When the history of America from 1980 - 2010 is written it might be described as the Age of Greed and Dishonesty. There are no self-imposed ethical restrictions on business that might put the brakes on greed - individual greed and corporate greed. Somehow we got the idea that what generates the most money defines "good." In order to minimize possible government restrictions founded in any kind of ethical thinking, however slight, those benefiting from laissez faire invest in the purchase of legislators. This compensates for the fact that there are not enough such beneficiaries to win elections by force of their numbers. It is easier to buy them than to elect them; one can buy whoever wins. Why worry?
We have disdain in sporting events against teams that pile on points after having assured victory. Yet we don't seem to have trouble swallowing when we hear of individuals making $100 million a year - more money than can be spent in the productive economy of goods and services. Where does it go? To banks and other financial institutions competing with one another to offer the highest returns. Do they care about the soundness of their investment products? The recent economic collapse had nothing to do with the underlying economy in which most of us live. It resulted from dishonesty in the financial community. And what did we do about it? We pumped trillions into these crooked organizations run by crooked executives so they could keep doing what they had been doing before: taking billions off the top (taxpayers' money this time) for themselves and making more hare-brained investments with our tax money. Everything goes. In some cases, they paid back the money that saved them from oblivion in order to avoid any restrictions on what their leadership could pay itself. And we swallow hard this time, but making a hundred million a year generates an attitude. They raise an eyebrow at us. We realize that we are not in this game at all.
We do however, need health care services for ourselves and our families, especially if we're 'boomers' getting ready to check out. This is good news for 'providers' and insurers. In fact, it's great news. We don't want to die, and they can help us. Are we going to quibble about price? Hardly - at first. But inflation in the cost of 'providers' outstrips everthing else for a couple of decades. Good grief, these CAT scans are a couple of grand apiece. The radiologist likes it because he/she owns a piece of the scanner. Do you need one? Of course, says your PCP who is in the same profit-making company as the radiologist. Besides, you get the warm feeling that they are doing everything they can for you. It's a good thing you have insurance - if you're not already ill and you don't change jobs in this vigorous econonomic climate. Ooopps. Insurance costs money, too - more and more every year. And now your employer is hurting; it either stops paying for as much of your insurance as it had, or it gets an insurance company that offers you less coverage for more money. Now you're starting to feel it. You see that when you retire, you won't be able to do much more than pay for your health care. Like I said, its not a good business, it's a great business.
If you're over 65, you can get Medicare. For some more money you can also get insurance to cover the 20% not covered by Medicare and a prescription drug policy as well. It's costly, but you need it, and you can rely on it. You don't care if it's one of those big government boondoggles. In fact you are terrified that the government will change it, pull it out from under you. And now, the government is talking about change. This can't be good; it could threaten your Medicare. They are talking about Obamacare! It will kill you. It will force you to have inferior care, as opposed to the good-government Medicare that you so love. You are angry at the thought. And some politicians who think it's just fine to spend half of your post-retirement income on health care (they're covered), who accept millions of dollars from the health care industry, tell you that you ought to be worried. This frightens you.
You go to a townhall meeting. You look Satan (your representative or senator) in the eye and you scream. And why not? The guy from Iowa told you that you ought to be afraid.A lot of people are getting richer than we can imagine, and we get to be scared. We aren't in this game as players, we're the stuff that other peoples' wealth is made of. We're angry. Where should we direct this anger? At the President of the United States who has been in office for 8 months? Or should we forget being angry and start thinking about whether we really like things as they are, or whether we're just afraid. Greed and dishonesty leave a big wake.
The 800-pound gorilla in health care costs is a combination of unnecessary or inefficacious procedures. Some say that the reason physicians are prone to over-diagnose and over-treat is the threat of malpractice suits. Others say it's making more money for them and their institutions. Still others say it's insistence by patients that whatever might be done must be done. The last factor goes to an important issue: people don't want to die. The plain fact is that we are grossly over-treated at great expense. AARP estimates that about one third of medical charges go for useless procedures. And it gets worse - some such procedures lead to side effects that, themselves, require further treatment and actually impair health.
What does this have to do with "deathers?" One can be sure that if the subject of over-treatment comes up, as well it should, they will call it murder of the weak and elderly by draconian Obamacare bureaucrats obsessed with rationing care. Do we have the courage to be rational?
If any proposal fails to reduce the cost of medical care, it deserves little support. In this regard, when I read today that the White House is calling a halt to seeking reductions of drug costs at the $80 billion level proposed by the industry, I have a bad feeling about the Administration's concern for matters of cost. I am especially concerned about dropping the simple business practice of buyers negotiating prices with sellers by not, once more, allowing Medicare (or other public plan) to play hardball on our collective account.
The fact that the largest share of medical-consumers' costs are for physician and hospital services, still leaves room for savings. We should not back any plan that fails to seek savings from these providers.
The effort to provide 'universal' coverage, in my view without providing a universal cost-reduction is a non-starter. I guess the problem is that someone's bottom line has to take a hit if we are to see any benefit to health care reform. Why people are so worried about rimbursement rates to physicians and hospitals is amazing to me. They are the drains on our resources - 52% of health care expenses. Let them operate more efficiently to keep their earnings up rather than clunking along charging us more and more.
Well, the 800-pound gorilla of Israeli life - fanatical ultra-orthodox groups - is shaking the living room wall these days. They are rioting in Jerusalem to 'protest' the opening of a parking lot on the Sabbath and the jailing of an alleged child-abuser who is one of them. About 20 police officers were injured in the melee. For two days in a row violent, fanatical 'settlers' have attacked Palestinian olive orchards, burning and cutting down olive trees that provide a living for their owners. The reason: revenge on Palestinians for the disassembly of illegal outposts by the Israeli government. Go figure.
Understanding the violent, uncompromising nature of ultra-orthodox 'settlers' is crucial to understanding all points of view about settlements. All Israeli politicians are afraid of them. Makes sense. They are crazy and violent. Remember who shot to death Yitzhak Rabin. They did because he made accords with Palestinians. In addition to fear of violence, Israeli governments depend on political parties espousing radical religious views (Shas, Yisrael Beiteynu, etc.) to form governments. Currently, PM Netanyahu repays his debt to the crazies by his emplacement of the racist, undemocratic (he's Russian) Avigdor Lieberman as Foreign Minister. He also has declared that settlements are not blocking peace because he supports them and he depends on them for political survival.
Palestinians of course understand that settlements are high up on the list of important barriers to peace, about the same as rocket attacks by Hamas on Israel. Can you imagine Abbas saying that the parties should not dwell on rocket attacks? Furthermore, as we see from their recent actions, law is not an obstacle to these well armed settlers. They serve as a military front line of the forces occupying land captured in 1967. Pit bulls. In short, settlers represent the fist of the occupation - the thumb in the eye of Palestinians.
President Obama, now joined by the EU and Russia (original home of many settlers), has started on the right track by focusing on halting settlement construction. Just as Palestinians must deal with Hamas to arrive at a peaceful position, so must Israel deal with its own religious fanatics to do likewise. Compromise on Israeli settlements is no more an option than is compromise on Palestinian rockets.
First, Senator Lieberman opposed the Democratic Party in the 2008 election by actively supporting the McCain/Palin ticket. Now he opposes the President's program on health care reform by seeking 'delay' of the process. This position threatens the party and flaunts the needs of his constituents, at least those who are not in the insurance or medical industries; if reform is not enacted, the position of the administration will take a serious blow. Of course, that is Lieberman's apparent goal, one that is in full accord with the Republican agenda - obstruct, delay and destroy. On health care, he is willing to throw us all under the bus to damage the President. We should expel him from the Democratic Caucus, criticize his views in op-ed pieces and letters to the editor and go public, perhaps by picketing his offices, in opposition to him. He is an opponent, and should be treated as such.
He gives us more of the same on the Middle East. His program is to strengthen right-wing governments in Israel. Period. He is not pro-Israel, he is pro-Shas and pro-Likud. As a consequence, like them, he is anti-peace, and his policies (like extended support of the disastrous war in Iraq) are not in the best interests of either America or Israel. He is in vehement opposition to the President's re-shaped policy in the region, which features a vision of what peace would look like rather than a view of how to keep the pot of war boiling. Joe Lieberman is not a Democrat and he is not driven by important needs of his constiuents and the nation. He must go - the farther the better. Let's help him to find his way to the door.
