Feeding the paranoia

The Obama administration is having a real problem right now with scandals of their own making.  

The right wing of the Republican Party has always seen Obama as a totalitarian in the making, and they have been screaming that his long range  design was a Big Brother Socialist take-over of the country.  The latest paranoia from the hard core Right Wing was that he was coming after their guns under the guise of background checks and limits on magazine sizes, that he was taking over the medical industry to create a socialist Utopian dream, and using government to destroy personal freedoms in order to empower his Socialist totalitarian state. 

This has always seemed silly to me, and just some combination of paranoia and political scare tactics to advance a political agenda.

But…what on earth is going on with this administration?

The Bengazi attack was spun for political purposes to look like it wasn't a terrorist attack, right in the middle of the presidential campaign.  The truth came out, and only three days after the infamous Susan Rice’s Sunday shows talking points that the attack was a response to an American anti-Muslim film, so I can easily write that off as the government message being muddled by inter-departmental fights over who was to blame for the disaster (C.I.A. vs State Department).  OK.

Then, we have the IRS scandal where obviously right wing political groups are targeted by the administration, again, in the middle of the presidential election cycle.  This is the kind of thing that Nixon was famously accused of doing back in his abuse of power days. 

Then, we have AP reporters’ phone logs being tracked by the Justice Department trying to track down sources of a story that the administration didn't like.

All of a sudden, the paranoid Right Wing has all the evidence that it needs that the government is mushrooming into the totalitarian monster that they have been warning of for the last four years plus. 

Obama needs to respond very quickly and harshly to punish these abuses of power.  The IRS and the AP scandals at least must have full investigative disclosure and people responsible must be removed, and perhaps prosecuted for criminal activity.

I understand that what the administration did seemed fully justified in their minds - preventing life threatening leaks and taking short cuts to weed out the legitimate from the illegitimate tax exempt and donor disclosure exempt organizations.  But, they appear to have crossed the line.  And it certainly feels like political persecution to their political opponents, who now have justification for their claims of persecution and suppression by the state.

What I have been writing about for some time is that if a party does not have a viable opposition, it will become corrupt and abuse power.  It is the nature of power to justify corrupt tactics to crush those who oppose it.  Power assumes it is doing good, and assumes that crushing opposition is good because it is part of pursuing the good it is trying to do. 

Obama needs to crush the abuses in his own administration in order to keep his legitimacy.  It is bad enough that the opposition is paranoid about his intentions, without having proof that he is abusing his power for political advantage.

Message to conservatives: innovate or die

Jennifer Rubin, conservative blogger and columnist for the Washington Post, has just written a wonderful and brave editorial.  It is so needed for conservatives to say what she said, not just for the sake of the Republican Party but for the country and the world.  The Republican Party is quickly becoming obsolete, and we need two good parties for this country to run. 

Her primary message is in her headline:  “Tear down this icon: why conservatives have to get over Ronald Reagan.”

Her main point is the one I have been making ever since I started blogging over three years ago:  Reaganism was needed in 1980, but new thinking is required over thirty years later. 

How to find the "new" conservatism?  

Isn't the heart of conservatism the empowerment of individuals?  Isn't it about empowering the middle class?  What is all this guff about taxes or gay marriage or contraception or abortion or high capacity spray guns or immigrants or endless wars in the Middle East or .. or .. or all of the things that so enrage or frighten the permanently enraged and frightened?   

Or for that matter what has an ever smaller government to do with conservatism?  

In 1979 Reagan was right when he said government was the problem.  Back then the country was over-regulated and over-taxed.  But now, after a near worldwide financial meltdown as a result of an under-regulated blood thirsty financial industry, that is no longer true, no longer true, no … longer … true.  How does the government empower the individual by being eviscerated?  How does the individual become empowered without the context of civilization that can only be created if it includes the essential factor an effective government? 

I switched my registration from Republican to “Declines to State” in California about four years ago.  My history is that I voted for: Cleaver, McGovern, Carter, Reagan, Reagan, HW, Clinton, W, W, Obama, Obama.  The Rigid Right drove me from their ranks, which I am sure is exactly what they wanted to do.  I am certainly not one of them.  Thank goodness.  But I am not a Democrat either.   

When I changed from liberal to conservative in 1980 I was aflame with the new ideas of conservatism.  It was conservatives who were coming up with creative new ideas, and it was liberals who were trying to relive the glories of FDR and LBJ.  The liberals were worn out, and had nothing much to offer other than the same old same old.

But, the creative and innovative thinking of today is now coming from the left.  All Rush and Glenn and DeMint and the '80s crowd are doing is hitting the replay button - old, old, old, tired, tired, tired, lazy, lazy, lazy, regurgitation.  I recently heard Rush say his job was ideological purity.  How true.  Simple job.  Thinking not required.  All he is is a replay button on the old jukebox.  All that is missing is the revolving mirrored ball with the Bee Gees playing for the dancers on the floor. 

Republicans need to innovate or die, to find the real heart of conservatism and create from there. 

They should start with empowering the individual and the middle class.  The Democrats have figured out the middle class part.  It’s now up to the conservatives to come up with better ideas to get that done by focusing on the individual empowerment part.

The TNT within terrorists’ minds that leads to “heroic” killings of … us

I celebrate the killing of one and the capture of the other young murderers who tried to terrorize the country by killing and maiming people in Boston.  At this point it appears that they were “self-radicalized” rather than operatives of al Qaida or some other transnational terrorist organization.  The older brother apparently spent months overseas before his attack, and I am sure that he completed his indoctrination in that environment, but I doubt that he and his younger brother will be discovered to be part of an organized campaign or some larger terrorist organization.  I could be wrong, but that’s what it looks like so far. 

We will find out more as time passes I am sure.

But, the big question to me is, who becomes a terrorist?  And why? 

Shortly after 9/11/2011 I thought the answer to that was pretty easy – I thought terrorism was a religious tenant of Islam.  There were many quotes from the Koran and from terrorists that proved to me that radical Islamists were on a religious mission to destroy Western Civilization and impose an Islamic Caliphate on the world. 

But, Chritopher Dickey, Paris bureau chief and Middle East editor for Newsweek and the Daily Beast, has written an article that makes sense to me.  He says that there is an explosive combination of three elements that go into the makeup of a terrorist – TNT.

First, is T as in Testosterone.  Nearly all terrorists are young men.

Second, is N as in Narrative.  Here he says:

“This is perhaps the most important and most misunderstood element in the shaping of a terrorist’s thinking.  It is often confused with ideology, and, in the case of Islam, with religion.”

What is actually in the minds of the terrorist is a Narrative, one where he is the hero who identifies with “a People” suffering repression by Others. The terrorists are often not victims of suffering themselves, but rather see themselves as Holy Knights “righting epic wrongs.”  Theirs is the narrative of a selfless hero, a martyr to a great cause, brave knights changing the course of history.  He gives examples of terrorists as the Irish under Britain, Jews in Palestine before 1948, Palestinians in Israel since then, Tamils under the Sinhalese, Latin American peasants under oligarchs, and Islamists under “Jews and Crusaders.”

The Islamist religion apparently can be twisted to provide the Narrative that cries out for a Brave Knight to battle the Oppressor Dragons, but by now it is pretty clear to me that bloody, brutal, killing jihad is not really fundamental to Muslim religion.  It is the motivation of men with personality problems who are manipulated by men with political aims.

And third, is T as in Theater.  They need their terrorism to be on a huge world stage, seen and feared by the Oppressors, seen and admired by those they are “saving.”

This is an explanation that makes sense to me.  Testoserone  plus Narrative plus Theater creates a terrorist.  Treat them like low life criminals, not like heroic knights storming our castles.

Letting the terrorist attack fail to terrorize us

I have been out of the country on business, and as a result have been less tuned into the news cycle than normally.  I am very saddened by the attack on innocent people at the Boston Marathon.  I don't know how people are reacting in the States, but my sense is that the country is not reacting with excessive shock and rage.  Certainly nothing like our reaction to the 9/11/2001 attack.  

My feeling is that our justice system is fully capable of finding, capturing, and prosecuting the attackers. 

What I hope the most is that the terrorists are unsuccessful in throwing the country into a state of terror.  The point of terrorism is to terrify a country, and if we can absorb this attack, respond decisively against the terrorists without overreacting and letting it absorb our entire national consciousness, and carry on with our lives, we will effectively defeat the purpose of the attack and of the terrorists themselves.  

We can refuse to become terrorized.  We can treat these people as low life criminals rather than monstrous threats to our way of life.

Or so I hope.

Liberals also don’t want to compromise (or negotiate, or commit politics)

I’ve been pretty critical of the rigidity of extreme conservatives on the right recently.  But I also know that there is also a very rigid wing of extreme liberals on the left.  The Washington Post’s Dana Milbank, center right editorialist, makes note of their calls to refuse to negotiate with Republicans, and attacking Obama’s budget as containing unacceptable compromises with conservatives. 

From Socialist Bernie Sanders of Vermont, to the AFL-CIO, NOW, MoveOn.org, Campaign for America’s Future, Progressive Change Campaign Committee, Democracy for America, and National Committee to Preserve Social Security, they all are appalled at Obama’s budget proposal that includes cuts to Social Security and Medicare. They apparently staged a protest yesterday against Obama's budget.

The key take-away to me from his article is that he posed a mirror image question to these folks from the Republican presidential campaign.  Remember that eight Republican candidates for president were asked if they would raise taxes evin if it had $10 of spending cuts for every dollar of tax increases?  And all eight said no, that under no circumstances would they raise taxes at all?  Well, Milbank writes that

“…At Tuesday’s protest, I put the reverse question to participants:  Could they accept a dollar of cuts in Medicare and Social Security benefits for every $10 of taxes on corporations and the wealthy?  All those I asked said they would decline.”

So much for the idea that only one side of this debate is unwilling to negotiate.

There is a difference between the two parties, however, I believe.  And that is that the Republican Party has been in the iron fisted grip of their non-compromisers, whereas the Democratic Party has iron-willed non-compromisers but isn’t totally in their grip. They are on the margins of the party.

My hope is that the 2012 election has gone at least a little way toward moving the Republican Party away from the right wing non-negotiators and into a place where they can actually do some politics and come to some agreements with the Democrats, i.e. the federal and state governments can actually start functioning again. 

The key is to have the voting public see the extremists as being in the margins  rather than in control.

A tribute to the Iron Lady

I have no doubt that the actress Meryl Streep is a liberal in good standing in Hollywood.  She brilliantly portrayed ex-Prime Minister Margaret Thatcher a couple of years ago and won an Oscar for that performance. 

Today, she made a very gracious statement to the press on the occasion of Margaret Thatcher’s passing due to a stroke at age 87.  Although Ms. Streep didn’t agree with Ms. Thatcher’s politics, she highlighted what was most important to her, and to young girls, about the Prime Minister – she was a model for women to be powerful in the world in a way that has nothing to do with their gender.  I think Meryl managed to highlight one of Margaret Thatcher’s greatest achievements – her own success against stunning odds. 

Her statement:

 “Margaret Thatcher was a pioneer, willingly or unwillingly, for the role of women in politics.

It is hard to imagine a part of our current history that has not been affected by measures she put forward in the UK at the end of the 20th century. Her hard-nosed fiscal measures took a toll on the poor, and her hands-off approach to financial regulation led to great wealth for others. There is an argument that her steadfast, almost emotional loyalty to the pound sterling has helped the UK weather the storms of European monetary uncertainty.

But to me she was a figure of awe for her personal strength and grit. To have come up, legitimately, through the ranks of the British political system,class bound and gender phobic as it was, in the time that she did and the way that she did, was a formidable achievement. To have won it, not because she inherited position as the daughter of a great man, or the widow of an important man, but by dint of her own striving. To have withstood the special hatred and ridicule, unprecedented in my opinion, leveled in our time at a public figure who was not a mass murderer; and to have managed to keep her convictions attached to fervent ideals and ideas- wrongheaded or misguided as we might see them now-without corruption- I see that as evidence of some kind of greatness, worthy for the argument of history to settle. To have given women and girls around the world reason to supplant fantasies of being princesses with a different dream: the real-life option of leading their nation; this was groundbreaking and admirable.

I was honored to try to imagine her late life journey, after power; but I have only a glancing understanding of what her many struggles were, and how she managed to sail through to the other side. I wish to convey my respectful condolences to her family and many friends.”

Margaret Thatcher was Prime Minister when I was changing my politics from liberal to conservative, and I still think she gave Britain and the world what was needed at that time.  Now, I think the time for Thatcherism has passed in Britain just as the time for Reaganism has passed in America.  But both leaders stood for what they believed was needed and were able to implement their visions.  And I believe that both leaders saw what was needed for their time.

Time passes and new visions are being hashed out in the messy arena of politics.  The world could do a lot worse than having new leaders arise with the integrity and strength and ability of Margaret Thatcher.  I honor her and her passing, and I thank Meryl Streep for a gracious eulogy for her.

Republicans strut their stuff, but why?

It is interesting to me that after the Republicans are handed a decisive loss in the 2012 election, they have decided to make as much of a display of their least popular ideological dogmas as possible. 

Taxes - they went to the mat to avoid raising taxes on the wealthy and forced The Sequester.  The House of Representatives voted for Paul Ryan's harsh budget which raises no taxes on anybody, especially the super wealthy, while cutting services to the middle class and poor.  To me, by refusing to raise taxes or cut defense spending they demonstrate that they are not serious about the budget, but only serious about cutting government services.  Only the true believers are on board with this harshness.

Choice/abortion - they ban abortion in some red states as early as six weeks. This thrills evangelicals, but there are many more voters who are not evangelicals, especially young ones and women.

Gay marriage/gay equality - they are going to the mat to ban gay marriage currently in the Supreme Court, fighting to stop something increasingly accepted by young voters.  Denial of equality always seems unfair.

Gun control/second amendment - even in the wake of the Newtown slaughter of small children they refuse to limit magazine clip size and insist that rapid fire spray guns are protected by the second amendment.  The gun manufacturers masquerade as second amendment purists, but I think they repel more than they attract.

Affirmative action - they are pushing to revive the debate about affirmative action in college admissions. They never stop the attack.

Health care - they keep promising to overturn Obamacare.  I guess they think losing is proof that they have a winning hand?

All of these things excite the conservative base. But they do not attract non-believers.  They seem to be doubling down on the ideology that lost them the election with the well worn, Limbaugh and Beck type calls for more hard core conservative crusades. The faithful still seem to think they are the vanguard of a movement that is sweeping the country and the world. 

I think they have lost touch with reality.  Just as they thought they were going to win a landslide victory in 2012, they still seem to think their only problem was that they weren't conservative enough, so they double down. 

One thing that I think they are doing is deeply branding themselves with their old and worn out ideas, just when savvier party politicians see that they need to re-brand themselves with new approaches.   

The old white guys are strutting their stuff, but their rigidity, stubbornness, and delusions are what they are really showing, or so it seems to me.

My hope is that this brand of conservativism becomes seen as the past of the Republican Party and becomes more and more marginalized, while the Republican Party itself finds a new center that speaks to values of conservatism in creative and innovative ways - and a new and exciting Republican Party is born.  

The old war horses aren't going to change, but most likely just gather themselves together and charge off at every increasing speed - over the cliff into the obscurity of a past that is long gone.

Iraq, ten years later

Ten years ago we went into Iraq.  I thought it was the right thing to do.  I was convinced that World War II had taught the civilized world that the only way to deal with tyrannical bullies was to stand up to them and refuse to appease them because appeasing them only caused them to attack.  The model was Hitler and Stalin.  Al Qaeda and Hussein seemed to me to fit that threatening mold and I thought knocking them over was needed to secure a safe future for America, for Democracy, for freedom.

And a few years into the war, I stopped believing what I had believed.  I started to notice that we were creating more enemies than we were killing.  And I backed off and wondered if I was wrong.

Now I think our attacking Iraq was a very serious mistake.  One of the reasons is the main strategic outcome of our war in Iraq was to strengthen Iran.  Iraq had been a counterbalance to Iran.  Iraq's power is gone, Iran's power has grown.  So now what?  Attack Iran?  Good heavens, no.  I have seen enough young Americans lose their lives, limbs, and their normality in the Middle East.  I do not want to see more of that.

I think the biggest mistake that America made in Iraq was the terrible intelligence that said Saddam had nukes and other WMD.  He didn't.  It was a bluff.  And our intelligence got it wrong.  Big mistake.

I think the second biggest mistake was to destroy the existing institutions of power of the Baath Party and army.  There was nothing left, and the country collapsed into civil war amongst the competing tribes.

David Ignatius is one of my most trusted voices on the Middle East.  He apologized to his readers today for being wrong about whether the war made sense.  He made some key points.  

He remembered two powerful conversations that had given him pause in 2003. 

The first was a man who had told him that if America were strong enough, they would succeed and the rest of the Middle East would follow.  But, America wasn't strong enough.  The civil war broke out beyond America's control.  And Bush couldn't sell the war to the American voters.  The army went off to war, and the country was split.

The second was a man who told him: 

"I am sorry for America.  You are stuck.  You have become a country of the Middle East.  America will never change Iraq, but Iraq will change America."

Personally, I'm tired of being "a country in the Middle East."

Another point he made was that the CIA was dead set against demolishing the Baath Party and the established order.  But they lost to Rumsfield and Chalabi. And of course it was W who was the decider.  Bush, with the Texas bravado of a kind of hyper-masculinity that defines itself by its toughness.  I'm for a new kind of masculinity that defines itself by its brains and heart.

His third, and perhaps most important point, was the enormous importance of dignity in the Arab world.  People who are impoverished, dominated, and disenfranchised crave dignity most of all.  

So, what do I conclude ten years later?  

Do not put Americans in harm's way in the middle of Middle Eastern civil wars.  

Stay out of Syria.  Stay out of Iran.  Let them fight their fights, without the shedding of the blood of American young men and women.  Time for the soft powers of persuasion, diplomacy, covert assistance, intelligence, and engagements that are based upon knowledge and tact and and technology and craft and politics rather than force and destruction.  

Political party based upon an idea of manliness?

The Republican Party is grappling with their identity as a result of their electoral failures in 2012.  They lost the presidential election by 4 percentage points when the president was mired in an economic slump, lost 2 net seats in the Senate during an election when many more Dems than Reps were up for re-election, and kept a majority of seats in the House of Representatives despite getting 1.4 million fewer votes for Republican House candidates (gerrymandering of districts resulted in more Republican House victories).

So, they got beaten at the polls pretty decisively.  And some are thinking that their ideas still won out.  Not a very astute idea, in my opinion.

What occurs to me is that the Movement Conservatives, in their continuing efforts to take over the Republican Party, might be best understood as people who are trying to base their party on a kind of odd definition of manliness.  To be a member of good standing in the core conservative movement is to express a deep commitment to what they think it means to be a True Man.

To be a True Republican Man apparently means:

• Not needing any help from anyone, especially the government
• Owning and using rapid fire weapons with huge ammunition capacities
• Refusing to compromise on any issues for any reason
• Keeping America safe from inferior men, i.e. gay men
• A right to control women, especially their reproductive and sexual lives
• A strong appetite for war
• A fierce belief in independence to the exclusion of any sense of community responsibilities

It is not surprising that the main constituency of the Republican Party, especially of the Movement Conservatives, is older white men.  Women, gays, and minorities are not really all that welcomed by the core movement men, regardless of whatever lip service they feel obliged to give at any given time.  And, indeed, women, gays, youth, and minorities don't see much in the Movement Conservative agenda that speaks to their lives or their concerns.

The Conservative Political Action Conference (CPAC) has moved into more extreme territory this year by excluding the most popular Republican in the country, Chris Christie, governor of New Jersey, and Virginia governor, Bob McDonnell among other Republican governors.  Sarah Palin and Michelle Bachman are not exactly messengers of flexibility and new thinking for a party in trouble.

It has been said that the Democrats are the "mommy party" and Republicans are the "daddy party", Dems more focused on nurturing and caring, Reps more focused on finances and defense.  And I think that has long been true, and a good thing to have both energies strongly voiced in our political parties.   

But, today's Republican "daddy party" seems to be on the verge of being taken over by caricatures of Clint Eastwood and superhero cartoon versions of what it is to be manly.  Not only are they not "nurturing mommy types" I'm not sure they are really very good representatives of manliness either - movie guy toughness is a poor substitute for the true complexity and authentic courage of actual men.

Dead extremists walking?

There could be a pattern emerging in politics –  a “dead extremists walking” pattern.  Apparently, when a man has been condemned in prison, he is referred to as a “dead man walking” because his future death is certain even though he is still walking around.  Perhaps much the same is happening to right wing extremists in the Republican Party now.  They continue their extremist politics but don’t realize that their time is over.  

An example may well be in South Carolina where Lindsay Graham, Republican Senator, went on the Senate floor to take issue with some things Rand Paul said during his filibuster of the CIA nominee on the grounds that he needed assurances that no president could use a drone to kill an American in America without oversight.  Perhaps that wasn’t an unreasonable position for Paul to take, but also apparently, the right wing movement extremists came forward with an explosion of support for Paul on hashtag: #StandWithRand. 

The same fervid conservative base also apparently went after Graham on hashtag: #PrimaryGraham, where they castigated Graham for not being in lock step with the extremist base, but spoke darkly of a primary overthrow of Graham be supporting Lee Bright, who apparently is one of them. 

The extremist Republican base, and perhaps Rand Paul as well, seem to live in perpetual terror that the government is about to become a totalitarian police state.  Many seem to think that day has already come in the form of the the Obama administration - I suppose they expect jack-booted thugs to pound on their doors in the dead of night demanding that they sign up for Obamacare health insurance, or allowing gay people to move into their spare bedrooms.

I guess the extremist base of the Republicans haven’t noticed that their movement has failed to capture the imagination of the country.  They are pretty successful at defeating more moderate conservatives in primary election, and also very good at losing general elections to Democrats. 

Maybe that is how the Republican Party is going to commit suicide – death by primary voters who will only nominate unelectable extremists like themselves.  There are many examples, Indiana being one of the most recent in the 2012 election, when long time center right Republican Senator Richard Lugar lost to an extremist primary victor,  Richard Mourdock , who went on to lose to the Democrat,  Joe Donnelly, by about six points , in the general election. 

That is the telling snapshot of politics today when looking at the future of the Republican Party, I believe. 

Or, perhaps, center right politicians can stage a comeback and marginalize the extremists and take the party back from them and their rigidity.  That is what I hope, at any rate. I believe the fate of the Republican Party stands in the balance.  And the country needs to have two strong and viable parties to keep from becoming a one party state, which leads inevitably to ideological blindness and personal corruption.

Crisis of greed, health care style

The government, the financial industry, and the medical industry have long ago realized that where the real money is - the middle classes.  Steven Brill's exhaustive 26,000 word article in Time Magazine looks at why health care costs too much.  This is a longer than normal post.

His first point is that the political fight over the passage of Obamacare was mostly over who would pay the bills.  But, the more important question may well be - why are the bills so high?  Hint - hospitals, medical device makers, and big pharma are at the heart of it according to Brill.  

I didn't realize that hospitals have a sliding scale for billing: the less money and power someone has the more they are charged.  Really.  It's amazing.  

Hospitals give patients itemized bills.  These are deliberately indecipherable with codes and acronyms.  They are deliberately confusing. They are intimidating. Individuals without insurance are expected to pay them, period.  These, of course, are the poorest amongst us.  Every hospital has charity outreach for the poor, but it is offered to a tiny fraction of patients and reduces the hospitals' bottom line by only tiny fractions.  The hospitals get their highest profit margins from their poorest patients, or patients who thought they had good insurance only to find out that it wasn't enough and they were on their own.  60% of bankruptcies are from medical bills. Those who didn't start out poor become poor.  Kind of disgusting, really.

The itemized bills are the product of each hospital's Chargemaster.  Each hospital has its own Chargemaster, which has thousands of codes for everything that they think they can get away with charging for.  No two hospitals have the same Chargemaster.  No one inside the hospital can explain how the charges on the Chargemaster is calculated.  Chargemaster charges are historically established and are probably bumped up across the board yearly to account for whatever increase in overall billing the hospital deems necessary or possible. Chargemasters are kind of like the list prices for services.  The hospitals actually see them as a beginning negotiating position to collecting money (except to those too ignorant and powerless to negotiate).  Of course, the general public doesn't understand that when they receive a hospital bill that it is only the first step in a long, painful, rigged negotiation designed to make patients give up and give in and pay as much as the hospitals can squeeze out of them. 

So, if you have no insurance, or if you have reduced insurance, or if your insurance has an upper limit that the charges vastly exceed, you are on your own and charged the full list prices.  Brill suggests that if you are in this position, you are best served by employing professional negotiators, medical-billing advocates, to do battle with the hospital for you.  Because you don't have a clue how to go about it on your own. 

If you have a good insurance, your insurance company does the negotiating.  They are large, they are professionals, they understand the codes, and they have leverage that individuals don't.  They get the bills negotiated to substantially lower payments.  Good for them and good for you.

If you have Medicare, Medicare does the negotiating, and Medicare is huge, has a lot of leverage, is staffed by government employees and independent private contractors, and they get bills negotiated to even lower payments than private insurers can.  Good for them, and good for you, and good for the taxpayers for keeping Medicare costs low.  A side note: the size and efficiency of Medicare is such that the cost of processing claims is less than half of even the major insurance companies.  Hard for conservatives to believe, but in this case the government seems to be much more efficient and effective than private companies - because of its size, leverage, and professionalism.

Some examples about how those on their own pay vs how much Medicare pays:

• RESP SVCS (supplying oxygen during hospital stay and testing breathing) $94,799 total ($134 per charge) vs $17.94 per charge
• Tropinin 1 (blood test to detect heart attack residue) - $199.50 vs $13.94
• CBC (complete blood count) - $157.61 vs $11.02
• NM MYO REST/SEPC EJCT MOT MUL (stress test using radioactive dye) $7.997.54 vs $554.
• Diabetes test strips - $18 vs $0.55
• Acetaminophen tablet - $1.50 vs $0.015
• Niacin pill - $24 vs $0.05
• Basic instruments like bandages, IV tubing, blanket warmers, marking pens - something vs $0.00
• Drawing blood during hospital stay - $15,000 vs a few hundred dollars
• 88 year old man with massive heart attack (survived) - $268,227 vs $43,320
• 90 year old woman who broke her wrist - $121,414 vs $16,949
• 91 year old man getting tests and being sedated before dying in hospital - $51,445 vs $19,242

We can see that Medicare negotiates dramatic reductions from the Chargemaster charges.  Insurance companies don't do nearly as well, and medical-billing advocates do even less well, I am sure. 

Although the medical industry claims that they can't make money on Medicare patients, they very actively seek them in places with high Medicare eligible patients, like Florida. So, the claims don't really hold up.

Americans pay over $8000 per person per year for health care, which is double what they pay in Japan, Spain, U.K.  Here are some interesting cost comparisons for health procedures:

• CT scan (head) - U.S. $510, Germany $272, France $141
• Appendectomy - U.S. $13,003, Germany $3,093, France $3,164
• Coronary bypass - U.S. $67,583, Germany $16,578, France $16,140

CTs and MRIs tests are extraordinarily expensive and produce huge profits to hospitals and labs.  But they are used to excess, mostly because they are needed to protect doctors and hospitals from malpractice lawsuits.  Malpractice reform, long touted by conservatives, would do a lot to lower the cost of healthcare in America.  Unfortunately, liberals are in the grip of trial lawyers, and efforts to institute "safe harbor laws" (legally sanctioning care given within the bounds of what peers establish as reasonable under the circumstances) are always killed by liberals in Congress.

Conservatives fare no better when it comes to blocking meaningful cost savings reforms.  Liberals have been pushing the comparative-effectiveness movement, which allows Medicare or insurance companies to choose the less expensive drugs or treatment.  Obamacare tried to implement a Patient-Centered Outcomes Research Institute to expand comparative-effectiveness of drugs and procedures.  Conservatives restricted it. For example, it would have allowed doctors to be paid to counsel end of life patients, excluding euthanasia, but Sarah Palin and conservatives stopped that obvious and compassionate service by labeling it "death panels." 

A bigger criticism of conservatives is for blocking Medicare from being able to negotiate the prices of drugs and durable medical equipment.  Keep those profits exorbitant, and keep those campaign contributions coming.

Obamacare mandates that after 2013 there be no cap on payments for patients, and nobody can be refused insurance if they have pre-existing conditions.  As long as the country has decided that people's health coverage will be paid by private insurance, the premiums for that insurance must go up in order to accommodate those two new laws. Insurance companies must increase the prices of their policies because their costs must go up to pay more to conform to the new law.  If they don't, they go out of business.  A lot has been written about the greed of health insurance, and much of it is probably true, but it seems to me that skyrocketing premiums are a pretty simple fact dictated by arithmetic of increased costs for private insurance.

How big is the medical industry?  A shocking fact, to me, is that of New York's 18 largest private employers, only four are banks, the rest are hospitals.  That is the size of these financial institutions - the hospitals I mean.

Another interesting fact demonstrating the size of this industry: ambulance revenues were over $12 billion last year, which is about 10% higher than Hollywood's box office take!

Another way of understanding the financial size and clout of the health care mega-industry is how much they spend on lobbying.  The health care industry, from doctors and hospitals, to pharmaceutical and health care product industries, nursing homes, health services and HMOs have spent $5.38 billion in lobbying since 1998 in Washington.  This is much more than either the entire defense and aerospace industry ($1.53 billion) and the oil and gas industry ($1.3 billion).  If you think Congress is in the pocket of the defense industry or the oil and gas industry, it must something of a shock to find out that the health care industry makes them look like small players in Washington.

The drug industry was looked at as well. We pay about 55% more for our drugs than in other developed countries.  The drug industry justifies their high prices as needed to cover their R&D costs, and I always thought that argument was a good one.  However, Brill points out that looking at securities filings of major drug companies show their R&D expenses to be 15 - 20% of their gross revenue.  This is substantially below the extra 55% they are charging us for their drugs.

When it comes to health care, there is no free market.  The argument against single payer or government provided health care is the free market is more efficient and provides better quality.  But, none of us is capable of shopping for hospitals, or drugs, or even doctors.  It is like going to the archives and deciding which Sanskrit tablet offers the most effective prayers.  Only the highly trained have any chance of making intelligent discernments.  This is a nearly perfect sellers' market selling to powerless buyers in a totally opaque system.  Keep the buyers ignorant and without the ability to make informed choices, and you end up with multimillionaire non-medical executives running these opaque, exploitative, and heartless profit machines.  

In many ways, it seems to me, the health care industry is a utility, i.e. it provides necessary-for-survival services without any real competition.  Utilities are regulated to keep them from exploiting their monopoly powers, but the health care industry's prices are unregulated and they do indeed exploit their monopoly powers.  

Since Congress has proven itself to be unable to do much to reign in the greed which is ruining our health care system, perhaps the only recourse is to embarrass the greedy with articles like Brill's in this week's Time Magazine.  Or maybe to embarrass Congress into meaningful reform.   

Because we like our doctors, we think of the health care industry as caring.  And I know that many doctors and nurses, and many others giving care are compassionate healers.  

But those running these business also care a lot - for wealth, theirs.  And they get it from the people who have it - the middle classes in America.

Time for RINOs to stand up

Kathleen Parker, center-right editorialist for the Washington Post, hopes that RINOs will take back the Republican Party.  So do I.

RINOs (Republicans In Name Only) are the definition of center-right politicians.  I believe they are the natural complement to Obama, who I consider to be center-left.  RINOs have long been attacked by the fervid on the far-right as being unworthy to be called Republicans.  But, I believe that it is the extremists on the right who are killing the Republican Party, and hurting the country in the bargain.  

The passionate and inflexible evangelicals, second amendment absolutists, libertarians, and social issue conservatives are all very sincere, rigidly committed to their own versions of idealism, and see compromise and deal making as signs of weakness and a failing of moral character.  They are fanatics. And fanatics cannot govern through the actions of politics, they are only temperamentally capable of ruling by decree. 

Indeed, I believe it is the far-right who are actually Republicans in name only.  Republican politicians, by definition it seems to me, are politicians.  And politicians, it seems to me, are by definition those who are dedicated to governing via the political process.  And the political process, it seems to me, is by definition the process of give and take, compromise, deal making, getting most of what you want in the context of negotiating with others who want different things.  

The far-right don’t seem to have any give on abortion, taxes, religious issues, military spending, unfettered free markets, etc. etc.  They seem to see politics itself as immoral.  I think if they are not marginalized by the mainstream Republicans, RINOs, the center-right Republicans, the Republican Party is in danger of becoming obsolete, and going the way of the Whigs.

Interestingly, enough, as I understand it, the Whigs had split into two factions prior to the Civil War: the Conscience Whigs (anti-slavery) and the Cotton Whigs (pro-South).  They eventually disappeared as the Conscience Whigs became part of the newly formed Republican Party, which was anti-slavery (some hard core abolitionists, and mostly Free-Soil members opposed to the expansion of slavery as the U.S. expanded into the west).  So, the Republican Party absorbed the northern anti-slavery Whigs, and the Democratic Party absorbed the southern pro-slavery Whigs.

If today’s Republican Party disintegrates, it is hard to see how a strong party can emerge.  I would seem that it would break up into Libertarian, Evangelical, and Moderates – none of which would have enough members to be a viable alternative to the Democratic Party.  So, perhaps the party’s only future lies in the RINOs taking over the party and having the Libertarians and evangelicals become less influential voices on the margins, but stay within the party trying to influence policy by – politics, persuasion, compromise, deal making.  

What I don’t want to happen is for the Democratic Party to become the only viable political party in the country, because, regardless of any party’s principles it will become corrupt and blind if it becomes a monopoly.

So, go RINOs go.

Time to lower the boom on Wall Street?

Is the Obama administration finally getting ready to lower the boom on Wall Street?  Perhaps.

I have been upset that Obama let the management of the monster financial firms off the hook after the meltdown of 2008.  He had a chance right after the collapse and government bailout of these firms, while Wall Street was weakened, to depose the management as a condition of their rescue, prosecute unethical behavior, and break them up so that they were no longer too-big-to-fail.  But he didn't, and I was disappointed in him and his administration.

But, Matthew Iglesias makes the suggestion that the newly appointed head of the Security and Exchange Commission (SEC), Mary Jo White, is a pretty tough cookie and was a former prosecutor in Manhattan.  In fairness, she was also a defense attorney, so we can't really predict her predilections, but there is reason for optimism for those of us who think Wall Street still needs to have their immense powers trimmed.  It could be that the SEC is finally going to go after some real prosecutions on Wall Street.

Also, we just received the news that the government is suing Standard and Poors rating agency for their allegedly criminal negligence in giving high evaluations and ratings to the toxic investments that were at the heart of the financial collapse in 2008.  Bravo, I say.

So, these two facts may be showing us that Obama might finally be getting tough with the financial industry.  I think there may be a couple of reasons for this.

First, Obama very clearly chose to rescue Wall Street and the financial system when he first came into office four years ago.  I agree that saving the system was necessary to preventing nation wide and world wide financial collapse and economic catastrophe, and therefore was the number one priority.  I believe that he decided that rescuing Wall Street was more important than prosecuting criminal activity, and more important than breaking up the banks.

Second, four years have passed and America's financial system has weathered the terrible storms that it created out of their recklessness and greed.  And Obama may be concluding that civil, and even criminal, prosecutions of these behemoths will no longer destabilize the financial industry or the economy.  Wall Street may well be stable enough to be able to withstand the next steps needed bring balance and soundness to the country's financial system.

So, civil and criminal prosecutions of the giants of Wall Street would likely be a positive step making our system healthier and less risky (by quashing the hyper-aggressive risk taking culture that apparently still runs these too-big-to-fail institutions), rather than threatening instability and collapse.

In addition to prosecutions, Obama could finally break up the too-big-to-fail, too-big-to-regulate, too-big-to-prosecute, too-big-to-manage dinosaurs.

This could finally be the death blow to the persistent Wall Street culture of high stakes risk taking that threatens us all with financial disaster.

Maybe Obama has been waiting for the financial industry to regain its footing enough to move to the next stage in reforming the financial system - prosecution and breaking up of the giant banks.

Obama's anti-Reagan voice

I finally got a chance to watch Obama's inaugural address (I've been out of town on business).  I thought it was a good presentation of his basic beliefs and desires and approach to his presidency.  There is no doubt but that it is a solid declaration of today's liberalism, in much the same way that Reagan spoke clearly of his conservative beliefs and desires and approach to his presidency.  Obama made a clean break from the old Reagan era with a pretty clean expression of his philosophy.

Reagan spoke out for the freeing of the individual and against the constrictions of an overbearing government.  Obama spoke out for focusing the constructive powers of the government to assist and improve the lives of its individuals.

Obama spoke of the power of working together as opposed to insisting that each must do all that is needed alone.  He spoke of the beneficial role that a national government can do to lift the country and its people into a better life.  He offered America's embrace of women, minorities, gays, and immigrants.  

Mostly, what I noticed is that Obama got his voice back.  The voice of Obama on the campaign trail of 2008 pretty much disappeared in his first term.  It looks to me like he has re-grounded himself in his basic beliefs and reasons for his political career. 

Reagan was a move away from over-reliance on government and toward individual responsibility and opportunity. I still believe that was the needed move for the country at that time.  Reagan said that the government was the problem, not the solution.

Obama is a move away from over-reliance on individual capabilities and toward government support and empowerment.  Obama says the government is a necessary part of the solutions, and we can't do it alone.  I believe that Obama's message is the needed move for the country at this time. 

If the Republicans get stuck in avid opposition and attempt a return to Reaganism, I believe that they will more and more marginalize themselves because their solutions are for an obsolete time.  The world of today is not the over-regulated, over-taxed, over-protected world that Reagan changed.  It is time for the Republicans to realize that they don't have to make the Reagan changes to America, Reagan already did that.  

It is now time for the Obama changes to be implemented as a response to an under-regultated, under-taxed, under-protected world left to him by the Reagan legacy.  

This should be a pretty interesting next four years.  I look forward to it.

New York passes a law against spray guns, with tougher health care standards

New York has just passed a gun and mental health bill that seems to make a lot of sense to me.  New York is a liberal state, dominated by a huge city, of course, so it is the place most likely to be for limiting the kinds of weapons that are legal.

Apparently, the new gun laws include outlawing assault weapons, broadening the definition of assault weapons, banning semi-automatic weapons with detachable magazines “and one military-style feature" (whatever that means), banning any gun magazine that can hold over 7 rounds, requiring background checks of gun buyers and ammunition buyers, automated alerts to law enforcement of high-volume purchases, background checks for “most private gun sales”, and a statewide gun-registration data base.  (I would hope there will eventually be a nationwide gun-registration data base)

To me, these laws do not violate an individual’s second amendment rights.  I believe in the second amendment, but I do not believe that the second amendment authorizes the citizenry to be armed with military weapons of mass killing.  Guns – yes - bazookas, tanks, grenades, flame throwers, anti-aircraft weapons, and spray guns – no.

I used to be opposed to most gun control. The two main arguments that used to be persuasive to me about gun control were:  first, outlawing spray guns will have no effect on what weapons the criminals will use, and second, individuals need spray guns to protect them against a tyrannical government.

These arguments no longer are persuasive to me.

First, concerning the inability of laws to keep spray guns out of the hands of the criminals.  So, what?  If only criminals have spray guns, they clearly identify themselves by their weapons and should be guaranteed a minimum of 25 years to life just for the fact of possessing such weapons, especially if used in the commission of a crime.  The best way to clear the streets of hardened criminals is to clearly identify them by their behavior, and if using a spray gun becomes a definition of criminal behavior, that becomes sufficient evidence for extreme incarceration, regardless of the rest of the charges and evidence of the crime involved.  The "Three Strikes" laws tried to get the hard core criminals off the streets; spray gun laws could do that very thing. Plus, citizens that think they stand a chance with their spray guns against practiced criminals with their spray guns are living in a fantasy world of macho bravado reinforced by watching movies where smart and tough good guys mow down dozens of dumb and incompetent bad guys.

Second, concerning needing spray guns to protect yourself against a tyrannical government out to get you.  This seems to me to be paranoia more than anything else.   There is a very strange, very paranoid strand of thought amongst the right wing extremes that the U.S. government is evil and tyrannical and that individuals need to arm themselves to the teeth to defend themselves.  First, the government isn't evil or tyrannical in America, even if they do some things that some individuals don't like. What is the fear? that Obama's jack booted military are going to come pounding on your door at 2 AM and force you to sign up for a government sanctioned health care insurance plan?  And besides, if the government of the United States actually decides to come after you, your only defense is to be the government of Russia or Germany, and even they eventually were conquered. A spray gun isn't going to help.

I say the most likely scenarios for law abiding citizens with spray guns are that civilians will hesitate for just a moment before pulling the trigger (and be  shot out of self defense by the bad guy looking at the barrel of a spray gun), or civilians will act irrationally and impulsively in a fit of rage and use the spray guns against loved ones, friends, neighbors, people they hate, and strangers that send them off, i.e. the citizens become the bad guys just long enough to destroy others and themselves.

Just as importantly, New York also is instituting new laws regarding mental illness and guns, including requiring mental health professionals to report those they believe to be a dangerous to mental health officials, expanding “Kendra’s Law” empowering judges to order mentally ill patients to seek outpatient treatment (too bad they didn’t go the next step and allow judges to order violently mentally ill patients to be institutionalized for inpatient treatment).

The weapons industry will object, of course, because apparently sales are their only objectives in life.  Sad lives, indeed, it seems to me.

The mental health professionals will object out of fear of losing clients who would fear being turned in for violent proclivities.

These laws won’t stop all the crazy people from getting spray guns and massacring children and other innocents.  So what?  These laws will reduce the ease and likelihood of these pathetic events happening.  These laws can  improve the situation. 

The new Ike?

Obama's latest cabinet choices are giving us a pretty clear indication of his vision for his second term. Kerry for Secretary of State shows a low key approach with a lot of private diplomacy, without a lot of headlines and grandstanding.  Hagel as Secretary of Defense shows a desire to cut back military excess and a commitment to be very reluctant to send troops into battle. Brennan at the CIA shows he wants to return that agency back into a more intelligence focused power with less paramilitary force. And Lew as Secretary of the Treasury pretty well keeps the status quo in the financial system with no intent for major reforms.

No-drama-Obama is stepping forward. The more extreme conservatives will fight him as hard as they can, of course, but under what circumstances wouldn't they?  I expect that their biggest fight will be against Hagel because they oppose any reduction in military spending. But, the irony is that Hagel's hero is the great Republican president, Eisenhower, who dramatically reduced the size of the military against fierce opposition from the generals, who did not scare Ike, and who did everything in his power to prevent the sending of troops off to wars, which he knew from deep personal experience never work out as planned.

It seems to me that Obama's approach in his upcoming term is very much like Ike's - increase back door diplomacy, limit military dominance over foreign policy, and do his best not to rock the economic ship.

Sounds something like Ike's America. We could do a lot worse.

Majority of the Majority rule broken in the House of Representatives

The good news is that both the Senate and the House voted to raise taxes and avoid the catastrophic fiscal cliff that was threatening the economy.  The stock market showed its relief by jumping over 300 points.  

The better news is that House Speaker Boehner put the vote to the floor of the House by breaking the "majority of the majority" unwritten rule, that is, he put it up for the entire House to vote even though the majority of Republicans opposed it.  Only 85 of 240 Republicans voted to raise the needed taxes.  The House voted 257 to 167 in favor of the bill, and it passed easily.

Breaking the dictatorial, uncompromising fanaticism of the Rigid Right was a big step toward a functioning government.

Now, we need to have our government do some serious work on spending cuts, including the preposterously bloated military budget as well as obvious Social Security and Medicare reforms, such as later retirement ages and means' testing.

We still have an overwhelming and dangerous deficit in this country, and it has always been obvious to me that we have to both raise taxes and cut spending.  The tax raising happened a little bit, more would have been better as far as I'm concerned, I think that taxes on everyone should go up a couple of percentage points, but that may be a fight for a later day.  So, more cutting and taxing should be in the future, but I'm happy with this modest but essential victory for common sense government that happened today.

In the best of all worlds, gerrymandering reform will sweep through the states and take away the power of politicians to create bizarrely shaped districts that guarantee safe seats for House members, which results in ever more extreme versions of Republicans and Democrats who end up not even existing on the same planet let alone existing in a deliberative body designed to find compromise, make deals, and stumble clumsily toward creating legislation and governing the country. Democrats got more total votes than Republicans in the recent 2012 election, but the gerrymandering still gave the Republicans control of the House by a 234 to 201 margin.  Something is wrong with that picture.

In the even better of all worlds, the voters of this country will finally realize that we can't demand a Rolls Royce government and be willing to only pay for a Ford Fiesta government.

Ending fascist control of our Congress

I think the biggest problem facing the country is the extreme polarization of our politics.  But there is a small window of possibility right now for a systemic change in congress that can marginalize the biggest source of that polarization, the extreme right wing of the Republican Party.  There is also an extreme left wing of the Democratic Party, but they don't hold the country hostage the way the right wing reactionaries do.

The Republican Speaker of the House, John Boehner, has been continuing a tradition of the House instituted by the former Republican speaker, Dennis Hastert, in 2004.  That is to say, the Republican speaker won't bring a vote to the floor unless he has counted that a majority of the Republicans will vote for it.  

What that means in practice, is that a minority of House members - in this case the Tea Party, evangelical, and libertarian extremists - can stop any legislation by voting against it.  So, rather than needing a majority of the House, which includes both Republicans and Democrats, what is really needed is only a majority of a little over half the House, a majority of the Republicans, to stop any legislation. In other words, only a little over a quarter of the House of Representatives needs to oppose a bill in order to defeat it.

This empowers the fanatics of either party to rule the country.  This is not good for the country.  The heart of fanaticism is fascism, either of the right or the left, that is to say, authoritative dogmatic zealotry for an ideology that allows no compromise or flexibility. The House of Representatives has been in the grip of intransigent fanaticism since the zealous rise of the Tea Party in 2010.  The zealots have always been there and have always done as much damage as they were able to do so, on both sides of the spectrum, long before 2010, but the country has been crippled for the last couple of years by these right wing  fanatics.

So, here we are facing the fiscal cliff.  

The president and the Senate can easily come up with legislation that will pass the Senate and be signed by the president into law that will raise taxes and cut spending and avoid the catastrophic effect of going over the fiscal cliff and severely damaging the economies of the U.S. and the world.  And, that legislation would be able to be passed by a vote of the entire House of Representatives, a combined vote of all Democrats and all Republicans.  The only thing that would stop that vote passing the House would be if the Republican Speaker refuses to put it on the floor unless he can get a majority of his Republicans to vote for it before he puts it on the floor.  And, of course the fanatics won't vote for it so they will stop it, once again.

The only hope, therefore, for the country to avoid the fiscal cliff is if Boehner puts it on the floor in violation of the majority of the majority tradition.  Put it on the floor for a vote even if a majority of the Republicans will vote against it. One can certainly assume, for example, that the former V.P. nominee, Paul Ryan, will vote against it.  A good thing he is not going to be the real V.P. of the country, or so it seems to me.

This will take a remarkable act of courage on the part of Boehner to do, since doing so may end his speakership and his political career.  He may plan to put off this decision until after the vote for the Speaker of the new House on January 3, 2013.  This is more than a matter of personal pride for John Boehner.  If he is challenged and beaten by a fanatic, that would be very bad news indeed for the country. We need politics in the House of Representatives to return to being politics, i.e. deal making and compromising to get the best each side can manage in the negotiating process of actual politics.  We cannot continue to be held hostage to the fanatical intransigence of about a quarter of the elected representatives in the House.

So, perhaps we don't get the bill to the House floor until the first week of January.  But if we do, and do so by abandoning the "majority of the majority" tradition of the last nine years, we will be seeing a needed structural change in the House of Representatives.  The Speaker will still decide what gets voted on, but he will no longer be held captive by his own party in making those decisions.

This applies in the future, regardless which party gets in power.  There is no doubt in my mind that the Democratic Party has the same kind of fascist authoritative dogmatic zealotry on the left that allows no compromise.  The country needs to insist on freedom from zealots.  This is a window of opportunity to free the House of those fascist tactics.

In addition, it appears that the Senate will also grapple with a way to free the Senate from the fanatical, fascistic tactics of the minority to stop legislation by abusing the filibuster rule.  I haven't read enough about the options being considered, but I believe that the essence of the filibuster can be maintained, i.e. slowing down legislation in order to allow extended debate and deal making, without crippling the Senate into inaction.  The Senate was not designed by our Founders to need 60% votes to pass legislation.  So, there should be a way out of that mess as well.

One can hope and pray...