Wednesday, January 27, 2010

We Has Met the Special Interests and They Is , Etc.

Angry Populism has burst forth across America, and high time. We haven't had any good quality Populism since Huey Long, unless you count the 1994 Gingrich-led hoo-hah. Let's do. So, take 2010, subtract 1994...let's see, borrow from the "tens", repeat from the "hundreds" column and...krimanee, it's been 16 years!

That's almost a generation of aimlessly bobbing around without the common folk steering a sensible course for our wallowing ship of state. I would never have thought that the elites could have insinuated themselves back into control so soon after Gingrich reached the "Contract With America". Guess the conservatives have a few elites of their own who think that they know how to steer, maybe even navigate. Bush/Cheney, now those boys could navigate and steer; in their time they reminded me of Columbus, the Italian who thought that he had reached the outskirts of China when he was actually in the Bahamas (and, he used Spain's money; attaboy Chris, a typical gummit project).

Anyway, it's "us" versus "them" now, the Real Americans (RAs) against those Elite Special Interest Bastards (ESIBs). The ESIBs don't care what is good for the Republic; they just care about what's good for them. And, the ESIBs have the ear of the lawmakers. But, methinks the tide is turning. Thanks to a recent split-decision by the conservative Roberts' Supreme Court, the RA Populists seem delighted that those ESIBs will now have even more money to wield in their....hmmm, wait, something's amiss here. Aren't most RAs fed up with big money influencing politics? So then...why are they cheering...oh, well, consistency of ideology was never that important to a staunch Populist. Anger, that's the ticket, consistency is for sissies.

I'm sure that Sarah Palin, RA in Extremis, will explain it in her charming, convoluted and somewhat tortured way on FOX. The other RAs will, no doubt, understand.

Just who are these ESIBs anyway? Let's review.

1. Anyone in the financial services business is an ESIB. They got bailed out by the RAs. As a result, they still have their fancy-schmancy 9 to 5 cushy jobs. CEOs, CFOs, loan officers, trust officers, check verifiers, tellers, branch managers, custodians and on-and-on. Schmucks. The RAs have seen through their game and insist that the government squash them like the bugs they are. I hope this doesn't mean that we can't still be friends when I need a loan.

2. Auto industry employees are ESIBs. Yo, fat cats, the RAs saved your behinds and your jobs; starting with the suits right down through the union guys bolting the axles onto the GMC Sierras. Morons, you couldn't build vehicles that RAs wanted and so you came whining to the RAs for money. Have you no shame?

3. Education Employees are ESIBs. Sure, educators claim to want better education for our little tykes. So, how come RAs can't fire a teacher's incompetent butt when it becomes clear that he or she couldn't teach a chimp to peel a banana? I'll tell you why, it's because they are part of a large and powerful ESIB group (a.k.a. a union).

4. Health Care Workers are ESIBs. This is a powerful group because of its size, 17% of our GDP: doctors, RNs, LPNs, lab technicians, hospital administrators, home health workers, makers of durable medical equipment, drug makers, ambulance companies, EMTs, etc. etc. Greedy Gus's the lot of them. A chicken pox on all of their houses. RAs are tired of the 8% health care price inflation every year and have risen up to kill any legislation that might slow it down even a littl.....wait, this inconsistency seems to need a Sarah Palin explanation.

5. Health Insurance Employees are ESIBs. As the premier category of ESIBs, this group causes slime to appear on my keyboard when I write about them too much. Ergo, I'll stop.

6. Agri-businesses (farmers) are ESIBs. Thought that you could hide from the wrath of the RAs you subsidy-taking slackers? Our good tax money is going into your pocket so that you WON'T PLANT STUFF! Puuuhlease. You've got those Congresspeople scared witless and you only account for about 3% of the nation's GDP. Please don't let this little rant keep you from putting some pork chops on my table this evening, plus a few artichoke hearts; I really, really love those artichoke hearts.

7. Business owners, large and small, are ESIBs. This category is so obvious that I hesitate to even write it out loud. Big businesses have the individual financial clout to buy all the "free political speech" that they need to get special favors and access, while the small businesses of America have the pooled resources of the National Chamber of Commerce, one of Washington's most feared and powerful arm twisters. Smack down those minimum hourly wage bills. Kick and scream about mandatory health insurance for your RA employees. RAs haven't been able to compete in this uneven policy marketplace but now they're fighting back. That Roberts Court decision is just a minor speed bump.

8. Churches are ESIBs. Reverend "Bucks-Up" in his Mercedes, Chrystal Cathedrals, Cable Network Clubs; they all rake it in on Sunday (as well as the rest of the week) and nary a tax dollar do they want to pay. And, they have all the best real estate, sans property tax of course. All this, while the RAs dutifully pay their fair share with no tax breaks in sight. Woe be to the politician who takes on this pious crowd.

9. Federal, State and Local Government Employees are ESIBs. Yet another category that almost goes without saying; too obvious. If there is any group of ESIBs that RAs really, truly despise, it's this one. The only exceptions are the enlisted military folk plus a few junior officers. Once a military man or woman reaches the Pentagon, however, they have clearly earned ESIB status. Bureaucrats are bureaucrats, uniform or no. I'm confident that this criticism of government employees won't impact my routine trash pick-up days (Tuesdays and Fridays with recyclables on Fridays) or my protection from enemies, foreign or domestic.

10. Non-Profit Enterprises are ESIBs. Tree-hugging, endangered-species-saving, soup-kitchen-operating, social-services-providing, bleeding-heart leeches. Do they want special favors? Yes. Do they want to pay taxes? No. (I sound like Donald Rumsfeld). These wimps appear before Congress and get all teary-eyed about this or that "special cause", contribute some campaign money--even more in the future thanks to the Roberts Court decision--and viola, get special deals; favors that simple, God-fearing RAs could never get. It's a damn shame is what it is.

11. Unions are ESIBs. Previously singled out in several of the categories above, the likes of the AFL-CIO, et al, are re-emerging as one of America's most influential ESIB groups. They don't want a tax on Cadillac health insurance plans, they condone--nearly outright encourage, in my experience--"featherbedding" and "closed shops" and favor anonymous union sign-up for employees. Tricksters. RAs are proud of the groups to which they belong and needn't hide behind some union rule in shame for their socialist beliefs.

12. Lawyers and Law Firms are ESIBs. This is another slime-producing category. As is their wont, these chameleons work both sides of the ideological street, often at the same time. They are either carrying the water for other ESIB groups who oppose RAs interests or are fighting proposed tort reform that would keep them from continuing to make a bundle off of the misfortunes of RAs (think John "Two Americas, One Illegitimate Baby" Edwards and his ten thousand square foot house).

13. Retirees are ESIBs. Need I say any more than "AARP"?

These thirteen categories do not constitute the entire list of ESIB groups. They do, however, cover those ESIB groups that provide the bulk of the special interest roadblocks that vex Real Americans at every turn.

This leaves me to identify the brave army of Real Americans, the Populists, who stand united against the special interests crowd; untainted in their desire for policies, procedures, taxes and services that benefit all equally and fairly, without favor and for the greater good of the Republic. By definition, an RA cannot be a part of an aforementioned ESIB group (or be dependent on anyone who is).

O.K., let's see, there's a guy in Omaha named Chuck; another fellow in Sacramento by the unlikely name of Carroll; two women in Tempe, Janet and Shirley (they don't know each other); a man and his adult son who live in an AirStream just outside of Joshua Tree National Park, Bill and Bill, Jr. and an unemployed husband and wife team in New Orleans whose last name is either DeCarbonnet or DeCarbonee, depending on which issue of the White Pages you are consulting. I continue to search for other qualified RAs and will find a few, no doubt. Right now, however, that's it. Eight Real Americans vs. a vast sea of ESIBs.

I'll give them credit, for such a small group, they have kicked up quite a fuss.


Observoid of the Day: A successful rain dance has a lot to do with timing.

Monday, January 11, 2010

Wait, Wait, Where Are All the Angels?

Come with me now, thrill-seekers, to that land where even angels are affeared. It's the land where the talk is of racism, religion, political correctness and women's studies.

Senator Harry Reid, the mild-mannered Mormon from Nevada has come under withering political fire from conservatives. For the better part of a year the criticism has focused on the Senator's role in shepherding health care reform legislation through the sausage grinder known as the U.S. Senate. Just recently, however, it has come to light that not only is Harry a Mormon, a bit of a sad looking sack, a legislative "water-carrier" for the Obama administration on health care but also a racist pig.

From no less an authority than Liz Cheney, a Washington pundit who proves that the "mean gene" can indeed be passed from generation-to-generation, we learn that, unlike the morally superior Republicans, not a single one of whom has ever harbored a racist thought, Harry Reid isn't fit to serve as Senate Majority Leader. His crime, in case you have been in the Gobi Desert until just today, was to utter the perfectly benign truth that Barack Obama is a "light-skinned African American"--for which he can blame his Kansas hippie white mother--and who "speaks without a Negro dialect unless he chooses to". The latter observation is also something for which Obama can blame his mother plus his grandmother and grandfather, none of who be talkin' a Negra dialeh 'round de howz when Barack was a tad. Further, none of them likely spoke as iffin he'us raised up in the holler a fur peas back 'round yonder. Ergo, Barack does not talk like Reba McEntire either.

(An aside: Had Barack been raised by his father, he would likely speak with a Kenyan accent and, to our American untrained ears, sound like Nelson Mandela.)

In any case, he wasn't. So, for many Americans, who would otherwise be uneasy with a presidential candidate who looked like Robert Mugabe and/or sounded like Ludacris, Barack Obama was a politician who looked and sounded like a reasoned and reasonable candidate. It's the same thinking that led Colin Powell to be considered a promising Republican presidential candidate. Liz Cheney will, no doubt, deny that this Powell observation ever arose around the Cheney family dinner table, given that the Cheney's are, apparently, completely free of any racial prejudices (except as relates to Middle Eastern and South Asian Muslims, all of whom should be legally tortured to extract "ticking time bomb" information in order to "Keep America").

The conservative gas bags claim that Reid's "racist statement" is equivalent to that of Trent Lott who was forced to relinquish his Senate leadership position after suggesting that the country would have been better off if Strom Thurmond--that paragon of racial harmony--had ascended to the presidency in 1948, thus maintaining racial segregation as the national standard.

So, let's review: Reid's statement, "because Obama is a light-skinned and well-spoken Negro, it was possible that he could get elected president" is equated, by the likes of Liz Cheney, to Lott's statement suggesting that America would be a better place if blacks kept to their own restaurants, rest rooms, schools, movie balconies, rear bus seats and water fountains. For my racial entertainment dollar, the comparison would be laughably priceless if it weren't so hypocritical and ludicrous; Ludacris would likely agree.

I believe that Mark Twain said, "If you want to make people angry, lie to them. If you want to make them purple with rage, tell them the truth.''

Here's my truth. All of us are racists; we only differ in degree. At the most harmless end are people who are probably much like Harry Reid and, hopefully, you, my dear reader. At the other end is the neo-Nazi skin-head. To claim that being positioned anywhere along this continuum is equally odious is to be completely out of touch with reality and human nature. Or, if you are Liz Cheney, to be looking to score political points, in spite of the fact that you really know better. Liz isn't dumb, just shameless.

Bulletin: Blacks (and other ethnic groups) harbor racists attitudes toward whites. Here again, however, the poles are widely separated. For instance, Obama might look at me and in a benign (and mostly correct) way, figure that I can't jump, don't dance very well, love New England pot roast with potatoes, listen to NPR and sleep in striped pj's to keep my small package warm. Louis Farrakhan, however, might see me as an evil manipulator who despises ethnic "others" and who would con them out of their money and, if it weren't for federal law, own slaves and insist on being called "massa" and who walks around with big money in my pocket (next to my small package) just begging to be mugged.

But, back to the neo-con wing nuts. Even George Will, a man never once accused of being a liberal of any sort, found Ms. Cheney's pronouncement too too, when they appeared together on this past Sunday's edition of "This Week with George Stephanopoulos", (a host who could sell several of his vowels to "Wheel of Fortune" and still have a long name). Save for Robert Reich, the world's shortest economist and a flagrant academic liberal, who briefly gnawed around Ms. Cheney's ankles, the other panelists failed to help George and Robert gang tackle Ms. Liz on this topic. They should have.


Observoid of the Day: Judge a man by the content of his character, not the color of his skin unless, of course, you are holding tryouts for an outside linebacker.

Monday, January 4, 2010

"The doctor will see you now......bwahahahahahah"

Perhaps you've noticed. When you visit your PCP (primary care physician), your time schedule and the doctor's time schedule are not in sync. This is the reason that you have ample time to fill out your entire medical history, beginning with your polio shots from third grade and then additional time to read and review a Sports Illustrated or Better Homes & Gardens issue from 1994.

Then, just as you are fully engrossed in learning about the Nancy Kerrigan/Tonya Harding dust-up, a nurse flings open an unmarked door, bellows your name and briskly leads you to a very public hallway scale where you are weighed, despite the fact that you still have your clothes on, are carrying a coat and toting a briefcase with a laptop inside; nurse clucking and scowling ensue. Then, you are taken to a small, chilly room, your blood pressure taken (more clucking and scowling) asked to disrobe, don a paper gown, not to be confused with anything Halston would design, and told, "The doctor will be right in". This is the medical equivalent of the phrase, "Of course I will respect you in the morning."

You spend enough time alone in this chilly room, in your non-insulated paper gown to discover and read more not-too-recently issued magazines--usually vintage 2003 to 2006 -- and to have various parts of your body react to the chill; depending on your gender, either enlargement or shrinkage.

Then, just as you are absorbed in an investigative Newsweek report about Dick Cheney having accidentally shot a fellow quail hunter in the face, in comes the doctor, looking confident but somewhat harried. There is brief small talk, a question or two, a quick look down your throat and into your ears and tah-dah, you're done. "What, what, wait; I forgot to ask about that burning sensation when I pee." Too late. You peek out the door one way, then the other, clutching the paper gown so as to keep your dignity, but the doctor is gone and, in that gown, there never was any dignity.

The nurse tells you that the burning sensation is "very common in people your age" and to try "cutting out spicy food." Total time at the doctor's office, two hours and twenty minutes; portion of that time with the doctor, twelve minutes.

However, if you have an appointment with a specialist, particularly some arcane medical specialty such as "Reproductive Organ Cosmetic Surgery" (I'm not making this up), you barely have time to hang your coat, grab a complimentary cup of Irish Mist Mocha Java and begin searching for reading material before you are graciously escorted into the inner sanctum. There, you are asked to disrobe so that the body part of interest is available for convenient inspection. You are provided a warm terry robe and the doctor and his or her assistant whisk efficiently into the room almost the moment you loosely knot the sash.

The specialist listens attentively, types notes in a laptop, clicks from screen to screen checking your medical history and the net present value of your previous procedures. Then, only after you have completely covered the reason for your visit and your vision for the eventual outcome, the doc carefully examines your present condition, followed by providing a thorough explanation of the procedure alternatives, likely outcomes and risks. There is a tasteful discussion of price ranges for the procedure and some clever banter about "lifestyle improvements". The doctor suggests that you call later if you have questions. He or she will take the call personally. You get dressed and you are done. Total time at the doctor's office, 45 minutes; portion of that with the doctor, 35 minutes. Who needs magazines?

Your primary care physician likely sees 30 or more patients every day and earns about $170,000 a year, less if he or she has a lot of Medicare patients.

The specialist may see six to 12 patients a day, three days a week and do procedures one or two days a week. The specialist will earn $400,000 a year at the low end and $1,000,000 (or significantly more) at the premier end of the income scale.

Let's see, the math indicates....divide the bigger by the smaller.... carry the 15.... add a decimal....hmmm......Wowzer! If you want to be a rich doctor and quickly pay off that pesky $200,000 student loan, then a specialty is for you. (By way of full disclosure, my oldest is a general surgery resident M.D. hoping that when he finishes his specialty training that there will be sufficient diseased gall bladders, inflamed appendixes, etc. to put him in the higher end of the income bracket).

Much as I appreciate financial success, especially among my own, there is a way big problem for America in the financial disincentive to become a PCP, family doctor, internist or geriatrician, each a category that falls well below the highly-compensated specialty clique. For those of you haven't been paying rapt attention and haven't already seen the hitch in this ointment (or maybe it's the fly in this git-a-long), here's the deal: the accepted wisdom is that America needs lots more PCP's, geriatricians, family practitioners and internists and fewer specialists but the current free market system works directly against that goal. Oh-oh.

If you are a Baby Boomer, you should be particularly uneasy. Should you reach the age of 65--and that begins to occur in 2011 for the oldest Boomers--you have an 80% chance of then living to 85+. Somewhere around 65, your body's biology begins to change measurably, much the same way that your biology changed markedly during junior high school, morphing you from child to a nearly-grown slightly crazed sex addict with acne and additional hair. Growing old reverses some of those changes. Providing appropriate medical care to geriatric patients is similar to providing appropriate pediatric care to children. The skill set for either is different than it is for treating young and middle-aged adults. For most readers, your doctor has very little, if any, training in geriatrics because our medical schools do not require it.

The number of geriatric patients in America is currently growing. In 2011 it will begin an 18-year slow motion explosion as the Baby Boom turns into 77 million cranky old sex addicts with multiple medical complaints, worn out body parts but less hair. There won't be nearly enough trained geriatricians--and I'm talking about a huge gap because the number of geriatricians is shrinking--to provide appropriate care. The end result will be millions of misdiagnoses, over-medication (already a troubling problem), unnecessary and expensive procedures (likewise) and a reduced quality of life for millions of Boomers who would otherwise do quite nicely with correct care.

The free market does many things very well. For instance, flat-screen, high definition TVs are becoming more affordable, in a classic case of free market creative destruction, foreign auto companies have run Detroit into the ditch (where the gummit should have left it) and department stores have something "On Sale until Midnight Tomorrow" 24/7, etc. However, in the realm of health care, the free market does a lousy job in a number of areas, including the one that determines how many of what kind of physicians we have, in spite of what we need.

The current proposed health care legislation takes some teeny weeny steps in the direction of addressing this problem. The loyal opposition (also known as Republicans) decry these modest proposals as "a gummit takeover of the health care system" and innocently look the other way while some of their nuttier supporters liken it to the policies of the Third Reich.

Should we fail to modestly change our current health care system, thanks to the loyal opposition, the irony will be that eventually, Mitch McConnell, Jim DeMint or some other loyal opponent will be misdiagnosed by a well-meaning but inadequately trained physician. The aging legislator's "advanced dementia" will actually be symptoms of clinical depression, poorly trimmed toenails and a urinary tract infection, none of which Aricept will improve. As a current example I give you Senator Robert Byrd who has been repeatedly misdiagnosed as "not quite dead yet". A geriatrician would have spotted the reality several months ago.


Observoid of the Day: It's not really winter until all of the kudzu has turned brown.