The American Dilemma and How We Can Fix It

Archive for the ‘healthcare’ Category


Since the Inauguration of President Trump anyone who’s flipped on a news program, watched a typical talk show, has picked up a newspaper or read stories on line has been besieged by a never-ending series of stories that are negative.  Most of those have been directed toward the president – but Republicans in general have also been beneficiaries of the sometimes brutal tripe that is put out for our consumption.

One of the loudest cries has been, “They have had seven years to come up with a replacement for Obamacare and they don’t have a plan to replace it.”  Well, the House passed a replacement plan the other week.  So, of course, the usual parade of vitriol, directed to a bill that will probably little resemble the final version if it even gets past the Senate, has begun.  Both sides are missing the point – and in their obfuscation of the facts, the American people have been led down the proverbial primrose path as well.

Neither the Obamacare legislation nor this replacement are about healthcare.  They are both about health insurance. Before I attempt to establish my point, we should have a brief discussion about the nature and purpose of insurance.

Insurance is a vehicle by which two parties share risk on an agreed basis and in exchange for a certain amount of money (premium).  That principle is the same whether the risk is a home, a car, an individual’s health or his life.  Having insurance does not suggest that your home won’t be lost in a fire, your car will never be involved in an accident, you will never get hospitalized or that you won’t die.  It merely mitigates the financial effect should any or all of these things happen.  That’s insurance plain and simple.

One, but not the only problem with the Obamacare insurance scheme, was that it was based not on reality but on ideology.  This explains why insurers are abandoning the exchanges in droves.  It might be politically correct to charge the same premium to men and women of the same age the same premium.  But those premium charges ignore the facts that women are more expensive to insure than men because they typically have more hospital stays than men – in part due to pregnancy.  Similarly, it is absurd to consider a person who has an extensive history of heroin addiction to be in the same health as a person who has never used the drug.  Yet their premiums were mandated to be the same by the law.  Abandoning sound, actuarial facts results in financial chaos for the insurers.  And that is the simple explanation of why they have been withdrawing from Obamacare.

Now those on the left will point to their exit as being a function of sheer greed on their part.  But think about this.  If an insurer cannot assemble a risk portfolio which enables them to earn a profit, eventually they will run out of capital to pay legitimate claims.

The new replacement law will probably not do much better because it also is predicated on the misconception that health insurance and healthcare are interchangeable terms – which they are not.  And this fixation on health insurance, were it not such a dominating force in this discussion, would be laughable.

I am not arguing that insurance, whether health or any other kind, has no value.  It does.  It gives the owner some peace of mind.  But insurance is unique in that it is the only product whose owner hopes never to collect on it thus recouping his premium payments.  No one wants their home blown away by a tornado or their car wrecked in an accident or wants to have a serious medical problem or have a loved one die just so they can collect on the insurance proceeds.

So as we have seen, the value of insurance is in mitigating the effect of a financially tragic event.  It does nothing to prevent that event.  Real healthcare would focus not on responding to disease but in preventing it in the first place.  That is an argument that is seldom heard in the Congress, the medical industry or the press.  One can only wonder why.  And the old saw, “Follow the money,” presents perhaps the simplest and most likely answer.

Our focus as individuals should be on staying healthy rather than getting better. So what if the new “healthcare” bill had a provision that funded a massive effort to eliminate cancer or cardiovascular disease?  That would be something that would receive great press and high endorsement from the voting population.  But one has to wonder if all those “charities” that have been raising money and paying their executives high six and seven figures for the last fifty years would be on board with that.

The truth of the matter is that there is a great deal of money and profit in having a population that is diseased.  If a cure for diabetes were announced, how would that impact the profits of those companies who manufacture insulin and all the ancillary products that are used to deliver it to the patient?  Their profits would plummet.  Do you feel they would adopt a laissez-faire attitude were the announcement of such a cure to be imminent?

We have spent hundreds of billions of dollars funding the CDC and NIH.  Presumably, we do so because we trust the research and recommendations that these two organizations make.  They are supposed to be independent and free from political pressure.  And they may well be.  But once they make a recommendation, it is up to our politicians to review and, if it has merit, to implement it.  So let’s look at the reality of what really happens.

Both of them have attributed the rampant ratchet up in overweight, obesity and diabetes to Americans’ over-consumption of sugar.  Have you heard even a whisper of this analysis in the “healthcare” debate?  Of course not.  And the reason is very simple.  The sugar industry not only contributes to the re-election campaigns of our politicians as do Coca-Cola and Pepsi, two of the companies that substantially contribute to Americans’ sugar consumption

One can understand how a company wants to maximize it’s profits and sell as much product as possible – irrespective of it’s harmful effects – until forced by public opinion and ultimately government to accept responsibility.  But what is truly amazing is that the American sugar industry is subsidized by our government, the NIH and CDC reports notwithstanding.  (By the way, the tobacco industry which is widely reviled, also still receives federal crop and insurance subsidies – even as the feds and local governments continue to heap large excise tax increases on tobacco products).  These obviously conflictive official and “real” policies can only be described as disturbing – if not downright corrupt.

This is an excellent example of the swamp about which candidate Trump spoke when he was campaigning. And I suspect now as president, Mr. Trump is probably amazed that swamp is as extensive and thoroughly alluring to those who have helped create it.  Sadly, running and fixing a massive federal bureaucracy is going to be more challenging than running or fixing a business.

Perhaps that reality is no more apparent than as regards the border wall.  What most voters believed was going to be a solid and impenetrable brick and mortar edifice may have morphed into something less contiguous and involving more modern methodologies than Hadrian employed in Britain.

What we should realize is that the point of building the wall is not “building the wall.”  It’s securing the border and cutting down on the inflow of illegal immigrants who have had free reign to come into the country.  One of the tools which, based on the recent decreased number of illegal entry attempts, is not the wall, which has not progressed, but the mere threat, the power of the Trump administration’s bully pulpit with respect to enforcing the laws that are already on the books.

I view and always have seen the “border wall” in somewhat metaphorical terms.  If we could accomplish the goal of reducing the illegal flow of people into the country without spending money to construct a physical structure, I’m fine with that.  After all, accomplishing that goal should be our primary focus.

Wouldn’t it be great if we viewed “healthcare” in that same light?














It finally arrived – the long awaited envelope.  It had been well over a week since I had sent away for it – but my letter had to make it from New York to Arizona and then the response had to come all the way back.

I had found an ad in one of my “Fantasy and Science Fiction” magazines and had responded.  Who wouldn’t answer this ad?  It promised to send the person who clipped the ad a “secret” way to accumulate wealth without really having to do much of anything.  It didn’t matter if you were young or old, a PhD or a high school drop out, the system would bring riches to whoever used it.   It was the American dream – and the information would be sent absolutely free of charge.

Some people are motivated by theory and others by practical concerns.  In my case, I wanted to become a fourteen year old success because I was tired of sleeping on the Castro convertible sofa and sharing my “bedroom” with the “dining room.”  If I made a lot of money we could move from our small apartment into one of the new high rises that were being built throughout Manhattan.  My parents had looked at several apartments in these new edifices, but decided that quadrupling the rent for just a small amount of additional space just didn’t make sense or fit our budget.

When Grandma handed me the envelope containing the “secret system” I took it and held it with the reverence due a holy relic.  I went to my desk, placed my school books on the side and laid it gently in the middle of the blotter.  I took the seldom-used letter opener and carefully opened it, making sure that my cut was even and neat.  After I completed that I waited a minute or two before daring to pull out and read its contents.  But I finally summoned up the courage.

Before me I had a pamphlet that explained how a person could make a huge amount of money by getting into mail order.  I read every word of this brochure, replete with “testimonials” from people who were identified only by their first names and an initial for their surnames and the city in which they lived – stories about how they had made a small fortune in mail order thanks to the secret system.

And what was it that they were selling?  They were selling copies of a booklet that explained how to get into mail order – a copy of which was reserved for me – if I merely completed the enclosed order form and returned it with my five dollar remittance.  Once I had received my copy, I would have the opportunity to purchase additional copies which I could sell at a “huge profit” and the booklet would explain the step by step way of doing that.  To say I was disappointed would be an understatement.

Even though I knew that something just didn’t add up, I was reluctant to give up so quickly on this opportunity to get my own bedroom.  So at dinner that evening I asked my parents to read the brochure and give me their opinion.  Needless to say, it did not survive their imprimatur.  Nevertheless, having explained why this was a scam  they still permitted me to purchase the book if I chose to spend my five dollars on it.  My parents allowed me to make my own mistakes – as long as they weren’t likely to be dangerous to my health or well being.  Their theory was that rather than hearing them preach, a little personal experience would be far more enlightening to me.

Even before I had given my folks the brochure I knew that something just didn’t sound right.  But I was hoping that I was wrong and that my parents would agree with my original opinion that I had latched on the key to riches.  After several days of soul searching, I concurred with my parents and tossed the brochure in the wastebasket.  My father summed up the experience with the statement, “When something seems too good to be true – it probably isn’t.”

In 2010 the Congress passed and President Obama signed the PPACA into law.  Now more commonly referred to as Obamacare, the law was touted by Obama and lawmakers who supported it as the best thing that had happened since the invention of sliced bread.  It offered every American the opportunity to get “affordable health insurance”; we would be able either to keep our existing insurance or get a better policy through the healthcare exchanges that were going to be established; despite the fact that these new policies would be better they would be less expensive; every American household would save $2500 per year for this insurance; and on top of all of that, this three thousand page bill would reduce the national debt.  It almost seemed too good to be true – and it wasn’t.

Nobody who took the trouble to read through the law believed that the promises could be delivered for a simple reason.  The numbers just didn’t add up – and they still don’t.  But without going into a detailed analysis of the math, if you think about the law’s purported primary goal – insuring all Americans with affordable, quality medical care – it should be clear that goal is inconsistent with providing quality healthcare.

Let’s assume that magically everyone suddenly signed up and there were no longer Americans who couldn’t see a doctor for lack of insurance.  How would this impact the quality of delivering medical services?  It would cause a lower quality of health care if, for no other reason, than that we have now added forty million potential patients to a system to which no new medical practitioners or hospital facilities have been added.  The overall effect would necessarily be longer wait times to get an appointment which in and of itself constitutes a decrease in the quality of healthcare.

We know that few if any legislators actually read the bill before voting to approve it – per then Speaker Nancy Pelosi.  That in itself is disturbing as that is the reason that we pay these people quite handsomely.  But if they had read the bill I sincerely wonder if they would have been much more elucidated on its contents than before they began that exercise.  Besides its length, the law is convoluted and the language goes beyond what we have come to expect from Washington speak.  For that reason perhaps, we employed an MIT professor, one Jonathan Gruber to advise those who wrote the law on how to craft it.  The Federal government and various state governments apparently paid Professor Gruber the sum of nearly $6 Million over several years for his insight.

Over the last ten days a series of videos have surfaced in which said professor has been recorded delivering a number of talks to various groups, mostly within the hallowed halls of academia, and explained that in order to secure the law’s passage, basically its contents had to be both disguised and lied about because it would never have passed if the public new what it actually contained.  In the course of his explanation he pointed out that, “The American public is stupid.”

While this academic apologized for the statement from the first of these videos which was released as an unfortunate malapropism, on several other occasions he made essentially the same comment.  This is not a faux pas but a reflection of the professor’s world view – and more generally – an example of the world view of most on the liberal left.  People are simply too stupid to do what is in their best interest – so it is up to enlightened do-gooders to enforce what is good for them on them.

These comments brought me back to the time I was able to attend “The Howdy Doody Show.”  It was much earlier than my experience with the magic mail order system.  I think I was about eight – and like all the ther kids who attended, I sat in “The Peanut Gallery.”  Like all the other “peanut attendees” I was wowed by Buffalo Bob, Princess Summerfallwinterspring and Mr. Bluster.  It was a half hour of pure fantasy and delight.  But I graduated from The Peanut Gallery.

I wonder if Professor Gruber ever had that same experience.

“Goober – a peanut.”  {Colloquially – A person of limited intelligence}.

“Gruber – a pompous, cynical ass paid nearly $6 Million by various government agencies to deceive the American goober to buy into Obamacare.”


After my mother’s death, my Aunt Helene readily inserted herself as a surrogate.  I had always been very close to Mom’s younger sister and I welcomed her nurturing and support at both that difficult time and for many years afterward.  I never failed to call her weekly and always sent her a wonderful birthday present.  On her 70th birthday I hosted a party for her, her three children and their spouses at The Four Seasons for dinner – although I had to specify that they gave the guests menus without prices on them – as she would have gone into cardiac arrest if she saw the cost of the meal and would have opted for bread and a glass of water.  She was a very practical lady.

There was a one year period when I was a child when my aunt disappeared from the scene.  It’s as though she had been abducted by aliens and transported to a distant planetary system.  In fact, although my parents never told me what happened and I learned the truth many years later, she had been consigned and confined to Bellevue Hospital to be treated for what was diagnosed as schizophrenia.  This was in the late 1950’s.

The “modern medicine” of that day frequently addressed this psychological illness with what today we may consider to be a rather primitive treatment.  It  was known as “shock therapy.”  If you saw the first “Lethal Weapon” Mel Gibson movie, you may remember the scene where he is suspended by his hands from the ceiling and water is poured over him as his interrogator hits him with electrodes to force him to talk.  That’s “shock therapy.”  It’s apparently extremely painful.

Well, the medical practitioners at Bellevue pronounced my aunt “cured” after she had been confined there for a year and undergone that treatment twice a week during her interment.  She returned home to her family, but I could see that she had gotten much more docile, measuring every word and making sure never to offend anyone.  She had always been a very gentle person but her gentility had transmuted to an almost submissive meekness.  It was many years before she rediscovered some of her previous élan.  And discussing that one year was so painful that no one in the family dared speak of it or ask for details – until many years later when my aunt felt comfortable discussing it and brought it up herself.

Four years went by and Aunt Helene began experiencing the same symptoms she had exhibited before her commitment.  Many years later she confided in me that she would have committed suicide rather than repeat her “therapy” at Bellevue, which incidentally, was known as one of the premier psychiatric hospitals in the country.  Fortunately, she had found an osteopathic doctor and had been seeing him for several years.  She described her current symptoms and told him about her stint at Bellevue.  He told her that he had a theory but he would need to request her medical records from the hospital before he could confirm his belief.  While waiting for those records he ordered some blood work done so that he would have those results when he received her transcript from Bellevue.

Two weeks later he called my aunt with news – some bad, some good.  “Helene, you do have a medical condition – that’s the bad news.  The good news is it isn’t schizophrenia – it’s hypoglycemia.  You have low blood sugar, the reverse of diabetes.  And hypoglycemia manifests itself in many symptomatic ways that may look like schizophrenia.  We need to raise your blood sugar level which we probably can accomplish through diet – and you should be just fine.”  My aunt told me that when she hung up from that call she felt as though the weight of the world had been lifted from her shoulders.  And she dealt with her condition through dietary management until her death at the age of 85.  I still miss her as she was a wonderful lady.

The blood work that Dr. Castin had received from Bellevue Hospital showed the same low blood sugar levels five years earlier.  But none of the physicians there caught it.  So my aunt went through nearly one hundred unnecessary shock treatments which left deep psychological scars.  Well, we all know the old joke that if you’re on the operating table the one thing you don’t want to hear your surgeon say as you float off under the anesthesia is, “Oops.”

Ebola is a potentially fatal disease – the mortality rates ranging between 50 – 70% according to the World Health Organization.  Mostly it has been confined to large areas of west Africa.  Probably those mortality rates would be lower in countries with more advanced infrastructure and medical systems.  Both the flu and traffic accidents kills more people in the United States than have fallen to Ebola in Africa.

As much as man would like to think he is in complete control of his own destiny, what we used to refer to as Mother Nature has a vote in the conversation – and she sometimes holds a very strong hand.  We have seen devastating plagues afflict human populations several times in recent and past history.  And while it is probably true that we are better equipped today than in the Middle Ages when bubonic plague ravaged Europe, it would be pure hubris to believe that we are so wise and so well prepared that we are impervious to a potentially ruinous outbreak of something the old gal has cooked up for us.  Admitting that would be to take the first step toward truly preparing for the potential of just such an outbreak.  And therein lies the problem.

Repeatedly since the first Ebola victim came to America from Liberia and subsequently died in Dallas, we have been told that any “large scale” outbreak of the virus is unlikely.  While that sounds reassuring, I for one would like to know the definition of “large scale.”  Is that one hundred patients; one thousand or one million?  That would seem a germane question since we have now been informed by the CDC that we have five hospitals which are prepared to handle just such an outbreak should it occur.  What the CDC has neglected to tell us is that between all five of those hospitals, spread throughout the country, there are a total of eleven beds to accommodate those who might come to them with the infection.

The CDC and its head, Dr.Tom Frieden have not exactly been reassuring in the way in which they have handled the situation thus far.  Nurses’ union leaders are complaining that they not only have not been instructed in the protocols that should be implemented to insure their safety and the proper treatment of the patients entrusted to them, but that they do not have the appropriate equipment nor instruction in how to use it.  That is a bit chilling.

The president assured us that there was no chance that Ebola would make its way to the United States.  As of this writing, we now have four such cases, the latest being a returning doctor who is with Doctors Without Borders and lives in our most populous city, New York.  He is currently quarantined in Bellevue Hospital.

This evening, from that hospital, the mayor of NYC, Bill de Blasio and NY governor, Andrew Cuomo together with the physicians who head NYC’s and the state’s health services appeared together at a news conference to update and reassure the public about the most recent Ebola patient and any potential threats to the health of New Yorkers because of the exposure he may have had to others.  I was impressed with several things at that press gathering.

First, in the finest tradition of the White House, the scheduled press conference began late.  In fact it started nearly forty minutes late.  Simple common sense would suggest that if you’re dealing with a restive public who are concerned about a situation, delaying a scheduled press briefing is not the way to instill confidence.

Second, I was struck by the almost robotic monotone in which the public was updated on the latest Ebola patient by both the mayor, the governor and the female doctor who heads NYC’s health department.  I will give credit to the state’s chief physician.  He appeared definitely to have a pulse and seemed to engage actively and with interest in the topic at hand.  I don’t expect a Periclean speech from either our elected officials and certainly not from appointed bureaucrats, but a little bit of emotion would convey a sense of actual interest.

Third, we are asked to rely on our government’s public health officials and agencies to keep us safe from harm.  One of those on a Federal level would be Sylvia Burwell, the head of Health and Human Services.  You’ll remember that agency which formerly was headed by Kathleen Sibelius who brought us the Obamacare website roll out.  In his remarks, Governor Cuomo, never a candidate for a MENSA application, referred to Ms. Burwell as the head of Homeland Security – a post currently occupied by Jeh Johnson.  Forgive me but I’m not instilled with the warm glow of security when those who are supposed to be in charge don’t know where those with whom they may need to coordinate actually work.

If we accept, perhaps with a grain of salt, that Ebola is fortunately a hard virus to transmit from one person to another, that may give us some comfort.  But what is disturbing is the response from those within Federal agencies which seem at best, confused and unprepared.  That is not unlike this administration’s response to a host of other issues which have surfaced in the last six years.

There are threats which nature provides and which man has created.  The two terrorist attacks which have occurred in Canada, I use the term terrorists because Canada’s PM has done so being unafraid to call it as he sees it, are truly disturbing, especially in this context.  We have seen recent purported uses of mustard gas in Syria.  After 9/11 we had a mini crisis as we worried about the dissemination of anthrax.  And terrorists in Japan have used sarin gas to advance their agendas.

In view of the savage brutality of the Islamic extremists (terrorists), it is not beyond the realm of possibility to believe that if they view their mission as destroying the infidel by any means possible they would eagerly resort to the dissemination of chemical weapons within major U. S. or other western population centers without regard to the niceties of international conventions to the contrary.

I hope that our officials are correct and that any outbreak of Ebola in the U. S. will be limited in nature and that we may assist in eradicating it in west Africa.  But based on the response we’ve seen to date, to put all one’s faith in that outcome might cause a trained medical professional to question the state of our mental health.


We all love a good news story.  And I’m going to be among the first to put one up if it should arrive on the scene.  So, you think I missed one – don’t you?  Juwannadoright, didn’t you notice that Congress just passed a bill that is going to reform the VA?  Well, sadly, I did notice – and the “reform” bill isn’t that promised good news story.  But it does look pretty good – as long as you don’t read it.  (Nancy Pelosi may her words be praised).

The bill comes on the heels of what might actually be some good news for the VA – the confirmation of Robert McDonald as its new Secretary.  The vote was unanimous in the Senate – which is perhaps the first sign of anything resembling bipartisanship in a coon’s age.  That’s a good thing.  Mr. McDonald has a great deal of management experience and, if permitted to do so, might actually bring some positive changes to the medical care of our sick and injured veterans.  But that is the question.  Will Secretary McDonald actually have the authority to reform this agency?

After a number of decades of watching politicians and how they generally act, I have reached a general conclusion (although there are some few but notable exceptions to this observation) that politicians are far less concerned about doing good than they are about looking good.  Unfortunately, the VA reform bill is just another example of that kind of legislation.

Let’s recap the VA problem for those of you who have been hiding in their bunker for the last several months in an effort to stay out of sight of any Obamadrones which might be in your neighborhood.

The VA, the largest medical provider in the U. S., has had problems for years in providing care to serve its large population of veterans who look to it for medical care.  In some respect the recent problems are the VA’s own fault because they set for themselves a mission goal of providing every veteran who requested an appointment a fourteen day window for that appointment.  That was an admirable goal – but unfortunately, one that simply wasn’t achievable.

The result was that in order to appear to be doing good, certain people in the VA developed a system that gave the appearance of looking good by creating multiple appointment lists which appeared to achieve that goal.  Sadly, at least fifty of our veterans died while being on one of these phony lists.  Now into this mix add the additional issue that employee bonuses were based on how closely to achieving this fourteen day goal each facility came.  This, of course, introduces the idea that it might have not been mere “face saving” but also greed which contributed to the problem.

Shortly after we realized that the creation of phony waiting lists was not something that was unique to the Phoenix VA, in fact the same system was in place in twenty-six VA facilities nationwide, one of the proposed solutions was that each veteran be given a voucher which he or she could take to any medical provider in the event that there was an inordinate delay in securing an appointment at a VA facility.  The bill that Congress passed attempts to address that.

The second issue that was raised was with reference to accountability within the VA and making it easier to fire employees who engaged in doubtful practices, such as developing or maintaining phony lists – among other issues.  The new law only peripherally addresses this issue – so one can only wonder how now Secretary McDonald will be able to implement any management changes he might develop to benefit our veterans.

Let’s look at what the bill actually says.  (Follow the bouncing ball Minority Leader Pelosi).

Should a veteran require medical attention. be unable to secure a VA appointment within fourteen days and live more than forty miles from a VA facility, he or she can request a letter from the VA. authorizing treatment at a private facility.  (There is no specificity in the law as to how long the VA has to provide that letter).  Now, armed with this authorization, the veteran may make an appointment with a non-VA doctor or facility.  But then that doctor or facility has to request a letter confirming the contents of the original confirmation before the veteran can receive treatment.  (Again, there is no specificity as to how long the VA has to respond to that second request).

As I read through this bureaucratese, I could see the loggers out in the Pacific Northwest, felling the giant redwoods to provide the pulp for all the paperwork that will be involved in this process.  No doubt we will have to add to the bureaucracy within the VA (much to the delight of the unions that represent its employees) to handle this new program.

As to the second point – enabling top VA management to fire incompetent or malfeasant employees more easily – the bill does absolutely nothing.  In its inimitable way the Congress did skirt the issue and address the question of bonuses which might have been one source of the problems.  It limited future bonuses to a mere $360 million – a moderate reduction from the amount that was handed out in the last fiscal year of $393 million.

How could the VA actually offer our veterans quality, timely care?  The answer is fairly straightforward.  It would require the VA to identify and classify its clients as being in need of “Urgent,” “Maintenance” or “Ordinary” care.  The most critical patients should get appointments within seven days; those who are going in for routine follow ups should get an appointment within thirty days; and those who need the VA’s services only occasionally should get vouchers to get treatment at private providers, thus freeing up the VA’s appointment calendar for those who have more critical needs – an area of medicine that the VA handles quite well.

How should we deal with employees who are less than fully competent since apparently outright firing is, at least for the moment, off the table?  If an employee is found to be less than fully competent, he or she should be ineligible either for a bonus or for any pay increase or COLA adjustment for a five year period.  That might encourage those who are not pulling their weight either to see the light and reform or seek employment elsewhere.

Who knows?  Someday there will be an act of Congress that passes that not only makes the legislators look good but actually does good.  I’ll keep you posted when I run across it.


“When ignorant folks want to advertise their ignorance, you don’t really have to do anything, you just let them talk.” – President Barack Obama (on the subject of Donald Sterling’s racial comments).

“If you like your health insurance you can keep your health insurance. Period.”

“If you like your doctor you can keep your doctor. Period.”

Moral – One man’s ignorance is another man’s political agenda.


In the United States we don’t get a lot of news from foreign sources.  I’ve never seen a copy of a newspaper published in Sri Lanka.  Perhaps the same is true of foreigners who may not be as informed about life in America – although the internet has helped democratize the process of news dissemination.

Making the assumption that matters of interest in the United States might not hold the same importance to my foreign readers, you’ve probably never heard of an American by the name of Kevin Trudeau.  In fact, I suspect there are a fair number of my countrymen who are similarly ignorant of this individual.

If you are an insomniac or just a television junkie, at some point over the last decade you’ve probably seen one of Trudeau’s infomercials.  For those of you abroad who may not know about infomercials, they are the advertising version of reality TV, normally lasting for one half hour.

A typical setting for an infomercial is a studio, the “pitchman” pushing the product is most often male and is usually accompanied by an attractive, younger female who asks insipid questions of the host or oohs as the host describes and normally demonstrates the product he is promoting.  These  might be vacuum cleaners, a kitchen appliance – or in Trudeau’s case – books.  Kevin has written a number of these whose subject matter includes “unique ways to get out of debt,” “’natural cures’” that the health care industry doesn’t want you to know about” and, of course America’s favorite health issue, “no effort ways to lose weight.”

You can certainly understand the reason that Mr. Trudeau appeals to a wide audience.  After all, being debt free, healthier and better looking are things that most of us would embrace as goals to which we would aspire.  In fact, at his sentencing hearing yesterday in Chicago, the courtroom was packed with his supporters as the judge remanded him to ten years in prison.

Mr. Trudeau had previously been convicted of bilking the public out of $37 million.  You see, what Mr. Trudeau promised to deliver the prospective buyer in his infomercials was substantially greater than the value of the advice which appeared in the printed word – or so the court found.

Mr. Trudeau has been imprisoned since his conviction late last year.  In an impassioned twenty minute speech he said that, “Prison has changed me.  If I ever write another book I promise that there will be no puffery, no embellishments, no lies and no mis-leading statements.”  Sadly for Mr. Trudeau, that plea fell on the ears of a deaf judge who agreed with the prosecution’s recommendation that he receive the full ten year term.

I’ve seen a number of Mr. Trudeau’s infomercials though I’ve never purchased any of his writings.  I can see how a person would be inclined, were they interested in the subject matter, to understand why he sold a lot of books.  Mr. Trudeau is an outstanding pitchman.  He’s the kind of person who is believable and could convince a farmer dealing with drought that he was the long awaited rainmaker.

But I couldn’t help thinking …

If we held the Congress and the president to the same standards regarding Obamacare as we held Mr. Trudeau, our correction facilities would be breaking out a lot of orange prison suits and we’d have a great number of political vacancies to fill.


Perhaps it’s my background in music but there is nothing that gets me more interested in a program, product or service than a theme song.

When I grew up there was that catchy “It’s Howdy Doody Time” song that let millions of us tykes know that Buffalo Bob, Princess Summerfallwinterspring and Mr. Bluster were about to show up on our little screens with our hero, Howdy Doody.

A few years later that iconic genius, Walt Disney began his wonderfully entertaining weekly show with “When You Wish Upon a Star” which he took from his earlier film, “Pinocchio.”  Those of us who had seen the movie couldn’t forget how that little wooden puppet hoped to become a real boy and how we hoped his wish would be fulfilled.

As to products, what theme song/jingle could have been more catchy than the one that pushed that all-American product, the hot dog by one of its premiere marketeers, The Oscar Mayer Corporation, now part of Kraft Foods.  For some reason their jingle encouraged a lot of budding singers to walk around all day “Wishing that they were Oscar Mayer wieners,” singing the catchy tune that seemed to dominate our television sets no matter the channel we had selected.

As I viewed the hearing yesterday and today by HHS Secretary Kathleen Sebelius as she updated the Congress on what was happening with regard to Obamacare enrollments, a thought occurred to me.  (Sometimes that happens).  The administration has done almost everything in its power short of offering enrollees a ten thousand dollar bonus for signing up to get this lead turkey off the ground.

With all the spin that’s going on I’m beginning to feel like the Chanukah dradle that some of my Jewish classmates used to play with.  My head is spinning from all the buzz and all the noise.  But the one thing that I’m not hearing is an “Obamacare Theme Song.”  So I’ve come up with one, courtesy of Fleetwood Mac that I think is appropriate.

I sure hope that they like my suggestion.


If you’re a mainstream liberal-left Democrat you undoubtedly subscribe to the mantra that all Republicans (in addition to being white, male and overweight) are uniformly misogynists, merciless and are actively engaged in the well-publicized “war on women.”  That’s true even if you can neither spell nor pronounce “misogynist” or know it’s meaning.  No matter.  When yelling slogans and enjoying the approval of the mindless mob, there’s no reason to think for yourself or form opinions which might conflict with what the politburo tells you to think.  Besides – thinking has been identified as a dangerous activity and has (or soon will be) outlawed – so why waste your time on it when you could be painting picket signs.

There is certainly some evidence that, if taken out of context, would suggest that those who are Republicans (code name conservatives) might fit the definition which you have been taught in your local cell.  After all, a lot of Republicans//conservatives (code name people who have a religious background) oppose abortion – and that, of course, is an assault on your “right to control your own body.”  Granted, there are some in that conservative camp who feel indisposed to pay for your voluntary indiscretion resulting in the need for an abortion.  Most would reluctantly agree to the procedure in the very rare cases where rape or incest is involved.  But rehashing Roe v. Wade is not the thrust of this post.

So you’ve hitched your star to those who are really concerned for the well-being of Americans – the Democrats – and point to all the wonderful things that Obamacare contains.  And there are some excellent features in the act.

It’s great that irrespective of pre-existing conditions, people will be able to get insurance.  Of course, given the fact that people with life-threatening or chronic conditions will pay the exact same premium as someone of his or her age who is disease or drug free means that you and I will contribute to their health insurance directly by paying higher premiums on our own policies and indirectly through the inevitable tax increases that will be forthcoming from Washington to reimburse the insurers when they fail to make money on the policies they are being mandated to sell.

It’s great that there is now portability of insurance.  If you lose your job you will be able to keep your current policy.  Of course, you will be required to pay the full amount of the premium a portion of which your previous employer subsidized.  It’s one of the benefits of having a job – something lost on approximately 13.6% of our populace who are unable or unwilling to find employment.

The main theory behind Obamacare is that in a nation that used to be as great as the United States it is unacceptable that thirty million of us should be without insurance.  Apparently, those who are in that condition are less impressed with their precarious perch than those in the marbled halls of Washington  since the latest polls indicate that three out of four or those uninsured mistrust Obamacare and do not plan on enrolling and a solid one quarter of them have never even heard of it – despite the hundreds of millions our government has spent on public relations to promote it.

We know from well-established studies that women, more than men, need health care and treatment.  Part of that is because women are child bearers and have internal configurations that are more complicated than their male counterparts.  In addition, women have a longer life expectancy than men which results in more medical attention for a longer period of time.  Therefore, it is not hard to conclude that women will be more impacted by the provisions of Obamacare than men.

Since women live longer than men, the $600 Billion cut in Medicare funding written into the law to pay for other parts of the law hits women especially hard.   One of those cuts will affect what are known as “home health services.”  Perhaps you’re familiar with this if you’ve seen commercials advertising “companions” who might assist an elderly woman who needs someone to prepare meals, do some cleaning or simply provide companionship.  There are 5.2 million elderly (the vast majority of whom are women) who will be losing insurance coverage for these services due to Obamacare.  That’s a lot of people who either are going to have to move into a nursing home or will be left to their own resources.

Now I realize that five million is not a lot of people.  After all, when that number lost their previous “crappy” insurance last year – the administration pooh poohed this as a “small number” so we shouldn’t really be too concerned about all these elderly people.  That is unless one of them happens to be your aunt, your mother, your sister – or you.  But there is hope.

Suddenly last Friday, el Presidente decided that those formerly “crappy” insurance policies were good enough so that people could keep them another two years.  Personally, I took that as an act of beneficence – not to mention an astute political move, deferring all the forthcoming cancellations beyond the mid-term elections.  (Shame on me for even thinking that there was a political motivation behind all this).

So ladies, if you’re lucky – you never know when Obama will whip out his pen and perhaps unilaterally change the law for the thirtieth time and restore the home health benefits that were dropped by the law and restore all the other cuts that were made to Medicare.  That would go a long way to end the Obamacare war on women.  And if you’re really fortunate, he may pick up his phone and call to let you know the good news.


Let me begin with a premise.  If a challenge exists, finding the most complex solution to it is probably not an effective response.  As evidence of this theory, let me offer the ACA legislation, more affectionately known (but no longer by Democrats) as Obamacare.

Much has been made of the fact that Obamacare is over 2400 pages long.  Now all of us recognize that’s a lot of trees that died for this legislation.  Put another way, the original act contains over 400,000 words.  That’s nearly the equivalent of the novel “War and Peace” in the original Russian.  Of course, Tolstoy had the cleverness to incorporate a plot in his epic work – something that Obamacare clearly lacks.

But let’s continue our analysis of this law.  You may remember the physics concept that, “for every action there is an equal and opposite reaction.”  Apparently that principle does not apply to legislation.

With a law as pithy as Obamacare someone has to decipher what it means and explain it to the legislators who passed it without bothering to read its contents.  Hence those in charge of administering it and writing regulations for it have, thus far, used up nearly 12 million of our perfect good English words that would have preferred to be out golfing with the president instead.  That is, by the way, twice the number of words in the Internal Revenue Code.  No wonder the IRS isn’t answering taxpayers’ question on the proper tax filing procedures.  Apparently, one of the BFOQ’s of working at IRS is not having a Certificate of Completion for the Evelyn Wood speed reading program.

Without a doubt the subject of Obamacare goes far beyond law and deeply into the innards of partisan politics.  Democrats accuse anyone who opposes it of being heartless, money grubbing and racist.  There is a bit of wavering on this subject by the Democrat senators who are up for re-election who voted for it and find that the results, thus far, have not been either what they or the president promised their constituents.  Republicans, smelling blood in the streets, have naturally stooped to conquer, citing instances of the disaster the law has brought on the populace.  They have a great deal of material from which to choose.  Meanwhile, the people whom the law was theoretically intended to help – the uninsured – have adopted a rather ho hum view of the law with less than one percent of them bothering to enroll through the end of January.  Perhaps their lack of enthusiasm and participation is that either they do not want to have health insurance or simply cannot afford it.

Without debating the merits or lack of them of the law and setting aside partisan politics, this provides an excellent example of the libertarian concept, “That government is best which governs least.”  Even some proponents of the law have admitted that it’s unveiling has been far worse than they anticipated.  One could include the president in that group since he has amended it twenty-eight times by the use of his mighty pen.  But this does raise a serious question – all politics aside.

I realize there are those who truly believe that government is the answer to all our problems – and others who believe that it is the root cause of most of them.  I consider myself to be somewhere in the middle of those two views, probably leaning more to the latter.  But whatever your political stripe or your view on the role of government, the rollout of Obamacare should give any rational person reason to pause.

By now we all know that the president repeatedly made promises about Obamacare which were patently untrue.  Whether he was ignorant of the truth or purposefully lied in order to sell the program is only moderately relevant.  If he were ignorant – he failed in his responsibility as chief executive and, if he were working in the private sector would have been fired.  If he were working in the private sector and lied to his shareholders (the American people in this case), he would have been removed from office.

Now health insurance is something which we are all mandated to own by the law and which any rational person hopes never to need to use.  Obviously, some of those who have insurance will find a reason to utilize it and others not.  So this issue only affects all of us on a theoretical basis.  But what if there were a crisis that affected everyone – a failure in the nationwide power grid, for example.  Given the track record of this administration, is there anyone who would feel confident that this government would be able to handle that crisis effectively?

Fortunately, I have a simple solution for the problems that Obamacare has encountered or created.

The president made it clear that, “He has a pen and a phone.”  (I guess that’s the original Obama phone).  So all he has to do is sign an executive order outlawing disease, accidents and genetic defects.  We will no longer have to fret about the uninsured since everyone will be healthy and the money we are spending repairing the website and expanding the bureaucracy to administer the law could be used to feed the hungry or clothe the poor.

You know, this simplicity thing, combined with the power of the pen has got a lot to commend it.  I think I’ll turn my attention next to Putin, Kim jung-un, and President Assad.  The sky’s the limit.  Well, at least if we don’t run out of ink.


No doubt you know the expression, “There are many ways to skin a cat.”  I know I’ve heard that countless times but, notwithstanding, I haven’t the faintest clue how you would even approach this project using any of the purported methods.  Nor am I inclined to check out You Tube for an instructional video on the subject.

True, I am a dog lover and prefer their company to that of our feline companions.  But I did have three cats in the house at one time who learned to be quite civil and extremely social proving that my dogs who instructed them on the finer points of good behavior could easily have been educators at the finest Ivy League schools.  At least my dogs’ feline pupils learned something.

Well, as we have now gone through that wonderful holiday known as Thanksgiving, you will, no doubt, have noticed that the grocery stores were well stocked with cans of cranberry sauce – both jellied and with whole cranberries – and only slightly more expensive than they were last year .  Although I normally make my own I did grab a couple of cans because it’s hard for me to resist a sale on cranberry sauce.

So I brought them home and added them to the larder in the pantry.  Much to my surprise as I rearranged the shelf on which cranberry sauce properly belongs, I discovered that I had a can of whole berry cranberry sauce left over from last year.  This little blighter had hidden itself in the Oriental fruit section, between the lychees and the sliced mangos in heavy syrup.  Who knew that cranberries could be so furtive?  Naturally, this annoyed me as I like to keep an organized pantry so I set about getting all the cranberry sauce organized in one place as every right thinking person knows it should be.

I was stacking the cans and was going to put the older can on top so that I would use it first when I made a discovery.  The old can was oversized compared to its new companions and didn’t nestle nicely as it should.  That was because the old can contained 14 ounces of cranberry sauce and the new cans only contained 12 ounces, a 14% reduction in the quantity of product.  No wonder the new cans were priced only a little higher than last year.  Higher price/Smaller quantity = Large Real Price Increase.

How does this apply to Obamacare?  It’s the same shell game.

One of my neighbors who is on Medicare and has an Advantage plan as her Medicare supplement asked me to review her new policy booklet for next year.  Like most of us, reading voluminous booklets is not one of her favorite activities and she finds it a bit daunting.  So I obliged her.  What I found in reviewing the plan booklets for this and next year was extremely informative.

There was no change in the planned premium which she pays to maintain this insurance.  That’s hard to understand if you’ve heard that in order to implement Obamacare there was $600 Billion cut from Medicare’s budget.  But the devil is in the details.  In order to disguise these cuts the Feds have generally chosen to incorporate them not in premium cost increases but rather in the co-insurance costs for which subscribers are responsible.

Although it’s difficult to say what the “average” increase in co-insurance will be for my friend, because it’s impossible to predict which, if any, specific services she might require, it is possible to look at specific procedures and benefits and see what the increases in co-insurance are.  They range between 40% for drugs to 100% for an ambulance.  This at a time when she was just notified that her Social Security payment which represents the majority of her income will increase by 1.5% next year.

This, of course, only deals with the Obamacare cutbacks from the standpoint of the consumer.  Doctors are discovering that their fees are also being cut – to the point where they cannot operate their offices profitably enough to keep their doors open.  A neurologist from Atlanta yesterday testified before a House Sub-Committee that he has been notified that certain drugs which have helped stabilize the conditions of his MS patients will no longer be covered and they will have to pay full cost out of pocket if they want to keep taking them.

Wait a second – this is a group of people who are one of the primary “beneficiaries” of Obamacare – those with pre-existing conditions.  But I think I’ve finally figured out and can sum up the essence of Obamacare.  You get to pay more and get less.

Please pass the cranberry sauce.

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