It's not the so-called President - it's us, stupid!

To put it succinctly; the problem is not that the so-called President is a serial liar and seemingly has little ability to discern fact from fantasy and seems to believe his own lies; or that he has bragged about sexually assaulting women and indeed that a number of women have accused him of doing what he has bragged about; or he is the most conflicted President ever elected with business interests that could directly profit based on the decisions he makes in office;  or that he has promoted false racist memes; or has promoted religious bigotry in the name of national security or some kind of religious entitlement; or has been willing to make health care unaffordable for tens of millions of Americans for the sake of cutting taxes for the wealthiest Americans; or seems to embrace or admire murderous autocrats around the world while criticizing and insulting trusted allies; or displays little intention of studying the important policy issues of the day or being informed of the real state of the world and how his own government works; and has an over-sized ego that has become the textbook definition of a kind of pathological egomania.  No, the real problem is that he was elected President, albeit via an election game that makes no logical sense and only superficially resembles a democratic process.

No, the real problem is that as many people voted for him as they did.  The fact that he received around 46% of the popular vote is the problem.  And that is the problem that needs solving.

Without the ability to read people's minds, as if the minds of many persons were actually coherent and readable, we can at best only speculate as to the reasons why a person would vote for someone like the so-called President.

If you were to ask someone of they would willingly and happily vote for a sexual assaulter, most would say "no."

If you asked a voter if they would vote for someone who repeatedly lied, had numerous conflicts of interest, would threaten the existence of their own health care, promoted racist ideas, targeted religious minorities, and did not want to do the difficult policy work of being President, an overwhelming majority would say "hell, no!"  But as it turned out, 46.1% of those who voted did vote for someone as just described.  How come?

My educated guess is that there are four overriding reasons:

1) Some people actually are OK with lying, sexism, racism, etc.  These are good attributes for them.  This is what a real leader is expected to do for some people.

2) Some people willing to overlook these obvious contemptible attributes in the hopes of some policy action that would personally benefit them, such as a tax cut for the wealthy.  This is selfishness in my book.

3) Others are simply incoherent.  They have drunk the Kool-Aid and are fans of the so-called President and can either rationalize away his incontestable faults or choose to not believe they are real.  As the so-called President has said, "I could stand in the middle of 5th Avenue and shoot somebody and I wouldn't lose voters."  Well, he might lose some voters, but definitely he would not lose all of them.  Go to http://www.cnn.com/2016/01/23/politics/donald-trump-shoot-somebody-support/  .

4) Some actually thought that the alternative choice for President was worse.  Some people actually believed that Secretary Clinton had conspired to kill various persons, see http://www.snopes.com/politics/clintons/bodycount.asp .  Some truly believed that she lied about Benghazi. Go see the Snopes web site:  http://www.snopes.com/?s=benghazi for objective info. Some people believed that the conflicts of interest due to the Clinton foundation were worse than the conflicts of the eventual so-called President despite the Clintons releasing numerous past tax returns and the so-called President releasing none.  Go to https://www.charitynavigator.org/index.cfm?bay=search.summary&orgid=16680 and https://www.charitywatch.org/ratings-and-metrics/bill-hillary-chelsea-clinton-foundation/478 and https://www.charitynavigator.org/index.cfm?bay=search.summary&orgid=16764 .  The Clintons made no money via their charity, did much good work and no evidence of policy influence has ever been evidenced.  Most of the bad things people believe about the Clintons can be classified as fake news, spin and mammoth exaggeration.  This is not a 100% right wing fringe problem - it turns out that many Bernie Sanders supporters were targeted by a disinformation campaign designed to discourage them for voting for Secretary Clinton. It worked.  Go see:  http://www.salon.com/2017/03/31/fake-news-websites-targeted-trump-bernie-sanders-supporters-to-spread-conspiracy-theories/  .

It is the last category where the most possible work needs to be done.  I am not talking about rehabilitating the image of the Clintons - I am talking about combating fake news and the inability of too many persons - enough to swing elections - to be influenced by fake news and their inability to discern between fact and obvious lies.

The work begins with promoting reason, evidence and skepticism while exposing irrationality, blind faith and  cynicism.  That is a topic for another day.

The First Step to Reducing Mass Gun Violence

This may sound random but the first step that must be taken in order to reduce the kind of mass gun violence such the crime perpetrated  recently in Roseberg, Oregon, and the ongoing everyday slaughter of Americans by guns is an obvious step and yet it is a step almost no one ever suggests when asked about the problem.  The step is - Campaign Finance Reform.

Right now I am sure many readers are nodding in recognition of this simple, obvious and never spoken of truth!

There is no chance anything can change if lobbying efforts and campaign donations continue to influence elected officials one way or the other on the issue of gun control and any other issue where billions and billions of dollars are at stake.  Gun control is not even remotely the issue that is most influenced by donations and lobbying; health care has that distinction, followed by the military industrial complex, and competes with numerous other lobbies, including agriculture, banks, union activists, anti-union activists and, well just about everything that involves profits or paychecks.  If  you want to know why the obvious never gets done in the U.S. despite the overwhelming desire of a vast majority of Americans, the explanation starts with the way we finance political campaigns.

The things that need to be done are pretty obvious; eliminate all donations over a modest dollar amount that almost any American could afford to donate and yet would be too small by itself or in total to influence an elected official.  That could be as low as $100 for a Senator or House Representative.  If a  candidate obtains a threshold number of donations they then qualify for public financing that would dwarf what they could raise privately $100 at a time, and that is all the would be allowed to spend, period.

All other donations would be considered attempted bribes, which in reality, is exactly what they are.

Independent fundraising PACs may not be possible to eliminate BUT they should be held accountable for mis-information and can be sued as an institution and the suit should extend to donors as well if a Court finds that they lied or libeled a candidate or lied about an issue.  Currently, as far as I know, PACs can accept donations privately and tell any lie they choose with impunity and face no consequences, or at least they have faced no consequences so far.  Perhaps criminal liability for someone within a PAC who interfered with an election by promoting false information to the Public would do the trick.  The difference from the  average citizen who ignorantly spread lies is money - the PAC was paid to spread the lies, an average voter was just expressing an incorrect opinion. The difference is the monetary motive.

In any other business, if a product causes damage or is defective, the producer of the product is liable.  If the producer of the product knowingly sold a defective or dangerous product, the producer is criminally liable, or should be.  PACs should be treated no differently.

The next thing to do would be to institute term limits at every level of government, generally 8 years for executives, 12 years for legislators and 20 years for judges.

Then we can outlaw gerrymandering and, instead, with computers we can draw electoral districts objectively.

Finally we can stop trying to pass laws restricting voting rights aimed at the voters of the opposition party.

ONLY at that point can the intractable problems of gun violence, health care, the deficit and so on can even be thought about.  My proof is the current state of affairs.

Greed, the American Health Care System and Campaign Finance Reform

One of the things most people just don't understand about the American Health Care System is the how the game is rigged in favor of pharmaceutical companies, medical equipment makers and hospitals, and who is rigging it this way.

This past week it came to light that a older drug, acquired by a new ownership group, had its price raised by over 4000%, from $13.50 per pill to over $750 per pill.  "Shkreli is the founder and chief executive of the pharmaceutical company Turing. He and his company have, of course, been the subjects of widespread news coverage this week after the New York Times highlighted Shkreli's decision to boost the cost of the more-than-60-year-old drug Daraprim from $13.50 to $750 after the company purchased the drug in August. The drug, developed long ago (i.e. the research costs were borne by a previous owner of the drug), is not exactly a frequently used medication but is considered the most effective drug and therefore the standard of care for people suffering with an infection called toxoplasmosis." http://www.washingtonpost.com/news/the-fix/wp/2015/09/23/martin-shkreli-a-new-icon-of-modern-greed/  This was a completely legal move.

This is not an isolated situation and in fact it is the rule, although in most cases, the price increase is nowhere near 4000%.  Consider, however the case of "Sovaldi," a drug made by Gilead, that cures a form of hepatitis.  "In the United States, Sovaldi costs $1,000 a pill, or $84,000 for a typical 12-week course of treatment. It is likely to be sold for less than $1,800 for a 24-week course of treatment in India, where people are generally infected with a different form of the virus and treatment regimens can take twice as long.  Gilead plans to introduce the drug in India for about $10 a pill — 1 percent of the price in the United States, Gregg H. Alton, Gilead’s executive vice president, said at a news conference."  http://www.nytimes.com/2014/09/16/business/international/maker-of-hepatitis-c-drug-strikes-deal-on-generics-for-poor-countries.html?_r=0  How can this be?  Why would Gilead sell the drug in India at $10 per pill while charging $1000 per pill in the U.S.?  If it's profitable in India at $10 per pill, why can't that be the price here as well?

The answer is that the game is rigged and its rigged by Congress and the Big Pharma lobby.  If you did not know, the Health Care Lobby is the largest lobby in the country, larger than military-industrial complex or any other lobby group.  They donate incredible amounts to campaigns and their support is crucial to may legislators financially.

Congress, the beneficiary of the huge campaign donations, has actually passed laws that prevent Medicare from negotiating the pricing of drugs with drug makers!  Medicare cannot use its enormous leverage to get the best prices out of the drug makers in the same way that other countries do within their single payer nationalized health care systems.  No, in the U.S., Medicare can only pay a premium over an average cost for drugs and that average is pretty high when the rest of the market consists of drug makers with monopolies on their drugs and a very fragmented market of numerous health insurance companies.  All the leverage is on the side of the drug makers.

Obviously the solution is to take the handcuffs off of Medicare and in fact, go to a 100% single payer system, a Medicare for All system, in the U.S.  To do this, we have to have a revolutionary campaign finance reform movement so that Congress is not in the pocket of their big donors.  Good luck with that!  Still, the first step to a better health care system, and solving numerous other problems, is campaign finance reform and  as difficult and hopeless as it seems to be, reform must begin.

Presidential candidate Hillary Clinton expressed outrage over the costs of the above drugs mentioned this week made some recommendations to prevent this from happening were she elected President.  "Under Mrs Clinton’s proposals, partially unveiled on September 22nd, Medicare, the government health scheme for elderly Americans, would be allowed to negotiate prices directly with drug companies—something the firms would fight tooth-and-nail. She also wants to stop drug firms treating the cost of direct-to-consumer advertising as a business expense allowable against tax; such ads encourage patients to demand specific drugs when there may be cheaper alternatives that are just as effective. And Mrs Clinton would require drug companies that benefit from government spending on research and development to invest a “sufficient amount” in R&D of their own. If she were elected president however, she might struggle to get much of this through Congress, and even then it might have only a marginal effect on the unrelenting rise in the cost of medicines." http://www.economist.com/news/business-and-finance/21665436-dramatic-rises-price-some-medicines-prompt-calls-action-hillary-clinton-promises 

This is a good proposal but it will not pass through Congress UNLESS Congress is no longer owned by the Health Care Lobby and greed is no longer rewarded in the American Health Care System.  Job Number One is Campaign Finance Reform.

Note: After Secretary Clinton's comments, Turing, the company that owns Daraprim, announced it would roll back the price to some as of yet unspecified lower price and the stock prices of many large pharmaceutical tanked on Wall Street.

Obamacare vs. Anarchy-care

Exactly what did Obamacare try to accomplish?  It really only tried to widen access to affordable health care insurance.  It was a reform that was long past overdue despite the fact that it falls short of accomplishing what is actually needed, which is the control of health care costs.

I should know. After my wife's permanent layoff from her job at a large company, I needed to purchase health care insurance as a very small business owner for my family. Since my company had way fewer than 50 employees, the choices were not abundant despite living on Long Island, NY.  I had 3 insurance companies in  total to choose from.  All the policies were odious.

The first year, 2002 or 2003, the cost of insurance was a shock to the system after being covered for relatively little out of pocket cost under my spouse's coverage from her job. But it got worse - much worse.  By 2009, health care was costing before taxes $25,000 per year counting premiums, deductibles and co-pays.  Unbelievable!

Fortunately, in 2010, my wife found a job with good benefits but the damage was done - we had spent about $175,000 on health care over about 7 or 8 years even though we were relatively healthy.  Boy do we miss that $175,000!

The loss of this money to health care costs is particularly bothersome to me because I am all too well aware that our "system" of health care is so idiotic; it's the most expensive in the world and it's not close to being the best.  In Canada, our neighbor to the north, the costs are a fraction of ours, yet Canadians live longer than we do.  There is no way to justify what we do compared to what the Canadians do; they simply have it better.  Anecdotal stories aside, the fact remains that Canadians are not clamoring to change their "Medicare for All" system.  In fact, they probably would rebel if their system was changed into OUR system.  Who wouldn't rebel?  Our system is nothing more than anarchy.

Is that too strong a word?

Health and Human Services Secretary Kathleen Sebelius has released an enormous data file containing the secret "Chargemaster" price lists of hospitals from around the country revealing an almost completely random, arbitrary and capricious pricing of various hospital services that vary wildly from hospital to hospital.  Truly the prices are inexplicable!

Steven Brill, who wrote the masterful article "Bitter Pill" highlighted in an earlier blog post, wrote on 5/8/2013, "For example, the first line in the more than 163,072 lines of data in the CMS file released May 8 covers the treatment of “extra cranial procedures” (“without complications”) at the Southeast Alabama Medical Center in Dothan, Ala. When Medicare reviewed the list prices on bills it received for 91 patients getting that treatment at the Dothan hospital in 2011, the average Chargemaster bill claimed by the hospital was $32,963. Medicare paid only an average of $5,777...

Helpfully, Sebelius points out in her announcement that “average inpatient charges for services a hospital may provide in connection with a joint replacement range from a low of $5,300 at a hospital in Ada, Oklahoma, to a high of $223,000 at a hospital in Monterey Park, California. Even within the same geographic area,” she notes, “hospital charges for similar services can vary significantly. For example, average inpatient hospital charges for services that may be provided to treat heart failure range from a low of $21,000 to a high of $46,000 in Denver, Colorado, and from a low of $9,000 to a high of $51,000 in Jackson, Mississippi.”

"  Go to
http://swampland.time.com/2013/05/08/an-end-to-medical-billing-secrecy/ .

Please note that the hospital, which makes a profit at the payment level that Medicare pays, would try to charge the uncovered about 600% more than it charges Medicare.  Those persons would most likely be lower income persons.  Furthermore, the Chargemaster price lists are the basis for their negotiations with health care insurers, none of whom have anywhere near the bargaining power of Medicare which has a monopoly on older health care consumers.  It is Medicare's bargaining power that is the key to lowering health care costs.  The only times Medicare is ineffective in bargaining is when its hands are tied legislatively; Congress prevents it from bargaining fully with medical equipment companies and drug companies.  Why?  Because these companies are the biggest lobbyists in Washington DC and spend huge amounts supporting their political candidates.  What a shock!

Is this crazy or not?  Why would we all not want Medicare for all?  If you think your taxes would go up, think again - the money saved in insurance premiums, deductibles and co-pays would be far greater than any tax increase since the total cost of health care expenses would decrease - a lot!  That decrease ends up in our pockets and it comes out of the pockets of hospitals, medical equipment companies and Big Pharma.  Do not cry for them, they will not starve.  But if we do not adopt some form of Medicare for All, perhaps we, the American taxpayer and consumer, will starve.