Tag Archives: politics

“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.

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.

So Shall Ye Reap

As of today (3/5/2016), it looks as if Donald Trump (whose ancestral surname was Drumpf) is steamrolling his way to the Republican nomination for President of our now dis-United States. To quote William Bendix in The Life of Riley, “What a revoltin’ development this is!” But, then, people generally get what they deserve, and the Republican poohbahs, now all with their panties in a bunch over what, to their horror, is perhaps the impending implosion of their beloved party, catalyzed by a boorish lout with bad hair, are simply reaping what they’ve sown.

Yes, friends, I repeat: what they’ve sown. For years Republicans have worked tirelessly to undermine governmental process and inculcate anger and intolerance in segments of the population too stupid and sheep-like to know better. Pushing the notion for years that government not only is not working but is actually bad, the geniuses of the Republican hierarchy have failed to recognize that people might begin to see them as part of what’s not working. Which leads us to an understanding of why Donald Trump can (and does) say anything and people won’t (and don’t) care because he’s not an “insider”. That he’s an arrogant, misogynistic, politically ignorant, bigoted lout matters not one bit. He’s not one of them, and that’s all Republican sheep with IQs less than their ages care about.

So what’s a Republican insider to do? Probably not much that will derail the Trump juggernaut, it being too late to reverse years of sowing the seeds of discontent in people too dumb to realize that by voting for Republicans all this time they’ve been voting against themselves. Remember the guy who bitched, “Keep the government out of my Medicare!” Yeah, well, reason with that, Reince.

Is there any hope? Well, there’s despicable Ted Cruz and the pathetic hack, Marco Rubio. John Kasich at least behaves like a grown-up but, like the other two, is mired in a sort of socially repressive and punitive frontier Puritanism , apparently oblivious to, or rejecting, the validity and urgency of domestic needs that are being met in all the developed western nations except ours. So, no, there is no hope in sight for Republicans. No matter who wins the nomination, the party will continue its headlong rush into irrelevance in a changing American society. In truth, it’s hard to know which of these clowns would make a worse President for our times. Each in his own unique way reflects the mean spirited foundation of currently dominant Republican philosophy, a mindset that takes as gospel the need for enforcement of a rigid class structure with the dominant, white rich on top and everyone else oppressed below: women, nonwhites, non-Christians, and even poor whites too stupid to know they’re being scammed. Yes, scammed. Modern Republican philosophy continues to promote long discredited trickle-down theory like the hucksters of a national pyramid scheme. Give us your support, let big business bleed you dry, and we’ll make you rich. Rich, I say! Right.

So, again, I would ask whether there is hope. Well, perhaps in the other court. Let’s face it, though. Even Hillary, as smart and relatively liberal as she is, is part of the establishment. But she, at least, is not likely to deepen the hole the Republicans keep digging for the country. And Bernie? Minimal chance either for the nomination or, if lightning were to strike, the Presidency. And Grampa Bernie probably wouldn’t get very far with Congress even if he were elected. So, Hillary really is our best hope, and if we don’t see a big turnout for her in November, if we end up with one of the current crop of GOP Neanderthals in the white house, well, despite being an atheist I’ll be hoping for divine intervention.

A Few Words about a Supreme

The death of Supreme Court Justice Antonin Scalia on 13 February came unexpectedly. Far be it for me to speak ill of the departed but, having said that, I fully expect there to be many critical opinions voiced regarding his philosophy and tenure, and I suppose that mine will be counted among them.

Now, don’t get me wrong. I don’t think Justice Scalia was a “bad man”. I just think that despite his purported brilliance, he was a Constitutional Neanderthal. After all, this is a guy who reveled in his view of the Constitution as a “dead” rather than a “living” document, a severely myopic view that supported the assumed perfection of the 18th Century society and minds that created our core document. Scalia refused to face the simple reality that time brings change and, with it, the need to adapt to evolving mores, priorities, and advances in knowledge. The Founding Fathers may have been brilliant and perceptive within the context of their era and, in some respects, beyond it, but we are now well over two hundred years farther along, and American society, not to mention the world in general, has grown more complex, sophisticated, and dangerous. Justice Scalia wished to preserve the nascent state of America despite overwhelming evidence that we simply are not the country that we were at our founding..

Scalia’s domineering personality, sarcastic wit on the bench, and reactionary philosophy combined over the three decades of his service on the Supreme Court to wreak havoc on established and evolving law. Bush v. Gore, Citizens United, a blow against voting rights for minorities…in his votes in these and other cases he as well as his conservative brethren vomited their contempt in large, discrete chunks for any semblance of social equality and fairness. Out of step with his time, he helped to fuel the fires of intolerance and made a travesty of those values and privileges that most Americans, and certainly most minorities, accept as the core of what makes America America.

I believe that the long historical view of Scalia will be that he had a markedly negative but fortunately transient, dramatic impact on the legal and social environment of the country, and that ultimately his efforts failed. He will be seen as a man out of his time attempting to use his position to reinstate an imagined era he felt was better than the one in which he lived. It will be broadly recognized that, paradoxically, his strict constructionist views actually favored far less freedom rather than more. As it is with other conservatives, Scalia was a man who believed that freedom was paramount as long as it didn’t conflict with his own biases. In an era in which the conservatives who supported him rail against activist judges, Scalia was one of the worst.

And so, I will not miss Justice Scalia, but I understand why Republicans, even before rigor mortis set in, trumpeted their desire to stonewall any – any — replacement nomination that will be made by President Obama. All of which leads me to believe that we truly need a Democrat as our next President, because another angry, reactionary, sarcastic, ultra-conservative driven by a right wing political agenda (don’t forget Bush v. Gore) is the last person this country needs on the Supreme Court. It’s critical to recognize that the country is speeding headlong towards a minority majority population, and radically conservative political views are ultimately doomed, no matter what happens in the short term. The fear, however, is that a lot of bad stuff can happen in the short term. History tells us that, at some point, events simply cross a line, and people rise up, unwilling to take it anymore. If Republicans don’t allow that uprising to take place at the ballot box, they may forever regret their unswerving support for the Second Amendment. Their behavior in the wake of Justice Scalia’s death suggests, however, that they don’t yet understand what they are risking. I’d like to think they’ll come to their senses, but based upon the recent behavior and pronouncements of those seeking the Republican presidential nomination, my hopes aren’t high.