Wednesday, November 5, 2008

Obama and the Next Black Revolution

As the media began to transition from the prospect of a President Obama to the reality of it, I was struck by the emphasis given to his race and the historic nature of it. For me, though the election of an African-American had been a wonderful achievement, it nevertheless was a sidebar to the man himself, who I had early pinned my hopes of true leadership for this Country. Still the attention to race gave me pause and got me thinking about what it meant. I don’t believe Obama’s race will have any immediate effect on the underlying problems associated with the darker side of America’s cultural evolution, but I’m hopeful that it will mark the beginning of changes in race relations that will bring us closer to being a colorless nation.

Real changes in race relations in the United States are not marked by events or people; they’re marked by decades and generations. Being part of the baby boom generation I can anecdotally see the changes that have taken place over that last 70 years by looking back at my parents and their contemporaries and then looking ahead at my children and their friends. Without even analyzing myself and my own generation, I can surmise that the baby boomers are likely the mean between that of my parents and children. It’s not hard to imagine the future mindset of my grandchildren and great-grandchildren in a very positive way. But I am not African-American and my experience is quite different from the Black experience. I don’t believe the change in my grandchildren will come from me, although I’d like to think it. The major changes that will take place over the next generations will come from America’s black culture, just as the prior changes have done, and the Obama election may historically be seen as the beginning of that period.

I believe the Black experience and White prejudice in American can, to date, be divided up into 3 distinct periods. In each the changes in the general prevailing attitude of White America has lagged behind the changes in Black culture. Of course the first period is obvious, early America was a nation that either tolerated or actively engaged in black slavery. Non-black slavery was essentially called indentured servitude, but the philosophical and ethical difference between the two was enormous since the difference between black and white was deemed biological and not just a difference of social class.

By 1870 and the end of the Reconstruction period after the Civil War, the Nation began the 2nd period of race relations which lasted for another 70 years, ending with World War II. It was a period of black acceptance of political freedom but social inequality. It many ways African-Americans were only elevated to the level of indentured servitude. They retained the economic shackles which denied them access to the means of becoming part of the economic mainstream, primarily education, but they also retained the stigma of being deemed biologically inferior. Except for the brief period of Reconstruction, Black history between the Civil War and WWII has minimal historical significance as African-Americans were not invited to the table where power and innovation were being served. Again, it took those 7 decades for Blacks to refuse acceptance of political and cultural inequality. Non-black America eventually followed with changes both in law and attitude, but only so far.

The 3rd period began with the close of WWII and perhaps ended with the election of Barack Obama. The civil rights movement was the natural end of the post-Civil War Jim Crow era which by the 60’s had ended statutory inequality between the races (and, in theory, all social sub-sets, such as women, religions, and gays). However, this third period was that in which the biological and cultural inferiority of African-Americans was attacked. Its beginning was marked by the efforts made during the 50s and 60s, not by such as Martin Luther King and his contemporaries, who finished the inequalities that began in 1870. Rather it began with what was seen at the time as radical behavior by Black America, with such movements as Black Power and Black is Beautiful, and spread to every corner of American culture such as politics, media, art, music, or athletics. These were the young people, primarily black but also many whites, who sought to elevate the black culture to a level of equality by emphasizing the uniqueness of the culture with a sense of pride. It evolved from the obvious need to overcome the philosophical and psychological chains that remained from the antebellum period.

The changes that have taken place over the 63 years since WWII have been as dramatic as the earlier changes that set the stage for the elimination of Jim Crow and the separate but equal myth. The contribution by Blacks to the American culture has been extraordinary over the past 6 decades and, as opposed to the post-Civil War period; recent history cannot be recorded without the significant impact of the African-American influence. I believe it can be argued that the election of Barack Obama is evidence of the success of cultural equality. But still, what have we got left?

The racial barriers that remain in the United States are still profound. The last 63 years may have eliminated the sense of cultural and biological inequality between races, personified by Barack Obama, but we still have a huge cultural divide created in great part by the efforts meant to achieve cultural equality; specifically the desire to be unique and separate from a perceived white culture. These barriers, complimented by the acceptance by both black and white cultures as being inherently separate, result in (among other things) depressed economics and the dilemma of Black poverty and social turmoil. As a consequence, most Americans, but primarily Black Americans, see the cultures of the races still distinctly black and white. Young Black men in particular view the assimilation into the greater economy as a conflict, or even denial of their own cultural heritage, which they may feel has been so recently vindicated.

Education is the key and the most important tools will be the English language and the family unit. It is my hope that the next revolution that may begin to take shape over the subsequent 10 years will be acceptance by the African-American community that there is but one Western economy in which they, as Americans, have an individual role to play. Not as Black Americans, but simply as Americans. White America will follow willingly. Maybe the next black President elected will get but 55% of both the white and black vote and no one will think anything of it. Then perhaps the racial differences of wealth, neighborhoods, languages, ethics, families, fears, or even skin color will be something my great-grandchildren will only read about, as they ponder their own generational challenges.

Friday, October 10, 2008

The Case Against Prescription Drug (Rx) Advertising

(This article is also found on the blog www.CAPDA.blogspot.com . Please visit that blog and lend your support for the legislative elimination of Rx advertising, thank you)


In 1987, under the banner of deregulated free markets holding sway during the Reagan/Bush years, Congress lifted the restriction on pharmaceutical companies to advertise on television and radio. Since that time the Nation’s drug suppliers have spent amounts approaching (or exceeding) $200 billion on “direct to consumer” advertising of prescription drugs (Rx). In 2005 the annual outlay was $29.9 billion (see New England Journal of Medicine). I suspect the 2008 expenditure will greatly exceed that.

There has little controversy to this practice surfacing from time to time, but mostly there has been a passive acceptance. The affect of advertising is normally positive in a free market, even necessary, but it is also potentially insidious. We view advertising submissively, rarely thinking about it. Its very purpose is to create recall only at the time of or decision to purchase.

The limited debate over Rx advertising has mostly focused on the affect advertising has on the decision making of the doctor, to what extent does the motivated patient adversely sways the doctor's decision making on which drug to use. I believe that debate is useless. It requires second guessing physicians and that cannot be determined in any practical way even if we intuitively know it’s true. The debate should be centered on the economics of Rx advertising, what is really happening and what the obvious consequences are.

Advertising by definition is targeted toward the consumer who might be interested in purchasing the product advertised, or to the individual who might influence the purchaser (such as advertising to small children). Rx falls loosely into that second category. The identity of the Rx consumer, however, is the first misnomer.

The patient is not the consumer when it comes to Rx, rather the purchaser is the physician. It is important to understand that the patient doesn’t buy Rx for himself, rather he/she buys it for the physician. Prior to the development of retail drug establishments, doctors disseminated Rx when the patient was seen and the patient would pay or reimburse the doctor as part of the overall cost of treatment, just as it’s currently often done in hospitals. As the number of Rx expanded it became impractical for doctors to maintain the inventory and so Drug Stores became a centralized point from which doctors could disperse medications.

Therefore, Rx advertising is directed toward individuals who can’t buy the product, any more than a three year old can buy that box of Cocoa Puffs she’s seen on TV. The difference is, of course, the Rx purchaser is an adult who actually thinks they are the one buying the Rx. At least the 3 year old intuitively knows their Cocoa Puffs are coming from mommy. I believe it is this fundamental misunderstanding by adult patients which maintained the restrictions of Rx advertising up to eleven years ago, and why most of the rest of the world still retains that restriction. However, it is far from the only reason why mass marketing in the form of television and radio advertising should be eliminated.

Cost of Health care and Prescription Drug Advertising: The cost of health care in the United States has reached the kind of insanity level that real estate values did in the second half of this decade (see http://www.pennyfound.blogspot.com/ article Health care…No Relief in Sight). The health care consumer must constantly be remembering that the cost of healthcare for him/her is revenue for someone else. There is a transfer of wealth in the US of over $1.7 Trillion annually (see current World Health Report). Over $30 billion of that amount goes to those involved with the marketing of Rx (advertisers, media, and the marketing overhead of the pharmaceutical companies). It matters not what health care plan our current or prospective political leaders espouse, none will work unless the cost of health care in the US is reversed. The billions spent on Rx advertising are perhaps the most wasteful dollars spent in our pending health care catastrophe as they do not directly benefit the health care recipient or the system generally. In fact, as implied above, there is no benefit, direct or indirect, to the patient.

Prescription Drug Advertising as a Disincentive for Drug Research: The argument frequently heard from drug companies is that the price of a drug is often very high due to the large investment that took place prior to the drug being released to the public. It is a good argument as those costs must be recovered, as well as the costs of research on failed drugs that ultimately are not released. However, once the drugs are released the revenues can be used for further research on new and improved Rx, but what happens? The Pharmaceutical Companies continue to invest in these drugs, in the billions of dollars, through mass marketing. Not only are those billions not being used for further research, but they drive up the cost. Further, with the Pharmaceutical Companies continuing to invest billions in a drug to make it more profitable, where is there incentive to develop new drugs that might not have the same profit margin or may even replace the highly marketed drug? It is simple human nature (and therefore business nature) that they will continue to support these marketed drugs rather than new ones due to the continued investment from which they have calculated an expected financial return. None of this equates to any benefit for the patient…past, present, or future.

Prescription Drug Advertising Adversely Impacting the Quality of Rx: As the Pharmaceutical Companies continue to invest in a prescription drug they become less likely to continue critical review of that drug, or maintain even a practical semblance of objectivity in any critical review. Again, why would they? Not only have they invested in the development of the drug, but after its release they continue that investment and now have projected levels of profits to defend. There is a further element, however.

With mass marketing the pharmaceutical companies have exposed themselves to more liability; both on a retail level which can affect shareholder equity, and on a tort level with possible injured parties. This has already been made obvious by several highly public drug failures such as with Vioxx and several statin drugs. The heavily marketed drug increases public awareness, which is what mass marketing is supposed to do. With that visibility, however, comes equally visible news worthiness should a drug fail. The declining affect on stock value for the owning pharmaceutical company can be huge. Further, the pharmaceutical companies know that a problem with a highly marketed drug could well disseminate to the public in such a way that a higher percentage of unaffected users may seek legal action against the company. In both those cases there is a built in incentive for the company to be defensive and disinclined to police the quality of the drug - in the legal world knowledge is poison. As an aside one should note those increased defensive costs are already factored in and increase the cost of the Rx, even as the company seeks to avoid them.

There are other less critical reasons why Rx advertising should once again be banned from radio and television.

The information regarding the prescription drug that is supposed to be provided with the advertisements is laughable and completely ignored by the FCC. It is the audible and visual equivalent of an 80 year old trying to read minuscule type on a label without glasses, she knows it’s there but it has no meaning. In fact, it is a practical impossibility further strengthening the point that drugs are marketed to the wrong people.

Unregulated mass marketing of Rx forces pharmaceutical companies to compete in the practice, even if internally they might prefer to do otherwise.

We know the uninformed influence of the patient adversely affects the doctor’s best decision making, we only don’t know how much, and we never will. We also will never know to what extent mass Rx advertising contributes to defensive medicine, although it surely does, putting both the patient at some additional risk and driving up cost.

The last point I’d like to make, although certainly not the last of the negatives, is that these ads, television commercials particularly, are incredibly annoying and often the television equivalent of fingernails on a backboard. They are either a painful manipulation or an insult to our intelligence…and they are constant (not surprising for $30 billion being spent). I know that’s true for me, but when ever I’ve broached the topic the response I get is the same. Generally speaking, nobody likes them, even as they are manipulated by them.

Mass marketing of prescription drugs exists because, for the most part, it accomplishes what it seeks to do. It gets the patient to influence the consumer (the doctor) to buy the Rx thus increasing sales and profit. However, in a world where healthcare should be an available standard commodity to all people, like clean water, then prescription mass marketing takes us in the wrong direction. It is far from an answer to the overall healthcare problem, but its elimination would take us one step further in the direction we need to go, and at $30 billion a year it would be no small step.

Wednesday, October 1, 2008

The Alien Liberal

The Richmond, Virginia radio market is a tough one for someone like me. I like talk radio, but in Richmond one is limited to the Rush Limbaugh storm troopers, with its assorted cadre of hypersensitive Christians, conspiracy nuts, second amendment fanatics, peach pie philosophers, and Alien enthusiasts (to name a few) calling in. I try to listen as long as I can, as if letting water drip on my forehead might prepare me for more challenging things, but it’s no use. I start to get angry, then incredulous, then resigned, and finally feeling very alone.

As a Liberal I’ve come to understand from Conservative broadcasters that my very existence has unleashed a horde of illegal, benefit laden Latinos, promiscuous women on welfare, mentally unstable college professors, and union lemmings (among others) to claw away at real patriotic American’s automatic weapons, steal their earnings, or perhaps leave their children unattended at bus stops. I always thought I was a nice liberal, but from what I listen to, that distinction is an oxymoron.

I’d like to think of myself as a Reagan Liberal. That would be a Liberal who ends his speaking points with an aw-shucks chuckle (well…gosh, Senator McCain…maybe that’s why mavericks never lead the herd). Mostly however, I’m just run of the mill. I don’t understand when we find ourselves in a world economy honeycombed with multi-national corporations, complex energy distribution, lightening fast communication, terrifying weapons (large and small), and unprecedented population growth why so many in this country are opposed to considering collective solutions to free market failures. Oh hell…of course I know… it’s the money, or more accurately those who stand to lose money and their extraordinary ability to scam people (usually through fear) that any restriction to the free market is like letting Lucifer in the front door.

I don’t like the “new” Liberal that calls him/herself a Progressive. I guess I just don’t like the term… it’s a copout, or at best confusing. The Liberal position is important and doesn’t need re-titling. It has been underrepresented in both government and our culture at large for over 30 years, yet it’s critical because the path that leads to the successful evolution of the American culture is laid between the Liberal and Conservative ideologies. Without the counterbalance we end up in the ditch and as of late we’ve been in the ditch that bears to the Right.

I’m really hoping that President Obama is a consensus builder and that the Conservative side of the highway retains enough ideologically sound champions to keep him in the road. Perhaps then we might actually create a single payer healthcare system which compliments business growth, or international cooperation which enhances American influence, or debt control which can be viewed as patriotic.

I will say this about the Conservative talk shows though…I think they may be on to something regarding UFOs and Aliens. If they’re right, the Aliens have to be widespread among us and totally stealth. I think I may have figured it out…it’s the squirrels. Think about it...we know they’re everywhere even though we only see them in random flashes. They’re always looking and examining, they’re obviously communicating in a fashion we can’t figure out, they’re very nervous, and isn’t it possible that the occasional squirrel one sees dangling from a power line suffered his fate for attempting to go to “the other side”? I think President Obama might consider trying to make contact. It would be the gracious thing for a Liberal to do.

Friday, September 19, 2008

McCain's Age Counts

Watching Carly Fiorina reproach Sen. Claire McCaskill on Meet the Press for mentioning John McCain’s age in a discussion about McCain’s choice of Sarah Palin, I was struck by McCaskill’s option not to respond. It was as if there was something turning in the back of her head saying; “don’t go there”. Whether it’s silence due to political correctness or the howling of a blatent discriminatory assault, in either case we don’t get the opportunity to address what should be freely discussed, and which is also quite relevant.

John McCain’s age is a factor in this election, no less a point of discussion than Obama’s experience or his race. Age brings with it a set of potential positives that are often ignored or overlooked. The most notable is that capability we used to revere: wisdom. There can be other characteristics enhanced by age as well, such as; patience, connections, demanding respect, and compassion. Most people are more aware of the possible negatives since we (certainly those over 50 say) dread their inclusion in their own lives. Those might be memory loss, confusion, and disabling health, to name a few.

When John McCain decided to run for the Presidency at the age of 72 the nation had the opportunity to make a judgment as to his fitness for the job. Thus far he has shown himself to be up for the task and it does not appear that primary voters saw him unfit. It is ludicrous, however, to think that the ordinary limitation that we associate with age wouldn’t become evident during the race. We all need to look and come to our own conclusions, and the people, the media, the competition, or the McCain campaign itself can’t be afraid to reflect on it.

McCain himself took it one step further, however. Certainly for his opposition to suggest the disqualification of his bid for the White House based purely on age would be unethical and simply wrong. However, the age and physical condition of the candidate is absolutely fair game in the discussion of the Vice President. That’s what I wanted to hear Claire McCaskill say. When McCain chose a running mate with virtually no national or international experience he allowed his age to become topic one.

The government’s actuarial tables show the average life span of an American male age 72 is 12 years. What that means is one-half (50%) of all American men age 72 will be dead prior to their 84 birthday. If you run the numbers it means that McCain has about an 18% chance of dying during his first term in office. The percentage possibility of him ending his Presidency is greater if you add the chances of incapacity to the chances of death. Of course, this is a simple average and a wealthy, white male has better odds, but then a cancer survivor has worse odds. Besides, many have justifiably argued that an American President ages 3 years for every 1 year in office. Bottom line, without any of the variables, there is a 20% likelihood that if McCain were elected, Sarah Palin would end up running the Country and the Free World. If a 1 in 5 chance of that happening isn’t enough to scare the begeebees out of the electorate, then plan on seeing the best and the brightest start flooding the Canadian border.

Sure McCain will have his senior moments (take his recent failure to remember Spain’s Prime Minister), but face it, all of us over 50 do. The key to whether that disqualifies him as a candidate will be his ability to admit and minimize the negative value of those moments. His campaign’s response to the Spain flub, saying he meant what he said, is not the way to do it.

However, his first decision and fatal flub, the nomination of Sarah Palin, make his age reason enough not to elect McCain. That alone should garner him no more votes than Bush might get were he running for a third term. I hope the subject of McCain’s age come up and often, as the consequences of the choices politicians make need to be trucked out in the light of day.

Saturday, September 13, 2008

The Palin Principal

There is an understandable complaint from Democrats, and probably many independent voters, that the Palin obsession which has gripped both the media and ardent Republicans is a distraction of major proportions. It is a distraction of course, but the complaint from Democrats has as much to do with attention diverted from Barack Obama as it does with the suspension of discussing critical issues that currently face this nation. I would argue that the affect the Alaskan Governor has had on both campaigns is an issue unto itself, not a distraction, and maybe more important (in terms of our electoral process) than the debates that have and will take place over energy, healthcare, abortion, education, and several other important domestic issues.

Lost in all the rhetoric that surrounds Presidential campaigns is the fact that the President of the United States has limited power over many of the policies they emphatically suggest will occur once they are in office. Somewhere around middle school, each citizen should have successfully learned that the President has direct control over the State Department, the Military (National Defense), and the direct spending of resources allocated to the administrative branches of government (headed by the various cabinet secretaries), and also the power to nominate the members of the Judiciary for consideration by Congress. Beyond that the President only acts as a check against legislation, and also influences national opinion from, as Teddy Roosevelt coined, the “bully pulpit”. Therefore, on matters other than foreign policy, the Presidential campaign rhetoric is like witnessing a hen house full of roosters… plenty of clucking, but not much yoke.

Does that make “debate” worthless, or worse…deceptive? Not at all. Foremost is the fact that foreign policy is much more important than the average American believes or understands, and that debate needs to take place. The importance of foreign policy in this shrinking and dangerous world, which includes the Military, cannot be understated, but that does not relate to the affects of the Palin nomination. Leave it to say that if a series of plausible events took place leaving Sarah Palin as President of the United States, the detriment to our foreign policy would make George W. Bush look like Winston Churchill. Her semi-candid description of our relationship with Russia, for example, quickly throwing military action on the table left me to believe that she has no concept of “mutually assured destruction”, by which both our countries survived the 40 year Cold War. She is a small town mayor and short term governor in a state where her understanding of Russia is based, she says, on its physical proximity. Perhaps Alaska’s lack of proximity to the continental United States explains why she is challenged by US foreign policy. Bottom line is we shouldn’t be expecting anything more.

The Palin issue is not about foreign affairs or even her competency to take the highest office in the land; it’s about how today the collective psyche of this country decides how we choose our leaders. It is an issue of determining what governance over ourselves means. Sarah Palin is not the first, but I can’t recall when a candidate has exposed a certain national mindset of leadership approval so quickly, so clearly, and so completely. Therefore, I herewith forever dub it the Palin Principal (and wouldn’t be the least bit surprised if that or some similar phrase eventually finds its way into our lexicon).

In listening and observing the Palin Principal I have been struck by the fact that she not only usurped the attention Obama had successfully cultivated with the media, but she also blew past McCain in popularity almost immediately. In fact, to hear at one point on the road McCain’s address to the audience being drowned out (rather rudely) by chants of “Sarah…Sarah…Sarah”, was the motivation for me to write this article. She is clearly the first choice between the two candidates representing the Republican faithful.

Sarah Palin was virtually unknown nationally prior to September 18th for a reason. There was nothing this woman had accomplished in her life that elevated her to a level of national attention… period. So why then was she accepted by so many people as being a person for whom the mantel of leader of the Free World could rightfully reside? Why was she accepted by so many people…fully accepted, when they knew practically nothing about her, and were not particularly interested in learning more? That’s what the Palin Principal looks like, but what exactly is it?

Definition: Palin Principal – The immediate acceptance of an individual to political leadership based on a perceived emotional empathy by the constituents.

The idea that an individual could garnish a following by things as simple as gestures, appearance, swagger, emotional issues (abortion) and simple language (lipstick and pit bulls) is hardly new, quite the contrary it is ingrained in our anthropology. In the purest sense we often call such followings cults. But leadership derived from intangibles is not only common, it is also appropriate. Barack Obama would be hard pressed to make his case for leadership based solely on his historical background and one must consider his knowledge and skills for leadership. Still in most all cases there is a courtship, a growth period where a bond is developed and a rationale for leadership is merged with more basic emotions. That is true even when there is the commonality of religious beliefs or social activism. That is not, however, the Palin Principal. Why is it then that Sarah Palin was accepted quickly, so quickly in fact that within just a couple of days of her coming out the Republican base would have replace John McCain with her without (as Sarah puts it) blinking an eye?

I believe the Palin Principal is different than the ascendency of past political leaders because the reason for it did not exist in the past. The Palin Principal has been born of Information Technology and the new demographics, our new ability to use lightening fast communications to invite someone into the lives of hundreds of millions of people, and then, just as fast, reflect on the emotional reactions of a subset of those people. That subset may only be a fraction of the population, but when the original numbers are in the hundreds of millions that fraction can still represent a huge number.

In the case of Sarah Palin she was trucked out one day and by the second most all of us had seen her attractive demeanor, her folksy charm, fed the generalizations of her record (80% approval rate, etc), and (most importantly) listened to the unflinching and excited approval of a small group of people. However, the size of the crowd whooping it up is not perceived as small. For those whom an emotional identification with Palin could be made, those devotees being broadcast on TV and internet represented the millions of people with which they identified. The problem of course is there wasn’t millions of people, but because of rapid communications, within days or even hours that small group of people, like a nuclear reaction, mushroomed into a national following.

The day after the Sarah Palin gave her first speech the Friday before the Republican Convention, my 86 year old mother (a lifelong Republican) called me. She said with great animation in her voice, “I’m so excited. I wasn’t sure I was going to vote for McCain (she’d been mulling about it for weeks), but now that he’s picked Governor Palin I’m definitively going to vote for him”. I asked her what she knew and liked about Palin (note: I talk to my mother gingerly on political matters). She knew virtually nothing about Palin except that she sounded great, the cheering was wonderful, and how dreadful the Democrats were in claiming Palin’s Down syndrome child was really her daughter’s.

I’m not sure how much risk the Palin Principal represents to the American people. When something or someone like Sarah Palin is placed on a pedestal made of ice cream, it doesn’t take long for even modest heat to make a rather unsightly mess on the floor. Given her first interviews it’s very hard for me to imagine that she will retain any but the blindest of devotees. But it is not a principal for us to taken lightly. In a free democracy in this day in age, a given set of circumstances might elevate someone to control this nation and, quite literally, have the ability to alter the face of the planet. If the reasons that place an individual in a position of authority don’t have the time to self-correct through public awareness (or enlightenment), then Representative Democracy will have lost its way from the beginnings of the American experience, the ability to accurately reflect the will of people.

Wednesday, September 10, 2008

Thursday, September 4, 2008

It's All About Abortion

The confounding choice of Sarah Palin to the Republican presidential ticket has created a firestorm of news, both critical and supportive for the VP nominee. It was speculated from the outset that part of the reason for her choice was to, in a sense, dominate the debate by dominating media attention. One might as well assume such since it has turned out to be so successful. After just 5 days one might wonder if Obama and Biden are on an extended vacation or for that matter if McCain is still with her on the ballot. During her announcement speech August 29th she referred to John McCain as “my running mate”, a title normally reserved for the VP slot, but no one appeared to notice or even question the reference. Perhaps that was telling. Certainly, in this brief window of the campaign, the question of who is going to be the next President seems to be rising and falling with swells caused by this little know political figure.

Is that the reason McCain made the pick? Of course not, despite the effective strategy. If not then, why was she chosen? Even Republican leaders at the Convention (amazingly) took no exception to the report that McCain had wanted Tom Ridge or Joe Lieberman, actually confirming the report. It was communicated in a public fashion that if one of those individuals was chosen there would be a floor fight during the Convention. So McCain succumbed. I heard one Republican leader say later during a radio interview, “(McCain) may have had his bones broken as a POW, but it didn’t affect his hearing”. So why did this “maverick” so quickly decide to run with herd? It’s simple...it’s all about abortion. As far Right as Palin is on other social issues; creationism, Christian orthodoxy, welfare, gun control, and healthcare for example, it is her strict, no exceptions stand on abortion that created the collective sigh of relief from the Republican base when she was picked for the VP spot.

What is it about this “issue” that engenders such divisiveness in our culture and which doesn’t have an equivalent anywhere else on earth? Barack Obama made only one reference to the abortion question during his acceptance speech and it was bi-partisan. He essentially said that the debate is not going to end and perhaps will never end, but at least there should be an effort by both sides to come together and commit to a common goal, that being to reduce the number of abortions. I believe John McCain would like to say the same thing, but he can’t.

I think the entire abortion debate is pretty much divided into 5 Groups; (1) those for whom the elimination of abortion is a showstopper, where there is no consideration of any other issue until that one has be accepted, (2) those who agree with the right to life philosophy, but accept that it is a social issue not shared by a great many people who are, on the whole, very nice people, (3) those who believe that women have both the God-given responsibility and burden to make decisions about what happens within their bodies, (4) those who think that the effort to pass laws which would restrict a woman’s right to choose is no more than the attempt to violate female civil rights, and (5) those who don’t give a flip, one way or the other.

Essentially all politicians fall in Groups 2 or 3 (with perhaps a smattering in Group 5 - the truth be known). In order for anyone to reach a position of governance they must address the priorities of the offices they seek and that forces them to look beyond the abortion debate once they’re elected. However, it’s the individuals in Groups 1 and 4 who drive the debate, and for the Republicans, spearheaded by evangelical Christians, the folks in Group 1 are currently holding sway. They have provided the springboard for other politicians, George Bush being the most recent major beneficiary, but nothing comes close to the power they wielded on the selection of Sarah Palin to (possibly) become the single human being in this country to lead us and the free world should her 72 to 76 year old, cancer surviving President become incapable of holding the office or die (check ordinary actuarial tables if you want to see how high the chances of that happening is. I doubt McCain could get life insurance – fortunate for him he doesn’t need it).

The reason that the extreme wing of the Republican Party forced this hand is because she is one of them. Where in their heart of hearts they know loyal politicians basically give them lip service (those in Group 2), with Palin they’re giddy when expressing that she’s the “real deal”. I think they’re right, that they now have on the national stage an authentic Group 1 politician. The fact that she is also a woman, a mother five times over, delivered a child she knew would be handicapped, talks of Jesus like he was the 4th branch of Government, and has a 17 year old daughter that neither embraces abortion, adoption, or (apparently) birth control is just icing on the cake.

The primary difficulty I see in this abortion debate is that the Group 1 folks have boxed themselves (literally and emotionally) into a corner from which they can’t emerge. They cannot separate their own personal belief from the controversy; that to live in a society that allows abortion is an unacceptable compromise to that belief. Ironically, their defiance to simply work for the common good (i.e. reduce abortions) radicalizes their position and assures that a significant subset of the population (probably a large majority) will never provide support. They feel, understandably, that this is a life and death position they defend which must be attained through legislation. They fail to see that the debate is really about decision making and, more amazingly, they fail to see that such decision making by the individual, choice itself, is totally consistent with Christian teachings.

The pro-choice people (Group 4) also often fail to understand and communicate that the burden of a life and death decision by a child-bearing woman was given by the same Power that created the woman in the first place, and not by the wise benevolence of a free society. As such they lose an ability to share the tragedy, dehumanizing their position. However, their position does allow them to look beyond the issue and place it in its proper context as it relates to governing a nation. Had they not and were forced to satisfy some some extreme wing of their party, we might be looking at the mayor of some other sheltered municipality of 7000 a heartbeat away from running this country of 300 million should Barack Obama become President. Once again, a collective sigh of relief.

Sunday, August 31, 2008

Stop it John...You're Killing Me

Is McCain playing with my head? I don't think so, but once again I am stunned by what I'm seeing in American national politics. The choice of Sarah Palin as the next VP seems to make the argument that if a politician does something stupid enough, people will give him (or her) the benefit of the doubt, even support, because the alternative of accepting that an individual risen to that level of national importance could do such a thing is so distasteful. After all, the current President Bush has turned that strategy into an art form.

Although I would like to express my wonderment and befuddlement over this extraordinary political choice by McCain, I will only address here the defense made by several individuals in the wake of this anointment, regarding Sarah Palin's lack of experience (which gives the word 'understatement' new meaning).

As with several (convention located) Republicans being interviewed this morning (the most outrageous being Lindsey Graham) the argument here is ‘why should her experience be questioned, just look at Obama’s’. Even though anyone staring down on this planet from space might look at the Palin nomination and think they were watching a Disney family movie, the imminently clear difference between Obama’s obvious limited experience and Palin’s is that Obama’s experience has been reviewed and judged by nearly 50 elections over the last 9 months in the most viewed and participated-in nominating contests in the history of this country. Sarah Palin, by comparison, achieved her position by winning an election (without a plurality – 48%) in a state with a population one-fourth the size of greater Cleveland, then was picked out of the blue, primarily by McCain’s advisers, and presented to the public on a plate – this is what’s on the menu, eat it or shut up.

That said, I am even more in awe of those defending the decision than the actual McCain’s team choice in the first place. But then I’m the guy, with a son in Iraq, who thought Bush would lose the 2004 election by a margin greater than Herbert Hoover lost his re-election. Is common sense officially dead in this country?

Tuesday, August 26, 2008

Healthcare...No Relief in Sight

Jay Morehouse
August 26, 2008


There is a malevolent undertone that runs beneath the healthcare debate in America. The wickedness is found in the confusion and uncertainty that seems to be generated by the participants. It mirrors the confusion and uncertainty which is inherent in sickness and disease, the precise anxiety that healthcare should be neutralizing. To try to understand what is happening (and what has been happening during the transition to mass healthcare world wide) one needs to step back and consider the fundamentals of human behavior, and why that behavior has kept this country from making that transition efficiently and effectively.

The published and accepted fact is that the per capita medical expense in the United States greatly exceeds that of every other country in the world. The 2006 World Health Report showed per capita spending in the US at $5,711 annually. By comparison the next largest country was Germany at $3,204 (44% less), then France at $2,981, Japan at $2,662 and Canada at $2,669. Other emerging industrial nations such as Brazil ($212), South Korea ($705), and Mexico ($372) increase the contrast.

There is no debate that within the US health industry there is a huge transfer of resources taking place. Further, and perhaps more important, there is no understanding by the American people, and our leaders, of what the upper limits of those healthcare costs are. The simple reason is that within the gargantuan and shadowy nature of our healthcare system, nobody knows.

What do we know then? As already stated, we know we spend a lot on healthcare. Despite the arguments, we do not know that our system of healthcare is better than other relatively wealthy, educated nations. There are absolutely no studies that definitively show technological advances available today not being extensively used by other nations sociologically and economically on par with the US. 

Nor is there any evidence that attention to healthcare, both treatment and prevention, is any better or worse overall. What we hear is anecdotal information (or disinformation) which is used to support a point of view. Given the enormous size of the healthcare systems in any country, making use of any one person’s experience is meaningless. We need to throw away the magnifying glass and just stare at the beast with eyes open.

So what is it about the American healthcare system that is “broken” as all players in the political debate have advocated. I suggest that ‘broken” is a convenient term for politicians to use because it infers that it was somehow unbroken at some point in the past (and they can be the one to put the egg back together again, provide they’re elected). 

Our healthcare system is not broken, nor has it fundamentally changed since the advent of modern medicine at the beginning of the 19th century. The better term to use is “old” or perhaps “outdated”. It is outdated because the unique American brand of independence, entrepreneurial spirit, and individual rights has clashed with the realities and dynamics of population growth and lightening fast communication. 

Not only did we need the system to gear up for the huge increase in patients, but the knowledge and understanding of medical treatment and its technological advances began to find its way to every segment of society setting new levels of expectations. As a result, the volume of business in the health field started a precipitous rise, and like all supply/demand equations, the costs began going up. What throws the demand side of the equation out of whack is that money to support it has been seemingly unlimited, but that leads to the question of why we so willingly and intentionally begin to pay for healthcare at any cost?

Countries that began regulated single payer or other similar systems effectively removed from the equation the one hallowed and revered behavior buried deep in our American capitalistic marrow, namely: profit. To most conservative thinkers, to question the concept of ‘profit’ is the equivalent of irreverent graffiti spray painted on the Statue of Liberty… you just don’t go there. Yet if we honestly step back and observe the Beast, the clear and obvious problem is that there is simply too much money in the system to be gained by too few.

Whenever there is that kind of uncheck transfer of wealth there are those who will view, not the opportunity to advance social gains, but to maximize their return on investment. For most businesses this is a fine process and more often than not the most efficient. But in most cases the supply/demand model will show a drop in demand as price goes up. That’s not the case with healthcare since the demand continues to be supported by both public (taxes) and (hard earned) private funds, and with huge amounts of debt, both the public and private.

Who benefits from the profit? Almost everybody on the deliver side of the service; medical corporations, pharmaceutical corporations, medical retail businesses, doctors and other medical professionals, medical advertisers, lawyers, medical supply and equipment companies, and the insurance companies are the ones that seem to stand up and salute first. 

The number of individuals is so large and so influential that the process of bringing real change to the system can seem almost as romantic as the change itself. Our politicians love to bash the corporations because it’s so easy to identify themselves as individuals (like you and me) trying to take the bull by the horns (good for votes). They only end up like flies in the field, annoying to the bull but nonetheless irrelevant. 

What kind of leader out there is going to take on the doctors and the lawyers? Nothing will happen without them in the formula. Who’s going to present the plan that cuts the profits of medical professionals or restricts the awards for tort lawyers? Who’s going to advocate taking the unlimited profit out of the System? I hear neither from McCain or Obama, quite the opposite. Neither of their proposals address the unchecked profits realized within the system; they only attempt to change the pattern to the flow of money so that fewer people (at least temporarily) will not fall through the cracks. It will, however, ultimately fail under its own unchecked weight.

McCain mind’s is as old as the aged system he refers to as ‘broken’. My hope is that once Obama is in office and the need for re-election is a minimum of 4 years away that a true change to an efficient universal healthcare system in the US may begin. He has suggested he represents a new leadership which is not shackled by special interests. We’ll see. Until then (if ever) we’ll just have to watch the transfer of wealth continue until the inevitable stress on the American public, that sees its assets evaporate, its future mortgaged, and no end in sight, finally fractures under the pressure.

Monday, August 25, 2008

Bless Those High Gas Prices...

...And Keep Them Coming

By
Jay Morehouse,
July 3, 2008


A few days ago I was leaving Sam’s Club on a warm, sunny June afternoon. Next to my vehicle, an empty space between, was a beautiful, shiny green, full size GMC Yukon Denali, the kind that could tow your mother to Florida, including her condo. It caught my eye because the engine was running, although it was closed up and I saw no driver. The air conditioner was cycling on and off. Curious, I ambled up to it only to be startled by the rapid, high pitched yapping of a small dog (the kind missing its muzzle). I was amazed and looked about. The store was pretty far away and I saw no one around. Irritated I left the owner a note under the wiper suggesting that in the future they leave their dog home (and some other things that suggested they were the cause for the entire energy and economic crisis we now face). In fact, I wasn’t totally exaggerating.

How high does the cost of gasoline have to go before that little dog has to wing it alone at home? The underlying tragedy in our energy debacle is that we have operated under an economic model that free market supply and demand will determine price, and that price in turn will self-correct available energy resources and alternatives. The reality is that the dynamics at play for both supply and demand are so fixed and expansive, relatively, that it requires the issue be addressed with long term planning. No where is that more important than in the United States where the per capital use of fossil fuels exceeds the rest of the world stratospherically. Our government, which we fondly refer to as We the People, has failed us (or does that mean we failed ourselves?). Perhaps by incompetence, callus disregard, political expediency, or in bending to the will of those who benefit financially by short term gains (I’m leaning mostly on the last…because in the end money talks and too many listen) we are in trouble, regardless of the reasons. Of course, that wasn’t always the case.

In the oil embargos, and resulting gas shortages (and price increases) that took place between 1976 and 1980, the administration of Jimmy Carter took some pains to look at the big picture. The Carter presidency was rife with poor judgment, much like the George W. Bush Administration, but without the ignorance, arrogance, and self-dealing we’ve come to be in awe of with our current President. Despite its shortcomings, the Carter Administration arrived at two important conclusions which were actually correct. First, that cheap oil was finite, and second, that the only way to transition from oil to other energy alternatives was through the combination of conservation and the public financing of alternatives. The reason was as obvious then as it is now; the infrastructure of our oil based economy is far too rigid to be changed by ordinary forces of the free market if cheap oil suddenly stopped (or even slowed down). Conservation by definition requires sacrifice and as business leaders can tell you, especially those in the oil and auto industries, if given a choice between sacrifice and self-interest people will always choose the latter (or would they just be speaking for themselves?).

The poor judgment used by our government in the late 70’s was to argue their case through the use of fear. We the People were told that we needed to begin to act as a new collective to address the realities of energy (and also pollution) by changing the way we used resources - that was good. However, they chose to convey that message and gather support for legislation by taking the roll of Chicken Little. Oil and natural gas, we were told, were going to run out and we would soon be living in our big empty-tank cars, surrounded by garbage, if something wasn’t done right away…at least that’s what I remember hearing. It was all going to happen in a time frame to affect the WW2 generation and younger. This drumbeat was nicely amplified by record high gas prices (only just recently surpassed in constant dollars) and high inflation.

Carter’s administration was actually gaining some traction with a variety of legislation which began to move the nation toward a more efficient demand. Whether it was auto mileage (overall MPG improved more in those 4 years then they have in the following 28), auto usage (reducing speed limits), electrical usage, mass transit, fiscal policy (tax incentives and credits on alternative energy), or simple conservation (from the bully pulpit), the general public, fearful of a future that was one big blackout, accepted the changes grudgingly. But like the Emperor’s New Clothes, there was one little boy out there who was about to point out that Jimmy Carter was stark naked, his name was Ronald.

When Reagan took office in 1981 one of the first actions he took was to deregulate domestic oil pricing, which had been suppressing domestic production. He also had skillfully worked out, prior to his taking office, the release of the hostages in Iran, which took place the day after his inauguration, and instantly added new stability in the Middle East. With both these acts the Middle East oil cartel fractured and the supply of oil mushroomed as the speculative price of oil plummeted. It’s been Katie-bar-the-door ever since, to the point that even as late as 1998 gasoline could be found for less than $1 per gallon, making it cheaper, in constant dollars, than at any time since Henry Ford began to mass produce his Model T. Conservative Republicans, Reagan included, accepted the Carter axiom that cheap oil was finite (as does every relevant study since the mid 20th century). The argument has always been ‘when’ the wells would begin to dry up, and Reagan knew for sure it wouldn’t be happening on his watch.

The long term energy considerations and conservation efforts of the 70s virtually evaporated. Thousands of small businesses and initiatives in the alternative energy field became defunct or were viewed as laughable. The American auto industry began its assent to produce the biggest, heaviest, most profitable behemoths that have ever crushed pavement on the American highways, and the foreign auto makers eventually followed suit. There has been no coherent, long term energy policy pursued by any administration or either political party since the Carter years, despite continued political rhetoric about “energy independence”. And why should there be? Guided by the free market, the American people have not had any incentive in the last 28 years to address what everyone agrees is inevitable. Certainly the lobbied leaders in Washington were not incented either, or were they incented to the contrary?

George Bush said we were “addicted” to oil, and he should know, being a key supplier of the petroleum equivalent syringes, rubber hoses, and cooking spoons. As Obama and McCain campaign around the country, I have not heard from either even the slightest glimmer of energy reality, only the same old, tired energy rhetoric. Neither has spoken to the true realities of our “addiction”. I could expect it from the pragmatic McCain, but I was hoping for something more from Obama. It appears both aspire to the old adage; the first job of any politician is to get elected. Obama at least calls for increased mileage standards from automakers, yet hedges on the goals. Has either called for an immediate and enforced drop in speed limits which would virtually overnight reduce US oil consumption by tens of millions of barrels annually? If they don’t have the confidence to advocate the obviously simple, how can we feel confident that either can lead the nation to more substantive changes?

The current spike in oil and, therefore, gasoline is difficult to decipher. An economic trend that is disproportionate to its relevant influences (world demand for oil for example, although continually growing, has not doubled in the last 6 months) normally will correct. We saw that with the dot.com insanity of the late 90s, and again with real estate in the first half of this decade. In both cases the demand was out of proportion to the true value. In both cases it was fed by erroneous speculation. Could oil be the same or are we actually experiencing the beginning of the end of cheap oil? The Peak Oil theorists (and there are plenty of respected scientists in that camp) have been proclaiming for some time, like bearded prophets on street corners, that the end is near. Even if they’re wrong, we still know there will be an end and we really don’t know when that will start. What is it that will make the world, and especially the American people, sit up and take notice on the off chance it isn’t actually too late? Clearly our leaders will not take the lead.

Will it be the $4 a gallon gas prices we now experience, or will it take $5 or $8 a gallon? What will it take for that SUV owner to leave his peka-whatever in the doggie bed at home? I know if I were King, aside from proclamations regarding industrial re-tooling and restrictions on energy wasting behavior, I would sign into law that the price of gasoline could not fall below whatever the price was that made people sit up and take notice. If that price was $5 a gallon then there it would stay. If the cost dropped below that price then the profits would be taxed 100%, with that revenue going directly toward rewarding success in the production of alternative energy and conservation, and providing assistance through tax credits to those truly impaired by the cost. The expectation of decreasing demand would cause the underlying price to drop and the resulting input of billions into new industries would spur economic growth.

But I’m not King (thank goodness), nor are we in a Kingdom. We have a government Of the People, but unless the representatives of the people are willing to look beyond their own elections and the profits of their well endowed constituents, we may continue to air condition our dogs with 475 horsepower V-8 engines until the cool air runs out.