Get your act together California

Admittedly it is a strange year in California. Tornado warnings in Los Angeles are an infrequent occurrence, yet it happened this week. Will someone please explain to me why Governor Arnold Schwarzenegger thinks the federal government owes California $6.9 billion? The logic I have heard is that since, he claims, Californians send more to the federal government than they receive back they are owed the money? Even if I accept the disputed claim and ignore the benefits all citizens of the country receive (e.g., defense of the nation, common currency), what is the basis of the argument? Where does it say we are to receive what we pay in? If that were the case, where is my money? Why is there a progressive income tax? Yes, I understand California has incurred a huge deficit and seems unable to take action to control spending or increase state revenues. Yes, I understand it is possible the federal government may not be reimbursing the state as it is obligated to do. Yes, I understand California by itself is one of the world's largest economies and bankruptcy threatens its foundation and would have adverse impacts on the nation. I also understand forty-five other states are facing a budget shortfall this year. For all states, I say, yes, the federal government should be held accountable to pay what it is committed to pay. Beyond that, though, I urge we accept that the nation, not just the states and local governments, are in financial crisis. We cannot afford to do what we do. Furthermore it is going to get worse, because when demand (technically the quantity demanded) starts to increase inflation will accompany it, the weakened dollar will not be financed by the foreign governments indefinitely, and interest rates will rise. The state and local government budget projections I see are based on the false assumption the cost of our debt (financed at artificially low short term rates) will remain constant. It cannot. There are no bailouts for any of us, and when political expediency grants them it is simply reallocating from, and probably shrinking, the pie. Our objectives must be to stabilize (e.g., do not spend more than you make) and then enlarge the economic pie.

Reference:

http://www.csmonitor.com/USA/2010/0120/Schwarzenegger-goes-to-Washington-to-collect-6.9-billion

Let us at least agree on the problems

I believe it is fair to assume there can be multiple, legitimate opinions on how to address a problem. The first step to assessing those opinions and options, is to define the problem. As a nation, though, we do not consistently define the problems to be addressed, which permits the politically expedient approach of blaming the other guy or taking statements or acts out of context. I am compelled to write this today after two events yesterday that I find frustrating. First, the politicians and pundits on every side provided analysis of Scott Brown's victory in the special Senate election in Massachusetts. What I learned yesterday is that the other guy is wrong and whatever the speaker favors has been endorsed. The other event I found frustrating yesterday was the congressional hearing before the House Armed Services Committee on the Fort Hood shootings. Oh come on, how can we expect to solve the problem if we do not acknowledge it was an act of terrorism? I recognize some may argue we do not know that it was an act of terrorism, that it may have simply been an act by a crazed individual and the word terrorism is inflammatory.

How is terrorism defined? Visual Thesaurus defines the term as follows:

• the calculated use of violence (or the threat of violence) against civilians in order to attain goals that are political or religious or ideological in nature; this is done through intimidation or coercion or instilling fear; or
• the use of extreme fear in order to coerce people (especially for political reasons).

While the act was committed on a military base, the targets were known to be unarmed and not positioned for military action, especially by a member of their own force, effectively they were civilians. In conjunction with statements by the shooter, these definitions appear to be satisfied. If one is unwilling to accept that, I offer that the acts were intended to terrorize the victims and a broader population and therefore it was an act of terrorism.

Why will we not admit the obvious? Even President Obama acknowledged the effort to blow up the Northwestern flight to Detroit on Christmas Day was an "act of war", but he declined to call it a terrorist act and endorsed the position of treating the person who committed the "act of war" as a civilian with all associated privileges. What???

You may disagree with my position that the Fourth World War is underway, but can we at least agree the problems need to be defined, evaluated, discussed, communicated, and action taken? This seems such a simple proposition, why do we not demand it?

Unnecessary redundancy in health care

My wife had surgery yesterday. The surgery went well and we are pleased with the medical care she received and thankful we have medical insurance that will pay the costs for the procedure and time at the hospital.

We were both surprised by the amount of redundancy built into the system. Before the surgeon met with her and she was wheeled off for surgery, seven different people met with her. Many asked the same questions, dutifully recording what they were told, and initialing off on their work. Just as in the airplanes I fly, for procedures affecting physical well being, I want redundancy. The catch is, I want redundancy that serves a purpose and applies to critical systems. We observed that did not appear to be the case yesterday. Instead of reducing the likelihood of error, the system is likely to increase it duplicative inputs and not having a common data repository. Human error happens. When the results of the error can be serious, such as in an airplane's system or a surgery, then steps should be taken to reduce the probability of the error or its seriousness. By so many people asking, and separately recording, my wife's allergies, for instance, it makes more sense to me to have the parties that need to know (e.g., the anesthesiologist) to confirm what the intake nurse already recorded. Every time more than one person inputs what is to be the same data into a system, and one that should be commonly accessed, the likelihood of error increases, not decreases. It is my understanding the reason each person is asking duplicative questions and submitting duplicative answers is because, well, a giant system of covering your ass. Why is that needed? I maintain it is primarily for legal protection, to minimize the liability if an error occurs. The fact that it is more likely to occur is irrelevant, because it can be targeted to a smaller cause, but all individuals and institutions involved then have to carry inordinate malpractice insurance, just in case. Costs go up, but because of my good insurance is going to be paid for, no one seems to care, yet everyone seems to be shocked by the continually rising cost of health care. (Health care is one of the two major components outpacing general inflation; the other being education. Interestingly, both areas are highly unionized and either highly regulated or administered by the government.)

In the last half year, I have undergone extensive and expensive medical tests. Beforehand my neurologist correctly told me what the results would be. The tests were conducted not because he thought they were necessary, but to rule out a couple of remote possibilities of what could be contributing to my symptoms. At most, the likelihood of my having either condition was estimated at less than two percent. If it had been up to my neurologist, he would have taken the safe bet the two percent chance of one of those conditions was not present and treated me accordingly. Instead he ordered the tests. Why? To cover his ass. Interestingly, my insurance provider did not disagree with the treatments - they need to cover their ass, too - but they did argue over where the tests should be performed. I suspect the difference in costs between the two sites was more than offset by the time spent arguing over where the procedures should be done. That said, I am talking about my life here and if there is a two percent chance that there is a treatable condition that left unchecked could be fatal, then I want it checked. If the two percent was you instead of me, I would feel at least the same way. My situation was never presented as the remote, fatal if not checked chance. though, so, despite the tribulations I have experienced over the years to get to the root cause of my symptoms, I would have said no. The tests were done. Costs were incurred, resources redirected, all because of the possibility I could become a plaintiff.

The American people voted for change in the election of Mr. Obama. He has made health insurance change a keystone of his presidency. Transparency, inclusion, and evaluation of options were promised. I do not know the answers to the issues of health care costs and coverage, but an obvious component is tort reform. This is a component missing from the legislation, for apparently old school politics reasons - litigators are major campaign contributors. From my vantage point, the only thing transparent about the change in Washington is heightened Tammany Hall politics.

Transparency, elitism, and The Republic

Transparency and open government were to be such a keystone of the Obama administration that the day after his inauguration, the President issued a memorandum for the Heads of Executive Departments and Agencies on the subject. In the memorandum and in the subsequent publication in the 21 January 2009 Federal Register, our President states government should be transparent, participatory, and collaborative. In soliciting public input in the Federal Register dated 21 May 2009, the Director, Office of Science and Technology Policy summarizes the benefit of this openness:

• Transparency promotes accountability and provides information to citizens about what their Government is doing;
• Participation enhances the Government’s effectiveness and improves the quality of its decisions by tapping knowledge that is widely dispersed in society; and
• Collaboration harnesses innovative tools, methods, and systems to promote cooperation across all levels of Government and with the private sector.

Consistent with these principles candidate Barack Obama stated 21 August 2008 regarding health care "we'll have the negotiations televised on C-SPAN, so the people can see who is making arguments on behalf of their constituents and who is making arguments on behalf of the drug companies or the insurance companies." Such openness is refreshingly laudable.

In a complete reversal of these principles House Speaker Nancy Pelosi talking at the White House on 06 January 2010 said "The House and Senate plan to put together the final health care reform bill behind closed doors according to an agreement by top Democrats." Press Secretary Robert Gibbs declined to refute the decision stressing instead "the president wants to get a bill to his desk as quickly as possible."

The reversal is not surprising. I posit the President, an academic, conceptually sees political utopia in Plato's The Republic. Plato, one of the cornerstones of public education, encourages telling our children false, but noble, stories to achieve desired ends. This is analogous to his statements of transparency. By excluding the population as a whole, Republican legislators, and even most Democrats, Plato's elitist guardian class - which apparently is, at least in this situation is defined as "top Democrats" - will determine what they deem to be best for the vast majority of us in the producers and auxiliaries classes. Given this perspective, it is completely rational to then exclude the guardian class, who by definition know best, from the rules imposed on the majority as they are different.

Today's so-called progressives should remember the conclusion of The Republic is the banishment of the poets, the same voices who praised the pursuit of justice.

References:

• http://www.whitehouse.gov/the_press_office/TransparencyandOpenGovernment/
• http://edocket.access.gpo.gov/2009/pdf/E9-12026.pdf
• Town hall meeting on 21 August 2008, in Chester, Va.
• http://www.politifact.com/truth-o-meter/promises/promise/517/health-care-reform-public-sessions-C-SPAN/
• http://www.cbsnews.com/stories/2010/01/06/eveningnews/main6064298.shtml