Healthcare reform debate seems incomplete when viewed through multiple links

Full disclosure: In the past, I have worked doing public relations for hospitals in Michigan, one large, one small.

News coverage of the healthcare reform debate can be fascinating, if you can set aside the human costs of inadequate health care.

A doctor bemoans the fate of medicine as health care becomes a business. Dr. Sandeep Jauhar writes in the New York Times that he became a physician to care for patients, not to be a businessman, but considering costs has become a high priority for doctors.

In the same issue of the Times an editorial suggests that as much as $700 billion per year, or 30 percent of U.S. healthcare spending is wasted.

That amount of waste seems plausible when you consider that the U.S. spends more per capita than any other country, according to World Health Organization (WHO) figures. Question: How is it that we can spend so much per person on health care when so many people are not covered by insurance and so, supposedly, do not access health care? According to this link, that and other assumptions about the uninsured are not necessarily correct. Still, with 15 percent of the population uninsured—almost 50 million individuals—the rate seems too high.

When the debate leaves numbers behind and goes to quality, there seems to be a difference of opinion as well. Does the United States have the best healthcare system in the world as some claim when they oppose healthcare reform? The WHO disagrees. (This information is from a 2000 report available here. The 2008 version also is available. Apparently the reports do not update the quality rankings each year.)

The point is not that conflicting opinions and information exist. The point is, that even with a cursory search of the Internet, and taking into account that the information from different sources isn't likely to be equally reliable, news media coverage of the current healthcare debate could be MUCH better.

More later,
Russ

Education is a culture we could choose to share... but don't

Cultural diversity is running rampant in the United States. Or, more accurately, most Americans claim a link to and a pride in their ethnic, geographic, religious, or other "roots."

What Americans aren't doing is becoming fluent in any culture but the one they like the best. There's nothing inherently wrong with embracing some aspect of your history, but as most Americans speak only English, most Americans only embrace or even acknowledge one culture.

We are all members of multiple cultures. Hardly anyone in the U.S. is a member of only one ethic group. The majority can trace their lineage back to multiple countries. Go back far enough and every family will find a change of religion somewhere in its history. But, many (I suspect most) people choose to identify with only one culture from their family or personal background.

Choosing one culture is not a problem. Choosing only one culture is a problem.

Why? Because it separates us and gives us notions such as "The War on Christmas," (which has spawned at least one book on the subject). A lack of multi-cultural fluency causes differences in cultural to be viewed as attacks.

One culture that we all should share (there are more) is the culture of education.

It's a fairly standard belief in the United States that going to college is a good thing. It is, but not for the reason most people cite – to get a good job. The most important thing college students can learn is how to be a part of the shared culture of education. Here are some aspects of that culture:

• be skeptical, but open-minded
• think critically
• evaluate the evidence
• if there is no evidence, do some research to find some
• respect other people's ideas
• give credit where credit is due

Anyone familiar with higher education in America might not recognize these as aspects of actual academic culture, and rightly so, but they serve as a starting point. This list is clearly not exhaustive and should apply to elementary and secondary education as well as higher education.

Americans go to public or private school, or are home-schooled because the law requires it. The law requires it because it gives Americans one basis for shared culture and understanding. It allows us to embrace our diversity without embracing separateness.

More later,
Russ

How many people are EMPLOYED?

The jobless rate is the top story for many news outlets, with a loss in June of 467,000 jobs, according to the New York Times. It's a huge number. It puts the U.S. unemployment rate at 9.5 percent. Our economy has lost 6.5 million jobs since January 2008. No surprise, the announcement sent the stock market lower. The market seems to react to news almost emotionally to almost any negative announcement.

Couldn't news be reported differently so that the market wouldn't be as "depressed" by the numbers? Journalists are taught that the significant is newsworthy. If that's true, than why isn't the number of EMPLOYED people being reported?

Is reporting only the negative a form of bias? I don't want to suggest that we should get only happy news, but how the news is reported makes a difference. Compare FOX News and MSNBC or the New York Times and the Washington Times. They report on the same news (mostly), but treat it differently.

Is reporting the employment rate as well as the unemployment rate an option? Would it make any difference? To people? To the stock market?

More later,
Russ

The "Best and Brightest" seem pretty dim these days

While I suspect that the George W. Bush economic policies, or lack thereof, are at least partly responsible for the current global recession, there is something much more important at the root of our economic woes, at least here in the United States.

America has seen itself as the best and the brightest of nations – innovative, talented, able to solve any problem – but that just doesn't seem to be true any more. Maybe it never was, but I think the United States, as a nation, lacks vision – in both senses of the word. We lack a vision of how to be innovators in all aspects of business, politics, life, and world leadership, and we can't seem to see that anything is wrong with us.

What's wrong? Here's my take:

Short-term thinking
The auto business is a good example of short-term thinking. American car companies focused more on SUVs and pick-up trucks because they would sell now, rather than focusing on the cars Americans would need in the future. They fought improved mileage standards and safety ratings rather than looking toward the future by developing more fuel-efficient vehicles. The result has been billions in losses and government bailouts.

The argument in favor of the Big Three groupthink has been that they are making cars the American people want and will buy. True enough as far as it goes, however, I can't fathom why auto industry executives, receiving huge salaries, couldn't see the changes coming (gas prices? pollution abatement?) and prepare for them unless there was a reward for short-term thinking and/or a punishment for long-term thinking.

The laws governing business, at least publicly-traded businesses, provide that reward and punishment. I'm generalizing here, but the rules governing businesses tracked by the Securities and Exchange Commission essentially state that the primary duty of a publicly-traded business (and its officers) is making money for shareholders. Therefore, any decision that negatively affects the stock price is a potential SEC violation. Investing in the future might be the smart thing to do, but it might also mean lower profits, lower stock prices, and dissatisfied shareholders.

Taken to the extreme, this is silly, but shareholders want money and they want it now. CEOs and boards of directors listen to shareholders. Shareholders have even been known to sue over actions that affect stock prices.

Stock prices or even high profits are not the only measures of a successful business. A business that gets away with illegally dumping toxic waste might be more profitable for its shareholders, but that doesn't make it a good company. The company's costs are just spread to the community at large in the form of (potentially) poor community health, degraded wildlife habitat, and toxic waste clean up.

Narrow thinking
Short-term thinking is in itself a form of narrow thinking, but being narrow minded has other aspects as well. Education is a great example. Most Americans would likely agree that a college education is a good thing. Why? There are a number of reasons: the ability to be a more effective citizen in a democracy, self-actualization, leaving a legacy of learning and knowledge to your children, better health, and others. But the main reason? The one everyone mentions first? Most often the only one people can think of? A college degree means a job that pays well.

A few years ago, I assigned students in several sections of a basic college composition class (English 101 or the equivalent) a paper that described the elements of a good education. Of the 90+ students who turned in a paper, ALL of them had only one requirement for a good education: a good education results in a job that pays well. Not a job that they loved, or at least could tolerate, only a job that provided a lot of money.

I can forgive this kind of narrow thinking in students. They are, by definition, ignorant of some of the more subtle aspects of education. One of the reasons for going to college is to learn to think more broadly. Unfortunately, many of the people in business and education in this country don't seem to have learned that lesson and America has suffered as a result. We have CEOs that can't think beyond profit and engineers that can't think beyond the way things were done 20 years ago.

Selfish thinking
All the narrow and short-term thinking, along with consumerism and a lack of understanding of what personal liberty really entails, has led Americans to be a particularly self-absorbed group. Too many people think that the world revolves around them, and only them.

While it's true that each of us can only respond to the world from our own experience, we should consider more than just ourselves when we interact with the world. Society is created from our interactions, and always interacting selfishly can lead to dire consequences.

Global warming? I don't know all the science, but response to global warming shows how we think selfishly. Critics suggest global warming does not exist or that it is not caused by human beings. I won't argue the points, but the general response to warnings seems to be that limiting emissions will hurt business. I have no doubt of it, but the potential death and suffering of billions of people does not seem comparable to reduced profits for business. I recognize that reduced profit affects people as well as businesses, however, the opportunity presented for business by the new technology required for doing business with limited emissions should more than overcome that suffering.

Caveats
This is obviously a book-length topic, so there are many arguments left unaddressed. I'm not sure if I have this book in me at the moment. In any event, comments are welcome, and if you know of a book that does cover this topic, let me know.

More later,
Russ

"Truth Commission" a must

Leonard Pitts Jr. is just one more "journalist" that doesn't get it. His column on why the U.S. should not have a "truth commission" characterizes the Bush administration as merely incompetent. In many ways it was incompetent, but when it comes to torture, warrantless wiretapping, and other "war on terror" misdeeds, the evidence seems to show that the Bush administration did these things mindfully. Whether or not anyone is convicted, the rule of law requires that we (Americans) investigate this possible law breaking. If we don't at least see if it's prosecutable, why would anyone hesitate to do it again?

More later,
Russ

North Korea to be punished for nukes: Who decides punishment?

North Korea has tested another nuclear weapon – this one seemingly more effective than the first – and the rest of the world cries for punishment.

Well, maybe not the whole world. The countries crying most loudly for sanctions on North Korea are the countries that already have nuclear weapons. If the United Nations called for sanctions on China, France, the United States, or Great Britain, each would respond arrogantly that nuclear weapons were their sovereign right, and that no amount of sanctions (never going to happen, but play along anyway) will force [insert country with nukes here] to give up needed tools for defense.

So my question is what gives the United States and others the sovereign right to nuclear weapons, but denies that right to other sovereign nations?

I don't think nuclear weapons are a good idea no matter which country has them, but for states that have them to sanction states that develop them seems more than a little self-serving. The argument against "rogue" states such as North Korea getting nuclear weapons is that the more nukes that exist, the better the chance they will be used. GOOD POINT!

Why then, don't the United States and other nuclear powers get rid of their nukes?

Mutually assured destruction? There's got to be a better way.

Smells like hypocrisy to me.

More later,
Russ

Logic is as logic does

Seeing the new Star Trek* movie this weekend reminded me of a definition of logic I employ often:

Logic is the set of assumptions you embrace to get the result you want.

I seriously doubt that this is original with me, but I haven't found a source for this beyond myself... so far. I will keep looking.

I also know that scholars of formal logic and reasoned thought may find this unpalatable, but in my experience this is how most people use logic.

More later,
Russ

*Logic, Vulcans, and all that, etc.

The rule of law is the ONLY way to fight terrorism

Torture: From left or right, nobody gets it
Two columnists, both distributed by Tribune Media Services, one identifying himself in the column as a northern liberal, and the other clearly conservative, had columns on the torture memos/controversy in my local paper recently.

Garrison Keillor and Cal Thomas each wrote about torture of "enemy combatants," the release of information about torture, and what should be done about it. Each had a good point or two, but both got it exactly wrong for the same reason.

The Liberal
Keillor wants a Truth Commission or Congressional investigation, but says no one should be held accountable:

The free play of sadism on the helpless in the name of national service is not to be ignored. What's needed is a fair and thorough congressional investigation. Subpoena witnesses and lay the whole wretched business out on the public record. Look into the heart of darkness and meditate on it. But don't round up a few symbolic suspects and throw the book at them and let all the others go free. Which is what would happen if we launch a criminal prosecution.

I'm all for the unvarnished truth, but "Look into the heart of darkness and meditate on it?" This is the kind of fuzzy-headed, pseudo-self-esteem building psychobabble that characterizes the worst of American liberalism. If all we do is gaze at our collective navel, our national self-esteem will be damaged even more than it has been by the "alleged" criminals in the Bush administration.

There's nothing wrong with feeling good about ourselves as a nation, but we also should feel bad about being Americans when the United States does things that are wrong — like torture.

The Conservative
Thomas, of course, says that there's nothing wrong with these "enhanced interrogation techniques" because getting information that will save American lives requires using any means necessary. These are bad guys so torturing them is OK.

Most of Thomas' column isn't about whether or not using torture should be allowed. That America should torture terrorists is a given for him. One of his arguments is that information about torture or "enhanced interrogation techniques" should not be released because it helps America's enemies. He quotes a former director of the CIA saying essentially that Loose Lips Sink Ships:

Porter Goss, the former director of the CIA and former chairman of the House Permanent Select Committee on Intelligence, wrote an op-ed column for The Washington Post recently in which he said, “I feel our government has crossed the red line between properly protecting our national security and trying to gain partisan political advantage. We can’t have a secret intelligence service if we keep giving away all the secrets.”

Goss is not a wishful thinker: “The suggestion that we are safer now because information about interrogation techniques is in the public domain conjures up images of unicorns and fairy dust. We have given our enemy invaluable information about the rules by which we operate.”

"The rules by which we operate" are the heart of the matter
What Keillor and Thomas fail to grasp, and what Goss accidentally pointed out, is that while Americans may not be able to come to agreement on the definition of torture, or whether or not information gathered using torture is reliable, or even the morality of using torture to possibly save lives, the United States was founded on the principle of the rule of law. We make rules (laws) and everyone in this country is obliged to follow them or face punishment.

Torture is banned by United States law. Prosecution must take place, even if it makes us uncomfortable. Ignorance of the law is no excuse. Even if it were, the release of so-called "torture memos" make it clear that no one involved was ignorant of the law against torture. Following orders, good intentions (how someone can torture another human being with good intentions is beyond me), or even saving lives are not viable excuses. They might mitigate punishment, but unless the rule of law is enforced, we are no better than terrorists.

More later,
Russ

Dick Cheney coverage misses the point

By now, anyone keeping up with the news has heard that former Vice President Dick Cheney (the king of secrets) wants the Obama administration to declassify MORE memos about torture.

The recently released memos show how the Bush administration lawyers justified torture. Cheney wants CIA memos that show how torture was effective because it led the U.S. to knowledge that allowed the CIA (or whomever) to foil terrorist plots. Journalists (at least in the news that I've seen, CNN & FOX are two) are building their coverage around pundits on either side.

THIS COVERAGE IS IRRELEVANT!

Torture is ILLEGAL under U.S. law, no matter what the pundits say. The reasons don't matter.

Torture is illegal whether it is done to foil terrorists or if it is done because the torturers just enjoy torturing people.

More later,
Russ