I have already addressed some of these issues but we were discussing them once again and I thought I would reorganize the thoughts, specifically about the new blue battle dress uniform (BDU) and some other Navy recent uniform changes. I have some questions for Task Force Uniform about the new blue BDU uniform.
First: This uniform can only be worn on naval installations and aboard ship. Sailors cannot stop for gas, groceries or any other routine stop between work and home. If the uniform has to be worn only among other naval personnel, who are the people in a camouflage uniform hiding from? Aboard a ship or on a naval installation should be the safest environment in which naval personnel will ever be located. Why is it necessary to wear camouflage?
Second: Assuming everyone is wearing this camouflage uniform on board a ship, does it make any sense at all to be wearing a blue camouflage uniform when a sailor falls overboard? It is hard enough to find someone in the ocean without the added disadvantage of having the person in the water in a purposely difficult to see uniform. Maybe a shipboard uniform, which is worn virtually nowhere else, should be reflective yellow or fuchsia to be seen.
Third: In rapid evolutions (man overboard or general quarters), why come up with a uniform that takes longer to don than the current uniforms? Having worn BDUs in many deployments, they are a hassle to wear correctly with trousers bloused. People will argue that blousing isn’t necessary in a hurry. The counter argument is then why put in place a uniform which ever requires blousing on a ship?
Fourth: Another justification for the BDUs which has been offered is that it will make sailors feel more like “warriors”. This has to be the most condescending, insulting comment ever. Is anyone actually implying that Sailors in blue jeans and white T-shirts who fought throughout World War II were wimps? Are submarine Sailors in coveralls that perform so admirably upon submarines not warriors? I suppose it is a good thing that Task Force Uniform finally came up with a uniform which will make SeALs feel like warriors. This is the worst made up excuse for a uniform ever.
Fifth: If a Sailor deploys in a joint arena with the Army or the Marine Corps, will a Sailor be able to wear this new BDU uniform? Of course not, it is BLUE. If it makes you feel like a warrior, why is it inappropriate? The Sailor will wear either the Army colors or Marine Corps colors to blend in. So now we have a battle dress uniform which can only be worn in battles at sea. It isn’t used in land battles. That is ridiculous. Why come up with a uniform for combat that can't be worn most of the places where combat happens?
Sixth: The cost of the new uniform is $410.05 before the name and rank devices are attached. This uniform costs two to four times the uniforms it replaces. That is a lot of money for a relatively useless uniform. Whose idea was it to come up with an almost prohibitively expensive uniform?
Seventh: The Army and the Air Force allow their members to stop for routine necessities in their BDU uniforms. Assuming that there is a legitimate reason for the uniform (which I haven’t found), why would Task Force Uniform agree to one that is so hideous that no one can be seen in public wearing it? If the Army and Air Force uniforms are acceptable, why not change to Navy versions of similar ones? Someone commented that the leadership wanted time to have people get used to wearing it. Once again, it is incredibly insulting to imply that experienced Sailors cannot figure out how to wear a new or changed uniform and follow instructions.
Now, let's talk about the new physical training uniform. Only Task Force Uniform could come up with a physical training uniform for Sailors which cannot be laundered on a ship. It melts. Additionally, when Sailors bought it, it was like a tourniquet on the upper thigh. It is obviously poorly thought out and a total waste of money.
Let's talk about the new boots for the useless BDU uniform. There are two varieties. All of the other services now have suede finish boots which do not require polish. They are easier to care for and, not coincidentally, harder to be spotted by enemy snipers. Task Force Uniform, in their infinite wisdom, came up with two different black boots. One suede finish boot can only be worn on shore installations. A smooth polished boot must be worn aboard ship because of the sole and steel toes. You can wear the smooth boot on ship or on shore. Let's see... at about $120 a pair, do you think anyone would buy the boot you can only wear on shore if the other can be worn anywhere? Of course, this means that if a Sailor goes anywhere on land in a combat zone, he/she will have to buy the khaki suede boots to go with the Army or Marine Corps uniform. So, my questions would be: Why not find a suede boot with the correct soles and steel toes? Manufacturers will climb over each other to produce them. Why not use the khaki boots everyone else uses? Marines wear the khaki boots when they are on amphibious assault ships. Should they be less safe than Sailors?
Task Force Uniform has really screwed the pooch on this one. Someone in authority needed to squash these things. This is analogous to the ill-fated enlisted uniform of the mid 1970s which temporarily replaced the classic blue jumper uniform. This is the "New Coke" of the Navy's recent past. I suppose the Task Force Uniform members feel obligated to do something to justify the billets and the budget but doing dumb stuff just to do something is not adequate justification for these fiascoes. One of two things will happen with this new blue uniform, either it will go away after a long enough trial period to allow the people who came up with it to save face (and the manufacturer to make a lot of money), or the policies will change and the uniform will have similar limitations to the Army and Air Force. In the mean time, Sailors will have to take the costs on the chin so some manufacturer can get rich.
Sunday, February 22, 2009
Friday, February 20, 2009
Complaining About the Inevitable Results of Your Choices
One of the silver linings of the re-election of Marion Barry as Washington, DC Mayor a few years ago after his crack cocaine bust was that the whole DC statehood issue went away. After all, could folks who elect a crack head as mayor possibly be reputable voters? The issue has recently reared its ugly head again but only because the Democrats want to try to have more seats in Congress. It has nothing to do with fairness or people’s rights. In addition, the Democratic White House wants to manipulate the 2010 census numbers to increase Democratic seats in Congress and funding to Democratic districts. President Obama may become “Papa Doc” Obama if Rahm Emmanuel is unchecked in his power to skew the census. It got me thinking of a broader set of issues which have to do with complaints about the results of knowing choices. The theme will emerge as we look at some seemingly disparate issues.
When you become a resident of Washington, DC, you do so knowing that since the advent of the city, it was meant to be and still is a federal territory providing a location for the federal government. It was created from land ceded to the federal government from Maryland and Virginia for specifically that purpose. The Virginia side was returned to the state in 1846. People have suggested all kind of options: making the District of Colombia a state, ceding it back to Maryland, etc. I suppose it is appropriate to point out that the establishment of the District of Columbia as a federal territory is mandated in the Constitution Article I, Section 8, Clause 17 and specifically argued for in Federalist No. 43. It was a sensitive issue after Continental soldiers marched on Philadelphia when it was the capitol and caused the Congress to flee to New Jersey. The point I am making is that when you move to a federal territory and then complain about living within the rules of a federal territory, you are an idiot. That is like moving from one state to another state by choice and complaining about the new home state’s sales tax. You moved there, suck it up.
In Virginia Beach, Virginia, the Oceana Naval Air Station has been an active home to many US Navy fighter and bomber jet squadrons for many years. As the city allowed development to sprawl because of the housing boom and their desire for tax revenue, developments of housing encroached closer and closer to the air station. A couple of years ago, there were many outcries from people who bought homes and lived near the air station complaining about the noise from the fighter jet engines as they passed overhead. It is funny how when the Navy proposed to move the entire base to Florida, taking hundreds of millions of tax dollars from Virginia Beach, all of a sudden everybody LOVED jet noise. If they had built the air station after you already lived there, you would have had a valid complaint. If you bought a house at the end of an existing runway and then complain about jet engine noise, you are an idiot. You moved there, suck it up.
If you live in a Democratic controlled state and you complain about the lack of tort reform, higher taxes, unfriendly atmosphere toward business, companies leaving the state, or social programs for illegal aliens funded out of your tax money, you should move or vote for someone else. Those are bedrock principles of the Democratic Party. The largest single contributor to the Democratic Party is the Trial Lawyers Association. If you think the Democrats will ever pass a law which costs lawyers money, you are smoking crack. Liberals always think the government knows more about what you need than you do. Other huge contributors to the Democratic Party are labor unions. Business is evil to liberals. Business is evil to labor unions. Therefore, a perfect marriage: liberals and labor unions. If you continue to vote those folks into office, businesses cannot prosper and go to where they can prosper, taxes stay high because the businesses leave, causing more to leave. What you end up with is Michigan. If you live in a place like that and support the liberals, you deserve what you get. You live there, suck it up.
I remember several young women in the US Air Force who were on CNN at the beginning of the first gulf war with their parents complaining about the war. These two “rocket scientists” actually had the gall to say, “We joined the Air Force to get a college education, not to go to war”. They might as well have “idiot” tattooed across their respective foreheads. If you join a military organization, you might find yourself doing military things. I have heard Sailors complaining about being at sea. In fact, it is said that a Sailor is never happy except when complaining. I suppose if you join the Navy, you should probably be aware that the Navy has ships which sail on and under the oceans. If you join the Army or Marine Corps, you should expect to spend some time with a rifle. If you join the Air Force, you might find yourself in an aircraft. Anyone who can’t figure out those things is an idiot. The American military is an all volunteer force. No one is drafted. You joined the service; suck it up.
The overwhelming majority of Americans are associated with some religion. The founding fathers did not want religious groups taking over the government and imposing their views on others who did not share the same views. That is the Islamic state model. In contrast to what is being espoused by some recently, the founding fathers were not against religion. In reading the writings of Alexander Hamilton, Thomas Jefferson, George Washington, James Madison, John Jay, and on and on, there was a common thought that the freedoms sought after in this country were of divine origin and that divine providence was part of the very formation of the nation. Currently, the American Civil Liberties Union wants to remove all reference to religion from everything the government touches. With the Democrats now controlling all three branches of government and expanding greatly on the Republican mistakes of late 2008, the US government is rapidly getting involved in the financial system, automobile manufacturing, the housing market, and other private industries. There will soon be nothing that the government does not touch. Therefore, there will be no place for religion in the nation. That is clearly not what the founding fathers intended. If you elect leaders who agree with this philosophy and who appoint judges who agree, you deserve what you get. If you elected them: don’t complain, suck it up.
The goofy woman who had eight embryos implanted and ended up with fourteen children despite being uneducated, unemployed and living in her parent’s home made a selfish choice. She is banking on the state of California welfare and Medicaid system to pay for her children. People will argue that you shouldn’t punish the children for the idiocy of the mother. I agree. Take the children and put them in proper homes. They are doomed with this incompetent arrogant fool as a parent. She made the choice to have them. She can either find a way to adequately care for them or lose them. The taxpayers have big hearts and have no problem helping distressed children. However, they have no obligation to help the mother. She made the choice; she can suck it up.
Most people who work for a living have a fairly good idea how much money they earn. Knowing that information is fairly important in determining how much stuff you can buy. I recently bought a house. Before I did so, I sat down and spent a great deal of time determining if I could afford the payments on the house. That is apparently a novel idea to some people. Because I did figure out how much I could afford, the current downturn in home values would only affect me greatly if I had to move anytime soon. Therefore, I do not plan on doing so. In fairness, I should point out that this does not apply to you if you lost your job in a lay off. I also saved some money just in case of hard times, another old school idea. Thank you for teaching me that lesson, Dad. There has been a recent wave of conspicuous consumption. Everyone has to have the biggest car, a huge plasma television, and the list goes on and on. Apparently, everyone wants to be on MTV Cribs. I am currently driving my well-maintained 2001 vehicle, watching my normal television, and not wearing ridiculously priced clothing. I do not run up tens of thousands of dollars in credit card debt which I cannot pay back. Therefore, if you do spend a lot more than you earn, I have no obligation whatsoever to bail you out. You spent the money; watch the bad economic news on your giant screen plasma television and suck it up.
In a much larger version of the same theme, California has for years passed ridiculous anti-business laws and watched the businesses flee from the state. California gives health care and free public education to illegal aliens. California passes liberal policies which cost fortunes and environmental policies which raise costs. California is sitting on billions of dollars in off shore oil and natural gas but won’t allow it to be tapped. To expect the other states which act responsibly to bail California out for its inane policies and irresponsible spending plans is idiotic. The people of California voted in that lame government, let them live with it. Other states are under no obligation to allow the state of California to continue with their insipid policies. California spent the money; they can suck it up.
There is an axiom that insanity is performing the same act over and over again and expecting a different result. Electing liberal politicians inevitably results in higher taxes, more intrusive government, disparagement of religion, discouragement of business, artificial inflation of wages for union workers, more money for attorneys resulting in increased insurance premiums, and less incentive to work. In the liberal world, nothing is ever anyone’s fault. Everyone is a victim of circumstance. A famous golfer once said that the harder he practiced, the luckier he became. Making any choice for which the outcome is inherently obvious and then complaining about that inevitable outcome and expecting someone else to come to your rescue for your foolish choice is shirking responsibility and idiotic. You live with the result of your choices. That is why they should be taken seriously.
When you become a resident of Washington, DC, you do so knowing that since the advent of the city, it was meant to be and still is a federal territory providing a location for the federal government. It was created from land ceded to the federal government from Maryland and Virginia for specifically that purpose. The Virginia side was returned to the state in 1846. People have suggested all kind of options: making the District of Colombia a state, ceding it back to Maryland, etc. I suppose it is appropriate to point out that the establishment of the District of Columbia as a federal territory is mandated in the Constitution Article I, Section 8, Clause 17 and specifically argued for in Federalist No. 43. It was a sensitive issue after Continental soldiers marched on Philadelphia when it was the capitol and caused the Congress to flee to New Jersey. The point I am making is that when you move to a federal territory and then complain about living within the rules of a federal territory, you are an idiot. That is like moving from one state to another state by choice and complaining about the new home state’s sales tax. You moved there, suck it up.
In Virginia Beach, Virginia, the Oceana Naval Air Station has been an active home to many US Navy fighter and bomber jet squadrons for many years. As the city allowed development to sprawl because of the housing boom and their desire for tax revenue, developments of housing encroached closer and closer to the air station. A couple of years ago, there were many outcries from people who bought homes and lived near the air station complaining about the noise from the fighter jet engines as they passed overhead. It is funny how when the Navy proposed to move the entire base to Florida, taking hundreds of millions of tax dollars from Virginia Beach, all of a sudden everybody LOVED jet noise. If they had built the air station after you already lived there, you would have had a valid complaint. If you bought a house at the end of an existing runway and then complain about jet engine noise, you are an idiot. You moved there, suck it up.
If you live in a Democratic controlled state and you complain about the lack of tort reform, higher taxes, unfriendly atmosphere toward business, companies leaving the state, or social programs for illegal aliens funded out of your tax money, you should move or vote for someone else. Those are bedrock principles of the Democratic Party. The largest single contributor to the Democratic Party is the Trial Lawyers Association. If you think the Democrats will ever pass a law which costs lawyers money, you are smoking crack. Liberals always think the government knows more about what you need than you do. Other huge contributors to the Democratic Party are labor unions. Business is evil to liberals. Business is evil to labor unions. Therefore, a perfect marriage: liberals and labor unions. If you continue to vote those folks into office, businesses cannot prosper and go to where they can prosper, taxes stay high because the businesses leave, causing more to leave. What you end up with is Michigan. If you live in a place like that and support the liberals, you deserve what you get. You live there, suck it up.
I remember several young women in the US Air Force who were on CNN at the beginning of the first gulf war with their parents complaining about the war. These two “rocket scientists” actually had the gall to say, “We joined the Air Force to get a college education, not to go to war”. They might as well have “idiot” tattooed across their respective foreheads. If you join a military organization, you might find yourself doing military things. I have heard Sailors complaining about being at sea. In fact, it is said that a Sailor is never happy except when complaining. I suppose if you join the Navy, you should probably be aware that the Navy has ships which sail on and under the oceans. If you join the Army or Marine Corps, you should expect to spend some time with a rifle. If you join the Air Force, you might find yourself in an aircraft. Anyone who can’t figure out those things is an idiot. The American military is an all volunteer force. No one is drafted. You joined the service; suck it up.
The overwhelming majority of Americans are associated with some religion. The founding fathers did not want religious groups taking over the government and imposing their views on others who did not share the same views. That is the Islamic state model. In contrast to what is being espoused by some recently, the founding fathers were not against religion. In reading the writings of Alexander Hamilton, Thomas Jefferson, George Washington, James Madison, John Jay, and on and on, there was a common thought that the freedoms sought after in this country were of divine origin and that divine providence was part of the very formation of the nation. Currently, the American Civil Liberties Union wants to remove all reference to religion from everything the government touches. With the Democrats now controlling all three branches of government and expanding greatly on the Republican mistakes of late 2008, the US government is rapidly getting involved in the financial system, automobile manufacturing, the housing market, and other private industries. There will soon be nothing that the government does not touch. Therefore, there will be no place for religion in the nation. That is clearly not what the founding fathers intended. If you elect leaders who agree with this philosophy and who appoint judges who agree, you deserve what you get. If you elected them: don’t complain, suck it up.
The goofy woman who had eight embryos implanted and ended up with fourteen children despite being uneducated, unemployed and living in her parent’s home made a selfish choice. She is banking on the state of California welfare and Medicaid system to pay for her children. People will argue that you shouldn’t punish the children for the idiocy of the mother. I agree. Take the children and put them in proper homes. They are doomed with this incompetent arrogant fool as a parent. She made the choice to have them. She can either find a way to adequately care for them or lose them. The taxpayers have big hearts and have no problem helping distressed children. However, they have no obligation to help the mother. She made the choice; she can suck it up.
Most people who work for a living have a fairly good idea how much money they earn. Knowing that information is fairly important in determining how much stuff you can buy. I recently bought a house. Before I did so, I sat down and spent a great deal of time determining if I could afford the payments on the house. That is apparently a novel idea to some people. Because I did figure out how much I could afford, the current downturn in home values would only affect me greatly if I had to move anytime soon. Therefore, I do not plan on doing so. In fairness, I should point out that this does not apply to you if you lost your job in a lay off. I also saved some money just in case of hard times, another old school idea. Thank you for teaching me that lesson, Dad. There has been a recent wave of conspicuous consumption. Everyone has to have the biggest car, a huge plasma television, and the list goes on and on. Apparently, everyone wants to be on MTV Cribs. I am currently driving my well-maintained 2001 vehicle, watching my normal television, and not wearing ridiculously priced clothing. I do not run up tens of thousands of dollars in credit card debt which I cannot pay back. Therefore, if you do spend a lot more than you earn, I have no obligation whatsoever to bail you out. You spent the money; watch the bad economic news on your giant screen plasma television and suck it up.
In a much larger version of the same theme, California has for years passed ridiculous anti-business laws and watched the businesses flee from the state. California gives health care and free public education to illegal aliens. California passes liberal policies which cost fortunes and environmental policies which raise costs. California is sitting on billions of dollars in off shore oil and natural gas but won’t allow it to be tapped. To expect the other states which act responsibly to bail California out for its inane policies and irresponsible spending plans is idiotic. The people of California voted in that lame government, let them live with it. Other states are under no obligation to allow the state of California to continue with their insipid policies. California spent the money; they can suck it up.
There is an axiom that insanity is performing the same act over and over again and expecting a different result. Electing liberal politicians inevitably results in higher taxes, more intrusive government, disparagement of religion, discouragement of business, artificial inflation of wages for union workers, more money for attorneys resulting in increased insurance premiums, and less incentive to work. In the liberal world, nothing is ever anyone’s fault. Everyone is a victim of circumstance. A famous golfer once said that the harder he practiced, the luckier he became. Making any choice for which the outcome is inherently obvious and then complaining about that inevitable outcome and expecting someone else to come to your rescue for your foolish choice is shirking responsibility and idiotic. You live with the result of your choices. That is why they should be taken seriously.
Wednesday, February 18, 2009
Another Day, Another Stimulus Hose Job
Well, here comes another “stimulus package”. This time it is $75 billion for troubled mortgages. Of course, there is no reduction in mortgage rates for anyone who is currently paying their mortgage on time. Is anyone else seeing the trend in all of these stimulus and bail out packages? Let’s see if we can spot a common theme in these packages.
In the case of the bank bail out, the Treasury Department takes money from the general revenue fund and “infuses it” into banks that are in trouble. Banks that did not engage in questionable lending practices do not receive any help and just get to pay their taxes on time. The successful banks are having their money taken to support the unsuccessful banks. It seems a little counterproductive. With the Federal Deposit Insurance Corporation guaranteeing that depositors would not lose money, banks that go under would be replaced by other successful banks rapidly and individuals would not lose any deposits less than $250,000.
In the case of the automobile manufacturers, there is no help for any of the successful companies in Tennessee, South Carolina, or Texas. The provision to give tax credits for all automobile purchases was stripped from the bill. Therefore, the only help is going to the automobile manufacturers in Michigan which have United Auto Workers Union plants. What a coincidence. Therefore, tax money from auto workers in the south who earn about $45 an hour is being used to prop up wages for union auto workers in Michigan who earn about $71 an hour. The successful companies are having their money taken away to support the unsuccessful companies. If the Michigan-based automobile companies stopped making cars, would everyone stop driving? I think not. People would buy cars and trucks from the more successful and better-run companies. The Democrats say the answer is more union involvement when the very millstone around the neck of the auto industry is the United Auto Workers.
In the case of the bail out to the states, tax money from states with responsible governments like Texas is used to bail out irresponsible state governments like California and will only encourage more bogus spending and will delay the state legislature making the appropriate decisions to balance their spending and income. California refuses to secure the Mexican border and continues to provide free health care and public education to illegal aliens. Should it surprise anyone that their budget is screwed up? The successful states are therefore being screwed to reward the unsuccessful states. Irresponsible governors like Schwarzenegger are not held responsible for their actions.
In the case of the mortgage bail out, tax money is being used to refinance mortgages of people who, in many cases, should have never qualified for a mortgage in the first place. Will those people suddenly be flush with money? What is always failed to be mentioned is that the mortgage lenders will have to make their money back somehow. Let’s see… how will they do it? They will increase the rates on newer mortgages. Who will receive those mortgages? Only those people who are well-qualified will receive them because the mortgages lenders have been burned once and won’t do it again. Therefore, money will be taken from successful home buyers to bail out unsuccessful home buyers. At least this one has a logical argument in that preventing foreclosures reduces inventory of existing homes and stabilizes home prices. It does hurt the rental market. In listening to President Obama today, to his credit, it seemed that at least someone has put some thought into this package. That is a refreshing change from "You have to sign it now or the Earth will explode" spending packages.
Did anyone notice that Senator Harry Reid snuck a hand-written amendment of five billion dollars in the stimulus bill for a light rail system from Los Angeles to Las Vegas? Bernie Madoff is a small-time operator next to Harry Reid. The worst part is that no other Senator will point out how crooked that is. Five billion dollars without a hearing, without oversight, without anything but a pen. It makes you want to vomit.
The common thread throughout the processes is obviously to reward the unsuccessful and sometimes criminal at the expense of the successful and responsible. It is economic redistribution which rewards bad behavior. In time, people who are responsible will either stop producing because it won’t be in their best interest to produce or everyone will jump on the bandwagon and just start behaving badly to get on the gravy train. The problem there is that someone has to pay for that gravy train because it is a government-sponsored Ponzi scheme. When enough people stop putting money in, the whole thing will crash. That is where we are heading with these “stimulus” packages. All they had to do was stabilize the housing market and let people keep more of their money and the problem would have corrected itself. Every time the new administration interferes, the stock market dips lower because smart business people recognize where this is headed. It is nice to finally see some effort to do something about housing. In this case, it seems the right thing to do.
In the case of the bank bail out, the Treasury Department takes money from the general revenue fund and “infuses it” into banks that are in trouble. Banks that did not engage in questionable lending practices do not receive any help and just get to pay their taxes on time. The successful banks are having their money taken to support the unsuccessful banks. It seems a little counterproductive. With the Federal Deposit Insurance Corporation guaranteeing that depositors would not lose money, banks that go under would be replaced by other successful banks rapidly and individuals would not lose any deposits less than $250,000.
In the case of the automobile manufacturers, there is no help for any of the successful companies in Tennessee, South Carolina, or Texas. The provision to give tax credits for all automobile purchases was stripped from the bill. Therefore, the only help is going to the automobile manufacturers in Michigan which have United Auto Workers Union plants. What a coincidence. Therefore, tax money from auto workers in the south who earn about $45 an hour is being used to prop up wages for union auto workers in Michigan who earn about $71 an hour. The successful companies are having their money taken away to support the unsuccessful companies. If the Michigan-based automobile companies stopped making cars, would everyone stop driving? I think not. People would buy cars and trucks from the more successful and better-run companies. The Democrats say the answer is more union involvement when the very millstone around the neck of the auto industry is the United Auto Workers.
In the case of the bail out to the states, tax money from states with responsible governments like Texas is used to bail out irresponsible state governments like California and will only encourage more bogus spending and will delay the state legislature making the appropriate decisions to balance their spending and income. California refuses to secure the Mexican border and continues to provide free health care and public education to illegal aliens. Should it surprise anyone that their budget is screwed up? The successful states are therefore being screwed to reward the unsuccessful states. Irresponsible governors like Schwarzenegger are not held responsible for their actions.
In the case of the mortgage bail out, tax money is being used to refinance mortgages of people who, in many cases, should have never qualified for a mortgage in the first place. Will those people suddenly be flush with money? What is always failed to be mentioned is that the mortgage lenders will have to make their money back somehow. Let’s see… how will they do it? They will increase the rates on newer mortgages. Who will receive those mortgages? Only those people who are well-qualified will receive them because the mortgages lenders have been burned once and won’t do it again. Therefore, money will be taken from successful home buyers to bail out unsuccessful home buyers. At least this one has a logical argument in that preventing foreclosures reduces inventory of existing homes and stabilizes home prices. It does hurt the rental market. In listening to President Obama today, to his credit, it seemed that at least someone has put some thought into this package. That is a refreshing change from "You have to sign it now or the Earth will explode" spending packages.
Did anyone notice that Senator Harry Reid snuck a hand-written amendment of five billion dollars in the stimulus bill for a light rail system from Los Angeles to Las Vegas? Bernie Madoff is a small-time operator next to Harry Reid. The worst part is that no other Senator will point out how crooked that is. Five billion dollars without a hearing, without oversight, without anything but a pen. It makes you want to vomit.
The common thread throughout the processes is obviously to reward the unsuccessful and sometimes criminal at the expense of the successful and responsible. It is economic redistribution which rewards bad behavior. In time, people who are responsible will either stop producing because it won’t be in their best interest to produce or everyone will jump on the bandwagon and just start behaving badly to get on the gravy train. The problem there is that someone has to pay for that gravy train because it is a government-sponsored Ponzi scheme. When enough people stop putting money in, the whole thing will crash. That is where we are heading with these “stimulus” packages. All they had to do was stabilize the housing market and let people keep more of their money and the problem would have corrected itself. Every time the new administration interferes, the stock market dips lower because smart business people recognize where this is headed. It is nice to finally see some effort to do something about housing. In this case, it seems the right thing to do.
Friday, February 13, 2009
Centralized Medical Records, Behavioral Modification and Security
The currently debated “stimulus” bill has about $300 million in it for establishment of an electronic medical record system for the government. I mentioned this briefly in a previous post but think it should probably be explored in more depth.
The idea of a central repository for all medical records has great merit in an ideal world. Information would be available, no matter where a patient was located, about past medical history, allergies, current medications, and past surgical history. Since everyone is altruistic and no one would access information that was not required, the system would be wonderful in an ideal world. We don’t live in an ideal world.
A central repository of any information of value is a hackers dream. That information would be so valuable to obtain that it could be sold surreptitiously to potential employers, insurance providers, for personal motives, etc. by anyone with access and enough temptation. Miscreants could erase or modify the records for profit or for malicious reasons. The government would counter with a back up system of records. That just provides a broader target to access the information. Even without hacking through computer safeguards, the records could be compromised by individuals through bribes or other personal motives. This is a relatively common occurrence when it comes to national security issues in the United States. People with agendas or personal political philosophical differences with the government pass information to liberal publications like the Washington Post and New York Times which routinely publish classified information. Even more recently, out of one hundred forty anonymous screening tests for baseball players concerning steroids, only the name of Alex Rodriguez was leaked to the press. Someone clearly had an agenda against Alex Rodriguez. It is easy to see similar leaks for candidates for office, other sports figures, celebrities, and for personal vengeance. A history of a sexually transmitted disease, elective abortion, or potential debilitating disease could be used for extortion or political blackmail.
The breadth of the system is inherently a security and bandwidth problem. In order to be effective, the records will have to be available to any medical facility in order to care for patients wherever they present for care. That means that tens or even hundreds of thousands of facilities will have access to the system. A system that large will be similar to the AHLTA military system which is slow, unwieldy, and crashes regularly. A system with that kind of capability probably doesn’t exist outside of the military or National Security Agency anywhere in the world. An electronic health record system which is undependable would be a danger to patients as necessary patient information would not be available when required. Additionally, with the many thousands of access points to the system, there is no practical way to adequately maintain the security of the system. It is like a fence with thousands and thousands of gates, any one of which when breeched makes the entire system accessible.
As a physician, I am well aware of the tendency of health care administrators to now view patient care as a “product line”. In a group of physicians, I have once actually been instructed by a senior administrator to increase patient throughput even if it increases risk of inadequate diagnosis. The reason I bring this up is that there is a tendency for anyone under a time constraint to avoid “reinventing the wheel”. Errors in records in a central repository will propagate because the information will convey authority and go unchallenged. Errors will be like bad tattoos and go with patients everywhere.
To use the hackneyed Orwellian analogy, all health care information in the hands of the government is not a good idea. I will point out that while the government will be a problem, it may not be the biggest problem. With a records system that will inevitably leak like a sieve, it is only a matter of time before private insurance providers get their hands on the information. With that information in hand, insurance companies will begin to modify their actuarial tables depending on your private information. If they note a minor injury while surfing, skiing, sky diving, playing contact sports, riding, etc. you will have the option of stopping the activity, not being covered while doing it, or paying higher premiums. This type of focus will eventually lead to widespread financial behavioral modification. The analogous government scenario is to force behavior modification by denying benefits for activities, diet, etc. that are not approved by some group of “experts” who decide what they want you to do and not do. This is not a new argument. There was a suggestion years ago that in states with motorcycle helmet laws, if you didn’t wear a helmet, there would be no government funding for your health care should you be injured on a motorcycle. The idea was fairly popular. The same has been suggested for bicycle riding for children and cigarette smoking. The idea being that the government says out of one side of the mouth, “We aren’t forcing anyone to change their behavior” while making the behavior so financially untenable that no sane person would engage in it. It is a slippery slope that eventually leads to only government and insurance approved lifestyles being covered. Anything else leaves you on your own.
One advantage proponents will claim is the ability to gather data about treatment options and outcomes. Former Senator Daschle has already written in his book about using those data to determine which treatments will be available. In other words, the financial behavioral modification will not only be used on patients, it will be used to force physicians to become robotic in their prescribing and treatment patterns. Once again, it will be “Treat the patient in the way you see fit, but we will only pay you if you do it the way we want.” If patients cannot be treated individually, we might as well scrap the entire health care system and have everyone use a site like WebMD to treat everyone. There is no reason to talk to patients and examine them if it isn’t going to make any difference in what you can do for them.
My counter proposal, which I have actually sent to Senators Graham and DeMint, is to not have the government establish an actual computer system but rather to establish national standards for the electronic medical record. The format of the record, type of computer storage file, and transmission protocols could be specified and monitored by the Department of Health and Human Services. In the past, similar standards have been established for radio and television transmission, automobile safety, food safety, air traffic control systems, and other systems. My suggestion is that a commission or committee of overpaid top notch experts to establish standards has miniscule costs compared to establishing and building a huge overpriced ineffective system of computer networks. Additionally, in a free market economy, software developers will come out of the woodwork in droves to develop and market commercial versions of software to make new electronic records and convert existing records. To paraphrase Field of Dreams, “If there is money to be made, they will definitely come”. Having private companies supply the software will create many high-paying jobs and result in substantial tax revenue to the government, instead of costing huge amounts in government payroll. Additional jobs will be created all across the country when people are hired by health care facilities to convert existing records into the standardized electronic format. The government virtually never gets the appropriate value for its contracts, there is no reason to assume that it will on this one. Therefore, in the spirit of the American entrepreneur, to save hundreds of millions of dollars in taxpayer money and to avoid the Orwellian consequences, I believe the system I am proposing is superior to the current thinking.
The idea of a central repository for all medical records has great merit in an ideal world. Information would be available, no matter where a patient was located, about past medical history, allergies, current medications, and past surgical history. Since everyone is altruistic and no one would access information that was not required, the system would be wonderful in an ideal world. We don’t live in an ideal world.
A central repository of any information of value is a hackers dream. That information would be so valuable to obtain that it could be sold surreptitiously to potential employers, insurance providers, for personal motives, etc. by anyone with access and enough temptation. Miscreants could erase or modify the records for profit or for malicious reasons. The government would counter with a back up system of records. That just provides a broader target to access the information. Even without hacking through computer safeguards, the records could be compromised by individuals through bribes or other personal motives. This is a relatively common occurrence when it comes to national security issues in the United States. People with agendas or personal political philosophical differences with the government pass information to liberal publications like the Washington Post and New York Times which routinely publish classified information. Even more recently, out of one hundred forty anonymous screening tests for baseball players concerning steroids, only the name of Alex Rodriguez was leaked to the press. Someone clearly had an agenda against Alex Rodriguez. It is easy to see similar leaks for candidates for office, other sports figures, celebrities, and for personal vengeance. A history of a sexually transmitted disease, elective abortion, or potential debilitating disease could be used for extortion or political blackmail.
The breadth of the system is inherently a security and bandwidth problem. In order to be effective, the records will have to be available to any medical facility in order to care for patients wherever they present for care. That means that tens or even hundreds of thousands of facilities will have access to the system. A system that large will be similar to the AHLTA military system which is slow, unwieldy, and crashes regularly. A system with that kind of capability probably doesn’t exist outside of the military or National Security Agency anywhere in the world. An electronic health record system which is undependable would be a danger to patients as necessary patient information would not be available when required. Additionally, with the many thousands of access points to the system, there is no practical way to adequately maintain the security of the system. It is like a fence with thousands and thousands of gates, any one of which when breeched makes the entire system accessible.
As a physician, I am well aware of the tendency of health care administrators to now view patient care as a “product line”. In a group of physicians, I have once actually been instructed by a senior administrator to increase patient throughput even if it increases risk of inadequate diagnosis. The reason I bring this up is that there is a tendency for anyone under a time constraint to avoid “reinventing the wheel”. Errors in records in a central repository will propagate because the information will convey authority and go unchallenged. Errors will be like bad tattoos and go with patients everywhere.
To use the hackneyed Orwellian analogy, all health care information in the hands of the government is not a good idea. I will point out that while the government will be a problem, it may not be the biggest problem. With a records system that will inevitably leak like a sieve, it is only a matter of time before private insurance providers get their hands on the information. With that information in hand, insurance companies will begin to modify their actuarial tables depending on your private information. If they note a minor injury while surfing, skiing, sky diving, playing contact sports, riding, etc. you will have the option of stopping the activity, not being covered while doing it, or paying higher premiums. This type of focus will eventually lead to widespread financial behavioral modification. The analogous government scenario is to force behavior modification by denying benefits for activities, diet, etc. that are not approved by some group of “experts” who decide what they want you to do and not do. This is not a new argument. There was a suggestion years ago that in states with motorcycle helmet laws, if you didn’t wear a helmet, there would be no government funding for your health care should you be injured on a motorcycle. The idea was fairly popular. The same has been suggested for bicycle riding for children and cigarette smoking. The idea being that the government says out of one side of the mouth, “We aren’t forcing anyone to change their behavior” while making the behavior so financially untenable that no sane person would engage in it. It is a slippery slope that eventually leads to only government and insurance approved lifestyles being covered. Anything else leaves you on your own.
One advantage proponents will claim is the ability to gather data about treatment options and outcomes. Former Senator Daschle has already written in his book about using those data to determine which treatments will be available. In other words, the financial behavioral modification will not only be used on patients, it will be used to force physicians to become robotic in their prescribing and treatment patterns. Once again, it will be “Treat the patient in the way you see fit, but we will only pay you if you do it the way we want.” If patients cannot be treated individually, we might as well scrap the entire health care system and have everyone use a site like WebMD to treat everyone. There is no reason to talk to patients and examine them if it isn’t going to make any difference in what you can do for them.
My counter proposal, which I have actually sent to Senators Graham and DeMint, is to not have the government establish an actual computer system but rather to establish national standards for the electronic medical record. The format of the record, type of computer storage file, and transmission protocols could be specified and monitored by the Department of Health and Human Services. In the past, similar standards have been established for radio and television transmission, automobile safety, food safety, air traffic control systems, and other systems. My suggestion is that a commission or committee of overpaid top notch experts to establish standards has miniscule costs compared to establishing and building a huge overpriced ineffective system of computer networks. Additionally, in a free market economy, software developers will come out of the woodwork in droves to develop and market commercial versions of software to make new electronic records and convert existing records. To paraphrase Field of Dreams, “If there is money to be made, they will definitely come”. Having private companies supply the software will create many high-paying jobs and result in substantial tax revenue to the government, instead of costing huge amounts in government payroll. Additional jobs will be created all across the country when people are hired by health care facilities to convert existing records into the standardized electronic format. The government virtually never gets the appropriate value for its contracts, there is no reason to assume that it will on this one. Therefore, in the spirit of the American entrepreneur, to save hundreds of millions of dollars in taxpayer money and to avoid the Orwellian consequences, I believe the system I am proposing is superior to the current thinking.
Wednesday, February 11, 2009
Killing an Insect with a Nuke and Missing
I cannot figure out who is giving financial advice to the Congress. Everyone knows, or at least they say they do, that the current United States financial crisis began with the issuing of sub-prime mortgages. I have written about that previously. Once those mortgages were bundled into securities by the securities fraud folks at Fannie Mae and Freddie Mac and sold to investment banks world-wide, the trap was sprung. Now, there is a lot of talk about how the credit market froze. They talk about it like it is unrelated. Why did that happen? It happened because all of those securities based on mortgages are bundled groups of mortgages. Some may be full value and some may be worth squat. Therein is the problem. Banks holding billions of dollars in purchases of those securities don’t know what they are worth. Worse yet, there currently seems to be no way to determine how much they are worth. Therefore, the banks don’t know whether they have money or not. Just like anyone else, they don’t lend money if they don’t know if they have any. And they certainly won’t lend to another bank holding a lot of those same securities. So, once again, we are back to mortgages and securities fraud.
In order to “stimulate” the economy, the Democratic congress has come up with a bill to spend almost $800 billion dollars on a lot of projects. No where in that bill is the mortgage crisis addressed. Thus, the title of this writing. They are trying to use an incredibly large program (nuclear weapon) to kill a pest (mortgage securities) which they should have just stepped on with their shoe (address the mortgage problem). Worst yet, they missed. If they took care of the uncertainty in the mortgage securities, banks would know how much money they have and the economy would begin to function normally again. Surely, it would take some time to recover but the base cause would be addressed. Making the next few generations bear the brunt of this by spending money we don’t have on things that should at least be discussed, not jammed through, is immoral. You don’t spend $800 billion dollars in slush funds without at least having some hearings on the content of the bill. This is Congress doing their best Bernie Madoff impression.
In order to “stimulate” the economy, the Democratic congress has come up with a bill to spend almost $800 billion dollars on a lot of projects. No where in that bill is the mortgage crisis addressed. Thus, the title of this writing. They are trying to use an incredibly large program (nuclear weapon) to kill a pest (mortgage securities) which they should have just stepped on with their shoe (address the mortgage problem). Worst yet, they missed. If they took care of the uncertainty in the mortgage securities, banks would know how much money they have and the economy would begin to function normally again. Surely, it would take some time to recover but the base cause would be addressed. Making the next few generations bear the brunt of this by spending money we don’t have on things that should at least be discussed, not jammed through, is immoral. You don’t spend $800 billion dollars in slush funds without at least having some hearings on the content of the bill. This is Congress doing their best Bernie Madoff impression.
Electronic Medical Records
A lot of discussion has gone on recently by the proponents of electronic medical records, including the current administration. I have discussed them before but wanted to take another look, including the views of a user. The military has already implemented an electronic system which was originally called CHCS (Composite Health Care System). When it was first introduced, it provided some valuable services despite its user unfriendliness. It allowed students and physicians to access laboratory results and radiology results without having to trek down to each department and go through a log book to retrieve them. When I was first training in medicine, that is exactly what we had to do each morning and evening. From that stand point, CHCS was a boon to efficiency. Those same tests could be ordered in the system although there was a learning curve as the names of the tests were not very intuitive. There were a lot of problems with the system. For example, if a laboratory technician entered an order from a drop down menu under the incorrect physician’s name, the results of the test would be returned to that physician and that physician would be asked to electronically sign the order. There was no way to correct the mistake. Even the administrators of the system could not fix them. Physicians were constantly receiving results and signing orders on patients they had never met. Rather than quibble on the other inconsistencies and problems with that system, let us move on.
The next iteration of the system was originally CHCS II, but has subsequently been renamed AHLTA (Armed Forces Health Longitudinal Technology Application). The AHLTA system has many of the same advantages in that no matter where you go (in theory) your drug allergies, medications, past medical history, etc. are available to a new physician to whom you present for care. That is not entirely true as I have been deployed eight times in the past five years and have never had access to the AHLTA system on any deployment. While the AHLTA folks consistently crow about the advantages of the system, they never discuss what it is like to use it. Let’s look at some of the results:
The Navy has decided that in order to improve efficiency, they want the physicians to see seventy five per cent of the productivity of major Health Maintenance Organizations (HMOs). Part of the reason is to lower costs, and part of the reason is that they are having trouble keeping enough people in the Navy to serve the patient population. In the brick and mortar hospitals, the current requirement for a General Surgeon is to see forty five clinic patients a week (based on HMO productivity). If that is only seventy five percent of what an HMO doctor sees, why should that be a problem? First, the average physician in civilian practice averages four support personnel per physician. The civilian practices know that the only person in a surgery office that makes a dime for the practice is the surgeon. Therefore, people are hired to keep the surgeon from doing anything which is not billable. Record keeping, billing, coding, telephones, communication, cleaning, education, etc. are all handled by trained assistants, freeing up the surgeon to do surgery and outpatient care for which billing can be generated. In the Navy, there are four physicians for each support person. Those people are Civil Service and we all know how much incentive the Civil Service has to work hard: none. Therefore, Navy physicians type their own notes, write their own consults, fill out their own preoperative and post operative packages, make phones call, schedule procedures, etc. I forgot to mention above that those forty five patients have to be seen in only two clinic days a week. Broken down evenly, this means twenty two patients on one clinic day and twenty three on the other.
Meanwhile back at the AHLTA system: Even after the training required to use the system, it is so cumbersome that trying to find your way through it is very time consuming and frustrating. I know how bad it is for surgeons. I can’t imagine how bad it is for primary care physicians who see such a wide variety of diagnoses. There are templates which can be customized for a specialty, which can save time but any unusual case will take a lot time to do the note. Additionally, the system can not keep up with the amount of usage so it is slow and crashes regularly. I have found the average AHLTA note to take between ten and twenty minutes to do even with a template. Therefore, twenty two times fifteen minutes equals three hundred thirty minutes. That is five and one half hours a day entering notes into AHLTA. If a surgical appointment is 20 minutes long, that means four hundred and forty minutes, or seven hours and twenty minutes a day talking to and examining patients. So far, we are up to twelve hours and fifty minutes each clinic day. Why do patients go to see a surgeon? Because they might need an operation. Assuming that only half of the patients need surgery, that means eleven preoperative packages (preoperative orders, admission paperwork, consent forms, notice to parent command, history and physical examination, etc.) need to be completed in addition to the AHLTA note for those eleven patients. Just for argument, let’s say that they only take fifteen minutes each (not realistic). That is another three hours and forty five minutes a clinic day. Now we are up to fifteen hours and thirty five minutes each clinic day. That is assuming that the physician never goes to the rest room, eats, or takes a break from paperwork. Additionally, the physician needs to round and care for inpatients which requires going to the ward or intensive care unit. Does anyone wonder why people leave for increased salaries and lots of administrative support?
Another phenomenon of the electronic record in the military is that performance evaluations have become partly based on the amount of relative value units (RVUs) billed as interpreted by the coding of each visit by the system. Subsequently, the smart physicians have learned to “game” the system and turn every visit into a coding bonanza with their templates. The coding is not based on what you do, it is based on what you write. Therefore, the smart ones learn to produce templates that over code visits by entering extraneous and unnecessary data into the AHLTA system. If you do what is considered a normal work up on a patient, you will fall way behind the coding curve. Since everyone is now forced to play the competitive coding game for advancement, even more time is spent on the computer entering redundant and irrelevant information.
Another interesting thing about the AHLTA system which has not been improved is that information, once entered is almost impossible to remove. Errors and diagnoses follow the patient around like a bad tattoo.
I wonder about the wisdom of a central repository of private medical information. I can see not only hackers but the Orwellian use of that repository for behavior modification and other abuses. It will not be hard for advocates to argue that anyone with a risky hobby (e.g., surfing or skiing) or diet should pay more for insurance or might not be looked on as favorably for employment. The proponents will argue that the privacy of the system will be guaranteed but if it is available to any physician (as it has to be to provide medical safety), it will be available to nearly anyone eventually. I believe a better alternative is for the government to establish standards for the format of electronic medical records and have them stored locally at physician offices or hospital records facilities. If records are required in another location, a secure and verified request can be made for those records and they can be instantly electronically transmitted to the requesting location. That system would also allow tracking of who requested records and for what reason. That should reduce the incentive for anyone to pry unnecessarily and would increase privacy.
Proponents of the electronic medical record argue that they will reduce medical errors by having allergies and medications available. That is intuitively true. I wonder how many errors will be produced by the lack of time to talk to and examine patients caused by the increased requirement for computer time to input data. If you want to reduce errors and provide better care, get some support personnel for the physicians so they can spend time taking care of patients and have some “scribes” enter the data into computers.
The next iteration of the system was originally CHCS II, but has subsequently been renamed AHLTA (Armed Forces Health Longitudinal Technology Application). The AHLTA system has many of the same advantages in that no matter where you go (in theory) your drug allergies, medications, past medical history, etc. are available to a new physician to whom you present for care. That is not entirely true as I have been deployed eight times in the past five years and have never had access to the AHLTA system on any deployment. While the AHLTA folks consistently crow about the advantages of the system, they never discuss what it is like to use it. Let’s look at some of the results:
The Navy has decided that in order to improve efficiency, they want the physicians to see seventy five per cent of the productivity of major Health Maintenance Organizations (HMOs). Part of the reason is to lower costs, and part of the reason is that they are having trouble keeping enough people in the Navy to serve the patient population. In the brick and mortar hospitals, the current requirement for a General Surgeon is to see forty five clinic patients a week (based on HMO productivity). If that is only seventy five percent of what an HMO doctor sees, why should that be a problem? First, the average physician in civilian practice averages four support personnel per physician. The civilian practices know that the only person in a surgery office that makes a dime for the practice is the surgeon. Therefore, people are hired to keep the surgeon from doing anything which is not billable. Record keeping, billing, coding, telephones, communication, cleaning, education, etc. are all handled by trained assistants, freeing up the surgeon to do surgery and outpatient care for which billing can be generated. In the Navy, there are four physicians for each support person. Those people are Civil Service and we all know how much incentive the Civil Service has to work hard: none. Therefore, Navy physicians type their own notes, write their own consults, fill out their own preoperative and post operative packages, make phones call, schedule procedures, etc. I forgot to mention above that those forty five patients have to be seen in only two clinic days a week. Broken down evenly, this means twenty two patients on one clinic day and twenty three on the other.
Meanwhile back at the AHLTA system: Even after the training required to use the system, it is so cumbersome that trying to find your way through it is very time consuming and frustrating. I know how bad it is for surgeons. I can’t imagine how bad it is for primary care physicians who see such a wide variety of diagnoses. There are templates which can be customized for a specialty, which can save time but any unusual case will take a lot time to do the note. Additionally, the system can not keep up with the amount of usage so it is slow and crashes regularly. I have found the average AHLTA note to take between ten and twenty minutes to do even with a template. Therefore, twenty two times fifteen minutes equals three hundred thirty minutes. That is five and one half hours a day entering notes into AHLTA. If a surgical appointment is 20 minutes long, that means four hundred and forty minutes, or seven hours and twenty minutes a day talking to and examining patients. So far, we are up to twelve hours and fifty minutes each clinic day. Why do patients go to see a surgeon? Because they might need an operation. Assuming that only half of the patients need surgery, that means eleven preoperative packages (preoperative orders, admission paperwork, consent forms, notice to parent command, history and physical examination, etc.) need to be completed in addition to the AHLTA note for those eleven patients. Just for argument, let’s say that they only take fifteen minutes each (not realistic). That is another three hours and forty five minutes a clinic day. Now we are up to fifteen hours and thirty five minutes each clinic day. That is assuming that the physician never goes to the rest room, eats, or takes a break from paperwork. Additionally, the physician needs to round and care for inpatients which requires going to the ward or intensive care unit. Does anyone wonder why people leave for increased salaries and lots of administrative support?
Another phenomenon of the electronic record in the military is that performance evaluations have become partly based on the amount of relative value units (RVUs) billed as interpreted by the coding of each visit by the system. Subsequently, the smart physicians have learned to “game” the system and turn every visit into a coding bonanza with their templates. The coding is not based on what you do, it is based on what you write. Therefore, the smart ones learn to produce templates that over code visits by entering extraneous and unnecessary data into the AHLTA system. If you do what is considered a normal work up on a patient, you will fall way behind the coding curve. Since everyone is now forced to play the competitive coding game for advancement, even more time is spent on the computer entering redundant and irrelevant information.
Another interesting thing about the AHLTA system which has not been improved is that information, once entered is almost impossible to remove. Errors and diagnoses follow the patient around like a bad tattoo.
I wonder about the wisdom of a central repository of private medical information. I can see not only hackers but the Orwellian use of that repository for behavior modification and other abuses. It will not be hard for advocates to argue that anyone with a risky hobby (e.g., surfing or skiing) or diet should pay more for insurance or might not be looked on as favorably for employment. The proponents will argue that the privacy of the system will be guaranteed but if it is available to any physician (as it has to be to provide medical safety), it will be available to nearly anyone eventually. I believe a better alternative is for the government to establish standards for the format of electronic medical records and have them stored locally at physician offices or hospital records facilities. If records are required in another location, a secure and verified request can be made for those records and they can be instantly electronically transmitted to the requesting location. That system would also allow tracking of who requested records and for what reason. That should reduce the incentive for anyone to pry unnecessarily and would increase privacy.
Proponents of the electronic medical record argue that they will reduce medical errors by having allergies and medications available. That is intuitively true. I wonder how many errors will be produced by the lack of time to talk to and examine patients caused by the increased requirement for computer time to input data. If you want to reduce errors and provide better care, get some support personnel for the physicians so they can spend time taking care of patients and have some “scribes” enter the data into computers.
Wednesday, February 4, 2009
How the Economy Doesn't Work and More Fabrications
A collection of thoughts about the last couple of weeks:
The "stimulus" bill now being considered in the Senate which passed in the House is being talked about non-stop by all the talking heads on television. As it continues to languish, someone described it as a rotting corpse. The longer is is exposed to the sunshine, the more it begins to stink.
Rep. Nancy Pelosi was just on television yesterday saying that "every month that the stimulus package is not passed, 500 million Americans will lose their jobs". I find that statistic interesting in that the population of the United States is just over 300 million people. How she can say something like that with a straight face means that she must have had a stroke or slow virus brain disease. It is not possible for what she said to be true and any middle schooler could tell you that it was not possible.
Spending by the government is a revolving door and does not stimulate the economy. You take taxes in, pay them out, and take them in again. It doesn't produce anything. It is money that is just being printed by the government and being covered by borrowing from foreign countries. In order for the economy to function, private industry must generate wealth and pay taxes into the government. The workers who are employed by those private industries must earn wages and pay taxes into the government. It is private industry that generates revenue, not the government. To think that the economic crisis will be resolved by just printing more money is idiotic and not very reassuring about the competence of those advocating that course. It has never worked in the past and is silly.
Another big lie is that this current wish list of a bill is a stimulus package at all. It is a laundry list of liberal wishes. Some of the ideas may have merit but they are not stimulative to the economy. As the people have seen more and more of this bill, public opinion has turned against it and rightly so. Fred Smith, CEO of Fedex was on television the other day and pointed out that the United States Tax Code is weighted substantially toward helping financial institutions and inhibiting the manufacturing sector. The Democrats constantly rail against manufacturers relocating facilities overseas yet never admit that their own tax policies are causing the movement. The obligation of any CEO of a corporation is to make a profit for the stockholders. If that CEO can find a more favorable environment to manufacture the companies products, he has an obligation to do so. Since the United States has the highest business taxes in the world, should it surprise anyone that businesses are going elsewhere? We have seen the same phenomenon within the United States with businesses relocating from the industrial north (Michigan, Pennsylvania, Ohio, Illinois, etc.) to the Southeast where the weather is better and the local and state governments are more friendly to business and the tax structure is better for business. That very thing is what has happened to the automobile industry in Michigan where dumb business decisions and liberal policies have whacked the industry. Automobile manufacturers in South Carolina, Tennessee, and Texas are doing fine.
If the Democrats wanted to stimulate the economy, they could have money in the people's pockets in two weeks: reduce payroll taxes. It would only require the stroke of a pen. There are things in the stimulus bill which cost tens of millions of dollars and produce only a dozen jobs. If you are you going to do that, just give me ten million dollars and say it is a job. I won't even tell on you. In every single instance in United States history, reducing the capital gains tax has resulted in increased revenue for the government. Additionally, every single time capital gains taxes are raised, government revenue decreases. Can anyone see what the right thing is to do? Duh.
The Obama people say giving a rebate check to the people is stimulative. Consider this when comparing the rebate check to tax relief: Would you be more likely to make a big purchase (car, washer, refrigerator, computer, etc.) with a single rebate check, or with more money every paycheck for the forseeable future? Anyone can see that tax relief makes more sense and will be more stimulative to the economy. To say otherwise is to show your partisanship and no knowledge of the economy.
The left, in order to pay back the big labor unions for their support in the elections, is trying to pass the goofy "card check" legislation which will take the right to secret ballots away from union elections. Perhaps we can establish a KGB and a Ministry of Propaganda as well. The secret ballot vote is a fundamental right of all Americans in all elections. How anyone can claim it is progress is demeaning to anyone that can think.
If only these guys would start looking out for the people and less about their own butts.
The "stimulus" bill now being considered in the Senate which passed in the House is being talked about non-stop by all the talking heads on television. As it continues to languish, someone described it as a rotting corpse. The longer is is exposed to the sunshine, the more it begins to stink.
Rep. Nancy Pelosi was just on television yesterday saying that "every month that the stimulus package is not passed, 500 million Americans will lose their jobs". I find that statistic interesting in that the population of the United States is just over 300 million people. How she can say something like that with a straight face means that she must have had a stroke or slow virus brain disease. It is not possible for what she said to be true and any middle schooler could tell you that it was not possible.
Spending by the government is a revolving door and does not stimulate the economy. You take taxes in, pay them out, and take them in again. It doesn't produce anything. It is money that is just being printed by the government and being covered by borrowing from foreign countries. In order for the economy to function, private industry must generate wealth and pay taxes into the government. The workers who are employed by those private industries must earn wages and pay taxes into the government. It is private industry that generates revenue, not the government. To think that the economic crisis will be resolved by just printing more money is idiotic and not very reassuring about the competence of those advocating that course. It has never worked in the past and is silly.
Another big lie is that this current wish list of a bill is a stimulus package at all. It is a laundry list of liberal wishes. Some of the ideas may have merit but they are not stimulative to the economy. As the people have seen more and more of this bill, public opinion has turned against it and rightly so. Fred Smith, CEO of Fedex was on television the other day and pointed out that the United States Tax Code is weighted substantially toward helping financial institutions and inhibiting the manufacturing sector. The Democrats constantly rail against manufacturers relocating facilities overseas yet never admit that their own tax policies are causing the movement. The obligation of any CEO of a corporation is to make a profit for the stockholders. If that CEO can find a more favorable environment to manufacture the companies products, he has an obligation to do so. Since the United States has the highest business taxes in the world, should it surprise anyone that businesses are going elsewhere? We have seen the same phenomenon within the United States with businesses relocating from the industrial north (Michigan, Pennsylvania, Ohio, Illinois, etc.) to the Southeast where the weather is better and the local and state governments are more friendly to business and the tax structure is better for business. That very thing is what has happened to the automobile industry in Michigan where dumb business decisions and liberal policies have whacked the industry. Automobile manufacturers in South Carolina, Tennessee, and Texas are doing fine.
If the Democrats wanted to stimulate the economy, they could have money in the people's pockets in two weeks: reduce payroll taxes. It would only require the stroke of a pen. There are things in the stimulus bill which cost tens of millions of dollars and produce only a dozen jobs. If you are you going to do that, just give me ten million dollars and say it is a job. I won't even tell on you. In every single instance in United States history, reducing the capital gains tax has resulted in increased revenue for the government. Additionally, every single time capital gains taxes are raised, government revenue decreases. Can anyone see what the right thing is to do? Duh.
The Obama people say giving a rebate check to the people is stimulative. Consider this when comparing the rebate check to tax relief: Would you be more likely to make a big purchase (car, washer, refrigerator, computer, etc.) with a single rebate check, or with more money every paycheck for the forseeable future? Anyone can see that tax relief makes more sense and will be more stimulative to the economy. To say otherwise is to show your partisanship and no knowledge of the economy.
The left, in order to pay back the big labor unions for their support in the elections, is trying to pass the goofy "card check" legislation which will take the right to secret ballots away from union elections. Perhaps we can establish a KGB and a Ministry of Propaganda as well. The secret ballot vote is a fundamental right of all Americans in all elections. How anyone can claim it is progress is demeaning to anyone that can think.
If only these guys would start looking out for the people and less about their own butts.
The Abuse of Power
In thinking of Rep. Charlie Rangel (cheating on his taxes), Gov. Bill Richardson (special favors for campaign contributions), Timothy Geitner (tax cheat), Sen. Tom Daschle (tax cheat), Rep. William Jefferson (bribes), Sen. Ted Stevens (bribes), Gov. Rod Blagojevich (pay for play), etc., it is apparent to me that what I wrote in an earlier entry about staying in politics too long being too corrupting is true. I can’t take credit for that being an original idea.
In Federalist 6, Alexander Hamilton wrote about situation leading to conflict between neighboring states and the motives of their leaders, “And there are others, not less numerous than either of the former, which take their origin entirely in private passions; in the attachments, enmities, interests, hopes, and fears, of leading individuals in the communities of which they are members. Men of this class, whether favourites of a king of a people, have in too many instances abused the confidence they possessed; and assuming the pretext of some public motive, have not scrupled to sacrifice the national tranquility to personal advantage, or personal gratification.”
In both Geitner’s and Daschle’s cases, I believe President Obama was duped by those individuals. Geitner received compensation from the International Monetary Fund and was reimbursed for taxes he owed to the United States. Every fiscal quarter, he received notification of those taxes and reimbursement and had to sign an acknowledgment form. He cannot credibly claim that he did not know he owed those taxes. This is a man billed as a financial wizard. Even more damning is that when he was audited back through 2002, he paid past due taxes for 2002 and 2003 pointed out to him by the Internal Revenue Service. He did not pay the same taxes due for 2000 and 2001 despite the situation being identical. Once again, it is not credible for him to state he didn’t know he owed the taxes. He is a tax cheat and now runs the Internal Revenue Service.
Daschle received free use of a limousine and a driver for four years. He received them from a man who was also paying him $1,000,000 a year in salary. I believe he could have afforded a car. Daschle says he made an inadvertent mistake. If that is true, why did he find out in July he owed the taxes from his accountant but not pay them until two days before his confirmation hearing for Secretary of Health and Human Services were to begin. The taxes were about $148,000. A regular person would have criminal charges filed for an amount like that. Daschle additionally “advised” health care companies which he would have had to regulate in the cabinet post. He is a Washington insider, a knowing tax cheat, and was forced to withdraw his nomination despite his statements and the Obama administration’s comments to the contrary.
The biggest lie in Washington is that “I am resigning because I desire to deal with personal issues and spend more time with my family”. That is Washington code for “I just got caught”.
In Federalist 6, Alexander Hamilton wrote about situation leading to conflict between neighboring states and the motives of their leaders, “And there are others, not less numerous than either of the former, which take their origin entirely in private passions; in the attachments, enmities, interests, hopes, and fears, of leading individuals in the communities of which they are members. Men of this class, whether favourites of a king of a people, have in too many instances abused the confidence they possessed; and assuming the pretext of some public motive, have not scrupled to sacrifice the national tranquility to personal advantage, or personal gratification.”
In both Geitner’s and Daschle’s cases, I believe President Obama was duped by those individuals. Geitner received compensation from the International Monetary Fund and was reimbursed for taxes he owed to the United States. Every fiscal quarter, he received notification of those taxes and reimbursement and had to sign an acknowledgment form. He cannot credibly claim that he did not know he owed those taxes. This is a man billed as a financial wizard. Even more damning is that when he was audited back through 2002, he paid past due taxes for 2002 and 2003 pointed out to him by the Internal Revenue Service. He did not pay the same taxes due for 2000 and 2001 despite the situation being identical. Once again, it is not credible for him to state he didn’t know he owed the taxes. He is a tax cheat and now runs the Internal Revenue Service.
Daschle received free use of a limousine and a driver for four years. He received them from a man who was also paying him $1,000,000 a year in salary. I believe he could have afforded a car. Daschle says he made an inadvertent mistake. If that is true, why did he find out in July he owed the taxes from his accountant but not pay them until two days before his confirmation hearing for Secretary of Health and Human Services were to begin. The taxes were about $148,000. A regular person would have criminal charges filed for an amount like that. Daschle additionally “advised” health care companies which he would have had to regulate in the cabinet post. He is a Washington insider, a knowing tax cheat, and was forced to withdraw his nomination despite his statements and the Obama administration’s comments to the contrary.
The biggest lie in Washington is that “I am resigning because I desire to deal with personal issues and spend more time with my family”. That is Washington code for “I just got caught”.
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