Category: Social Commentary

TRUMP
Haters Are Gonna Hate

Haters Are Gonna Hate

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If you watched the State of the Union address this past Tuesday, you saw encapsulated the two faces of America at the outset of 2018. On one side of the aisle the Republicans for the most part cheered and gave standing ovations to just about everything President Donald Trump had to say. On the other side, the Democrats sat there stone-faced and belligerent, at times not even sure whether to applaud or not when the President said things almost anyone could get behind and support.

Having watched the address, I’d have to say it was – in the commonly applicable term – “presidential,” and touched on many of the issues that Trump voters, specifically, and a broad part of the population otherwise, are concerned about. And for once Trump didn’t step on his own small victory by tweeting contrary thoughts the next morning. That’s not just my assessment, either. A poll by CBS News – certainly no advocate for the President – showed that 75 percent of viewers approved of the President’s speech, including 43 percent of Democratic viewers. Eight in 10 viewers said they thought the President was trying to unite the country while two-thirds said the speech made them feel proud.

An unscientific viewer poll conducted by CNN – again, no friend of the President – showed that 62 percent of respondents said they thought the President was moving the country in the right direction. The percentage of viewers – 48 percent – who said they had a “very positive” view of the President’s speech was the same percentage who had a “very positive” view of President Obama’s first State of the Union address in 2009. Not bad for a president that, if you listen to most of what is reported in the media, is equivalent to the devil incarnate and the harbinger of Armageddon.

In fact, rising overall poll numbers for the President underscore that he’s tapping into many of the issues a wide range of Americans care about. But you’d never know that looking at the Democratic side of the aisle during Tuesday’s address.

While it would be too much to expect that everyone would agree with everything Trump laid out, there was enough juicy goodness there that just about any American could get behind. This was especially the case with the several moving examples of heroism, citizen action, and hardship that he called out, recognizing a number of guests in the audience for their accomplishments or experiences. Still, some House and Senate Democrats in attendance had a hard time digesting how it was the citizens themselves, and not Trump, who deserved the recognition.

House Minority Leader Nancy Pelosi later criticized the President for the many guests he honored, saying he had nothing to do with their accomplishments. Of course, the President never claimed he did and, since President Ronald Reagan started the tradition in 1982, it has become a part of every State of the Union address to recognize the achievements of individual citizens, especially when they underscore the message and policy positions of the given president. Pelosi’s criticism came across as small, but it wasn’t the only statement she made that showed how out-of-touch she is with most Americans. We’ll get to that a bit later.

Now I understand that State of the Union addresses are partisan affairs, and one side of the aisle or the other is going to get more things to jump up and clap for than is the other. That was certainly the case when President Obama gave his addresses, when it was the Dems’ turn to applaud. And it clearly was the case Tuesday with President Trump’s address. Still, there are enough moments in any State of the Union address when, as Americans, both sides have reason for support and celebration. But to watch the Democratic side of the aisle in this State of the Union address, one was forced to wonder what exactly the Dems do stand for, other than abject hatred of the President.

Clearly the most telling moment came when the President said that the black unemployment rate had reached a 45-year low. That seemed like something everyone could get behind, along with his statement that the Hispanic unemployment rate had reached an historic low. But when the cameras panned to the Congressional Black Caucus – some members of which didn’t even attend the address – nary a hand clapped. Some sets of eyes cast about, reflecting doubt about what their owners should do. Many watching this display can be forgiven for asking what it would take for the black members of Congress to at least recognize something that has benefited black people, regardless how they feel about Trump or whether they credit him or his predecessor for most of that accomplishment. On PR value alone, this was a lost opportunity and showed caucus members as petty and petulant.

Another telling moment came when the President discussed immigration, and highlighted his proposal to offer a path to citizenship for 1.8 million “dreamers” – non-citizens brought here illegally by their parents as children – more than double the 700,000 that the Democrats would protect under their proposals. Perhaps the most memorable quote of the entire address came when the President said, “Americans are dreamers, too.” As the President made clear, his primary duty, as well as the primary duty of all members of Congress, is to look after the interests of Americans. Seemed reasonable enough.

But when Trump outlined his overall immigration proposals, aimed at benefiting American workers and citizens, things one would expect to be Democratic goals, too, the reaction was anything but supportive or even willingness to listen. Key parts of Trump’s proposals include eliminating the visa-lottery program and reducing chain migration based on family relations – something many concerned with immigration issues have supported for a very long time – not only didn’t they applaud, but there actually were boos from the Democrats. Of course, not much has been made in the media of this overt show of disrespect for the President, certainly nowhere near the brouhaha that erupted when South Carolina Rep. Joe Wilson shouted out “You lie!” to President Obama during a 2009 address to Congress on healthcare issues. But we’ve come to expect this kind of double standard where Trump is concerned.

Another show of disrespect came when Illinois Rep. Luis Gutiérrez booked for the exit while the Republican side spontaneously chanted “USA, USA.” Gutiérrez later denied that his early departure had anything to do with the chant but rather that he was late for an interview appointment with Univision. Whatever the reason, it didn’t help the Dems’ optics.

If the Democrats have more to offer than intransigence and hatred of the President, it wasn’t clear what that was, either in the Democratic rebuttal to the President’s address or in those comments Pelosi made after the speech. The withered Pelosi, herself worth $101 million as of 2014*, called the bonuses and tax cuts worth thousands of dollars each that many Americans are getting as a result of the Republican-sponsored tax bill, “crumbs.” Now $2,000 or $3,000 may be “crumbs” to a multi-millionaire like Pelosi, but I wonder how many less monied Americans see those amounts that way. Even Costco CEO Craig Jelinek called Pelosi’s comments “unthoughtful.” Costco is one of 300 companies that so far have announced bonuses to be paid their employees as the result of the new tax bill, and that doesn’t even account for the benefits most working Americans will get as the result of greatly increased standard deductions on their tax bills.

The Democrat’s choice of Congressman Joe Kennedy III to deliver the party’s rebuttal to the President’s speech also reflected the Dem’s bankruptcy when it comes either to ideas or personalities. It would probably be too blatant a non-forced error to select a Clinton, so the party went back to the Kennedy name. Even many Dems asked what it says about the party when its leadership picks a Massachusetts politician, part of the Kennedy dynasty, himself worth $43.2 million*, to deliver an address focused on assisting working Americans.

Kennedy, grandson of the late Robert F. Kennedy, seemed an incongruous choice, even as he spoke in terms of Democratic identity politics, reverting at one point to the cliché of delivering part of his address in Spanish. So while the Dems argue that Dreamers are Americans, Kennedy spoke to them as immigrants, and not even immigrants who speak English. The further irony is that, as his party moves further and further to the left, Kennedy’s grandfather and granduncle, JFK, would today most likely be viewed as conservatives in comparison.

I came to the State of the Union address expecting Trump to do a credible job, and hoping he wouldn’t tweet it away the next morning, and I was gratified on both counts. I also expected a somewhat truculent and unenthusiastic Democratic side of the chamber, but I didn’t expect it to be as gloomy and seemingly hate-filled as it was. That came as a shock even to skeptical me, and it tends to underscore the existence of this phenomenon that has come to be dubbed Trump Derangement Syndrome. That may be a non-clinical term or condition, but like any disorder, it distorts judgment and leads to non-productive actions.

That’s what I think is going on with the Dems. They seem intent on being haters and not much else, and haters are gonna hate. Whether anything more productive comes from them, that remains to be seen, all the more so after Tuesday’s performance.

* Source: members-of-congress.insidegov.com

Christmas car
‘Tis the Season

‘Tis the Season

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Indeed, ’tis the season to find a deal on a new car. Even I’m sniffing around to see what I might find to sate my very limited preferences to replace, or at least supplement, my current ride, the Ford Windstar I’ve had for 14 years (and which is actually 21 years young), is pushing 250,000 miles/400,000 kms, and stubbornly refuses to die.

In these parts, the commercials run on local TV are mostly for car dealers, tort lawyers, back surgeons, furniture vendors, and, of course, drogas. There is hardly a station break (of which there are lots and lots) without at least one car ad.

It’s interesting observing the different kinds of buyers each marque is aiming for through its TV advertising. For instance, Chrysler-Fiat and Nissan appear pitted in a competition to see which can appeal more to the remaining muscle-car drivers out there. You know, the kind of drivers who get their thrills driving through walls and burning rubber on the open road in a quest to see who can be first to the finish line somewhere out on the salt flats, or accumulate the maximum number of speeding tickets. Meanwhile, Chevy mostly makes use of supposed buyers in its ads, revealing in those chosen to appear the low opinion in which GM must hold its customers. Lately, though, in the spirit of the season, Chevrolet has been running its employee-discount commercials, and based on those apparently Chevy employees are vastly more intelligent and appealing than Chevy buyers. For its part, Ford also makes use of prospective buyers in its commercials but, based on the ads, Ford buyers are a great deal smarter and more likable than Chevy buyers.

Kids, you may have noticed, figure in a disproportionate number of car ads. Car manufacturers and their advertising proxies have calculated that kids help sell cars to families, and a little child exploitation is worth the bump in sales. This trend is all the more apparent in this festive holiday car-selling season.

I’m not sure to what kind of people Honda is appealing with its advertising, but I’m pretty sure I don’t want to meet them. Hyundai, on the other hand, mixes music and humor to appeal to buyers’ lighter side. Upscale Lexus, though, both in its advertising and design philosophy, seems intent on appealing to buyers who like cars so aggressively ugly it would not be unfair to characterize them as the Darth Vaders of the automotive world. Meanwhile, Kia takes on Lexus directly in its Sorento commercials, belittling the Lexus driver for not realizing he was being out-flanked by the supposedly off-road competent Kia Sorento.

Taking a different tack, Lexus competitor Infiniti focuses on the kind of nice people having fun with its cars that it’s hoping to attract, while Acura, word in the industry has it, is focusing more on mobile advertising, with a barrage of vertical images and music by Kid Ink, aimed at a younger yet upscale audience.

Among European manufacturers, Volkswagen is out there slugging, its commercials aimed at mostly younger buyers, maybe folks out buying their first new car, and looking it. At the other end of the spectrum is Mercedes-Benz, which futilely attempts to convince us that kids (speaking of unbridled child exploitation) fantasize about owning a Daimler when they grow up. I recall my childhood car cravings, and Mercedes never once figured into them, the marque more associated in my mind with stodgy old people, crooked lawyers, and wearers of mink coats. Not the kind of car most kids would aspire to driving. But at least the current breed of Mercedes commercials, unlike an earlier iteration, don’t feature cars sliding sideways and crashing through plate glass windows, apparently careering into young children dreaming of Mercedeses inside those windows.

In fact, for awhile it seemed that the only direction most cars in automotive advertising went was sideways. That unfortunate trend seems, happily, to be reaching an end, or at least tapering down. But now the latest thing is to show how a car stops by itself, or comes veering back into its lane after nearly sideswiping a passing vehicle. Or, clever trick, parallel-parks itself, positively impressing lovers and prospective relatives. Drivers, passengers, and passers-by all seem incredulous at these amazing feats of the semi-self-driving cars. Of course, one would not be faulted for wondering what drivers would have done had the car not stopped itself or corrected course. Would they have just allowed the car to plow ahead into whatever caused it to stop itself, or maybe paid a bit more attention before drifting out of a lane? Or, gasp, perhaps going to the trouble to learn how to parallel-park? Increasingly, possession of those skills seems to be too much to hope for in late 2017 on the cusp of 2018. My guess is that all these car tricks can only encourage more distracted driving, leading careless drivers to believe they can get away with texting or yakking away on the phone while behind the wheel.

Indicative of how things are going, Volvo, the Swedish car maker now owned by the Chinese after its sale by Ford, previously always focused on the safety features of its cars in its advertising. Now it looks, based on recent Volvo advertising, that the car’s self-driving features can compensate for brainless drivers who find it bothersome to pay even modest attention to their driving. And then there are the other Volvo commercials showing cars just driving in ordinary ways on ordinary roads, with the warning in small type at the bottom of the screen admonishing, “Professional driver on closed course. Do not attempt.”

And I guess that’s where we’re headed out on the road. If you don’t have a car that does everything for you, don’t attempt to drive. Or if you’re one of those drivers who actually are in control of their vehicle, maybe you shouldn’t attempt to drive, either, given all those other idiots out there whose cars have taken over for them.

Come to think of it, judging by some of the driving I see regularly, maybe it’s better to just stay home and watch car commercials, and let the admen and adwomen do the driving for you.

Happy New Year, everyone!

VIrtual, Not Real, Reality
Stop the Madness

Stop the Madness

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I don’t mean to sound like a curmudgeon, since I’m not, really, but there are some things that just need to be said about how things clearly are headed in this technological world we inhabit.

News of interactive appliances, self-driving cars, bots and algorithms that determine what gets fed to us over the Internet has gotten to be pretty much old hat. Those things would be enough to give us pause, but no, nothing is about to stop there, it seems.

It’s bad enough that we have to fear our washing machine or refrigerator turning us in for some transgression, or feeding our habits to an advertising program that will just try to sell us more stuff we probably don’t need. And if I can’t open the door of the fridge to see how much milk or eggs or cream cheese is left, someone really needs to put me out of my misery, and soon. But things have already reached that stage.

There is a way of looking at things that seems to have gotten lost in the quest to come up with the next technological advance. It’s pretty simple, really: Just because it’s possible to do something doesn’t mean it’s a good idea to do it. That’s where we’re at, maybe already well past it, and the lesson seems to be lost on those who are planning our “brave” new world of technological wonders. It’s time to stop the madness, though I’m not encouraged by what I see and hear about almost on a daily basis now.

Take cars, for example. Now there’s a subject. Some of us actually don’t want our car making decisions for us. Cars that stop on their own, keep us from wandering into the next lane, open and close their own doors, and which park themselves already go further than some of us, those who were taught to drive properly and enjoy being in charge of the process of guiding a machine down the road, want. Now we’re looking at cars, and even trucks, that drive themselves. They’re already out there, sharing the roads with us. But apparently that is not enough for those who think up these things. The next step – I am not making this up – are cars that will carry on a conversation with us while they drive us around.

Am I some sort of raving radical when I say I don’t really want to have a conversation with my car? I don’t even like riding in taxis since I’d rather not converse with the driver. How much less will I want to speak with a machine? Just guessing here, but I’d say a lot. A really lot. A lot a lot. What could my car even have to say that would interest me? At least with cab drivers I can learn about other cultures and the kinds of things that brought them here. I really don’t need to hear from my car how things were in Korea or Mexico or Canada or wherever before they came here, or how they’re running hot and they just don’t feel up to par these days. And suppose their hearing or grasp of the language isn’t so good? One can only imagine the misunderstandings that might ensue.

Now we’re hearing about pills that send out little signals so that our doctors can spy on us and see whether we’re taking the bloody things as they’ve instructed. I can’t get my doctors on the phone or even send them an email, but now they’re going to be listening in on what’s going on inside my stomach? Sorry, I don’t think so. The manufacturers of these spybot pills say they’re perfectly safe. Well, I’m less concerned about that then I am about what other purposes they might be put to, like programming our refrigerators not to let us touch the bacon or the ice cream that dwells within them. Or someone hacking into those interactive pills to find out more about us, things our insurance company or Russian scammers might want to know.

We’ve become so hungry to consume that having packages delivered to our doorstep isn’t enough anymore. Now Amazon is offering “in home” delivery – literally, their delivery people will come inside our home to drop off our latest gizmo. But do I want strangers coming into my home? Hell, no. It’s bad enough they know where I live. I certainly don’t want them crossing the threshold and coming inside. And I don’t care if some hidden camera or Alexa, Amazon’s other way of getting into our house and life – and two more things I don’t want in my home — is there to observe them.

Increasingly bots and algorithms determine what we read, what ads are fed us, what vids pop up on our computer screens. Google thinks its algorithms are so smart they can tell where we are and feed us local ads. Ha, Google. FYI, I don’t live in Chicago, nowhere within a thousand miles of it, even if my ISP is located there, so you can stop sending me all those ads for vendors in the Windy City. We’re still a long way from when these things will be fool-proof, if ever, but meanwhile they’ve been unleashed on us. For instance, now we read that with the YouTube Kids application – Google owns YouTube, too, if you didn’t know – the algorithms are feeding the little darlings cartoons in which the characters drink bleach, appear as gore-covered zombies, or get it on with other characters. With parents increasingly substituting screens for actual parenting, who couldn’t see this coming? Nothing like a bot to handle the babysitting, right?

When I was a kid, my dad would take me outside on cold nights to look through a telescope at the moon and the planets. I wonder how many parents and kids do that today, and I’d be willing to wager that the only way most kids today see celestial bodies, if at all, is on a screen.

More and more we’re seeing machines and electronics and robots taking over ever-more things that used to be the province of people, of actual human beings, to do. We’re told that many manufacturing jobs will never come back because technology and robots have replaced the workers that used to be in them. And while the machines, for all their faults, get smarter and smarter, it seems people are getting dumber and dumber, with no end in sight for either trend.

There has been a question on my mind for a very long time, long before the popular future vision began to become a reality. And that is, if machines and technology can do all this stuff, what will people do? Or more precisely, what will people do to earn a living to pay for all these luxuries, all these gadgets, all these robots and technological advances? The vision of the future was a place where people could live lives of total leisure, never having to lift a finger. It seems that’s what the people developing these technologies have in mind, but is anyone thinking about the economics and the politics of it all?

I can just imagine sitting at home drinking mint juleps, prepared by Alexa, and watching on a screen as my self-driving car heads out on a scenic road that I get to enjoy vicariously from my living room. Drones are dropping off packages I’ve ordered online and bots carry them inside, while my robot vacuum cleaner does the den and my refrigerator orders up restocks of the bananas and hot dogs. My imaginary kids are playing video games and learning about life from cartoons, and all the while ads and click-bait stories about celebrities pop up on screens all over the house.

If that’s my life, who is paying for it? I can easily see a society – we’re almost there now — where a permanent underclass is forced to support the more privileged among us. Proles who support members of the Inner and Outer Party (thank you, George Orwell, for painting such a vivid picture of this notional future in the perhaps prophetic Nineteen Eighty-Four, the year in the title maybe just four decades early).

At one time we used to worry about big corporations taking on too much power and controlling our lives too much. Yet, these new corporations of technology have become bigger, more powerful, and with more influence on our lives than any ITT, GM, IBM, or AT&T of the past. Somehow we’ve come to see the Googles and Apples and Microsofts of the world as benign, looking after our well being and making our lives better and easier, and not as the profit-making, market-share-grabbing machines that they are. Maybe a comparison could be drawn with the Omni Consumer Products (OCP) corporation of 1987’s RoboCop film.

I also have to wonder what politics all this will lead to, with the political order mirroring and supporting the economic one. Already we’ve become polarized and divided almost as never before, and I can only see this trend growing as our societal dialogue becomes increasingly fractured, splintered, and Balkanized, with each individual picking and choosing what version of reality he or she prefers. And with the decline of the national dialogue and the dumbing-down of the population, it will become easier and easier for Big Brother (who also comes to us from Nineteen Eighty-Four) to simply manipulate and control a society whose creature comforts and diet of electronic pap fed them will take precedence over more traditional political values, like dissent and the freedoms of speech and association.

Already otherwise intelligent people appear to have a hard time writing anything that exceeds 140 (or 280, for the truly verbose) characters, and what at one time would be intelligent correspondence and debate has been reduced to gibberish, repetition, and name-slinging. A large proportion of the population sees the world through the medium of a phone, and the quality of their communication reflects this.

I’m not going to claim that technology is inherently bad – after all, I’m writing this on a laptop computer, and the thought of doing so on a typewriter is a chilling one – but we need to think about how far things can be carried before the beneficial becomes detrimental. Like I said near the outset, just because it’s possible to do something doesn’t mean it should be done.

It’s time to stop the madness.

The New Normal
The New Normal

The New Normal

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“The New Normal.” That phrase, already becoming hackneyed through use, pretty much tells it like it is.

Whether in New York or Nice or London or Barcelona, terrorists’ use of vehicles to mow down innocent people has become part of that “new normal.” Why bother with hijacking or blowing up an airliner when one can rent a truck, penetrate low-security areas, and make one’s twisted point with the blood and broken bones and murder of innocent people? With this approach, every low-level fanatic or miscreant worldwide becomes a tool for ISIS or other such groups to spread their message of terror.

Sad, but I believe accurate, to say, what happened in New York on Hallowe’en afternoon when Uzbeki émigré Sayfullo Saipov used a rented truck to career down a bike and pedestrian lane to take the lives of eight innocent people and injure at least another 15 embodies this “new normal.” And while it isn’t the first, by no means will it be the last time we see such an attack. What’s more, the ease and economy of mounting attacks of this nature makes everyone who ventures outside or who takes part in enjoying group activities or just taking a walk on a nice day a potential target.

It has been reported that ISIS put out the word through its social-media channels encouraging its adherents worldwide to mark Hallowe’en by doing exactly what Saipov did. Probably the only remarkable thing is that there weren’t other such attacks to mark the day and provide ISIS with more of the impact it seeks. But that should not offer any solace or encouragement. There is every reason to believe that there will be more vehicular and other low-level attacks and they will, in fact, figure into this “new normal.”

Other than personal vigilance and being acutely aware of one’s surroundings, there isn’t a huge amount anyone really can do to protect against attacks of this nature. It’s hard to tread a path somewhere between being blithely unaware and persistent paranoia. Somewhat akin to awareness of the potential for criminal activity in any public place or on any public conveyance, staying on what I would term “Condition Yellow” – being attuned to what’s going on around oneself and being prepared to react quickly to a perceived threat – should probably become the base condition for any of us when out and about.

In terms of public safety, a better response demands keen and focused policing. It’s now known that the authorities were aware of Saipov, who figured into various security investigations that were under way. Why Saipov’s plans were not uncovered and why he was not picked-up before he could carry out his heinous attack remains to be seen. Whether we’ll ever know the answer to this question also remains to be seen. We see shades of the Boston Marathon bombers, Tamarlan and Dzhokhar Tsarnaev, who also were in the FBI’s radar. The FBI even had been warned about the Chechen brothers by the dreaded Russians, but the FBI failed to take the pair into custody in advance of their murderous 2013 attack that killed three people and injured hundreds of others.

Failures in intelligence gathering and failures to act on intelligence leads are serious and have real-world consequences. Boston and New York and many of the other terrorist attacks that have taken place here and abroad where it later came out that the terrorists were on officials’ radar demonstrate the truth of this.

One thing that has come under scrutiny as a result of the Hallowe’en bombing is what is known as the Diversity Visa Program (DVP), better known as the Visa Lottery Program. Saipov had been admitted to the U.S. in 2010 under this program. While it might be a stretch to say that were it not for the DVP the New York attack – or at least others like it – would not have happened, it is a program that demands scrutiny.

As a consular officer in 1990 when DVP was first introduced, the “brain child” – to speak euphemistically – of the U.S. Congress, I and other consular officers with whom I worked were appalled by the program. Not only did it offer one more way for foreign nationals to skirt the normal strictures of our immigration law, it took the value of immigration to the U.S. and debased it, making it a matter of simple luck. Neither skills nor specific qualifications nor even family relations played any role in being selected for a DVP visa. All it took was being a citizen of what was deemed to be an “under-represented” country and having a post card with one’s name on it picked at random. Winning a visa under the DVP was the same as winning any other lottery.

Now, 27 years later, the only substantive change to the DVP is that the numbers of visas allowed have increased from 20,000 to close to 50,000. While the initial rationalization for DVP was to benefit Irish would-be immigrants, 48,000 of whom were legalized in the first three years of the program, the mix of DVP immigrants today is strongly tilted toward Asia, Africa, the Middle East, and Eastern Europe. I can’t help but ask why the most diverse country on earth needs to resort to a lottery to further that diversity?

While admission of would-be terrorists can’t be any more directly attributed to DVP than to any other U.S. immigration category, it’s pretty clear it was the source for Saipov being in the country in the first place. It’s also pretty clear that Saipov, described by people who knew and worked with him as a disgruntled truck driver with a poor driving record, lacks any of the higher-level skills that the country needs and which DPV fails to address. If, as a matter of policy, the country wants to open up immigration to other than simply family members of those already here and to encourage merit-based immigration, the answer is not a visa lottery but rather a points-based immigration system, much like Canada, Australia, New Zealand, and other countries have. To see why, be sure to read my posting on Pointing Immigration in the Right Direction.

Regardless what happens with the DVP, it’s clear that we’ve moved into the era of a “new normal” where terrorism is concerned. So be alert, stay on Condition Yellow when in public, and let’s hope those whose responsibility it is to track and apprehend those who would do us harm do a better job than they have in cases like Saipov and the Tsarnaev brothers.

Frustration
Physician, Heal Thyself!

Physician, Heal Thyself!

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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!