in turn, the government, insurance companies and you and me. Any physician working for or receiving remuneration from a drug company should be barred from academia and clinical practice for 5 years.

Physicians average an income level that puts them in the upper percentiles financially. If they need free dinners at expensive diners and frequent trips to exclusive resorts in order to read medical studies or listen to paid hawkers of snake oil, they might hold on to their Lexus SUVs an extra year or two. If passed along, the drug companies’ savings would be of considerable help to patients and taxpayers.

Give us real science. We don’t automatically accept the defendant’s account in a courtroom. Why do we accept a drug pusher’s claims for his products? Time after time we see violations of accepted scientific protocols. This isn’t an occasional gotcha. This is de rigueur for the entire industry.

Destroy the FDA and start from scratch. Why are drug companies allowed to pay the FDA to divert their resources? The drug company will only pay for what it thinks is a profitable product. That translates to “me-to” and lifestyle drugs. The FDA’s priority focus of resources should be to needed drugs. The revolving door between the FDA and PhARMA should be boarded up. FDA personnel should not be allowed to work for the drug companies on the side.

When you add up the number of people covered by Medicare, Medicaid, SCHIP, the military, the VA and civilian employees of the government it turns out that the government is already paying 45% of the entire healthcare bill.

Simply extending Medicare to everyone would give us a single-payer system. That would be far more practical and far less expensive than putting the entire population on the Congressional payroll. We would get a better plan though.

The potential savings I have covered are not exhaustive. They are, however, sufficient to pay for a single-payer system without taxing health benefits or being burdened by any of the other straw men the industry is using to scare you.

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Who do you trust? John Belushi got it right. Most academics get it wrong.

Everyone in academia knows just what a symposium is. At least they think they know. Have you read Plato’s Dialogues? One was named Symposium. Yes, the Greeks had a word for it: a drunken party. I could have heard much more intelligent talk at an Animal House toga party than I heard at a medical symposium held at Vanderbilt University.

Just remember, these are the people into whose hands you put your health, well-being and life. Take no aspirin and call me in the morning.

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Where does the Congress stand on healthcare reform? Who knows?

Nancy Pelosi is the leader of the House of Representatives. She has a commanding edge of Democrats over Regressives. One would think that would give her more leeway than Senator Reid. She should be able to at least make a stab at formulating a rational reform plan. See, you thought you understood politics.

Salvador Dali may have understood what his art represented. Or, maybe not. Either way it isn’t always clear to every observer. I find we are in the same situation with regard to what Congress means. It is also fairly certain that Senor Dali had a firmer grasp of what he intended than does Congress.

Below are excerpts from Speaker Pelosi’s recent press conference. I removed those parts not related to healthcare. My comments have been interspersed at appropriate points to highlight errors, confusion and inanities in Nancy’s answers.

I should note that Chris Weigant sent me the transcript and suggested that I compose a post based on it. Chris is one of the few bloggers left on Huffington Post. He is also one of those special friends from the Internet that I someday hope to meet.

PELOSI: Health care reform will be part of how we address reducing the deficit. This and the point that real reform can make our industries more competitive are two points that need to be given far more emphasis.
Health care reform is entitlement reform, as the President so clearly states.

With that, I would be pleased to take any questions.

QUESTION: On health care, Madam Speaker?

PELOSI: Yes, ma’am.

QUESTION: There are bipartisan discussions in the Senate about an idea, looking at creating a privately run cooperative instead of a public option. I am just wondering what you think of the concept. And given the concerns among some of your moderate members about a public option, is this something you might be open to?
Co-op proposals are a sham put forward by the insurance corporations and their toadies. They are intended to be too small to be a problem for private plans. They cannot be made actuarially viable. It is an attempt to substitute uncompetitive plans for public options.

PELOSI: Not instead of a public option, no. In our Caucus, I think Members have been — I know that Members have been very clear about what their concerns might be about a public option. And I agree it should be actuarially sound, it should be administratively self sufficient. It should be a real competitor with the private sector and not have an unfair advantage. When you say the words “public option,” if that is the term of art we will be using, you have to say right next to it “level playing field.” But in our House, there is strong support for a public option, and great respect for the concerns that have been raised within our Caucus. And we will address them.
More shams. The complete inanities of a supposed “level playing field” and the overwhelming problems with all of the public options being floated in Congress are addressed in my last post, It Ain’t No Game.

QUESTION: Madam Speaker, on health care, given what you just described is going to be very complicated for people to understand, and given the experience that the Clinton health plan had, and then that we had with Medicare part D, with public worries and anxieties and confusion, what strategy are you going to follow to explain this massive bill to people? Because health care is people’s most — one of their most basic worries in life.
This is just one more reason to go to a single-payer system. Make it simple. Medicare should be expanded into Medicare-For-All. It has been around for more than 40 years. People generally find the concept understandable.

PELOSI: It sure is. It is a personal worry in terms of their health and well being. It is also an economic issue for them as well. And I always say everybody in the country is an expert on his or her health care and how to be able to afford it.
A comment such as this is patently untrue and is mere pandering.

We have our overarching message of affordability, accessibility, and quality that the President has put forth. In that framework, we will have the initiatives to help us meet those goals and are deeply rooted in those values.
This sounds good but you would be well-advised to take it with as much faith as politicians commonly deserve.
Right now, the bill is being considered, and I can only speak to the House. The three committees are working in unison, practically, with a unified staff. They will have something on the table in a week or two. Hopefully, most of it will already be scored, because at some point we have to know how much each element of it costs to see what we can afford and then how we pay for it. Because it will be paid for. And that challenge for us is to relate what we are doing here to the lives of the American people and how this makes a difference to them.
A single-payer system has such great cost advantages that it essentially pays for itself, even as it provides coverage for all of those presently uninsured and under-insured. It means that funding sources must be juggled. Some of what is now termed premiums would be called taxes. The total amount of premiums and taxes could remain the same or, given several possible refinements, actually be less than what our system presently costs.

But we are very excited about it, whether it is about prevention and wellness, which is the important part of it, investments in scientific research, that we can have personalized, customized care for all Americans, with investments in technology so that we have a common record for all people to be on it, whether it is investments in community health centers to reach out to achieve this, as many people being involved as possible, because that is hard, and community health centers will enable us to do that. Whether it is having the resources to have sufficient health care providers at every step of the way.

We will be able to explain the bill to the American people once it is — a mark comes forward, and then Congress will work its will, people will make suggestions (Except that suggestions of a single-payer system will continue to be ignored), and we will have a product that will meet the President’s values, meet the needs of the American people, be paid for, and make America healthier.

QUESTION: Madam Speaker, on health care and the public plan or government plan, whatever you want to call it, is it your belief that this is central, you know, an essential element of health care reform? Can you have effective health care reform without a public or government plan?

PELOSI: Well, let me say at the health summit the President was asked this question by Senator Grassley. You may have heard him. He said, “Don’t you think that having a public health plan is unfair in terms of competition with the private plans?” The President said, “I think a public option is a way to keep the private sector honest.” But, and we want to achieve what I just said, accessibility, quality, and affordability so that all Americans have access to quality health care. He then said if you have another way to do that, put it on the table. And that is where we are.
The majority of the President’s supporters, and many who continue to call themselves Republicans, are not being allowed to put single-payer on the table. So, that is where we really are, or aren’t.

Everything should be on the table. (Should be, but isn’t.) From our perspective here, though, there is strong support for a public option right from the start.
There is a problem in that public option is often thought to mean single-payer. They are not the same. The confusion is intentional.
And there is also full support for having it be a real competitor, not something that has an overwhelming advantage. Of course it is not for profit and it doesn’t advertise. So it doesn’t have some of the overhead that the private sector has.
Remember, to be a real competitor would require a public option to be priced artificially high in order not to significantly undercut private plans. This is to require those with a public plan to subsidize the private plans and the profits of the leeches that have put us in the position of desperately needing reform.

Already just the thought of having a public option has sort of eliminated words from the health insurance glossary of precondition, portability. Everybody seems to be subscribing to the idea that we shouldn’t have a precondition in order to get eliminating you for health insurance.
Eliminating denials due to preconditions is essential but will cause present private plans to become even more expensive.

So this is what we have come to do. Our three chairmen have asked that Chairman Dingell be the author of this bill. Every year since he has been here he has been the author of universal health care. Before that his father was. When he was a young Member of Congress in the ‘60s, he gaveled Medicare. He gaveled down (?) the Medicare bill. Very few Republican votes, by the way, on Medicare. Very few Republican votes.

So we have heard the same concerns before. But it is a pretty — as I say, this is the life work for many Members of Congress, and it certainly is the responsibility for all of us. This will happen. We told the President we would have a bill by the end of July, that it would be paid for, and that is the course of action we are on. And I commend our three chairmen, Chairman Rangel, Chairman Waxman, and Chairman George Miller , for working together, eliminating any turf challenges that occurred in the mid- or early ‘90s, 1993 or 1994, and to facilitate this improvement in the lives of the American people.

Thank you all very much.

One may think that much of what she says sounds good. Those are known as platitudes. They are also the reason for the confusion. Those platitudes must come face-to-face with the realities of the proposals to which the Congress and the President are limiting themselves, and us. They want reform without harming the health insurance and drug corporations. One or the other. Choose. We can’t have both.

For those naive enough to think that the corporations that caused this mess need to be guaranteed continued existence and unconscionable profits, email me with a list of all of those countries with a national health system who are conducting a national debate about swapping their system for one like ours.

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They are arguing the inarguable. The Regressives in Washington are arguing an issue that should have been settled during the Truman Administration.

Had we instituted a national healthcare system based on a single-payer, we would now be without a national debt. This would be true even if all the wasteful spending on the military and in other areas remained unchanged. This would be true even if the leeches on Wall Street and the prostitutes in Congress had behaved exactly as they have. How does that grab you?

While all of this unnecessary arguing has been going on, the healthcare leeches have been sneaking around putting another of their favorite ripoffs on the agenda. They have reportedly garnered the support of President Obama for banning malpractice suits. This is intended to become a part of any “reform” package.

There is no questioning Obama’s intelligence or political skills. This, however, could be a matter of his plate being too full for him to be able to adequately juggle everything being tossed into the pot.

Most people reading this have likely already formed an opinion on the issue of malpractice that differs from mine. Stay with me on this. The marketing of this nonsense has been so successful that most people are in a position of being against rationality, legal tradition, and their own self-interest, their own rights.

The American Medical Association would have you believe that all malpractice suits are frivolous. Absolutely Wrong. They would have you believe that malpractice suits are driving up the costs of health care. Wrong again. You need to take a look at malpractice suits and malpractice insurance.

Malpractice insurance rates are not tied to malpractice claims. Since the year 2000, malpractice claims have gone down substantially. Malpractice insurance premiums have risen substantially. Why? The insurance companies put the premiums into Wall Street. Part of their problem was the bursting of the dotcom bubble. Actually, since 2000, these insurance companies have done significantly worst than just about all other major investors.

These malpractice insurance companies, just as the health insurance companies, are going to continue making those obscene profits. In this instance the physicians get screwed. As the premiums increase, the physicians try even harder to protect themselves. They order more unnecessary tests; tests that end up costing everyone more. The physicians are riding a dead horse. Whatever they do will have little or no effect on the premiums they pay.

All of that was just about money. Let’s get to the real obscenity.

Prescription drugs are the 4th leading cause of death. Physicians receive almost all of their pharmaceutical training from the drug pushers. They are encouraged to use drugs in what is called “off label.” This means using these potions and nostrums for problems not authorized by an already too industry-friendly FDA.

They are also encouraged to prescribe these drugs for children when they have never been tested on children. Children are not medically just little adults. There are numerous physical, chemical and physiological differences between children and adults. Additionally, their systems are weaker and less resilient.

There is a particular problem with the area of mental health. Eighty percent of all prescriptions for psychopharmaceuticals are written by physicians in specialties other than psychiatry. Psychiatrists are incorrectly trained on the subject of mental illness. But, the other specialties are completely untrained. Eighty percent of prescriptions are written by people who rely entirely on the lies of drug salespeople. They do this out of either hubris, a desire for greater income or both.

That is just a small sample of the problems with drugs. That does not speak to the multitude of other types of problems that may be classified as malpractice. Remember, 50% of all physicians finished in the bottom half of their class.

As I write this, the television is on. President Obama is smoozing a meeting of the AMA, that group of totally unbiased people who have fought every attempt to bring healthcare to all Americans. But, back to the topic at hand.

You have probably never heard any “authority” speak simply of a malpractice suit. It seems to always be a “frivolous malpractice suit.” Can they all be frivolous? That’s unlikely. The well is being poisoned. The discourse is being intentionally slanted.

What if you have reason for seeking redress for a problem caused by a physician, a hospital, a drug company, the denial of coverage by an insurance company, et al. Do you want to be denied your chance for redress? I thought not.

We have had the right to ask the courts for relief for several hundred years. Civilization has not crumbled. If you are charged with a serious felony, you put your hopes in 12 of your fellow citizens. They are your most important barrier to unbridled government power. Do you really want to discard the judgment of your fellows if you or a loved one has been sentenced to death or disability by the ineptitude of one you pay to heal you or yours?

Are you willing to cast aside all of the legal protections you have that were developed over several centuries? Are you prepared to deny yourself any chance of redress of your grievances because one group of elitists wants a free ride? Once the medical industry gets exemption from accountability, who’s next? Will Walmart want to be exempt if one of their big screen televisions falls off the shelf and breaks your big toe? Where will it stop?

Some physicians only see their premiums rise and accept the explanation of the insurance company. Few really understand the dynamics, logistics and operations of the corporation sending them that bill. They are not the ones best placed to tell you why you should give up your rights.

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I am initiating a new, virtual award. It is dedicated to our endless supply of bottom feeders. The difficult part is, and will continue to be, deciding among the superabundance of candidates. If I had the time this could be an hourly award. Okay, who has the honor of being the first recipient?

My attention, of late, has been on the economy. For the very first award, however, I return to the area that has commanded the bulk of my attention (and my book) for the past couple of decades.

Have you heard of Vioxx? Oh, that’s so passé, so yesterday. What? You don’t subscribe to any Australian newspapers? It seems that about a thousand people in Australia are suing Merck & Company, the maker of Vioxx. First, just a reminder of what happened here in the good ol’ US of A.

The government admitted that at least 28,000 people died from heart attacks or strokes caused by the drug. Another 50,000 to 113,000 experienced non-fatal heart attacks or strokes. Remember, this is the count for just 3 of the 4 years it was on the American market. They settled for a payout of a bit under $5 billion and took it off the  market.

Why would they cave? Several facts came to light during the trial but one in particular was enlightening. An internal email was discovered from 1996. In that email staff members warned management that the drug was a killer. Management went ahead and made considerably more money from the drug than the $5 billion they paid out.

To me, that smells an awful lot like killing for money. Prescription drugs are the 4th leading cause of death. Also, even though that 28,000 is only a partial count, it is about 10 times the number killed in the destruction of the Twin Towers on 9-11. But these guys didn’t die in their operation. They just got richer.

It reminded me of a cartoon from The New Yorker that is no longer available for linking.

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