Category: Healthcare

Back to the Plantation

Back to the Plantation

One of the vestiges of the plantation system which depended on slavery for its existence was the racial divisiveness perpetrated by economic elites to maintain their power and control over both blacks and whites. In simplest terms, this translates to “divide and rule.”

“You are kept apart that you may be separately fleeced of your earnings,” Georgia populist leader Tom Watson told a gathering of white and black laborers in 1892. ““You are made to hate each other because upon that hatred is rested the keystone of the arch of financial despotism which enslaves you both.”

Lyndon Baines Johnson, who rose through the ranks of Texas racist politics to become the president who, after decades of helping block civil rights legislation in the House and the Senate, fostered passage of the Civil Rights Act of 1964, once related essentially the same theory to Bill Moyers. In classic LBJ style, Johnson told Moyers, a Johnson staffer before he became White House Press Secretary and, later, a journalist, “If you can convince the lowest white man he’s better than the best colored man, he won’t notice you’re picking his pocket. Hell, give him somebody to look down on, and he’ll empty his pockets for you.”

Women March on Washington
Women March on Washington, August 28, 1963. Library of Congress.

This was a theory I first learned in the aftermath of the civil rights movement of the 1960s. It made sense to me then, and it still makes sense to me, though the nature of those elites have changed during the intervening half century, as have their tools. And it wasn’t just white populists who laid out the theory, plain as day for anyone who cared to look.

The white liberal and the new plantation

The white liberal is the worst enemy to America and the worse enemy to the black man.”

That’s not a quote from Sean Hannity or Rush Limbaugh. It’s a quote from Malcolm X, the black liberation theology leader and firebrand, who said it about the same time LBJ was getting the civil rights theology and launching his War on Poverty, and not long before Malcolm X’s assassination on February 21, 1965.

The white liberal aren’t white people who are for independence, who are moral and ethical in their thinking. They are just a faction of white people that are jockeying for power,” he said. “The same as the white conservative is a faction of white people that are jockeying for power. They are fighting each other for power and prestige, and the one that is the football in the game is the Negro, 20 million black people. A political football, a political pawn, an economic football, and economic pawn. A social football, a social pawn.”

Malcolm X
Malcolm X. Source unknown. Used under Fair Use.

Malcolm X’s message – it’s worth reading the full quote, which is quite long – was that blacks need to solve their own problems and not depend on whites of either persuasion, liberal or conservative, Democrat or Republican, since for either of them it’s just a game of power and control.

The worst enemy that the Negro have is this white man that runs around here drooling at the mouth professing to love Negros, and calling himself a liberal, and it is following these white liberals that has perpetuated problems that Negros have. If the Negro wasn’t taken, tricked, or deceived by the white liberal then Negros would get together and solve our own problems.”

Now, 55 years later, Malcolm X’s message still hasn’t gotten through to many African Americans, much less to both white and black people who continue to pursue and support policies that effectively keep blacks, and all people of the underclass, down on the new plantation. I’m reminded of his message watching the multi-millionaire Nancy Pelosi and her hypocritical House Democrats kneeling in Kente cloths draped around their necks, and as trendy young white people proclaim on social media that they “stand against racism,” as if any right-thinking person doesn’t stand against racism, any less than someone might stand against kicking puppies or drowning babies. Or as politicians, lacking as much in balls as brains, call for disbanding the police, when it is black people who will be the main victims of the lawlessness, violence, and vigilantism that inevitably would ensue.

Look at what people do, not what they say

By way of disclosure, I’ve never considered myself a liberal, even during my radical phase (aspects of which persist). Like Malcolm X, I’ve never trusted self-proclaimed liberals who always have struck me as having ulterior motives or who operate under some sort of misplaced guilt or, at best, a Pollyannish view of the world. I tend to discount what people say in favor of what they do and, even more, the results they obtain through their actions and policies. This is highly relevant if you want to see the principle of “divide and rule” at work in contemporary liberal politics.

Consider this crucially important fact: While the U.S. has spent somewhere north of $22 trillionthat’s trillion, as in a thousand billion or a million million dollars, 22 times over (by some estimates, depending on how you count it, it’s closer to $27 trillion) – since LBJ declared the War on Poverty in his 1964 State of the Union address, the percentage of the population living in poverty has hardly changed at all in the past half century. Given that in the most recent normal year total U.S. GDP was just over $21 trillion, that’s a powerful lot of money to garner zero real reduction in the poverty rate. How can this be, you ask?

Look at the charts, below, to get a visual picture of the reality. What we see is that poverty was in major decline beginning in 1959, five years before Johnson’s declaration of his war on it. That decline continued for another five years, running through 1969. Beginning in 1970, a full 50 years ago, there has been essentially no long-term change in the poverty rate even as the country threw trillions of dollars of the national treasure at it.

As is visible, there have been blips up and down through both Democratic and Republican administrations and congresses, but the same overall reality persists across the span of a half century. As the third chart demonstrates, the African-American poverty rate has shown, marginally, the most improvement, especially when compared with the Hispanic and general poverty rates. But an interesting and undeniable reality emerges when you look at the first and third charts: The highest recent poverty levels in all three key categories – African-American, Hispanic, and the general population – peaked during the Obama administration, and all three reached historic lows during the Trump administration. How can this be, you might ask, given that Obama is painted as a friend of the poor and minorities and Trump is portrayed not only as their enemy, but as an out-and-out racist?

Like I said, get below the rhetoric and the reality emerges. Clearly taking the brakes off the economy and creating jobs that lower the unemployment rate and empower individuals and families, as Trump did in stark contrast to the effect his predecessor’s policies had on the economy, provides a road map for reducing poverty. Jobs are a key factor, if not the only one, in poverty reduction. There are other factors at work, too, and we’ll look at them toward the end of this piece.

Follow the money

Follow the money” is a phrase that we learned from Deep Throat during the Watergate scandal of the early 1970s. It’s salient to our discussion here.

I had a sociology professor when I was an undergrad at Rutgers University sometime in the late 1960s. I don’t recall his name, but he was a black man, and I always looked forward to his classes. One thing about him was that he was straightforward and honest in his discussion of social issues and didn’t try to promote any ideology, something that seems to have become a hallmark of more recent sociological education (I can say this having since been a professor of sociology myself and seeing the ideological blather in the text books, and ostensibly believed by other professors, that is fed to students in the field).

In any case, my professor had previously worked with an anti-poverty agency on Long Island in New York. He told us how this agency had spun its wheels “studying” how to provide low-income housing to people, how much money passed through it, how it debated one approach and another approach, and in the end, not a single unit of housing was built. My professor said that, had the money the agency spent been given to the people it ostensibly had been set up to help, every one of those families could have gone out and bought their own house.

Sadly, my professor’s example is far from a unique case, given the trillions of dollars spent on “helping” poor people over the intervening five decades without any real effect (a similar calculation was made for FEMA’s spending after Hurricane Katrina when it was determined that the money the agency spent bureaucratically could have paid for a new house and two new cars for everyone who lost their home in the storm, and that, too, is far from unique).

If you still have any doubt that the vast bulk of the money spent fighting poverty doesn’t go to the people in poverty, the chart below should dispel that doubt. As per-person spending has climbed inexorably over the past six decades, it certainly hasn’t gotten to those in need of the funds. As per-person spending approaches $20,000, the poverty level this year for a family of four is set at $26,200. If the preponderance of the money went to that same theoretical family, they’d be receiving nearly $80,000, a long, long way from the poverty level. Needless to say, that’s not where most of the money goes.

When you look at the sheer volume of money involved, is it any wonder that those into whose hands, and pockets, it passes want to be sure to keep their constituents in poverty? In this context, what is said about one party in particular, the Democratic Party, that it depends on the existence of a permanent underclass for its very existence, begins to make sense and takes on credibility. Looking strictly at the numbers, the existence of poverty, maintaining as many people as possible dependent on the largesse of what passes for anti-poverty spending, bolsters its electoral power and, more, furthers the interests of its power brokers while favoring their influence and their wealth. They are the new plantation masters.

Down on the urban plantation

It’s a clever ploy, a revival of “divide and rule” for more than half a century, and the Democratic Party continues to rely on this strategy, keeping its black constituents down on the urban plantation, well into the 21st Century. Consider for a moment these facts:

  • Democrats run 35 of the nation’s 50 largest cities (37 if you count the “Independent” mayors of San Antonio and Las Vegas, both of whom ran with Democratic support).
  • Democrats run 15 of the 16 cities ranked the worst-run cities in America in 2019 by WalletHub, including Washington, D.C., which came in 150th out of 150 cities ranked. Other cities in the bottom 16 include Los Angeles (ranked 135th) , Philadelphia (137th), St. Louis (139th), Chicago (140th), Cleveland (141st), Oakland (144th), Detroit (145th), New York (146th), Chattanooga (147th), and San Francisco (148th). Gulfport, Miss., ranked 149th, is the only one of the worst-run cities with a Republican mayor. The only big city to rank in the top 10 of best-run cities was Oklahoma City, also with a Republican mayor.

    Detroit decay
    Detroit decay. Pixabay.
  • All of the top 10 most dangerous cities in the country, including Detroit, St. Louis, Oakland, Memphis, Birmingham, Atlanta, Baltimore, Stockton, Cleveland, and Buffalo, have Democratic mayors. Of the top 25 most dangerous cities, most are controlled by Dems, and have poverty rates between 18 and 39 percent, compared with a 2019 national average of 12.3 percent. As gun violence runs rampant in these cities, most have strict gun control laws, giving meaning to the phrase, when guns are outlawed only outlaws will have guns.
  • All but two of the 10 cities rated “least healthy” on two different lists are run by Democrats.
  • All 10 cities with the highest numbers of homeless residents, led by Los Angeles with an estimated 58,000 homeless people, are Democratic-run sanctuary cities which provide refuge to illegal immigrants, disadvantaging lower-income legal residents of those cities and creating unsafe and unhealthy conditions for all residents.
  • The Democratic virtual one-party state of California, with one of the largest and most prosperous economies in the world, has the highest poverty rate of any state in the union, according to the U.S. Census Bureau’s Supplemental Poverty Measure.
  • Six of the 10 least educated cities in America are in the same Democratic one-party state of California. In Democratic stronghold Baltimore, which ranks fourth in per-student educational spending in the nation, not a single student in 13 public high schools is proficient at math, and nine of 10 black boys in the city’s schools can’t read at grade level. Meanwhile, thousands of consultants, contractors, and administrators are paid salaries in excess of $100,000 a year by the city’s school system.
  • Many of the cities run by Democrats haven’t elected a Republican mayor in more than 100 years. That’s the case in Newark, N.J., ranked the fifth worst city in the nation to live in. Detroit, once the wealthiest city in America and the one LBJ planned to be the “Model City” of his Great Society, and which today is ranked the country’s worst city, hasn’t elected a Republican mayor since 1957, about the
    Detroit decay
    Decay of Detroit, the “Model City.” Daniel Lincoln/Unsplash.

    time its golden era began its swan song. Chicago, one of the country’s most segregated and violent cities, elected its last Republican mayor in 1927. St. Louis, one of the nation’s most dangerous and poverty-stricken cities, has been electing Democrats as mayor for 71 years. Philadelphia, for 68 years. Baltimore and Oakland for more than half a century. In Flint, Mich., Dems have been mayors for 88 years. In New Orleans, mayors have been Democrats since 1872 – 148 years, longer than most countries have been in existence. What do all these cities have in common, besides being Democratic fiefdoms? They’re all wracked by poverty, crime, corruption, and urban decay. If anyone cares to argue that the Democratic Party, the party that in its history supported slavery and Jim Crow, has changed over all those decades, if anything the change has been for the worse where these cities’ residents are concerned and as their condition has continued to deteriorate over the decades.

So where have all those trillions of anti-poverty dollars gone? That would be a good question to ask these mayors, city councils, state governments, their Congressional backers, and those running the various anti-poverty agencies and failed school systems, spread from coast to coast to coast. And maybe their bankers and investment brokers and real estate agents, too.

And don’t buy into the argument that other developed countries spend more on anti-poverty programs than the U.S. (for the most part, they don’t), or on healthcare (they don’t), or education (they don’t). Money, at least not its lack, isn’t the problem. Misguided programs, corrupt officials and politicians, and just plain bad policies are. Given the dismal results of those policies over such a long period of time, one has to assume that malice of intent more than just bad judgment lies at the heart of their failure. Divide and rule: Keep those poor folk down on the plantation and rake in the big bucks. Follow the money.

Martin Luther King Jr. march on Washington
Martin Luther King, Jr., leads the march on Washington, August 28, 1963. Library of Congress.

What things work and how the plantation masters work against them

There are some things that are known, at least empirically, to help people get out of poverty. The plantation masters know this, and they work against them methodically, often under cover of some sort of politico-babble. We’ll look, briefly, at them here.

Education

Getting a decent education and at least a high school diploma – and, better, a college degree — is one of the known routes out of poverty. Educational choice, through vouchers and charter schools, in many cases have been shown to offer low-income people a better education than often available in the normal public school system. Even Barack Obama said “The best anti-poverty program is a world-class education.” So why do he and so many of the urban plantation masters oppose both vouchers and charter schools (while putting their own kids in private schools)?

Two-parent families

Two-parent families are another antidote to poverty. The overall child poverty rate is 17.5 percent. For children in homes headed by a single mother, it’s 50 percent. In 2015, 77.3 percent of non-immigrant black births were to unmarried mothers. For Hispanic immigrants, it was 48.9 percent. For whites, it was 30 percent. In 1965, the rate was 24 percent for black babies and 3.1 percent for white babies. There are many factors involved in this differential, the role of welfare rules that favor single mothers, households without a man or father, being just one of them. Whatever the reasons, the economic impact is significant.

Helping black men improve their situation

A better educational environment, improved employment opportunities, and staying out of trouble with the law help black men improve their situation, which overall has a positive impact on reducing poverty among African-Americans. Trump’s answers have been improving employment prospects, economic opportunity zones in under-privileged communities, and criminal justice reform. The answer of at least one Democratic candidate, Bernie Sanders, is to help African American, Latino, and Native American communities “start businesses selling legal marijuana.” Yup, keep those poor folks in the drug culture. After all, it’s been such a big help to their communities over many years.

Full-time employment

Finding and keeping full-time employment Is another of those elements that are basic to getting out of poverty. Rather than depending on public assistance, becoming self-sufficient is a critical step in upward mobility, and its efficacy is evidenced by the relation between a declining unemployment rate and declining poverty rate. But the new plantation masters would rather depress employment, shutter whole industries and send jobs to China, thus increasing dependency on them.

These are not the only things that impact on poverty, but they are some of the bigger ones. By now, 56 years on, it’s time to declare America’s longest war – the War on Poverty – a lost cause, and to begin to empower all people in poverty, and most especially African-Americans, as Malcolm X said, to solve their own problems, and to send the new plantation masters packing. All the signs are that they won’t go easily, and they’re already figuring out new ways of fleecing the populace and keeping folks down on the plantation. Divide and rule is as relevant today as it was in 1892, and as long as people buy into it, its impact will be as pernicious and long-lasting.

Featured image: Sugar Cane Plantation. North Wind Picture Archives/Alamy Stock. Used under Fair Use.

Bigger Than a Big Weather Story

Bigger Than a Big Weather Story

When I was a practicing journalist I came to learn that there are few stories bigger than a big weather story. I still remember, more than three decades later, my managing editor at the daily paper where I worked standing in the middle of the newsroom as a tropical storm was headed our way and bellowing, “Blow it all out of proportion!” And we dutifully did.

So what’s bigger than a big weather story? The current furor over COVID-19, AKA the coronavirus, reminds me of our coverage of tropical storms and hurricanes, but on steroids. The media has certainly seen to the task of blowing it all out of proportion, making it bigger by far than a big weather story.

Now I can already hear the protests and mocking retorts. “But, BUT! This thing is deadly! It’s killing people! It’s a pandemic! It will destroy civilization as we know it!”

Yes, yes, I know all that (except the last one, of course), and I don’t mean to minimize the potential for death and destruction that this virus can wreak, any more than I would minimize the potential of seriously bad weather to kill and destroy. I’m also not intending to discourage people from taking reasonable precautions to protect themselves and others, though I am advocating that people not overreact. While some people, mostly older people and those with serious underlying medical conditions, are at high risk, many cases of the virus in the U.S. have been relatively mild. I think it’s both useful and even hugely beneficial to keep things in perspective and not run off the cliff by blowing things all out of proportion.

Striking a balance

As with any emergency, two factors are critically important. One is to recognize the danger and how to best address it, and the other is to stay calm and avoid panic. The kind of media coverage we’ve gotten on COVID-19, for the most part, has been heavy on the former (even as it was late in coming and largely distorted, which it remains), and exceedingly light on the later. I don’t think it has done what it could to make people safer and shockingly little to calm them or put things in perspective. We’ve seen the results of this as people rush to alter their everyday lives in ways that often are gross overreactions while not necessarily making them any safer. Meanwhile, the impact on the economy, with more than a 20% drop in the markets and massive slow-downs and shut-downs of whole industries, appears to be perhaps more harmful to the country than the virus itself.

We’ve watched on television as people in places, mostly on the West and East Coasts, stripped store shelves bare, as if theynauris-pukis-S0XbrnbUo-g-unsplash close quarters were expecting some sort of plague of locusts to descend on them. By way of comparison, as recently as a few days ago everything remained normal here where I live in North-Central Florida. I felt people were being sensible, given the remote risk involved, and there were no signs of panic. And then the dominoes started falling here as elsewhere. The National Hot Rod Association announced it was postponing the Gator Nationals hot rod races in Gainesville, which particularly pissed me off, partly because I had already bought my ticket, but more because it is an outdoor event, furchrissake. Florida colleges and universities are considering moving all classes online. And then yesterday I visited some of the local stores and, while I wouldn’t characterize the atmosphere as one of panic, it clearly had shifted from the usual norm. I’m not an expert, but I have to think the chance of contracting a virus in the closed confines of a supermarket has to be greater than in the open air.

As in other places, along with water, toilet paper and some other products had been stripped from the shelves. While I can kind of understand and even expected the water – these stores run out of water even in more normal times – but toilet paper? Folks, this isn’t a dysentery epidemic. What possible need for toilet paper, beyond normal consumption, can anyone have? And it turns out this isn’t just happening in this country, but overseas, too. There is the family in Australia who (by mistake) ordered not 48 rolls but 48 cases of toilet paper. By their estimate, 12 years worth of the stuff. Now admittedly the order was placed before the coronavirus furor reached full bore, but the family is finding they’ve become very popular among people who can’t find TP in the stores in Oz and are re-selling the rolls as a fundraiser.

Watching people rolling carts topped to the brim with products, one wonders if they’re planning on withdrawing to underground bunkers to await the all-clear after the radioactive fallout from nuclear war has stopped dropping or for when the invading aliens have returned to their distant galaxy. In large part promoted by the media, this sort of rush is now under way across the country.

One report I got was from my contractor, who described the scene in coastal Mississippi: “I stocked up on enough food and supplies to last a month just in case we have to be isolated but I’ve seen people buying enough to last for the rest of the year. It’s absolutely ridiculous.” Number, as of today, of confirmed cases of COVID-19 in Mississippi: 10, at least one of which originated out of state. Number of deaths in the state from COVID-19: 0. Mississippi’s population: 2.99 million.

Ridiculous, indeed.

Putting things in perspective

To further see how ridiculous, let’s put things in perspective a bit. As of today, this county where I live has had a grand total of no cases of coronavirus. The county to the east has had five cases, the county to the north has had one (which came from Georgia, the state, not the country), and one to the southwest has recorded one case. None of the other four counties that border on this county has had any cases, and no deaths have been recorded in any of these counties. The state of Florida, which has about 22 million people, not counting its many visitors, has so far confirmed 76 cases and three deaths, several cases involving people who had traveled abroad or were from other states.

Meanwhile, so far this year, if averages from other recent years can be relied on, in just 75 days something like 630 people have died in road accidents on the state’s streets and highways and another 51,000 or so have been injured. Perhaps if people paid more attention to their driving and less to concern about wiping their butts they’d be a lot better off.

I haven’t even been able to find accurate statistics on how many people have come down from the flu or died from it in Florida, but nationwide, the Centers for Disease Control (CDC) estimates that as many as 49 million people this flu season alone have contracted the flu, there have been up to 23 million medical visits and 620,000 hospitalizations, and 52,000 deaths, including 144 children to date (that includes 12 so far in Florida). By comparison, the CDC is reporting 1,629 cases of coronavirus in 46 states and the District of Columbia, and 41 deaths, with no child deaths in the U.S. Not that any of those cases or deaths are to be dismissed, but the comparison with the illness and deaths from the flu and other things can’t be ignored. In this country, we see more than 67,000 people die each year from opioids.

Hysteria and playing politics

If you look objectively at what the current Administration in the White House has done to control introduction and spread of this virus, it has acted decisively and quickly. When it became apparent that the virus had originated in or around the city of Wuhan in China, the President on Jan. 31 ordered a limited ban on entry into the U.S. by most travelers coming from China, and it went into effect on Feb. 2. This past week, on March 11, the President ordered a similar ban on travel from Europe, with exemptions for travelers from the U.K. and Ireland, both of which were later added to the ban. And on March 13 he declared a national state of emergency, with the effect of releasing additional federal resources and funding to deal with the crisis.

To assure a coordinated approach, the President on Feb. 26 had put Vice President Mike Pence in charge of the government’s response to the coronavirus, with experts from the CDC and National Institutes of Health (NIH) leading the medical response to the threat posed by COVID-19. If you didn’t see that press conference you should now since I think it was one of the most explanatory and straightforward presidential press conference I’ve ever seen.

You’d almost never know that President Trump was doing anything to address the threat of coronavirus if you only follow the never-Trumpers on the left wing of the media who, along with some on the Democratic side of the aisle in Congress, have disgustingly done their utmost to politicize what is a national crisis. It reached the point where on some networks program hosts blatantly squelched any views that offered support to the President. This was transparently obvious, for instance, to anyone watching as CNN’s Don Lemon – who, in my assessment, would have a hard time beating out a clever hamster in an intelligence contest – repeatedly shut down former Ohio Gov. John Kasich (himself no big Trump supporter) as Kasich attempted to defend the President’s response to the crisis.

Along with the anti-Trump prejudice, we heard such inanities as commentators saying it was “zenophobic” and “racist” to call macau-photo-agency-4I6VHLP5Ws4-unsplash masked familythe virus “the Wuhan virus” or “the Chinese virus,” despite the fact that the origins of the virus in and around Wuhan is little disputed. That encouraged Chinese officials to blast the U.S. for saying the virus originated in China and even to threaten to withhold vital medications from the U.S. Meanwhile, lots of viruses and ailments, including Ebola, West Nile, Zika, and Lyme, not to mention “the Spanish flu” and “the Asian flu” – remember those, from 1918 and 1957, respectively? – have been named after the area in which they originated, and no one ever called those names racist or zenophobic.

Two big scandals exposed by the coronavirus

Not to sugar coat anything, there are at least two big national scandals this coronavirus thing has in fact uncovered, and we should be grateful that it has. One is the lack of our capacity to produce kits to test for the virus on a massive scale. While South Korea has been able to test 20,000 people a day, it is safe to say we don’t really know how many people in the U.S. have been tested. We do know that testing capacity in this country has been severely limited – perhaps no more than 20,000 tests in total performed to date – and this falls squarely on the shoulders of the CDC. Conflicts between the CDC and some states, such as the conflict with Washington Gov. Jay Inslee, at the epicenter of the outbreak, have been reported, and little has been done to tap the capacity of the private sector to produce test kits of sufficient number. Fortunately, on March 13 the FDA approved pharmaceutical giant Roche’s new automated test, which should allow a rapid ramp-up of testing capability as it begins to roll out. Roche says it already has 500,000 tests ready and can produce another 1.5 million of them per month. Going forward, a more flexible approach to developing and deploying testing for various diseases needs to be implemented.

The other big scandal, and perhaps the bigger and more difficult one to address, is how dependent the U.S. has become on overseas production of pharmaceuticals and pharmaceutical components, with China holding the lion’s share of production of some key medications. It is estimated that China is the source of 97 percent of the antibiotics used in the U.S., and two countries, China and India, produce most of the pharmaceuticals and pharmaceutical materials used in the U.S. Along with the strategic threat this preponderance of source represents, there also have been issues of quality control and corruption in the Chinese pharmaceutical industry. It would seem that moves should begin immediately to domesticate key elements of this country’s pharmaceuticals production, something other countries also should do.

We have learned lessons from previous pandemics, such as the H1N1 pandemic of a decade ago, but sometimes lessons are forgotten and each new pandemic brings with it new challenges. Making systemic fixes to address such obvious and serious problems as these two needs to be a national priority. And that is not blowing things out of proportion.

Photo credits: Featured image: Max LaRochelle/Unsplash; Crowded: Nauris Pukis/Unsplash; Masked Family: Macau Photo Agency/Unsplash

Going Off the Rails With No Way Back

Going Off the Rails With No Way Back

At the risk of sounding like a curmudgeon once again, there are some things that need to be said. If I’m a curmudgeon — I don’t think I am — so be it.

What brought this sudden bout of curmudeonness on, you ask? It began Saturday morning with telephone conversations with two different bankers in Maryland. I’d written two checks to a friend of mine visiting from Albania, repayment of an old debt. She took the checks to a local branch of Wells Fargo Bank (I’m naming names this time), the bank on which the checks were drawn, and someone from the branch called me to verify the checks’ legitimacy. Okay, I can see the point of that, though I wonder if they would have done the same if my friend was American or had, say, a British or Canadian passport and not an Albanian one. I also have questions about the need for a call given that Wells Fargo seems to have policies in place that deliberately make it as difficult as possible for customers to access their own funds. But that is a whole other story.

In any case, one of the checks was for $2,000.00, and the other one was for $9,000.06. I put the numerical amount as I always do, $2,000.00/100 for the first check, and $9,000.06/100 for the second one. And then I wrote out the amount in the proper format, the one I’ve been using for some 50 years virtually without incident: Two Thousand and No Hundreths Dollars, and Nine Thousand and Six Hundreths Dollars. Okay, granted, the proper spelling is hundredths, but close enough for government work since the words spell out what the numerals already show, and in my haste I dropped the “d.” But that wasn’t the issue.

Now, I don’t know, but I think anyone from about the age of 5 should know that a hundredth of a dollar is a cent. A penny. One hundredth of a dollar is one cent, six hundredths of a dollar is six cents. Even misspelled, I’d bet most 5 year olds can figure that out. But apparently this fine point is lost on Wells Fargo bankers, and I had to explain to two different genius bankers that Nine Thousand and Six Hundreths (sic) Dollars was not $9,600, but $9,000.06. The first banker said their branch policy was not to accept checks with the cents expressed that way. That made no sense to me, but finally he conceded and said they’d cash the checks. All good, right?

Not quite. A few minutes later another banker, the first one’s manager, called me, and after a few unnecessary and unwanted pleasantries, she repeated that the branch didn’t normally accept checks where the cents were expressed as they were on my check. She had me read off the amount of the check, and confirm the intended amount. I was rapidly losing my patience with this whole thing, and I told her I’d been writing checks like this for 50 years, it was the proper way to write a check, and what exactly didn’t she understand? She then feigned a brief reconsideration of the matter, and finally confirmed that they would accept the check. Hurrah. I got to tell a banker what should have been obvious to her by reading the check as it had been written. Duh.

Now I have better ways of spending my Saturday mornings than explaining the obvious to bankers, but this whole affair served to remind me the extent to which this country is going to hell in a hand basket. The signs are increasingly everywhere, how far off the rails we’re going, this just being the most recent one. It seems people, and the country as a whole, just get stupider and stupider by the day.

I’ve railed against the madness in the direction we’re headed before, but it’s time to do it again, drilling down a bit this time.

In the course of a typical day, I get messages – obviously written on a phone with a run-away spell corrector – that are virtually incomprehensible. I’m asked questions that I already answered, sometimes multiple times. And I get abbreviated messages that fail to respond to issues I raised. In short, I can almost always tell when someone is writing me from a phone, and the communication is seriously impaired as a result. This is a significant matter, since communication should be primary, not to mention I don’t understand how people don’t go crazy typing and reading on a small screen. Well, maybe they do, and we just don’t have a name yet for this mental illness.

If you’re a parent in this country, it probably doesn’t come as a surprise to you that your little darlings are no longer expected to learn cursive writing. At one point, some 45 states and the District of Columbia had dropped the requirement to teach cursive writing, and the dreaded Common Core was at least in large part responsible for that since Common Core doesn’t require cursive as part of the curriculum. Now blaming Common Cause for stupidity is a bit like blaming phones for errors. It’s the people behind Common Core who are exhibiting their ignorance, and the curriculum is just the symptomatic outcome of that.

There has been some retrenchment in a handful of states that realized the folly of dropping cursive writing from the curriculum, but overall this country is on the verge of entering a new Dark Ages where kids can’t even sign their own names. The idea is that they can do everything on a keyboard, but somehow that seems equivalent to saying they don’t need to learn to walk since they can get driven around everywhere by their parents.

Additionally, as studies confirm, the ability to write, and not just type, promotes some cognitive and motor skills that typing does not. Writing is not the same as typing, and while both skills might be worthwhile, school districts and states don’t want to spend the money teaching both. So out goes cursive writing, and with it one of the traits of an educated person. And people wonder why I’d never put any child of mine in a public, and probably most private, schools.

While this has been going on in more recent years, another long term trend – grade inflation in the nation’s colleges and universities – has been underway for more than half a century. It’s true that a degree of grade inflation began during the Vietnam War years, Recent GPA Trendswhen I was in college. Some attribute this to the desire on the part of many professors to keep students out of the draft, which worked for awhile, but based on my own experience it also probably had to do with the proliferation of pass-fail grading during the turmoil of years of sit-ins, walk-outs, and student strikes that closed some institutions, including the one I attended, for nearly entire semesters. But the grade inflation of that period pales to what has been going on since the 1980s, when grade-point averages have been rising an average of 0.1 points a decade, and the percentage of A grades given has gone up 5 to 6 percentage points a decade.

Since the 1990s, the A grade is the most common grade given in four-year colleges, and As are now three times more common than they were in 1960. At that time Cs were most common, and in my own era, Bs were most common. Now if they don’t get an A, students are at the professor’s throat as if the failing rests with the prof and not with their own performance. If you believe that is because college students have gotten that much smarter since 1960, I have a nice athletic building on a fine campus I’d like to sell you. Very good price. Just sign right here. Oh, wait, you can’t sign, because you never learned cursive. Okay, put your “X” on the line there.

Having been a college professor, I can tell you there is a strong tendency toward treating what are supposed to be young (and sometimes not so young) adults as 50 Years Rise of A Gradechildren. There is a stress on not offending the students, sandwiching any critical remarks in between praise, not being unduly harsh in comments even in the face of abject and repeated refusal on the part of the student to follow guidance. This is called the Student as Consumer Era, and it is indicative of schools that need to cultivate their students to stay enrolled and to pay the exorbitant tuitions and fees charged them and their parents. And instead of challenging their minds and belief systems, these educational institutions allow students to retreat to so-called “safe spaces” and to drive speakers with views divergent from their own off campus, allowing a new form of Fascism and sheltered closed-mindedness to run rampant on college campuses.

Moving from the swamp of so-called education, we have cars that stop themselves or keep themselves in their own lanes, ostensibly so their owners (“drivers” is too strong a word for them) can text and talk on the phone. Things seem increasingly geared toward the lazy and the ignorant. My own car turns its own lights on and off, doesn’t have a key, and tells me how many miles I can go before I run out of fuel. Thank goodness it doesn’t stop itself or do that lane thing, which would be way beyond what I would tolerate of my car. It does open its own trunk, though, for unknown reasons and at very inconvenient times, sometimes multiple times in a row. I guess taunting its owner is part of the deal. I can almost hear it laugh when it does this.

In the course of all these trends, we continue to lose human contact at an almost alarming rate. My most recent two forays into paying entry fees – one at a movie theater, the other at a major conference I attended – were done at terminals. Gone were the friendly ticket girl and the helpful conference gatekeeper, replaced by screens and credit card readers and keyboards. That may all be more efficient, but it’s a bit disconcerting, too. My local Walmart has installed all sorts of self-check-out equipment, but I have never found self-check-out to be faster or more efficient than dealing with a human cashier, and it’s also a tad insulting, I think. If the store wants my money, it should at least have a sufficient number of humans on hand to take it. So, unless I have just one or two items and am in a major hurry, I won’t use the self-check-out.

Meanwhile, the medical profession – one area that might benefit from more, rather than less, technology in enabling improved communication between physicians and patients – remains mired back a century or two. If anyone is able to email their doctor, or even their doctor’s office, I’d love to hear about it. And our prescription drug system seems designed to breed frustration and inefficiency, and we wonder why healthcare costs continue to escalate. I’ve written on these things before, and on the inherent inequities and inefficiencies of the medical system, and the most I’ve gotten in response from doctors is a smile and a laugh, as if I were proposing absurdities.

Call me a curmudgeon if you like, but somehow this all feels like we’re headed off the rails with no way back. Maybe, as the illustration says, you’ll get it eventually, but by then it might be — probably will be — too late. I could be wrong, but I don’t think I am. Am I the only one who feels this way? I’d love to hear your thoughts on all this, regardless which side of things you come down on.

Charts from http://www.gradeinflation.com 

The View From the Shoulder

The View From the Shoulder

To point out the obvious, I survived the surgery that was the subject of my last posting, and have been in a process of slow recovery over the past three and a half weeks. The surgery – a quintuple cardiac bypass, which I didn’t even know was a thing – went well, and I’m told my recovery has been as good as could be expected. I’m grateful to my surgeon and all the others who were involved in getting me through this, as insane as it all seems to me.

Where I’m at now is a world of difference from where I was in the first few days after the surgery. There are still lots of inconveniences and things that are not yet back to normal, but at least I’m past the excruciating pain and weakness that characterized those initial days. At that time I had to wonder why I ever put myself through such mutilation and torture, and still I can’t imagine ever going through anything like that again. I had a pretty clear sense throughout the whole ordeal that I could return to normal functioning and an active life, but I realized that if all I had to look forward to was permanent disability and struggle, as others I saw around me, I’d have a pretty hard time justifying it. Even today, as far as I’ve come, I had to wonder how the mechanisms that are my heart and body could sustain all this and keep on functioning. This is a mystery I may never unravel.

In case you’re wondering about the title for this posting, as much as I’m now ambulatory and functioning at a relative level of normalcy, I still feel I’m sitting on the shoulder of the road. Other than emails and shopping lists and questions for my doctors and a couple of business-related items, this is the first piece of any sort of coherency and even marginal creativity I’ve been able to write in 26 days. And it’s admittedly pretty thin. I’m hoping in the next several days I’ll be able to write more, and then more, and I can resume more regular posting to these blogs, but I’ve found that gathering mental energy is virtually as hard as gathering physical energy. And having anything worth saying is yet a step beyond that.

Four days past the surgery I attempted to get online, and was met with the shocking reality that I had forgotten all my passwords. I still couldn’t muster the strength to have someone fetch my laptop from its bag or to hold it on me, and trying to do things on my phone reinforced the feeling of insanity of doing anything serious on a phone, even when in normal health. I had that sense before the surgery, and that disconcerting experience only confirmed it. Two days later, when I finally did get onto my laptop, I was astounded at the number of typing mistakes I made. It was like my fingers were not in direct contact with my brain and they took on twitches and strokes that defied my best attempts to control them. Not quite as disjointed as the time I tried to work on a Turkish keyboard, but close. I’m told that anesthesia can really scramble both brain and body cells, and so I’m chalking these aberrations up to that. I’m doing a lot better now with typing and other fine motor skills, and the files on my laptop helped me recover my passwords, but the process has been a continuum.

Other bodily functions – notably an astoundingly annoying throat irritation and coughing, and problems with peeing – have slowly been recovering, and while not back to what I’d characterize as normal, are hugely better than they were in the early days.

I had five and part of a sixth day in the hospital following the surgery, and then four and part of a fifth day in a rehab center, located on the same complex as the hospital, after that. At that point I got the boot, and two wonderful friends and fellow boat people came to fetch me, assist with getting food and medications, and establish me back aboard my boat, which is my home. I don’t know what I would have done without them, and I’ll be forever grateful to them. It’s two weeks today that I’ve been back aboard, and I think returning here was the best alternative. This past Tuesday my surgeon, with some persuasion, gave me back my driving privileges, and that made a huge difference in my life. And two days ago my primary physician told me I’m very impatient. I told her I know I’m a pain in the ass, but I wasn’t challenging her expertise. That’s just me. And she laughed.

I’m going to have lots more to say about the medical and healthcare situation in this country in coming weeks and months here on FJY.US and I may have some fictional things to say about it on Stoned Cherry. I’m fortunate in that I have access to Medicare and private insurance, and that made a huge difference. It shocks some people, but I really have nothing negative to say about my insurance company. And I have lots of praise for the doctors, nurses, aides (known, it appears, as Patient Care Technicians in some circles these days), therapists, and all the others who assisted and supported me through all this. That said, when there were rare failures they were pretty notable, and one thing I came to discover is that it usually is the little things, the small details, that can have the biggest impact on a patient and the patient’s experience. I’ll have more to say on this, too.

I really feel bad for writing all this self-centered drivel, but I felt some explanation of where I’ve been for the past weeks was in order, a kind of transition from the breakdown on the shoulder I went through to getting back into the traffic pattern. I’ve seen the moon and the sun since my last posting, and so day-by-day it’s time to get on with life. I promise, barring any unforeseen circumstances, this will be the last posting focusing on this whole thing, and I now can say, enough of these adventures.

I’ll be pulling off the shoulder pretty soon, so watch this space for what’s to come.

Physician, Heal Thyself!

Physician, Heal Thyself!

No, this isn’t about drugs or addiction or ODing, or any of those things. It is about frustration, though. Frustration with the medical profession. Frustration in trying to create sense where sense seems not to exist. Frustration that can lead to scenes such as in the image. Fall down on the floor, tear out your hair, rend your garments sort of frustration.

To be perfectly clear, this posting is based on a personal incident – drama is more like it – playing out now with certain elements of the medical profession. To protect both the innocent and the guilty, I’m not going to name any names. Now. But if I continue to be stymied, that decision might change. Watch this space.

If you’ve read my piece on The Biggest Shell Game in the World, which you should before reading on here, you know how I feel about the so-called “healthcare system” we have in this country. You’ll also see I elaborated on some specific actions that might help ease the growth in the cost of healthcare. That posting focuses on the macro dynamic of the system. This posting focuses on the micro dynamic, the one on the doctor level.

It’s no longer a laughing matter – it never was a joke – to say that much of the medical profession is still anchored, not just in the last century, but maybe even the one before it.

When I lived in Montana some dozen years ago, my physician – an author of the reputed Helena Heart Study, so no slouch – presented himself as advanced because he took his notes on a laptop. Why that should have been considered advanced when small computers had been in fairly wide business use for a quarter century already is a good question to ask, if you’re inclined to ask questions. Now, all the doctors I go to use laptops for their notetaking and recordkeeping. Of course, it is, at last count, 2017.

The one thing my Montana doctor did that really stood out was to communicate by email. Quick, easy, asynchronous. Email. One would think this also would be pretty standard now. That’s what I thought. I mean, I run a global business and communicate with clients all over the world at close to 100% by email. So picture my surprise to be out of Montana and in a southeastern state that also shall remain nameless (besides, I often reverse the “d” and the “i” in the name, which is embarrassing) and to find that email does not play a role in typical doctor-patient communication.

Does one even have to wonder why calling a doctor’s office often leads to more frustration, lengthy stays on hold listening to dreadful “hold” music and self-serving promotions, being asked, finally when you get past the official hold, “Can you hold, please?” (Okay, at that I’m tempted to fire back, what are my options here?)

Again, how can almost any organization in 2017 function without email? It’s not only a fast and easy means of communication, but it also can be used as a system of sending health information to patients and even, if one is allowed a bit of crassness, as a marketing device. But, no, this seems to be beyond the understanding of most doctors.

Then there are those doctors’ portals. Potentially great idea, completely mutilated, misused, and just plain not used, in execution and practice. First, they’re all clunky in that clunky way that special-purpose software (like used in lawyer and, yes, doctor offices) always is. I don’t know, maybe it’s me, but I’ve had a litany of problems with the portals of several doctors and healthcare groups. Sometimes I’d have to enter a new password each time I signed in. Sometimes things I’d want to see, like reports, are there. Sometimes not. One portal doesn’t even tell me my next appointment, which would seem pretty basic. I’ve yet to be able to get a prescription refill put through based on a request posted on a portal site. And, perhaps the biggest issue I’ve encountered, often doctors’ front offices don’t mind the sites, so sending a message to the office through the portal is like throwing a quarter down a deep well. “Pathetic” is too kind a word.

Okay, despite all that, that’s not my biggest problem nor the most immediate. Oh, no. I have a far bigger gripe, which we’ll get to now. The one that concerns the Health Insurance Portabliity and Accountabillity Act – HIPAA – and how doctors not only seem not to know much about its requirements but, worse, seem to think it exists to protect them and not the patient. Which is wrong.

I had one doctor earnestly tell me that there is a $50,000 fine attached to a single HIPAA violation. Well, he was part right. Fines can range from $100 to $50,000, or $1.5 million maximum per year for ongoing violations. What puzzled me then, and which irks me now, is that the implication was that the doctor had to protect himself against violations and resultant hefty fines. The point that was completely missed, even inverted, is that denying a patient access to his or her records in whatever way the patient deems suitable seems like a more sure route to a violation than just providing what it is the patient requests, in the form or via the means requested by the patient.

Now that doctor’s office will fax me things like test results. Some will even (horror!) email them. And then there are others, like another one of my doctors, who refuses to provide records or results in any form other than by mail, or picking it up in person. Never mind the inconvenience of the latter choice, I would defy anyone to show me how snail mail is any less prone to pilferage or misdelivery than a fax or email. I even maintain an encrypted email account for highly sensitive information. But all that is irrelevant. The Department of Health and Human Services (HHS), which oversees application of HIPAA, is clear on the subject: A provider should email, fax, or accommodate alternative delivery means as requested by the patient. Look it up. It’s right there, explicitly spelled out by HHS, in the department’s HIPAA FAQs.

That’s really the key issue: Patients have a right to see and receive their own records and results, and HIPAA exists to protect them, not the doctor or other provider. So if a patient wants his or her bloody records emailed or faxed to them, HHS says the provider should accommodate that request. But you’d never know that from the patchwork of restrictions, most of which make little to no sense anyway, that one encounters when requesting one’s records.

Of course, all this assumes that a patient has signed a statement authorizing release of information to the patient and whatever third-party designees, if any, that the patient might include in the release. Now here is a suggestion – a strong one: Why not include a check-off box with a line where the patient authorizes positively (by checking the box) transmittal of records via email or fax? Easy-peasy, and takes care of any misunderstanding. And while you’re at it, how about another line with a check-off box authorizing the same thing for any third-party designees? Two lines, and you can sleep better at night knowing the patient has asked for this and HHS says you should give it to them. And it’s in writing, no less.

All this leads to the source of my current distemperous mood toward doctors and things medical. It’s been four weeks – not hours, not days, not business days, but weeks – that I have been requesting the results of an MRI from a certain specialist. I requested that the doctor or his nurse-practitioner call me before I left on an extended trip so I could at least have a sense of what the MRI revealed. I was told, well, he probably won’t call you. He likes to do things in person.

Well, I like to do things in person, too, when that works. But in this case, it wasn’t even possible to get an appointment in less than a month or more. And I was clear that I was leaving the state and needed the information before I went.

Ha. Fat chance. Four weeks have gone by, I’ve lost count of the number of times I’ve called this doctor’s office, had my primary care physician’s office call him, even the insurance company called the office when I filed a grievance with them over this. And still I can’t get either the doctor or the nurse-practitioner (which would be fine) to speak with me and discuss the test results, much less actually get those results. Now if ever there is a HIPAA violation, it would seem this is it. It will take a formal complaint to HHS, but that is imminent. I now even have my attorney on the case.

The doctor might have his procedures, but there are two parties to the transaction, the other being the patient, and in this case this patient has different procedures. And HIPAA is on his side.

It’s bad enough having to deal with doctors and tests and health issues without having to be put under further stress and duress by providers and offices that just throw more roadblocks and obstacles in the patient’s path.

All this seems very 19th Century to me. Doctors hold themselves up as miniature deities and patients are just supposed to accept whatever inconveniences, incompetence, or affronts that the doctor and doctor’s minions subject them to. And there are others besides those discussed here. Let’s just save my rant on the prescription system for some other time, ‘kay?

If you’ve encountered any of these issues in dealing with doctors, I invite you to tell everyone about it in the comments. And if you have a different and more positive story to tell, by all means post that, too, in the comments. And if you question the premises on which this piece is based, well, fire away with that, too.

Meanwhile, I’m going to fax this piece off to a few doctors I know (I have to fax them since I don’t have their email addresses) and maybe shake a few trees. Or else things will just go on as they always do. And watch this space if I decide it’s necessary to start naming names.

Physician, heal thyself!