Wednesday, September 30, 2009

Polanski and L.A. law

The reason for my last blog was to point out some of the idiocies Polanski's supporters have been saying about the seriousness of his crime, and the difference between how some "celebrities" view what he did and how nearly everyone else views it.

Having already discussed that, I'd also like to add that there are some serious issues concerning his original plea bargain, lack of sentencing, and the timing of his arrest. A lot of this smells bad: serious charges of judicial misconduct for example. Even here there is ambiguity since one of the allegers of misconduct just today retracted his charge, saying he lied in the movie. I don't actually believe he is honest, but who knows? And that's the point: we don't know the facts yet. The only way this will be settled is by Polanski returning to the U.S. and having his staff of attorneys have at it. I have no idea how this will turn out, but I believe he will be well represented. His crime may have been reprehensible but that doesn't mean his prosecuters and persecuters aren't as well.

One final thing. I said that the President of France supported Polanski, but it was actually the minister of culture and the foreign minister who had jumped on the celebrity bandwagon. M. Sarkozy has been more circumspect. I was about to say "to his credit" but, of course, he has become aware of the popular reaction against the "just a youthful indiscretion of a great man" point of view of his ministers and some others.

Is child rape OK if done artistically?

Today's N.Y. Times editorial pretty much sums up my feelings on the case:

though perhaps not forcefully enough. In 1977 Polanski drugged and raped a young girl: he was 44, she was 13. Of this there is no doubt; in fact, he pleaded guilty to the essentials of the crime. There were extraneous issues: he was a holocaust surviver and beginning his career as a celebrity director; the girl was likely being peddled by her mother as a young starlet; he claims the sex was consensual and the girl looked older. These are beside the point.

Most civilized countries -- even European ones -- believe that 13 year olds can not give consent to sex with an adult. Most civilized countries believe that drugging a human to have sex is rape. What many civilized countries apparently still do not believe is that famous and wealthy people should pay for their crimes.

Some years ago I served for 3 months on a grand jury. Unlike regular juries, grand juries review hundreds of arrests -- we heard over 200 cases -- and only determine probable cause. Of the many sex cases we heard, there were three main categories. The first were cases of violent or aggravated rape, whose criminality is unambiguous. The second group consisted of relatively young people engaged in consensual sex, but with one of the partners under "the age of consent" (18 here in Massachusetts). This constitutes statutory rape -- rape under the law's "statutes". Many if not most of these cases were travesties, typically a young man making love with his somewhat underaged girlfriend. Totally consensual according to both parties, but usually brought to the attention of the police by the girl's parent(s) who were reluctant to accept either the boy or their daughter's sexuality. Because of the nature of the law we were obliged to forward these cases to trial. Our jury was made up of a broad cross-section of citizens, but nearly all of us hoped that the legal system would be lenient on most of this class of defendents.

The third type of case involved an older person -- invariably male in our experience -- who preyed on young children. Often this child was the son or daughter of the older person's spouse or partner, who herself was often an enabler or almost willfully ignorant of what was going on. We really hated these cases because of the self-centered often icy viciousness of the perpetrator. To a person we felt that the statutory rape laws were most justified in deterring and punishing such behavior. The Polanski case reminds me exactly of my experiences in these grand jury cases.

The interesting phenomenon in this story is that when it broke all the news media were full of the indignations of the jet-setting and connected. Famous folk, from Hollywood's elite to the president of France, were tut-tutting the U.S. for somehow being anti-art, anti-culture and once again so, so ... barbarian... in trying to bring to justice a gifted celebrity who had raped a young child, served 42 days in prison, and then skipped out illegally before sentencing. But then we began to hear from the large numbers of people who thought that maybe drugging and raping a child should entail some penalties other than having to pay expenses for jet travel and maintaining two international mansions outside the U.S. See, for example, some of the letters and comments in your local newspaper. The Huffington Post, which printed a lot of star blather about Polanski, received outraged letters from its readers, who in a lopsided ratio supported equal application of the laws to everyone. Check out British opinion in: .

I think "liberals" better be mighty careful in dumping on the U.S. for protecting children from sexual predators. Many American policies are deplorable, but this ain't one of them.

Tuesday, September 29, 2009

Abortion and healthcare

Anti-abortion activists and politicians want an outright ban, in healthcare reform proposals, on government subsidies going to any healthcare insurer that pays for abortions. This means that any insurance company that pays for abortions can not offer its plan to individuals who obtain government subsidies; this would include, under plans under consideration, anyone earning up to 300% (400% under some legislation) of the poverty level.

According to the N.Y. Times,

"Democratic Congressional leaders say the latest House and Senate health care bills preserve the spirit of the current ban on federal abortion financing by requiring insurers to segregate their public subsidies into separate accounts from individual premiums and co-payments. Insurers could use money only from private sources to pay for abortions. "

Anti-abortion advocates reject this, claiming (probably correctly) that the this segregation is a purely bookkeeping fiction, since the money eventually comes from the underlying pool of company assets. In other words, the money from either account can be used to support operating expenses etc., removing this expense from the other account. Ultimately, of course, their goal is to prevent anyone from getting an abortion at any time. Their proposed outright ban would pretty much eliminate all abortion coverage under new healthcare programs, since insurance companies providing such coverage could not be part of any new national program -- all of which offer subsidies -- hence would be effectively put out of business. Thus, women who now have this coverage, which is nearly all women with private health insurance, would lose it.

(I don't know what the anti-abortion people are willing to concede about abortions for pregnancies due to rape or incest, or to save the life or health of the mother. Some take a pretty hard line even in these cases.)

Obama, of course, should reject such a ban outright, since it would effectively make his support for abortion rights during his campaign a mockery. What he should do is say: "OK, you want to play hardball, let's be consistent here. Any organization, including a church, which gets government subsidies of any sort, including tax exemption, must be strictly prevented from using any of its money -- publicly or privately provided -- for any sort of political speech or advocacy. This includes supporting or opposing any political candidate or party in any way in any campaign. For example, church leaders may say abortion is wrong, but they may not instruct their flock to vote in any way on the issue. To do otherwise would violate the separation of church and state and the provisions of the tax code. Violators would lose any government grants as well as their tax exemption. Similarly, any organization which uses any part of its budget for religious proselytizing cannot receive any federal funding."

This kind of strong statement is, in fact, merely asking that current rules be obeyed strictly, which they haven't been for decades. Religious organization have long claimed that their budgets are "segregated" into work that is public and work that is religious in nature. But, as the opponents of abortion payments in healthcare have said, this segregation is purely a bookkeeping fiction.

Would Obama or any of the Democratic wimps actually have the guts to make everyone play by the rules?

Monday, September 28, 2009

Obama as "referee"

There have been reports that President Obama will be asked to "referee" disputes among Democrats about features of healthcare reform that will appear in congressional bills -- especially the Senate bill that is now identified with Sen. Max Baucus.

Well of course!

What is long overdue is some Democratic party discipline. Obama has to spell out to the party what he absolutely needs from a health care plan, and then the party has to write it into the bill and present a unified front in supporting it. I'm sure that there are ways of twisting arms -- especially for a majority party. Senators Ben Nelson and Mary Landrieu, for example, have to be presented with an ultimatum: support a bill that the vast majority of the party supports, or face the consequences in terms of committee assignments or party support for some future bill that they want, or party support for their own re-election campaigns.

Are Democrats prepared to play hardball or do they want to lose the health care battle once again and sink to minority laughingstockness yet again. If Obama can't exercise strong leadership in his own party, what's the point of having him president?

I have nightmares about an escalating and perhaps unwinnable war in Afghanistan and another lost battle for healthcare. It's all the disadvantages of LBJ (war) and none of the advantages (Civil Rights Act, Medicare).

Sunday, September 27, 2009

More on Medicare and Advantage from N.Y. Times

Today's Times has an editorial making some of the same points I made yesterday. Here it is:

Friday, September 25, 2009

The Disadvantages of Advantage plans

Republicans are now trying to convince people who use and depend on Medicare that reforms to the program will cost seniors important benefits. This should be unconvincing, coming from the party that largely opposed Medicare (see since the inception of the program.

The party of the rich has been pointing to a Congressional Budget Office (CBO) report that under proposed health care reforms, the government would severely cut and probably eliminate the so-called Medicare Advantage (MA) plans. Maybe 20 - 25% of America's seniors belong to such plans. As a result of these cuts, the GOP is claiming that Medicare recipients will see their benefits decrease. How likely is it that the party that fought Medicare is correct in charging that the party that created Medicare is trying to harm its beneficiaries?

Here's some background. The basic, straightforward Medicare program came first in 1965 (under LBJ). This established parts A hospital (patients pay deductible but no premiums) and B doctors (patients have copays + premiums) coverages. The part B copays are 20%, but part B is optional. Later (1997) a Medicare + Choice (M+C)plan was created which enabled subscribers to buy insurance covering the hospital deductibles and doctor copays; in this simple form it is often called Medi-gap or "supplemental" Medicare, and is offered by private insurance companies.

It was theorized in 1997 that Medi-gap would be very popular, and its no-frills price would be kept low by competition among insurance companies. However, in 2003 the Medicare Modernization Act (MMA) established the Drug Benefit or Medicare Part D as well as the existence of the MA (Advantage) plans. Both of these aspects resulted, arguably, from the Republicans traditional desire to help big business. In the case of Part D it was "Big Pharma" -- the pharmaceutical industry -- and in the case of the MA plans it was the insurance companies. For the drug plan the collusion was out in the open. Far from promoting competition, the MMA explicitly forbid the government from negotiating favorable rates with drug companies; it also established the infamous "doughnut hole": the interval of drug expenses uncovered by Medicare, where seniors were often forced to chose between their prescription drugs and food or rent.

The Advantage plans were another story, puncturing once again the tired myth that elimination of regulation combined with the "free market" would lower costs through competition. Under these plans, the entire benefit that a retiree would have under Medicare -- and then some -- would be directed to an insurance company. In other words, Medicare would not pay doctors directly, but pay the premiums for a private insurance plan. The consumer is effectively out of the loop. The only protections are from cancellation or rejection due to health risks or pre-existing conditions. (Also, by law, seniors can opt out or change plans once a year.)

In theory, MA plans offer extra benefits above doctors' care; these sometimes include dental or optical care, or extras such as free health club memberships and certain preventive measures such a periodic check-ups and tests. Because the benefits are set by the insurance company, the theory is that competition, control of the level of care and medical salaries, and preventive care, would keep medical costs down, hence keep the rates charged to the government Medicare system low. One of the main tools created for doing this was the HMO or Health Maintainance Organization, a group of doctors, nurses and other medical personel contracted by the insurance company to handle each patient's total medical care.

And here is where "rationing of healthcare" became manifest. Since HMOs are under contract to the insurance companies, there is an obvious tension between their direct expenses in the form of therapies and doctors' hours, and their reimbursment by the insurers. Since Advantage plans by-pass the Medicare 20 - 80% copays, they can charge the government more -- which they do. They also put the squeeze on the HMOs., which is, in turn, reflected in less choice for the patients and more restrictions on procedures and visits covered; thus, what get what we now call rationing.

In reaction to actual rationing and perceived rationing, other types of care plans were invented -- alternatives to HMOs. These include PPOs, which offer more flexibility in which doctors a patient may see. There are also PSOs, in which groups of health care providers themselves replace the insurance companies.

Finally, insurance companies and many -- maybe most -- HMOs or PSOs are for-profit organizations, which have obligations to stockholders and highly-paid corporate officers.
The result has been exactly the opposite of what was initially promised. Medical Advantage plans became more expensive -- about 8% more -- than pure Medicare FFS (Fee For Service). Also, according to many studies, there is no hard evidence that these plans actually provide more or better care for their members, in spite of the eyeglasses and health clubs. However, the government is still subsidizing MAs to the tune of the extra 8%, which amounts to billions of dollars annually. Meanwhile, healthcare costs are going up at a rate about 3 times the rate of increase in family income.

There is simply no reason for the government to subsidize insurance company and for-profit HMO stockholders and executives. Advantage plans are not improving hardly anyone's health care and their existence is yet another straw breaking the Medicare camel's back.*

Monday, September 21, 2009

Baucus' ugly bill

The health plan from Sen. Max Baucus (D Mont) is about as bad as such a plan could be without being the product of a Republican. In particular, there are two aspects which are particularly egregious.

I. The "free ride" provision determines what happens to those business which don't provide health care. Instead of levying a fee on them proportional to their salary pool (about 8% under the House plan), the Baucus proposal exacts a paltry fee computed in the following way. It is the lesser of (a) $400 times the total number employees, or (b) the average subsidy of the subsidized workers (those whose incomes don't exceed 300% of the "poverty level") times the number of such workers.

Simple calculations show that this heavily discourages businesses from hiring subsidized -- low-income -- workers, especially those with children. On his blog, Ezra Klein of the Washington Post has some illustrative examples of how this works; go to:

Furthermore, the amount of revenue that this provision would generate is so low, especially in comparison with the House bill, that it won't generate much revenue and, more importantly, won't encourage businesses to pay for health care for their employees. In fact, it will force the federal government -- viz. the taxpayers -- to cough up more money. This is something that Obama should nix from the get-go, but so far he has remained silent. Let's hope this provision is dead in the water.

II. The disparity in premiums that insurance companies are allowed to charge under the Baucus plan is excessive. Under the House plan, for example, insurers can charge older workers, who on average consume more health care benefits, only up to twice what younger workers pay. Under Baucus' plan this multiple could be as much as five times. Coincidentally, this is the recommendation of the insurance companies' propaganda group America's Health Insurance Plans. Charging huge premium differentials to higher risk groups is good for profits, but defeats the whole purpose of insurance, which is to spread the risk. If insurance companies could predict the future and determine exactly who would have an auto accident or need medical attention, and only charge those people premiums, it would save everyone else lots of money but it wouldn't be insurance.

This is exactly typical of the extreme anti-cooperative, anti-help-your-neighbor attitude of faceless corporatism. It is anti-human nature as well. Poll after poll and survey after survey show that we want to help our neighbors and share the risk. Corporations are designed to limit liability of, and make profits for, their shareholders; they collude but they don't cooperate. This is another good reason why corporations should not be considered individuals and granted the rights that human beings have under our constitution. Unfortunately, the Roberts court is in the process of doing just that in the context of testing the limits imposed on corporate political spending.

Finally: Baucus of course rejects the "public option," replacing it with the plan to allow independent "co-ops" -- the weakest alternative to nothing. The point here is that, if all insurance is sold through the private sector, it is necessary to be able to negotiate low prices with insurance companies. Without being in a group plan through a large employer, a consumer has little bargaining power -- the insurance companies will "skim off" the healthiest of such applicants. What's needed is a group once again large enough to spread the risk, so that there will be a statistical mix of consumers of various likelihoods of medical need. Many small co-ops will play into industry hands. Absent the public option, the best way to gain statistical bargaining power is by having negotiating pools of at least the size of a state; however, a national purchasing co-op is even better; Jay Rockefeller's Amendment #5 (also known as Rockefeller 185) to the Baucus' bill creates such an entity. It is available, along with all current amendments, on the Senate web page ( Here is a description of Rockefeller's provision:

This amendment would strike the provisions to establish state exchanges, multiple competing exchanges, and regional exchanges, and create one national exchange implemented and regulated by the U.S. Secretary of Health and Human Services (HHS). One, single exchange would minimize insurance enrollment churning, lower administrative costs, and improve the value of benefits and coverage while lowering premiums by creating a larger risk pool.

This, and Rockefeller's other amendments, are all good and deserve support.

For another list of amendments, see Igor Volsky's summary at:

Friday, September 18, 2009

Carter, Racism and the G.O.P.

As far as I am concerned, a Republican politician from the Deep (secessionist) South is suspect when it comes to racial matters. Here's why.

As we all know, the Democrats were the original pro-slavery, states' rights, and pro-segregation party in the U.S. It was Lincoln and the newly-formed Republican party -- "radical Republicans" as they were almost uniformly referred to in Dixie -- that was hated down south during the Civil War and Reconstruction. Oddly, it was a coalition of northern liberals and southern segregationists that enabled Roosevelt to pass his New Deal legislation. Roosevelt apparently did little if anything to disrupt this rather strange group of bedfellows since lynchings, poll-taxes and other parts of Jim Crow thrived until the passage of civil rights legislation near the end of the 20th century.

However, under Richard Nixon, there was a major realignment. It's not that the Republicans overtly embraced racism -- in fact, the party had a pretty good record in support of civil rights laws -- at least until fairly recently. Everett Dirksen, a G.O.P. senator from Illinois (and champion of the marigold as national flower), was a leading ally of Hubert Humphrey and Lyndon Johnson in getting anti-Jim Crow legislation passed. However, the Republicans, following Nixon's advisor Kevin Phillips, made it clear that they were the loyal supporters of the political views and goals of Jim Crow intransigence: anti-Federalism, revisionist descriptions of the Civil War -- or, as they like to call it, "the War Between the States" -- and, especially, States' Rights. I think it was Kevin Phillips himself who told the G.O.P. not to bother opposing civil rights laws: it was not necessary. Just paint the Democrats as the party of the urban north and "government interference." People will then automatically blame them for more black voters and black mayors. Rabid anti-communism was another tool, since, whatever its many failings, the C.P.U.S.A. was a major advocate of unionism and racial solidarity. Ronald Reagan's anecdotal images of "Welfare Queens" driving Cadillacs, and general attacks on social programs -- which, in point of fact, benefitted the rural poor as well as the largely black urban poor -- reinforced the message: We Republicans understand your resentments against the big Federal government -- "you know what we mean..."

Nixon and Reagan both pursued Phillips' "Southern Strategy" by making so-called "conservative" judicial appointments throughout the courts. Here "conservative" means most likely to support states' rights and find fault with social and pro-labor legislation. (Nixon went too far in trying to appoint overt reactionaries Clement Haynsworth and G. Harrold Carswell to the Supreme Court -- but even the Congress wouldn't buy them and they were rejected.)

Black people throughout the United States got the message as well as anyone. They went from lovers of "father Abraham" and the Republicans to the most dependable block of Democratic voters. The solid Dixiecrat south went from Democratic to Republican.

Politicians like Joe Wilson owe their offices to this realignment of the parties, which had tacit but well-understood messages. Wilson was one of the few South Carolina politicians who actually voted to keep the Confederate flag flying over the South Carolina statehouse.

The upshot of this is: Even if you don't say anything overtly racist, the fact that you benefit from racism and try to thwart those fighting it, makes you legitimately open to the charge that you are a racist. It is in this sense the Jimmy Carter is quite justified in raising the issue about Joe Wilson and some of the G.O.P.'s more virulent Obama haters.

Thursday, September 17, 2009

Pulling your LEGS

OK, I've been reading about toxic mortgages and credit default swaps and things like that. So, here's a new idea for "Life Estate Generated Securities" or LEGS: just in time for baby-boomer senior citizens.

In case you didn't know about them, "life estates" are ways for older citizens to qualify for Medicaid or other subsidized programs by giving away their homes to -- as is most usual -- their children. The point is that Medicaid has an income and asset limit to qualify, with a 5-year lookback. So, by giving away their homes at least 5 years before they might want to use such a program, this enormous asset doesn't count against them. (There are probate advantages as well.) However, many seniors are fearful that their "dear relatives" may eventually throw them out of the homes which are no longer theirs, or give control of the home to a golddigging future partner. So life estates have the provision that the donor retains the right to live in the house (now owned by the donees) for as long as he or she wishes to (or is alive), with the provision that the donor remains responsible for taxes and upkeep. Let's call this the Right.

Now the interesting thing is that this Right to live in the house is actually worth something, and is legally transferable. The worth is determined by formulas based on statistical estimates of the donor's life span (remember, the Right only persists for as long as the donor is alive). Thus, the donor could sell the Right on the open market, which would give the buyer the Right to live in the house (even though it is owned by the donees) for as long as the donor is alive. The face or base value of the Right is determined, as I said, by government longevity statistics; however, the value the market places on it could vary considerably, depending on cost of housing and the average age of the donors. Of course, there is always the risk that the donor could die shortly after the sale of the Right, rendering it worthless.

So here's a thought. Some enterprising entrepreneur or investment group or bank could buy up many of these Rights from seniors who no longer need them since they are about to enter assisted-living or nursing homes. They then bundle the Rights into security-like packages and make a market in them. Initially they would be discounted based on the statistical likelihood that certain of the Rights would become worthless due to the demise of the donors. These are the Life Estate Generated Securities or LEGS mentioned above.

Who would buy such securities? People interested in short term (several years) housing, or people interested in providing such housing for others -- say for senior-citizen tourists (beats RVs, after all), the homeless, or visiting academics etc.

Now we apply the subtle ideas from the recent past: create insurance policies on these LEGS. After all, you don't want to be caught with a bagful of LEGS whose donors die too soon. Then you create a market for these policies themselves...

As a calculus teacher, I always loved derivatives.

Somehow this reminds me of the Yiddish saying: "If the rich could pay people to die for them, the poor could make a good living."

(Anyone know the actual Yiddish for this?)

Tuesday, September 15, 2009

Back from Maine

We just got back from a mini-vacation in Central Maine: beautiful weather, good gardening, hiking and cycling, even a bluegrass festival. Makes one forget politics -- at least for a while.

Caught Obama's speech on the radio (no TV) and thought it was pretty good.

More later.

Tuesday, September 8, 2009

Economics and Jurassic Park

In this past Sunday's NY Times Magazine, economist Paul Krugman has an interesting article "How Did Economists Get It So Wrong?"; it can be found here:

It is incredible that economists could believe that they could use mathematics to "prove" anything beyond the simplest and most basic propositions about very simple systems. First of all, the factors that contribute to the behavior of anything of any real interest in macro-economic (large-scale state or national) systems are huge in number and interact in very complicated ways. Some of this is psychological (the minds and fears of investors), some of it is physical (time-related interactions of supplies, demands etc.) and some of it is the interrelation of the two (fads and panics caused by perceptions of actual fluctuations).

Now it is true that we are not talking about trying to understand, mathematically, the behavior of individuals or individual commodities or economic quantities. Just as fluid or statistical dynamics in physics tries to understand the overall gross behavior of gases and liquids, so economists try to understand the overall behavior or interactions of large economic groups and quantities. Just as in physics, however, the mathematics nearly always leads to equations (actually, differential equations) that are non-linear, hence "unstable" or chaotic. This means that the solutions of the equations, describing the evolution of the system, depend on knowing the initial state of the system in excruciating detail. In fact, as in weather forecasting (an application of fluid dynamics), knowing anything even modestly far into the future (more than a few days) requires initial knowledge so precise as to be impossible in practice or in theory to obtain. We will never be able to predict weather accurately more than a week or so in advance.

Thus, the second reason why mathematics can't "prove" complicated theorems in economics is that economic prediction is inherently non-linear, hence inherently chaotic. Without theoretical stability, even defining things such as the true or exact worth or value of a product or commodity is not really possible. One has a way out by simply stating that a quantity is worth what the market at any time says it's worth, but this removes any content from the statement that "the market always values a quantity at exactly its worth". The only way such a tautological statement could be of use would be if one could predict, with accuracy, what such a value would be in the future. But this prediction is exactly what can't be done -- as we've seen recently in the case of house prices, which weren't supposed to be so unstable, and the predicted values of certain bundled mortgages say, or credit default swaps and other financial constructions, which are even now unknown.

The problem is a little like the situation in the book/movie "Jurassic Park" where the scientists and engineers theorized that they had figured out exactly what could or couldn't happen to the dinosaur clones. The mathematician Ian Malcolm pointed out that such a theory could not hope to be 100% correct because of the chaotic element in such a complicated system; hence, their complacency was dangerous. Sure enough, aberrant human behavior plunged the system into chaos, and the proof that the number of velociraptors was limited -- depending on the sterility of an all female population -- turned out to be exactly wrong. While calling this application of "Murphy's Law" Chaos Theory is perhaps a bit overblown, there is nevertheless a strong germ of mathematical truth in it.

Whatever hope there might be in protecting us from economic disaster (or from T. Rex clones) lies in vigilance and multiple layers of protection. "Jurassic Park" is just a story, but we have yet to learn this lesson on the very real economic front.

Monday, September 7, 2009

Fahrenheit 451

There is a new version of Ray Bradbury's "Fahrenheit 451", redone as a graphic novel. It is the joint work of Bradbury and Tim Hamilton. I intend to pick up a copy.

I remember reading this short novel as a kid in the mid 1950s, several years after it was written (1953). Bradbury was well-known to us Sci-Fi buffs through his collection "The Martian Chronicles" and other works. This time was still near the high-water mark of McCarthyism and any book (or play or song or movie) about free speech or book-burning automatically came with at least a slight frisson of fear. Politicians, writers and teachers all were conscious of what they said and how it might be interpreted. This is not to say that everyone was cowed -- far from it -- but this wariness was in the air, and it certainly filtered down to us teens.

Bradbury did not intend this novella to be a statement about free speech and red-baiting; in fact, he has specifically said that he was more concerned about the effects of increased TV watching on the reading of books -- on the future of books in general. But everyone I knew interpreted his story as an attack on anti-intellectualism and political thought-suppression (which I'm still sure it was -- at least partially -- no matter what Bradbury says).

The story is about the "fireman" Guy Montag. I still remember the chilling moment when I realized that he was a fireman in the sense that he made fires -- to burn books. In this view of the future, books are despised and suspect, and when discovered are destroyed by professional burners like Montag. I don't remember the details of the plot any more -- that's why I want to read this new version. Even if I did recall, I wouldn't ruin it by revealing it in this blog. I can say that Montag is led to question his profession.

A movie was made of the novel in the mid sixties by Truffaut, starring Oskar Werner and Julie Christie. I saw the film and recall liking it, though I think it took liberties with the book. I hear a remake is being planned.

If you have any comments on either the original or new novel, or the film, please send them in.

Thursday, September 3, 2009

Lessons from Roosevelt

The Times of Thursday, Sept 2 had a very enlightening column by Jean Edward Smith (Roosevelt biographer) entitled "Roosevelt: The Great Divider"; it can be found here:

I really wish Obama were more like Roosevelt. Heck, I wish any national Democrat these days had Roosevelt's spunk.

Saving money on healtcare: PCPs etc.

You can save money in a healthcare plan in two ways. One is to control the "supply side" -- i.e. the amount charged by either the insurer or the actual care provider (hospital, doctors, drug supplier). The other is to control what the consumer chooses to purchase -- the "consumer side."

Conservatives, who purport to believe in individual choice, pretty much believe in saving on the consumer side. This usually means offering the healthcare purchaser financial incentives to purchase less healthcare. Ways to do this are to present high deductibles and large co-payments, with certain tests and procedures made particularly expensive. Briefly, this is controlling costs through worse care -- John Mackey's position, discussed in previous blogs. Most of us generally have little medical expertise and can not effectively choose between expense and safety. When you have to pay for tests, you tend to get fewer tests. Sometimes this is OK (saves money) sometimes not (you get much sicker). Statistics show that consumers exert almost no leverage on actual prices charged, just on the care they get or afford. This is the plan most insurance companies prefer, since they have to provide less and can always blame poor outcomes on bad consumer choices (rent and food over higher premiums). Is it at all realistic to think that patients will argue with their doctor to keep expenses down by questioning various tests and procedures that the doctor prescribes? Conservatives, in order to defeat healthcare reform, have whipped up a storm about healthcare "rationing." But this is contradictory: you can't ask people to resist rationing and then ask them to argue against their doctor's recommendations.

Non-conservatives tend to favor regulatory controls over health care which include forcing rates to be affordable and requiring insurers to pay for "pre-existing" conditions. Hardly anyone could directly argue against this in principle, but regulations have to come from government, and by trying to discredit government at every turn, convervatives in effect are advocating the status quo where largely unregulated insurers control healthcare.

I personally think that it is essential for every patient to have a Primary Care Physician (PCP) who is familiar with the patient's entire medical history and can help make decisions about tests, procedures and medicines. (PCPs used to be called "family doctors.) These days, PCPs are found in all Health Maintainence Organizations (HMOs) and in some PPOs (Preferred Provider Organizations) as well; they are often assisted by highly-trained Nurse Practitioners. PCPs can help control expenses by filtering out unneeded or redundant tests, and by helping make informed and realistic decisions about treatments and medications. PCPs are particularly crucial when you have to be hospitalized, because a whole new set of doctors become involved. A close family member of mine who didn't have a PCP to check on her care was badly medicated when returning from a hospital stay because there was no single person who knew her history and could spot a duplication of medication on one hand, and a contradictory series of prescriptions on the other (all from two sets of hospital physicians who did not coordinate their treatments). This kind of thing happens all the time.

Tuesday, September 1, 2009

The rights of corporations

It is unfortunate that there is a split within progressive ranks on the issue of corporate rights to publishing and promoting partisan material . This all proceeds from a corporate-sponsored hatchet job about Hillary Clinton. On one side is the group which recognizes the danger of powerful businesses distorting the political process. On the other side are those, like the ACLU, who see suppression of this "documentary" by campaign reform laws as a blow at free speech.

Sorry, but both sides miss the real point, which is the treatment of corporations as if they were people having the protections afforded by the Bill of Rights. Even though this concept is supported by the usual knee jerk conservatives, it is an example of judicial activism from the 19th century. That era saw the amassing of tremendous economic and political power by the railroads, banks and other corporate entities. The turning point was the infamous case of Santa Clara County v. Southern Pacific Railroad (1886) which established that these entities were the equivalent of individuals, and hence had human rights. This case specifically determined that the 14th ("due process") amendment, passed to protect ex-slaves, applied to corporations as well. It opened the door to the application of the other amendments also. Surely the "Founding Fathers" would have been outraged -- especially Thomas Jefferson. American "conservatives", who supposedly abhor judicial activism, have eaten it up, thus showing that conservatism in the U.S. is simply another name for protection of the rich and powerful.

The rift within liberalism caused by the Hillary Clinton work is easily remedied: pass laws explicitly declaring that only human beings have the rights guaranteed by our Constitution. This would go a long way toward restoring the true support for human freedom that this country was based on.