“Inauged”: My New Word for “Now We’ve Been F**ked by You Know Who”

Well, it’s done. He is the President. Yup. Trump and his coterie of billionaire country rapists are now our official leaders. How does it feel? Like you could benefit from several hours on a bidet? I feel your pain.

As most of my readers know, especially if they’ve clicked on the “Books by” link on my Facebook site, I write and have two published works of fiction, Zendoscopy (a serio-comic coming-of-age tale) and Spacebraid and Other Tales of a Dystopian Universe (sci-fi fantasy stories). What many may not know, however, is that I’m a retired M.D. An ob/gyn, to be precise about it. I spent 16 years in clinical practice, and then segued into administrative medicine, taking on several roles during the balance of my career: senior health plan executive, market medical director for a large health plan and, ultimately, heading up physician, hospital, and ancillary provider peer review (medical quality of care management) for 13 western states for a very large insurance company. Along the way, I also did some teaching in a university-affiliated ob/gyn residency program. Having worked in these several sectors of our health care environment, I’ve developed some pretty strong opinions about where health care should be heading. And folks, lemme tell ya, it ain’t a goin’ in that direction today.

At first, I thought I’d provide you with a historical review of how we got to where we currently find ourselves but, as I began to write, I realized I could fill far more paragraphs than anyone would want to assimilate on the subject. So, instead, here’s a considerably shorter review with my take on it all.

The pre-mid-1980s 80/20 insurance plans and employer-based health care model provided coverage that encouraged people to ask for everything and physicians to provide it…and more. This led to uncontrolled costs and opened the door for so-called “managed care”, a model that promised evidence-based health care with cost controls and some inevitable loss of choice for patients. Big business saw an opening and stepped in to run it, leading to substantial abuse in the name of bolstering corporate profit. The promise of better care at lower cost was sacrificed on the altar of stratospheric executive pay. Health care, quite simply, became an immoral, profit-centered business.

The Affordable Care Act (the “ACA”, or “Obamacare”) was an attempt to deal with the problem and provide coverage for the millions of Americans who lacked health insurance. It is important to remember that the basic idea from which grew the ACA was, in fact, a Republican plan and was even implemented in Massachusetts by then-governor Mitt Romney. But the version known as the Affordable Care Act was the specific plan promoted by our nation’s first black President, and as Senator Mitch McConnell famously articulated, nothing proposed by President Obama would ever be approved by Republicans, including the formerly articulated Republican health care plan. The racism inherent in the Republican position was obvious and odious.

President Obama’s offering included a “public option”, essentially a program of universal coverage provided through an alternative that would, in effect, compete with the private health care system. This was a non-starter for business-protectionist Republicans, who screamed “socialized medicine” and forced Obama to drop it. As a result, the ACA ultimately passed on a straight party-line vote without the one component that would have led to truly comprehensive coverage availability for everyone. The ACA as enacted was far from perfect but it was a compromise that Republicans could at least say didn’t eliminate the insurance companies from the health care market, and it did allow more than 20 million people who formerly lacked insurance to gain coverage. Other benefits of the ACA are well known and I won’t take time to delineate them here.

Now, the Republicans, who’ve tried some sixty times without success to dismantle the ACA, see their chance finally to kill it. But as in all the years since its adoption, they have been unable to present a viable alternative. What they’re learning is that health care does not operate according to simple market-based supply and demand rules. Demand for health care is relatively inelastic – everyone needs it eventually and, often, unpredictably. To drop 20 million or more from the insurance roles will only cause them to delay care, become sicker, and then seek care in emergency rooms, where treatment is outrageously expensive and, to a great extent, paid for by taxpayers in the form of government expenditures and increased direct health care costs. It isn’t more cost effective than covering people through insurance and, being wasteful of resources and inefficient, it makes no sense to abandon the ACA with this as the inevitable result.

What is the answer? No matter how distasteful it is for the right wing, the ONLY viable answer is universal coverage, sometimes referred to as “Medicare for all”, although it would likely differ in some respects from Medicare. It would, in essence, be a federally funded program that could use private insurance companies as fiscal intermediaries under contract for reimbursement. Everyone would be covered by a safety net assuring a basic standard of care. Those who could afford it could purchase upgraded levels of coverage from the insurance companies, say, for cosmetic or advanced infertility treatment. We would abandon the dysfunctional employer-based health care model, with funding (as now for Medicare/Medicaid) coming from tax revenues. It would not be more expensive per capita than what we are paying now in premiums.

That’s a somewhat oversimplified view of what needs to happen, but I’m confident in predicting that it won’t happen anytime soon. Entrenched interests will see to that. But how long will we be able to justify our present system or whatever the Republicans may try to implement when we’re confronted by the well-functioning universal coverage systems of other Western, developed nations? Our present system, with its fragmented incentives of patients v. doctors v. hospitals v. insurance companies v. drug companies is an utterly unnecessary disgrace with higher costs and worse health outcomes than most if not all Western European countries. But we won’t get what we need until we all stand up for it. This will take a degree of political awareness and activity sorely lacking today in the American public, many of whom voted against their own best interests in the recent Presidential election.

Maybe those folks will eventually wake up and realize they’ve been conned. If so, I hope it happens before the suffering becomes too severe. Say, in time for the next midterm elections.

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Buy a Binky for Donald!

OK, the truth is that I, as a one of those elitist, left wing liberal, rational secular humanists, am as dismayed as every other one of my similarly minded friends over the election of Donald Trump as our 45th President. But I’ve got an idea to express our huge sense of foreboding about what’s coming while maybe effecting some positive change in the man’s abysmal behavior..

Let’s start with a description of he who would be our fascist leader. Supremely experientially and temperamentally unqualified for office, racist, anti-immigrant, willfully ignorant, lacking of any understanding of the country’s founding principles, pandering, mendacious, misogynistic, loaded with conflicts of interest, amoral, and, to the point of this little essay, drowning in infantile narcissism. Yup, that’s most of it.

Trump reminds one of a spoiled, bullying brat with a skin so thin (and orange, apparently) that he cannot tolerate even the slightest criticism without lashing out like a petulant, infantile  adolescent  with unrestricted access to social media. Nothing escapes his tweeted outrage. Most recent example: Meryl Streep at the Golden Globes, eliciting this rude imbecility, “…a Hillary flunky who lost big,” and  the gratuitous dig, “…one of the most over-rated actresses in Hollywood.”

So, what do we do with an oversized, whiny, bullying pea-brain whose tantrums seem uncontrollable? Well, I’ve been a pretty good parent in my lifetime, if I do say so myself, and I’ve learned that when babies get really irritable and can’t be otherwise controlled, all that nervous energy can usually be dissipated by sucking. And based upon all the available evidence, Donald Trump is a baby who sucks big. Ergo, my new campaign, which I’ve chosen to call “Buy a Binky* for Donald”.

Given that the guy’s lack of self-control is a manifestation of extreme immaturity, excess nervous energy, and deeply seated insecurity (not uncommon in bullies), why not let him stuff a Binky into his pie hole to suck his way into more socially acceptable behavior? To accomplish this, we should, each and every one of us, send him a pacifier so he’ll have a “huge” supply, say, enough to carry him through his impeachment. After all, if he’s going to act like an out of control and immature sociopath, let’s treat him like one. You can send it to him at Trump Tower. I’ve given the address, below.

BUY A BINKY FOR DONALD!

Send a Binky to Donald at:

President–Elect Donald J. Trump, Trump Tower, 721 Fifth Avenue, New York, NY  10022

* Binky is the registered trademark of  Edgewell Personal Care Brands, LLC.

 

President Elect Trump’s Inaugural Address

I am pleased to announce that an unnamed and highly disloyal source close to President Elect Trump has hacked into his laptop and discovered a draft of his inaugural address which, as a public service, I reprint below.

INAUGURAL ADDRESS: DONALD J. TRUMP (“I wrote it and it’s HUGE.”)

My fellow Christian Americans. I stand before you today as the forty-somethingeth (shoulda taken those briefings – they’d a told me) President of the United States. To those of you who voted for me, I express my deep gratitude. To those who didn’t, F you.

My agenda for the next four years is an ambitious one, one that bears little resemblance to anything I promised during the campaign but, I can assure you, it’s gonna be great. Just to name a few things, I’m going to radiate goodwill toward all by lowering taxes on the upper 1%. These are the job creators of our economy and deserve to be rolling in dough. And in fairness, the rest of you will continue to pay and pay to support those creators. Remember, taxation of the 99% is a privilege. It’s the American way. Or at least, the Republican way.

For another example, I offer my version of the gutting of Obamacare, the worst social program ever devised by an Afro-American Muslim Kenyan terrorist sympathizer. You know what I mean. First, we kill the mandate. Then we kill preexisting conditions. Then we kill keeping dependents on until age 26. Then we kill taxation on medical devices. Yes, I know I promised we’d replace it with something great, but, hell, I haven’t got a clue what that would be. And as everyone knows, health care isn’t a right. It’s for people who can pay for it, and if 20 million people can’t pay the freight, well, screw ‘em.

We need to improve our relationship with Russia. Vlad and I are buddies, and continuing to nurture that relationship will help me financially and only marginally destroy American security. Which leads me to comment on that whole hacking thing. There’s no way that Vlad would do that just for me – to us, I mean. And actually, I’ve heard that the hackers were actually based on Nauru, with plans to invade the West Coast after bringing us to our cyber-knees. Some guy named Assange told me that.

Finally, let me say that I truly respect all people. Excluding, of course, Muslims, blacks, Mexicans, Jews – except for my son-in-law, and I’m not too sure about him  — and most anyone else who isn’t either Christian, white, male, or Ivanka. Ivanka. My little vixen!

So, my fellow Americans, let us move backward to a better time, the days of Jim Crow, no reproductive rights, and pussy grabbing without fear. After all, we are Americans, and we are going to make America great again!

Does Donald Trump Have ADHD?

We have all learned over time and especially during the course of the Republican cluster fuck of debates and primaries, and his recent performance in the first Presidential debate, that Donald Trump is a bloviating, unprepared and unqualified, misogynistic bully. But does he have ADHD? Consider the following:

  • Lack of preparation for the debate with Clinton: Was this because of an inability to concentrate on the vast amount of material that would need to be in his command for the debate and ultimately, of course, as a qualification to be President?
  • His frequent (51 by general agreement on the number) interruptions of Clinton during her allotted debate speaking time: Was this simple rudeness or a manifestation of poor impulse control?
  • His facial expressions, sniffling as if he’d just snorted cocaine, and one word or sound utterings: Were these things a manifestation of his inability to hold still and focus?
  • His frequent, disjointed, rambling answers, in which he would string together almost random thoughts separated by the nonsensical, non-contextual “because”.

I would suggest that these easily observed and impossible to ignore behaviors are sufficient for at least the suspicion that Trump suffers from adult attention deficit  hyperactivity disorder, more commonly known as “ADHD”.

And so we come to the critical question: Is the Presidency a job for someone with ADHD and its associated poor impulse control and lack of ability to focus, to be coherent, and to control his facial expressions? His appalling attitudes, social views, and political ignorance aside, do we really want someone like this to represent the United States of America both domestically and abroad?

The time to come out and vote is almost upon us. Can anyone justify the position taken by one woman who was interviewed after the debate? She called Trump a “jackass” but said that party loyalty demanded that she vote for him. Is this the immorally low bar to which we have sunk?

Yes, Clinton has made some mistakes over time, but is there really any choice here? If you care about the country, you should know the answer.

Donald Trump is a Russian Spy (Maybe)

I think that Donald Trump is a Russian spy. Here’s the evidence.

First and foremost, he is an ardent admirer of Vlad (the Impaler) Putin. Of course, I can’t be sure whether it’s political or sexual attraction to the ex-KGB guy with the penchant for going shirtless, but I’ll give The Donald the benefit of the doubt and assume the attraction is political. Philosophically, they do seem to be well aligned. And they’re both bullies.

Next, Trump supports the Russian invasion of the Crimea and feels that the US should recognize the extended Russian claims over Ukraine.

And then there is his urging of Russian cyber-intelligence to hack into US servers, especially Hillary Clinton’s private e-mail server. In other words, he’s advocating espionage against the United States by a foreign entity. One more step over the line and he’ll be guilty of treason.

Trump spends most of his time running down the country as an out of control mess, a place where everywhere you turn you expose yourself to the possibility of a violent death at the hands of people who don’t look like you (read: white). And in much of the time during which he isn’t trying to scare the bejesus out of the poorly educated and bigoted masses, he disparages the military, thus providing propaganda support for Russia. His recent attack on the parents of an American soldier, including his unconcealed racist insinuations about Muslim culture forcing the soldier’s mother to remain silent, goes far beyond the limits of decency and, again, speaks to his lack of loyalty and respect for American ideals and institutions. In this latter regard, no one is spared from his attacks, as evidenced by his recent verbal attacks on firefighters for simply enforcing limits on legal occupancy at his rallies. Firefighters!

While all this speaks to his borderline treasonous behavior, one has to ask why he’s acting this way. Could it be that he’s in severe financial trouble and needs money from the Russians to keep him afloat? Well, that’s just unsubstantiated speculation on my part, something Trump does all the time as he makes de facto accusations with implicit rather than explicit language.

Of course none of this Russian stuff explains why he also seems to be supporting ISIS. You don’t believe that he supports radical Islamic terrorist activity? For starters, just look at his ongoing denigration of America and its armed services, or his railing against what he says is the incompetence of the American government. He’s the best propaganda tool ISIS could wish for.

All of which leads me to ask one final question. Who would ever have thought that the Republicans, of all people, would nominate a modern incarnation of Benedict Arnold? Apparently all their flag waving is just a cover for the real goal of modern Republicanism: fascist, racist, ignorant dictatorship with Donald J. Trump as their anointed leader. So who’s Trump, himself, actually aspiring to be? I’ll leave the possible names from history unsaid, but you know who they are.

And the irony of all this is that Republicans brought this on, themselves. Trump is neither more nor less than the logical, inevitable outcome of years of Republican radicalism, bigotry, and waging economic and class warfare. Some Republicans are finally waking up to this ugly fact and the monstrous mess they’ve created, but party leadership remains spineless. How else to explain McConnell, Ryan, Priebus, et al., as they express their disapproval but refuse to retract their endorsement of the Party’s candidate. With gutless wonders like these at the head of the Party, is it any wonder that white supremacists and high school dropouts have felt justified in crawling out from under their rocks to support the beast?

As of today (3 August), some Party regulars are openly hoping Trump will voluntarily drop out of the race. Hah! Still no spine – just sit back, take no action, and wish for the high flying egotist to back out. The cowardice would be shocking if it weren’t so predictable. On the other hand, maybe Trump will be “disappeared” by a Russian extraction team. After all, that’s what they do when a spy’s cover is blown. And wouldn’t that be just dandy?

Of Mobs and Demagoguery: The Republican Convention of 2016

The 2016 Republican National Convention has now (thankfully) passed into history, but its effects are likely to be long-lasting. In no particular order, here is a listing of some relevant aspects of its frightening legacy, along with some observations of my own (of course).

  • The initially unlikely nomination of Donald Trump, a bloviating, bigoted, xenophobic, nationalistic, verbally abusive egomaniac has become a reality, the result of the Republican takeover by right wing extremists and evangelists. The party is now, de facto, the party of white supremacists, religious nut cases, and those with no understanding of the actual history of the United States and its founders.
  • The virtually complete takeover of the Convention’s proceedings by Trump forces resulted in trampling dissent and led to a mob mentality with behavior of the delegates that all too often (e.g., during Chris Christie’s kangaroo court performance), resembled that seen during the rise of the Third Reich. Personally, I found all those raised arms pretty terrifying.
  • Although one expects negative hyperbole denigrating the candidate of the opposing party, the behavior of the delegates as egged on by many speakers transcended the bounds of decency. Instead of being a celebration of the Republican nominee, the convention became an ugly hatefest, and if all that unites the base is hate, one wonders what Republicans will be voting for, rather than against in November.
  • We learned that Melania Trump is, as reported by the L.A. Times, an admirer of Michelle Obama, certainly an embarrassment of sorts for The Donald and others who have spent such an inordinate amount of time hating the Obamas.
  • The honesty, hard work, and dedication to principle so touted by Melania in her plagiarized speech bears no resemblance to the actual conduct of the candidate. In fact, listening to her, one would have been more than hard pressed to identify whom she was speaking about if she weren’t the candidate’s wife.
  • Every time the camera panned to the Trump family and showed his beautiful children, the only thought I could entertain was “Stepford”. In fact, so many of the women, in particular, in the arena had the same blond appearance of the Trump women that I considered the possibility that they were all programmed robots. Of course, an awful lot of the men on the convention floor looked more like beer swilling knuckle-draggers than intelligent specimens of the human species. Just sayin…but we know that Trump’s major appeal is to the white, poorly educated of our country. Just those whom we want to choose our leaders, right? And it is worth noting that this convention reportedly had fewer minority attendees than any other recent Republican convention despite the Party’s sticking some minority speakers on the program for show.
  • After the 2012 re-election of President Obama, the Republicans held that much touted autopsy on their stunning failure and came up with some reasonable conclusions about the Party’s wrong direction and what needed to be done to redirect efforts to broaden their base. The current outcome is the result of the party’s total failure to channel their own findings toward any sort of remedial action and a demonstration of how moderate influences within the party were completely overrun by the darker forces of radical religion and what now passes for conservatism but is really a complex mixture of paranoia, fear, bigotry, and a foundational philosophy anchored in preserving an American caste system.
  • Trump’s final address to the convention on Thursday night was simply raw meat for the already converted. It was a classic example of playing to white fears, denigrating the opposition, and offering no specifics while throwing out a few barely acknowledged platitudes in the vain attempt to convince a wider audience to support the ticket. And, boy, did he sound angry.
  • Neither Trump nor any other speaker acknowledged the overt bigotry and radical, chauvinistic nature of the Party’s platform, suggesting either total hypocrisy or an overt intention to deceive. In fact, if one looks at the history of VP nominee Mike Pence (Mike Pence???), one can see clearly through the deception. He is, in fact, the embodiment of the platform: a radically conservative, angry white guy out to “restore” the country to an idealized state that, in fact, never actually existed. If he and all the others of his ilk get their way, millions will lose their health care, women will once again begin dying from septic illegal abortions, climate change will be ignored, environmental degradation allowed to proceed unchecked, quality education reserved only for those who can afford it, and voter suppression will continue to run unchecked, among other “conservative” delights. Oh! Wait! It really is the Republican Party’s platform!
  • The funniest thing I heard anyone say all week came from Stephen Colbert, who commented, “Mike Pence was born after a bolt of lightning struck a jar of mayonnaise.” (See prior bullet point…)
  • In the final analysis, the 2016 Republican gathering accomplished only one thing. It played successfully to the already committed base without expanding support among elements of the public it needs to attract to have any chance of winning in the November election. Pundits say that the Party is losing more voters than it has been gaining, resulting in a net loss. We can only hope.

Unroofing the Polluted Well

Anyone who has read my blog over time knows my political views, so it will come as no surprise to read of my dismay over what the candidacy of Donald Trump has revealed about a substantial minority of the American populace. The deep dark, polluted well of bigotry and intolerance which Trump has unroofed has led to the cockroaches feeling empowered to creep out into daylight, and it has not been a pretty sight.

First, let’s review a bit of history. The founders of our country were both brilliant and selectively blind. Their brilliance, as reflected in the Declaration of Independence, the Constitution and its appended Bill of Rights, is evident for all to see. These documents have enshrined the highest aspirations for society, including certain specific rights we hold most valuable of all. And yet, these same founders permitted slavery and other forms of discrimination which, in today’s world, are seen to be totally unacceptable by most thinking, educated individuals. Unfortunately, however, it is only “most” and not all.

Within the country, bigotry exists: racial, ethnic, religious, and all tend to be generalized. Whether its anti-black, anti-Asian, anti-Latino/Hispanic, anti-Jewish, anti-Catholic, or anti-Muslim, the tendency is to paint with a very large brush. For those individuals and groups of individuals holding such views, no amount of logic or reason, education, shaming, or objective example can so much as dent their internalized biases.

Many of those harboring these belief systems understand that to reveal them to the larger public would result in significantly adverse social consequences, so they keep their views to themselves. Increasingly, however, they and their more vocal counterparts have come to feel empowered  to express themselves.

The largest, but perhaps not the only, enabling force in this has been the Republican Party which, for years, has drifted increasingly rightward under the influence of religious fundamentalists, white bigots (the so called “angry white men”, although there are many angry white women, too), and those with money buying their way into government for their own gain. Republican philosophy has become increasingly based upon policies that maintain a rigid social structure in which there is a permanent underclass that is always slighted in legislation and preyed upon by those who continue to benefit and exert ever increasing influence over legislation.

Donald Trump has become the almost inevitable end product of the Republican Party’s acceptance of, and conquest by, these expressive and controlling forces. The party of Lincoln has been co-opted by the radical right, the business elite, the NRA, intolerant religious fundamentalists, and white supremacists. One need only take the most obvious example of this over the past 8 years: the racially motivated, unending campaign to discredit President Obama by labeling him as a foreign born Muslim. As recently as immediately following the Orlando mass shooting, Donald Trump (who still supports the “birther” movement), strongly implied that President Obama was complicit in the attack. Examples abound, but who needs more than this to understand the nightmare that the Republican Party has unleashed.

The most disheartening aspect of this, aside from the fact of Trump’s ongoing support by those who feel as he does, is that influential Republicans are continuing to support him: Ryan, McConnell, Perry, Rubio(!), et al. are all placing “party unity” and irrational hatred of Hillary Clinton above their previously expressed opinions regarding Trumps behavior. This could mean one two things. Either their feelings haven’t changed about Trump but they’re simply morally bankrupt, or despite their criticism of Trump, they actually see him giving vent to their own views, which is just another way of saying they’re morally bankrupt. Either way, it’s pretty damned depressing. In the end, though, one thing is clear: the Republican Party has become neo-fascist, racist, class-conscious, angry, and militant, and has adopted a punitive attitude toward all with whom they disagree or toward whom they harbor deeply seated bias. It does not bode well as it serves to empower other elements in the country holding similar views. One can only hope that changing demographics along with an increasingly secular, humanistic orientation of the highly educated in our county will ultimately overtake and drown out the voices of anger and intolerance. It’d sure be nice.