Watch And Learn

Some Sunday mornings, I actually learn something from the Sunday morning Washington, D. C. – based network political talk shows.  Yesterday was one of those days.  In fact, I learned several things.

First of all, I learned there are actually some persons who understand $17 T in debt coupled with $ 65 T in long term unfunded liability cannot be eradicated without fundamental restructuring of the benefits code.  Confiscating the 1% cash assets wouldn’t even balance the budget in one year, let alone solve the unfunded liability questions.  Yet, I am not optimistic Congress has sufficient numbers of like serious persons and I am quite sadly certain the general public does not.

One of the ways I am certain is to listen to folks like Paul Krugman, a New York Times columnist and occasional ABC Sunday morning panelist.  Mr. Krugman continues to call for more “stimulus” government spending, conveniently ignoring the Keynesian blast Washington has been engaged in the past 6 years, which by the most charitable views has failed.  So, you learn some folks will not learn from history, so stuck in their ideology as to be blind.

You learn some folks are simply on dream street, so far disassociated with reality as to not be worth debating.  This learning (OK, I actually already knew this) occurred on a show entitled “Up” on MSNBC on Saturday morning.  Sure, it’s MSNBC, so there was no one even within sniffing distance of a conservative to correct the errors, but it was instructive nonetheless.  There was a woman on the show representing, she said, something called Occupy Student Loans, or something like that.  She actually was advocating student debt be forgiven!  She did not identify how this might actually work (dreamers often haven’t thought out the action end of such fantasies, I suppose).  I guess she is not bothered by the taxpayers’ exposure to Fannie and Freddie, as she apparently advocates something similar for student debt.

It is remarkable that with all the discussion of student debt this week and especially this weekend, I heard only a single mention of the notion that the availability of student loans is a major driver in the cost of higher education.  I heard no one asking what the colleges and universities are doing with the money they reaped as tuitions have exploded in the past decade.  Oh, well, better to find someone (Mr. Taxpayer, of course) to fund this, rather than ask tough questions…

I have (again) concluded one of the problems is the cowardice shown by the Republican Party.  That’s right.  They do not, with a couple of exceptions, have the courage to advocate specifics about how they would balance the budget and modify Medicare, Medicaid and Social Security, so worried are they about losing the next election.  Consequently, most GOP’ers simply criticize their wild – spending, irresponsible Democrat opponents, while offering none of the specifics that must be identified to actually fix our problems.

Finally, Mr. Krugman again who also took the report from the Medicare and Social Security trustee this week (which showed both programs, of course, in ongoing financial dire straits) as something less than the horrible news it was.  He teaches us that idelologues, even Nobel Prize winners, will espouse anything that they think helps their side.

You would think responsible journalists would require such persons identify themselves in such roundtables.  Indeed, responsible journalists would demand this, but ABC and MSNBC’s failure to do so is a discussion for another time…when we decide to discuss problems for which the networks will never seek a solution.

And, keep in mind, only around 1% of our nation was watching and thinking about these problems this weekend.  And, as we see, many of them aren’t thinking with reason as their ally.  And, yet, they got the most TV air time.

Let’s see a show of hands from those who think enough politicians with courage will arise to start solving some of these problems…yeah, me neither.

Lugar For Senate

I am going to vote for Senator Richard Lugar in the Indiana May 8th Republican Primary.  I think.  It is not a decision I have come to easily.

I would have greatly preferred Senator Lugar would have chosen retirement from the U. S. Senate.  He would have been able to say he served with distinction and merit, in addition to longevity.  Seantor Lugar has not appeared particularly interested in many of the ‘hot button’ issues the past few years and, let’s be honest, if you have been in Washington, D. C. for 30 years, you are certainly part of the problem and most unlikely to be part of the solution.

However, Senator Lugar wants another 6-year term in the Senate.  As my friend Rex Early says, you know that it means the job is too good when no one will ever quit.  U. S. Senate perks must be very good, indeed.  I believe strongly in an amendment to the U. S. Constitution that would limit folks to somewhere between 6 and 8 House terms  and 2-3 Senate terms.

So, how then can I be voting for Senator Lugar, you might wonder?  Not easily, that’s for sure.  However, I believe Richard Mourdock is not nearly smart enough to be a U. S. Senator.  When you listen to his canned pablum campaign schtick about, for instance, closing down the Dept. of Energy, he just doesn’t seem to know that this is where those who watch over and regulate nuclear power plants work.  I don’t think he will add much to the Senate, traditionally and once a scene for great debate.  I believe if he were twice as smart as I think he is he wouldn’t be smart enough to be a U. S. Senator.  For me, it’s really that simple.

I know of some folks who were thinking about making the GOP primary race against Senator Lugar but decided, in the end, not to do it.  These folks are very smart persons who would have made outstanding candidates and wonderful U. S. Senators, in my judgement.  Sadly, Richard Mourdock was and is not one of those folks.

Still, I am so much a believer that someone who has been part of the polluted Washington D. C. culture for 30 years should not be returned to office that I had to consider voting for Richard Mourdock.  I can’t do it.  I just am totally unimpressed with his intellectual heft, or lack thereof.  Sending a diminutive intellect to replace Richard Lugar makes even less sense to me than returning a 30-year veteran.  Hearing that Sarah Palin, who backed such bright lights as Sharron Angle in Nevada and Christine O’Donnell in Deleware, supports Mourdock fortifies my thinking.

I am not sure I am right about voting for Senator Lugar, but I am more than certain Richard Mourdock just isn’t very bright and shouldn’t even be a guest in the U. S. Senate, let alone a member.

Giving (World) Peace A Chance, Etc.

Some sports odds and ends to wrap up the week before the Kentucky Derby…

No one can/should be surprised Metta World Peace disrupted same with another violent assault on another human being.  Ron Artest, aka Metta World Peace (a legality he foisted upon us all last summer; has there ever been a more ironic moniker?), visciously elbowed another NBA player in the head last Sunday…

From my time as Indiana Pacers’ internist, I can tell you Mr. Artest is not a very smart man…or anywhere close to that…at all…ever.  His IQ is certainly far below average.  When you couple that with a long history of being unable to control his emotions and manifestations of a variety of other psychiatric illnesses (biplolar, depression, schizophrenia) which he has demonstrated over the years, problems will occur.  And, they have…

Now, once his declining offensive skills finally usher him out of the league  for good, well, that’s when the rest of us have to start worrying…this multimillioinaire will end up broke and in jail…

For the moment, the NBA should have suspended him throughout year’s playoffs and only reinstate him nextg autumn once he is involved with a long-term pscyhiatric treatment plan with which he must follow – up on an ongoing basis, in order to maintain his eligibility.  The fact NBA Commissioner David Stern uspended World Peace only 7 games must make Pacers’ fans wonder why.  It’s simple:  Indy  v.  LA.  At least no one has to wonder if there is a league double standard any longer…now, t’is proven…

As his life goes downhill from here, tt won’t be a societal tragedy.  Many, many persons have tried to help Mr. Artest.  To date, his problems have simply proven untreatable…

The pressure will really be on the Indiana Pacers in the NBA’s Eastern Conference first round.  They have to win.  Period.  If this is a team that is really going to round into a contender, they must beat Orlando (who is without their megastar Dwight Howard) in the first round.  No amount of explaining will be able to cover a Pacers’ failure here…

I snicker every time I hear some self – annointed NFL draft expert on a sports talk show saying he hopes the Colts, or whomever, pick Joe Dokes from State U in the 3rd round because “that guy can really play…”  These guys have no clue, but are all over the radio and TV…

all you have to do is watch game film and interview the guy, to be certain he is not the NFL’s version of Ron Artest and you’ll know if you need/want him…

NHL playoff hockey is, for my money, the next best thing to the World Series…it’s been remarkably disrupted this year, however, by a few cheap shot, violent hits….it’s not fighting that is the NHL’s big problem…it’s 4th line players KO’ing one of the other teams’ stars with an illegal check/hit…

I was watching Rangers v. Senators in a 1st round NHL playoff Game 7 last night, rather than the NFL Draft…and, it was a great game…and, not just becauses my beloved NY Rangers won 2-1…

now, if the Yankees can just get some starting pitching….

 

In The Air

There is more trouble brewing for the air traveling public.  The likely result is rising prices, fewer options and longer waits upon the tarmac.  Sounds great.  Why is this happening?

First of all, Southwest has merged with / purchased Air Tran.  Both of these carriers did somewhat the same thing:  direct flights, without the ‘hub’ strategies of the so – called legacy carriers (though Air Tran flew an awful lot of folks through Atlanta).  The result has been a curtailment of service to smaller and medium – sized cities that United, Delta, American and USAir had already deemed non-profitable.

Now. US Airways is trying to inject itself into AMR’s (American Airlines’ parent company) bankruptcy, offering a sweeter deal to the unions than AMR was offering in reorganizing.  That is surprising to me, on the surface, as US Airways is smaller than American and has already had its share of labor troubles.  I guess a judge will sort all that out.

We the air travelers should be rooting for AMR to maintain control of American Airlines and American Eagle.  Reducing the field to only 3 large carriers will result in even higher prices (they are already rising, ostensibly, the airlines say, due to rising fuel prices), fewer flights and longer waits.  Their ‘hub’ strategy will work, if they require everyone to fly to those hubs.  The delays in Dallas, Chicago O’Hare, Atlanta and the northeastern airports will lengthen.  Alot.

It is very hard these days for airlines to make money.  But, allowing the legacy carriers to swallow one another up is of no benefit to the consumer.  We will see whether the federal government and the courts allow USAir (a frequent bankruptcy court flyer themselves) to take over American Airlines.

I surely hope not.

5th Congressional District Candidate Forum Results

I had the privilege of moderating the 5th Congressional District Candidate Forum Monday night at St. Elizabeth Ann Seaton Catholic Church in Carmel.  Six Republican and one Libertarian candidate were there, along with an overflow crowd of around 350.  This was the largest crowd, according to all of the candidates, they  had appeared in front of the entire campaign.

The first three questions all dealt with some fundamental aspect of the U. S. Constitution.  Chard Reid (Libertarian) and David McIntosh both took the time to mention the 10th Amendment in their answers.  The 10th Amendment leaves to the states everything which is not specifically outlined for the federal government.  Jack Lugar and Dr. John McGoff both cited Article I, Section 8, which is where the government, essentially, cedes the point of the 10th Amendment.  Marion Mayor Wayne Sebold spoke of Congressional oversight of federal, state and local agencies.

On the question of what, specifically, Medicare needed to be sustainable, several of the candidates tepidly raised their hads quite briefly (too briefly for us to record) to support raising the age of eligibility for Medicare in some fashion.  Mr. Reid strongly did NOT support such a change.  No one otherwise provided any specifics of how Medicare would change, but all 7 persons present sasid Medicare and Medicaid were unsustainable in their current form.

On the question of taking money out of politics, all agreed that it creates undue influence and raises problems in other ways, too.  Mr. William Salin took this opportunity to voice his support for a flat tax.

The next question dealt with how to proceed if, indeed, the Seante doesn’t produce a budget again this year.  Mayor Seybold favored halting the pay of both Congresspersons and their staffs in the absence of a budget.  Mr. McIntosh, Jason Anderson, Dr. McGoff and Mr. Salin all raised their hands to say they would vote to shut down the government if there was no budget, rather than agree to another Continuing Resolution codifying current spending.

All supported a Balanced Budget Amendment and no one disputed the need for an emergency ‘escape’ and no one suggested they were opposed to about a 60% override provision in each chamber and the ‘escape.’

Mr. Lugar and Mr. Slain did not support an Amendment to the U. S. Constitution to limit terms in the House somewhere between 6-8 and in the Senate to somewhere between 2 and 3.  The others all said they support such an Amendment.

Mr. Lugar did not want to wind down the activities of Fannie Mae and Freddie Mac but spoke of getting the government out of the way in the housing market, allowing the market to seek its level where reinvestment can begin in earnest, etc.  The others all wanted to either wind down Fannie and Freddie or at least limit their new mortgage exposure to those putting at least 10% down and able to attain at least a credit score 90% of standard.

All of the seven wanted to abandon ALL of the ObamaCare planks listed for choice in front of them, rather than identify one aspect of ObamaCare which was worse than all the others.  Mr. McIntosh said the one thing he was going to go ‘to the mattresses’ to defeat in the realm of government health care was to defund Planned Parenthood.

Personally, some observations:  with a couple of exceptions, I think the GOP will be well served in the fall election.  I thought there were 4 of the six who well espouse conservative Republican principles.  Mr. Reid, who is unopposed in the Libertarian Party primary in November, capably gives voice to the Libertarian views and will well represent them in November.

Finally, I was flalttered to have been asked to moderate and I very much enjoyed what I thought was an informative evening and I am sorry I didn’t get this up yesterday like I had planned.  People get sick whenever they get sick and rarely respect other calendars!

The French Say “Mais Non!”

Francoise Hollande has won the first round of French elections, whatever that means in their system.  What it means for France and the rest of the world is big, big trouble.

Monsieur Hollande is described in an AP story as “a 57-year old Socialst… a lifelong politician…party boss…”  In other words, a party hack who, to quote Hilary Rosen, “hasn’t worked a day in his life.”  Actually, maybe he had a paper route once, I don’t know.

But, I know it means French voters were unhappy having their lavish government benefits threatened by the austerity Germany, the sole semi-stable economy in Europe, had pushed upon them.  Rather than rioting, as in Athens, they voted themselves a pay raise.  Actually, the Greeks tried this a few times first, too, before the rest of the world said we’re not loaning you any more money.  Then, having run out of someone else’s money, they rioted when their lifestyles were threatened.

We laugh at such foolishness, but some in America (Hello, President Obama!) seem determined to have our country follow this social spending path that has landed most of Europe in a train wreck financially.  The French say, mais non, we are not interested in revising the social safety net that has long ago become a hammock for the French.  We want to go on pretending we can spend what we wish.  This, essentially, is what Mr. Hollande is promising.

The French long ago abandoned the premise a sovereign country should have a viable military.  They spend on social programs.  Now, they’re broke and, surprise of surprises, those who have grown accustomed to such largese vote that they get to keep on getting the money.

A popular televison program in the U. S is “Are you smarter than a 5th grader?”  Even more disconcertingly, are we smarter than the French?

Fifth Congerssional District Candidate Forum

Tomorrow evening at 7 p.m/ Saint Elizabeth Ann Seaton Catholic Church will host a candidate forum for those running for the 5th Congressional District.  Six Republicans and one Libertarian candidate will be present.  One Republican and both Democrats running in the May 8th primary election are unable to attend.

The questions have been given to the candidates in advance for a couple of reasons.  First of all, the typical media ‘Gotcha!’ approach is not in anyone’s best interest, but it must make good TV, because they keep doing it.  In fact, Congresspersons almost NEVER need the quality of thinking quickly.  Congress takes two months to discuss whether or not next week should be National Tulip Week.

Secondly, the first three questions are important questions about the Constitutional authority of Congress and we want to know the candidates’ interpretation of the First Amendment to the U. S. Constitution.  It is fine with us that they have had the opportunity to think about their answers.  We are going to think about them very carefully, too.

The next seven questions, and we may not get to all ten questions in approximately 90 minutes, are yes/no or multiple choice questions, so we can get everyone on the record regarding term limits, Fannie & Freddie, etc.

This blog will report on all the answers to the questions we receive tomorrow night.

Hope to see you there.

 

Resisting The Tidal Wave

I am in New Orleans for the annual American College of Physicians meeting.  Yesterday, I met a couple of married internists.  They’re story is instructive…and, very scary.

They work in a suburban setting, outside of a college town.  They both go to work as internists every day, but they have both a son (14) and daughter (9), so they divide child responsibilities, as well as weekend call, though the majority of the former fall to her and the majority of the latter fall to him.  They make it work.

They are part of a four person group.  They have had overtures from the hospital in the area to buy their group, make them hospital employees.  To date, they have resisted.  However, they both admit they may well not resist for much longer.  They cannot control their expenses (they buy health insurance for their employees, too) and their reimbursement keeps falling.  The hospital offers, at least initially, a better deal.  Even though they don’t trust hospital administrators (I tried to encourage them to maintain this healthy emotion), over the short term, it looks like a good deal.  Their two partners, home minding the office and hospital this week, are ready to jump.

I asked them what the primary driver was to join up with the hospital.  ObamaCare and the Accountable Care Organizations it mandates was their immediate answer.  If they don’t get with the hospital and get to be part of their ACO, how will they get paid for the care to hospitalized patients they care for?

Less than 50 % of doctors remain in private practice in this country and it is speculated that number will fall to less than 5% by 2020.  I don’t doubt it.

However, I advised the late – 30s couple I was talking to:  try to hang in there.  Someday, and that day will happen a long time before 2020, you will be so, so thankful you are independent and can’t be dictated to by the hospital (who will be being dictated to by government).  The world is going to turn upside down and one of your biggest enemies, big insurance companies, might well end up being your only ally.

But, giving up your sovereign practice to be part of an ACO will be a very, very short term benefit only.

I didn’t think, from the looks on their faces, that they doubted I am right.  I also didn’t see the determination on their faces it will take to resist the tidal wave, particularly if Mr. Obama is re-elected in November.

They promised to stay in touch.  I hope they do…as independent patient advocates, also known as internists.

More ObamaCare Unintentional (??!?) Fallout

In an amazing development, The New England Journal of Medicine allowed an article to be published in their “Perspective” section in last week’s edition that was critical of an element of ObamaCare.  I suspect there will be repercussions!

In truth, the Journal has had their short skirts on and their pompoms flailing in support of government – run single payer medicine, or, failing that, ObamaCare, for a long time.  The “Perspective” section of their weekly publication has had one pro – ObamaCare piece after another for 3 years now.  It was truly remarkable two doctors from the Department of Health Policy and Management at Harvard, the primary source for “Perspective” writings, were allowed to be even mildly critical.

Doctors Joynt and Jha point out that the financial penalties under ObamaCare for hospitals having patients re-admitted in the four weeks following their discharge are too penal.  They correctly point out that hospitals will do what they have to do to survive financially and since the financial penalties are far greater for readmissions than they are for “poorer care” (i.e., high mortality rates, high rates of avoidable adverse events, etc.) ObamaCare “sends a clear signal about where hospital should focus their efforts.”

Let me quote the last two sentences of their essay.  ” ‘ We are asking U. S. hospitals to spend their limited resources on ensuring that patients are not readmitted as many as 4 weeks after discharge — events that are largely outside the hospitals’ control.  But, the most important consequence of this policy is the improvements  in quality and  ssafety that hospitals will forgo, and those will be far more difficult to measure.”

Wow.  Persons from New England critical of portions of ObamaCare (many persons from the midwest are critical of nearly ALL of ObamaCare).

Of course, since this policy would greatly threaten the Boston hospitals where these doctors work, the authorsa recommend relatively minor changes in the rules.  I mean, come on, if they called for wholesale repeal of ObamaCare, they would certainly not be published and might be fired.

I have no such concerns.  I advocate, for this reason and the others you have read here in the past two years, the Patient Safety and Affordable Care Act (which, ironically, is neither) be repealed in its entirity.

Certainly, I think it’s main advocate ought not return to 1600 Pennsylvania Avenue!

Breathtaking Presidential Hypocrisy

Too often my respect for the positions held by President Obama could fill only a thimble.  Today, even the thimble is empty.  The President has shown himself guilty of hypocrisy of breathtaking proportions, even by his subterranean standards.

The President is pushing for the so – called Buffet Rule (defeated in the Senate last night and having no chance to pass the House), compelling everyone making any significant income (? more than $ 220,000 annually for a couple filing jointly) to pay no less than 30% of that income in federal income taxes.  This push is being done, mind you, while apparently even Mr. Buffet doesn’t believe in this, since he is not paying that rate and is fighting a tax case the government has brought agaisnt NetJets (of which he has a major ownership position).

Now, we find today Mr. Obama doesn’t believe it either, since he is paying only 20% of his 2011 income in taxes.  The President and First Lady, appaprently, have joined Mr. Buffett in taking a pass on voluntarily paying more income tax.  The Story Family had less 2011 income that the Obamas and paid at a higher rate.

All of this simply underlies the case for major tax reform, such as Rep. Ryan, R., WI, has called for in the budget that passed the House.  You will recall, no doubt, the Democrat – controlled U. S. Senate (the President’s political party), for their third year running, has produced no budget bill for the House to debate, send to conference committee and send off for Presidential signature.

And, without significant change in Washington, there will be no major tax reform.  If Congress greatly simplified the tax code, why would anyone pay any attention to them?  What else do they do?  If Congress can’t pass out tax goodies to sufficient donors, they’ll pale into insignificance (such as the Framers imagined?) and their time in Washington, D. C. could be greatly cut and their time in their home districts/states could be greatly expanded.  So, don’t count on tax reform any time soon…

In the interim, continue, apparently, to expect President Obama to demagogue issue after issue.  Today, it’s tax fairness.

If I had my way, April 15th would be election day.  Not to worry, though, I won’t have forgotten by November.