Category: Public Policy

Russian Honor Guard
Why I Don’t Care About the Russia Thing

Why I Don’t Care About the Russia Thing

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Let me say it right up front: I don’t give a ruble (which is not very much) about the Russia thing. There, you’ve got the main point, right in the lead. Now let me explain why I don’t care about it.

First, let me say that I’m convinced that corruption has become so deep-seated in our political process that it’s become as American as apple pie and F-150 pickups. Same with incompetence. That’s as American as our so-called public education system and our inability to solve such problems as urban blight and poverty. It’s not that I’m happy with these things, since I’m not. But they are realities, just as the compass orientations of sunrises and sunsets and the phases of the moon are. It makes no more sense to rail against these overriding problems than it does to argue for new coordinates for the sun or a different schedule for the moon.

That might sound like a cop-out to you, and fair enough. In a way, it is. But that’s just touching the surface of things. It’s just setting the stage for the other things I have to say, the things I have to say about why I don’t care about the Russia thing. Did I tell you I don’t care about it? It’s true. I don’t.

I hope I don’t have to explain the Russia thing. Turn to almost any radio, TV, or print news or commentary, and you’ll hear or read probably more than you want to hear or read about the Russia thing. It’s almost impossible to ignore it, as much as you might want to. And depending on the slant of the medium to which you have turned, it’s either the worst thing since (pick one) Watergate/the Vietnam War/the Civil War/the beginning of recorded history, or it’s overblown and (in the words of former Obama-era Special Advisor for Green Jobs Van Jones) “a big nothing-burger” (to be fair to Jones, if that’s called for, he later clarified his statement to mean that nothing will come of the Russia thing, not that it wasn’t significant, in his view).

Russian Rubles
Photo FreeImages.com/2happy

So now here’s where I come down on this. It’s not that I don’t think corruption and incompetence are inconsequential – lord knows we’ve been saddled with both for most of this new millennium, which has gotten us where we now find ourselves – but just that I think things need to be put into perspective. And there has to be some sort of fair apportionment of blame and punishment, if there is to be any at all. And at the moment, I don’t think there is any likelihood of either, whether any perspective, nor any fair apportionment of blame or punishment.

As I’ve said in previous postings, it shouldn’t come as news to anyone that the Russians, and before them the Soviets, have been meddling, or at least trying to, in U.S. affairs for decades and decades. The earnestness with which it’s declared that there was Russian attempts to influence our elections is equivalent to Captain Renault, in Casablanca, declaring that he was “ . . . shocked – shocked – to find that gambling is going on here!” Oh, come on. Grow up, will you? At least Renault knew he was play- acting, which is more than can be said about our hysterical mainstream media and the Democratic side of the aisle.

There also is zero evidence that even one vote was changed or influenced by whatever Russia might have done, or not done. But there is tons of evidence that the internal corruption of the Democratic Party (not based in Moscow, last time I checked) had enormous influence on the outcome of delegate selection despite the results of many state primary elections in which Bernie Sanders came out the winner, or close behind, versus Hillary Clinton. Now one can reasonably argue that there is little chance Sanders could have bested a Trump, or almost anyone else the Republicans put up, but that isn’t the point. The point is the influence that Democratic National Committee corruption and incompetence had on the selection of H. Clinton as the Democratic candidate, or at least on the margin of delegates voting for her.

One can argue endlessly over whether it was the Kremlin that hacked and then released the tens of thousands of DNC emails – 44,053 emails and 12,761 attachments in the first tranche alone, released in July 2016 by Wikileaks – or an intermediary, or an independent third party. Wikileaks head Julian Assange, once a darling of the left, insists it wasn’t the Russian government, but he won’t divulge who the actual source was. Regardless, it was the substance of the emails leaked, more than who did the leaking, that, if anything, had an impact on how American voters viewed Hillary Clinton and the Dems. When I was a Foreign Service Officer and had a close call to make, the equation I’d put into play is how, whatever the decision was, it would look on the front page of the Washington Post. This apparently was not an equation that ever occurred to the top people of the DNC, like Debbie Wasserman Schultz, Donna Brazile, John Podesta, or many other top operatives within the DNC and the Clinton campaign. So instead of admitting to what they did, it’s easier to point the finger at the Russians and say it’s all their fault and, by some sort of illogical extension, Donald Trump’s fault, that things turned out as they did.

But things go beyond this, to one of my key issues about why I don’t care about the Russia thing. And that is the lack of impartial imposition of either justice or injustice, depending on how you see it. For her entire time as Secretary of State, Hillary Clinton used a private email server to conduct official State Department business, a clear violation of law and regulation covering handling of classified material, as well as any official government communication. Again, drawing on my experience having been in positions of trust handling highly classified materials, and familiarity with the documents I had to sign acknowledging my acceptance of the stringent requirements for handling such sensitive materials, I have never for a moment doubted that, had I done what Hillary Clinton did, I would have been put in prison. Which is where she should be. But instead, the political powers that be shielded Clinton from prosecution, with none other than FBI Director James Comey inventing a whole new legal concept, called “intent,” to exonerate her from prosecution while at the same time confirming she had broken the law. Pretty good line of reasoning, and one I bet a lot of criminals wish they could call on in their own defenses.

Regardless, what Hillary did almost certainly harmed national security far more, and provided more help and succor to the dreaded Russians, than anything Trump might have done.

But wait, it goes beyond that. Comey, in public testimony, admitted he had demurred to then-Attorney General Loretta Lynch’s suggestion that he refer to the Clinton investigation as “a matter” rather than as an investigation, and that isn’t called “collusion” on the part of Lynch and even Comey himself. But when President Trump asked Comey to conclude his investigation of Russian involvement in his campaign, after Comey on at least three occasions confirmed to Trump he was not the subject of the investigation, that is categorized as “collusion” and “obstruction of justice.”

Vintage Russian Car
Photo FreeImages.com/Ivaylo Georgiev

Going still further, now we have this meeting last June involving Donald Trump, Jr., and the Russian attorney Natalia Veselnitskaya. Here is where things get unbelievably smelly, and there are growing indications, if not actual evidence, that this meeting, and the entire supposed scandal, were actually engineering by Democratic operatives in an effort to frame the President and his son. One can reasonably argue that Trump Jr. should not have taken on this meeting, but it is now known that Fusion GPS, a group that initially worked with anti-Trump Republican candidates before turning to assisting the Clinton camp, set up the meeting with Veselnitskaya. This same group was responsible for release of a whole rack of salacious, and false, accusations concerning Trump Sr., including the now discredited report that he had engaged Russian prostitutes in a golden shower incident in a Moscow hotel.

If that is not enough, we see Veselnikskaya posting statements supporting anti-Trump demonstrations in Chicago on her Facebook page, but even that isn’t the punch line. The real punch line is when we see that Veselnikskaya was permitted into the U.S., after her visa application was denied, on what is called humanitarian parole, granted by, once more, former-AG Loretta Lynch. She additionally remained in the U.S. even after her parole expired in January 2016. Again, drawing on my consular and diplomatic experience, granting of humanitarian parole is an extraordinary measure, usually reserved for children and others seeking family unification, for emergency medical treatment, or for urgent refugee protection, outside normal visa guidelines. I have never heard of it being granted in a case like this, and the political implications are too hard to ignore.

Now Fusion GPS head Glenn Simpson says he will plead the Fifth if forced to testify before Congress. Republican Chuck Grassley and Democrat Dianne Feinstein have both said they want Simpson subpoenaed to testify before the Senate Judiciary Committee. Just to pose the question, if Fusion GPS is blameless in all this, why would Simpson need to hide behind the Fifth Amendment to avoid answering the committee’s questions?

Russian Street Kids
Photo FreeImages.com/Chris Greene

It’s now known that Obama knew of Russian efforts at meddling in the electoral process going back as far as July. But he failed to take any action until after Trump’s election when he imposed sanctions on the Russians, in December. Why would the President ignore what has now become such a big issue? There can be only one plausible explanation, which is that he never expected Trump to win and he didn’t want to muddy the political waters with his knowledge. But once Trump was elected, then the knowledge became the basis for attempting to embarrass the President-elect and to bolster the Democratic campaign to question his legitimacy.

One other key issue has gotten short shrift, and that is the extent of leaks coming from within the intelligence community and elsewhere in the government, Many of these leakers are actually committing felonies, releasing classified information to the media, and even Comey himself copped to being a leaker during his Senate testimony in June. But to date no one has been charged or prosecuted for these offenses.

Finally, we get to the media (how could we not?) Ever since the results of November 8 came in, it’s been “all Trump, all the time” for the mainstream media. Normally I wouldn’t object to the media trying to get to the heart of things – after all, I used to be a journalist, too – but where have most of the media been through the onslaught of scandals that cascaded out almost non-stop during the Obama years? Ask most Americans, and I would wager few have even heard of, much less could describe, the Fast-and-Furious scandal, the IRS scandal, or (though a few more might) the VA scandal. Most would not be able to tell you what happened at Benghazi, Libya, on September 11, 2012, or why the Obama Administration (including Hillary Clinton and then-U.N. Ambassador Susan Rice, and the President himself) chose to tell the American people a lie about the cause of those events for weeks and weeks afterwards. And it has never been made clear, in most U.S. media, why or how Hillary Clinton broke federal law and put U.S. security in jeopardy by her careless, callous, and illegal use of a private email server during her tenure as Secretary of State. And I could go on beyond these most notable scandals – there are many others most Americans have never even heard about — but the point is made.

Now we’re inundated with this Russia thing, and we’re to believe that not only were laws broken and our election stolen, but that treason and high crimes and misdemeanors were committed by the President and members of his close team. To which I say, first, bullcrap, and second, so? Even if these accusations are true, for which there is no evidence, why the unfair prosecution (whether in the media or the judicial system) of Trump when so many egregious offenses committed by Clinton, Lynch, Comey, Rice, and others, including Barrack Obama, go virtually unmentioned?

Meanwhile, real issues facing the country, ranging from healthcare to tax reform, from what to do about ISIS to what to do about Afghanistan, and on and on and on, get shuffled away under this tidal wave of the Russia thing and the one-sided coverage of “all Trump, all the time.”

Like I said earlier, if justice, or lack thereof, is to apply to one party, then let it apply to all parties. Until it does, and there is no sign that it will, then, no, I don’t care about the Russia thing.

This piece also appears on Medium. Follow me there, and here, and if you like the post please comment and share it.

Shell Game
The Biggest Shell Game in the World

The Biggest Shell Game in the World

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Healthcare has been all in the news these days with the U.S. Senate considering its version of whatever is to replace Obamacare. So it seems fitting to take a look at the intractable morass that is the American healthcare system. Which, as I see it, is better seen as the biggest shell game in the world, and as long as it is, resolving the issues surrounding it are likely to remain intractable.

You probably know what a shell game is. That’s the scam that sometimes crops up on city streets where the scammer, also known as a tosser, places a small ball or pea under one of three shells or cups, and then moves the shells or cups around on the table. The marks – people betting they can beat the tosser – have to guess which shell or cup contains the ball or pea. But of course the game is rigged, often with the ball or pea surreptitiously removed from the table altogether, so the marks lose their money. And that, of course, is the scammer’s objective. They’re not in the game for their health.

Now I don’t claim to be an expert on our healthcare system, but I’ve engaged with it enough and watched some of its inner machinations over the years to see how it resembles a classic shell game. You’ve probably seen it, too. How about those band aids that show up on the hospital bill for $8 (or whatever the current going rate is – a hospital in New Jersey charged a patient $8,200 for a band aid on a cut finger, plus $800 for a tetanus shot and a few other basic things). Or those $15 Tylenols, which can add into the hundreds of dollars during a typical hospital stay? And what about those nameless “specialists” who rush up to patients as they’re heading into the operating room so they touch the patient’s arm, crack a joke or two, and then send a sizable bill for hundreds or thousands of dollars for their “services.” And then there are those “itemized” hospital bills that can run pages long. Ever try checking one of those for “errors”?

I’ve done some research, too. For instance, the average cost of an MRI in the U.S. is $2,611. But price around to various hospitals and health centers, and you’ll find costs ranging from about $1,000 up to twice the national average (that’s what I found). Doing some number crunching, I determined the actual cost, depending on the rate of utilization and maintenance costs for any given installation, should be in the $250 – $500 range, which is close to what an MRI costs in Canada when paid for privately or with private insurance. The national average cost of a CT scan is $1,200, but the actual cost can range from $250 to $4,600. And during the discussion going on in the past week, I heard one person say they actually paid $9,000 for a CT scan. And that was after pricing around and driving something like 60 or 80 miles to get to it. What a deal!

The shell game doesn’t end there. A three-day hospital stay costs, on average, $30,000, and the average emergency-room visit runs $1,233. But I personally know of a case where someone was billed $6,300 for a four-hour visit where she spent most of that time sitting in a room by herself with a monitor draped around her neck. And that was 10 years ago. Yet, there are community health centers where one can be seen and treated for $20, or less. I’ve even had minor surgery at one of these centers, performed by a doctor, for $20. I can’t imagine what the same procedure would have cost had I gone to a hospital or private clinic.

Costs can also vary enormously, depending on whether one has insurance, the kind and terms of the insurance, is on Medicaid, pays cash, pays on time, or doesn’t pay at all. All these factors, which go to the heart of how our healthcare system is run and costs are assigned, guarantee these results. And the problems go beyond healthcare, reaching down into our educational system, where the outrageous costs of medical school cause medical students to run up enormous student-loan debt, often of a quarter of a million dollars and more. While eventually many of these medical graduates will earn significant salaries, the salaries for recent graduates and residents are a far cry from generous, falling in the range of $51,000 to $66,000 per year, before taxes, for an 80-hour work week. Taking that $51,000 figure, a new doctor working 48 weeks a year is averaging $13.28 an hour, less than many retail employees.

While the House, the Senate, the Administration, the Congressional Budget Office, and commentators on all sides of the current healthcare debate parse the finer points of the various bills and proposals on the table, the bigger issues seem to be lost in the cacophony. I can’t help but think that the special interests, the insurance companies and industry lobbyists, are given more consideration than the lowly patient. And whenever one hears the word “comprehensive,” it’s time to run for the exits since the fix is almost certainly in.

Perhaps the biggest issue of all concerns the near-complete divorce of healthcare costs from market forces. Healthcare providers, whether hospitals, private doctors, diagnostic labs, or clinics, are essentially businesses and, in aggregate, they form an enormous industry. In what other business or industry are costs not known, not set out in formal tariffs or schedules, and not subject to public scrutiny? Even airlines, for all their multitudinous fares and conditions, are forced to lay out their tariffs, and before customers buy tickets they know exactly how much they will cost.

While government regulates – to various degrees of effectiveness – the nature and quality of healthcare and medical practice, it does little to promote market forces. It is my contention that any healthcare provider should be required to post the rates or costs for any given procedure, action, or item. Even if there are different tariffs for different methods of payment, the consumer will at least have something to go on in deciding how and where to spend his or her healthcare dollar. And this will inevitably lead to price competition between providers and a brake on upwardly spiraling costs.

This divorce of healthcare costs from market forces also stems from how many Americans obtain their insurance, which is paid for or subsidized by their employers. There is no incentive for many Americans to price around (even if they could, given the price morass) and obtain the best bang for their buck. “Oh, the insurance will cover it,” is often the refrain. Now some insurance policies and plans do enforce certain limits on what providers within the plan can charge or be reimbursed for, and that helps control costs to some degree, but there is often a downside to the insured.

One downside is a limitation of choice, but the other side is the cost of administering these various insurance plans, approvals, billing, and so forth. In the U.S., 25% of healthcare spending goes to administrative costs. A full quarter of what we spend on healthcare. In our neighbor to the north, Canada, the administrative burden is half that – 12% – and most other countries have far lower administrative burdens than ours. Perhaps the only country that comes close to our burden is The Netherlands, with a 20% administrative burden.

While the U.S. often is criticized for lack of public support for healthcare, in fact our governments, federal, state, and local, spend more on healthcare than that spent by the governments of most other OECD countries. Overall per capita spending on healthcare puts the U.S. at the top of a list of 13 high-income countries – more than $9,000 per year, nearly three times the OECD average and more than double the next biggest spender, France – it is also near the top of the list of countries in public per capita spending on healthcare. Only Norway and The Netherlands spend more public funds on healthcare than the U.S., while Switzerland and Sweden rank just below the U.S. In fact, per capita public spending on healthcare in the U.S. is a third higher than in Canada.

What this indicates is that the U.S. does – and doesn’t – have a spending problem when it comes to healthcare. We’re certainly spending much more than what other countries are spending on healthcare overall, and even our public spending on healthcare exceeds what most other countries spend. But we’re not getting the results of some other countries in terms of total coverage of the population. And while it’s true that U.S. health results, measured in terms of life expectancy, infant mortality, and some other indicators, are below those of other countries even with our high outlays, there are mitigating factors influencing those results that are not as present in other countries.

By most standards, the quality of care in the U.S. is good, even excellent. And compared with other countries – including, again, our neighbor to the north – waiting times to see doctors, referrals to specialists, and to receive diagnostics and operations are significantly lower overall, though these can vary significantly from one area or region to another. While gaining access to the healthcare system can pose a challenge to many Americans, once that access is gained things tend to work pretty well, and better than in some countries with so-called universal coverage.

So where do we go from here? Okay, I have some ideas. These are my proposals, and while I can’t cite empirical data supporting their efficacy, I think they merit serious consideration and may allow us to gain control over this nationwide shell game:

● Introducing market forces by requiring all healthcare providers to develop, publicly post, and operate under specific costs and tariffs;

● Instituting public oversight of costs and charges of healthcare providers, including hospitals, clinics, private practitioners, and diagnostic labs, and allowing private suits and administrative processes challenging unreasonable or unsupportable costs;

● Encouraging individual initiative by expanding health savings plans where people can set aside a portion of their income to be applied to healthcare costs, and allowing them to roll over funds not expended from year-to-year;

● Encouraging employers to offer their employees allowances which employees can use to shop around and acquire their own insurance plans (often at lower cost than group policies), and further allowing tax deductions to cover insurance premiums and other healthcare costs;

● Allowing insurers to offer a variety of plans covering a range of services, and not requiring services that a given insured determines he or she is unlikely to need, such as mental health services or pregnancy coverage;

● Not restricting insurers to certain states but allowing them to operate across state lines;

● Taking steps to reduce the administrative burden and associated costs;

● Directing greater public funding toward community health centers and using these centers to provide health care, on sliding cost scales, especially to lower income and uninsured parties;

● Encouraging formation of healthcare cooperatives, both private and public, and allowing both insured and uninsured people to join them;

● Developing public policies and pressure to reduce the cost of medical education;

● Allowing write-offs of most or all debt or costs incurred by medical students in return for a certain period of service, at reduced salary levels, in rural and other under-served areas (as is done in some countries);

● Developing policies increasing the numbers of medical, nursing, and allied health students to address national shortages in these fields, applying the law of supply and demand to reduce costs and improve access;

● Applying both public and private initiatives to controlling the cost of pharmaceuticals;

● Instituting reasonable limits on medical malpractice claims to help contain the cost of malpractice insurance.

Again, I don’t claim to be an expert on healthcare, and I don’t claim to have all the answers. But I think these steps could go far toward expanding access to healthcare, controlling costs, and getting the runaway train of American healthcare back under control, without further straining public budgets. And it’s time we put a stop to the shell game inherent to the American healthcare system.

I welcome comments, criticisms, and other suggestions to what is said and proposed here. And please share this posting with your social networks and others who might have interest in the topic.

This piece also appears on Medium. Follow me there, and here, and if you like it please comment and share it.