Killer Klowns

 

 

Oscar Wilde in his novel Picture of Dorian Gray created the indelible image of the ageless man whose sins, increasing with age, do not show on his face but on the face of his portrait.  It is a pity that nature does not provide us with such a guide so that we could look at each other and easily see what deeds are written there.  Politicians are the Dorian Grays of our moral lives.  We look at them and know very well that they are corrupt, heartless and self-seeking, but amazingly their faces are blank slates.  They ratify a system of hypocrisy and duplicity which we are desperate to preserve, otherwise we too should be caught out.  It is a version of the emperor's new clothes but in this case we are staring at a monster rather than a fool and very few have the courage to point it out.

 

The present scandal over the lane closings on the George Washington Bridge last September and the role that New Jersey governor Chris Christie played in those closings presents us with the newest example of malfeasance in high office.  Of what that malfeasance consists is still to be determined.  Did Governor Christie actually have a direct hand in the lane closings which were used as a retributive measure against political opponents or did he simply preside over an administration encouraged and permitted to take such steps?  There is little doubt that persons closest to Christie and his administration ordered and coordinated the closings, apparently as political retribution targeted at those who would not endorse Christie for governor in the then upcoming elections.

 

Many people shrug this episode off as simply political business as usual.  It is far more serious than that.  Corrupt politicians who take kickbacks or sell or trade favors do the public a serious disservice which when taken together weighs the system down with inefficiencies and costs.  The closing are of another order of magnitude.  Traffic was backed up for hours causing harms that are heartbreaking.  Obviously, when the business of life is delayed for thousands of people on the busiest bridge in the United States, there are going to be effects ranging from fairly trivial to the fatally serious.  Emergency vehicles were stymied in their movements.   Schoolchildren on buses were delayed during the first week of school.  A story of a fellow unemployed for a year on the first day of a new job driving into Manhattan arrived to work late.  One can only imagine the catalog of woe caused by these delays.  Certainly traffic jams are common and when they occur the same results are expected.  What should not be expected is that those delays and their melancholy results are caused by those in whom we place our civic trust.  But since the people delayed were driving from the New Jersey side to New York, there is the irony that many of those delayed went to the polls the following November and re-elected Christie as their governor, without knowing, of course, he may have had a hand in their discomfiture.  Given the nature of the American electorate at this moment, it would not be a surprise if a Killer Klown might not win an election by appealing to those who are so frightened of Taxes, they would gladly embrace Death.

 

 

 

 

Can I Please Have Some More?

[A recent column by Dr. John Lilly in the Springfield News-Leader of Springfield Missouri gave me cause to fulminate a bit today because of its preposterous assertions.  Its title - "Breakfast Plans Boost Nanny State" - hide the fact that the good doctor is complaining that a free breakfast program in the public schools sends all the wrong messages.  His column is as close as it comes to a perfectly wrong message.  My comments are below, but to really understand the source of my consternation you need to read his column, at least as much of it as you can stomach.]

Enough! With the latest column by Dr. John Lilly (“Breakfast Plan boosts nanny state – January 24, 2012) the News-Leader sponsors new levels of sophistry and perversity. Does he in fact speak for “taxpayers” who believe that the government has no role in feeding hungry children? That Springfield Public Schools will provide a breakfast meal for the children who attend should be a cause for congratulation. Instead, Dr. Lilly finds reason to suspect the motives and condemn the consequences of such a plan. Why? Because the children will ostensibly learn a false lesson: that they can depend upon their government. To translate into more humane terms: that the community around them is concerned about their welfare.

But Dr. Lilly reserves such action for “churches and charities” and, were he living in 19th century England, one would suppose the local parish board of the workhouse. This contemporary Scrooge repeats in his complaint the words “the taxpayers” as if such a phrase ends all debate. As a taxpayer he objects to this” misuse” of his money. The parents of these children are also taxpayers as are their aunts, uncles, grandparents, and distant cousins. Some of them have fought in this nation’s wars and some of them died in them. That he can cast himself and his imagined community of taxpayers against a rabble of ill-fed, ill-clothed peasants who only deserve attention from “churches and charities” adequately discloses his crabbed mentality. Churches and charities certainly play their part in the larger social scheme, but they neither have the means nor the will to take on the social responsibilities of a modern state, especially a secular state. Are churches in the financial position to take on the enormous burdens of social welfare faced by a nation of 300 millions, even considering the fact these institutions are not taxed? Contributions to churches and charities are voluntary, paying taxes is not. That is, of course, what gets under Dr. Lilly’s skin. The reason that the government had to take on this burden, obvious to any schoolchild by the end of the 19th century, is that “churches and charities” were no longer able, if they ever were. We should all be pleased that the essence of Christian virtue has been assumed by our government in its desire to assist the widow, the orphan, the disabled, the hungry, the elderly, and those struggling to find their place – the children.

This fear that public school children are scamming the rest of us out of our hard earned cash seems to be a common refrain these days. Newt Gingrich, a candidate for President in the Republican primaries, has suggested that elementary school children be used to perform janitorial services in their public schools. I do not believe there has existed in living memory such contempt for other people’s children, except when the question of race was involved. Now it appears the tactics that were used to isolate and segregate Blacks in our society have re-emerged, but this time those tactics are directed at economic and social groups rather than strictly racial ones. My faith in “churches and charities” is seriously diminished by the fact that they do not rise up in fury and deal with these “taxpayers” as they deserve. A good caning from the beadle might change their mind.

Utterly Transformed



It’s not a film that I would have seen on my own, but since my son wanted to expose me to the 3-D experience at I-MAX a la the movie Transformers: Dark Side of the Moon, who could refuse? An experience it truly was. We sat fairly close to get the full effect, meaning that one could almost smell the oily armpits of Sentinel Prime, a major mechanical character in this rusty junkyard come alive. As a movie it is as good as it gets in this age of special effect extravaganza. My comment on the film itself is that it represents what you get when its producers have unlimited access to the latest digital technology on the one hand and the dictionary of ten thousand clichés on the other. It was verrrrrrrrrry long and the dialogue further confirmed that since Bette Davis they don’t make films for grownups.

As a parable with pretensions to any meaning, a grade of “F” for this creaky mélange would be overpraise. But then again, we are constantly reminded, films are meant as vehicles for escape. Well, congratulations. Those Polaroid cheaters that are worn through the film provide some serious escape. The anti-hero played by Shia LaBeouf experiences the standard vindication of his bumbling and seeming ineptitude played against a vaguely patriotic theme of the threatened human race. The humans are in league with robots who have “hearts of gold” (or other precious metal) called Autobots fighting the evil Decepticons, robots operating out of total self interest (sounds like some brokers I’ve known). Unfortunately, I got no uplift as Chicago was laid waste by ponderous machines, some speaking with the voices of easily identifiable American icons. Sentinel Prime in all the august majesty of his well made shocks and struts has the voice of Leonard Nimoy. One can detect John Wayne among others. How cheap.

What did occur to me while the screen piled up increasing amounts of mechanical clutter was the brilliance of the technology. This is not your grandmother’s 3-D animation. The old song “How Ya Gonna Keep ‘um Down on the Farm” seems apt. Why would anyone be satisfied watching any film that wasn’t made with this technology? I imagined some really great films made with it such as the life of Christ or Buddha or Michelangelo, the tales of Sherlock Holmes, documentaries depicting the real dilemmas facing the world. The experience and interest of the audience could be immeasurably enriched. I will not hold my breath until such films are made. American audiences are so stultified that making historical films is almost out of the question. The Civil War is now 150 years behind us but making an historical film of that war in 3-D would not be easy because it appears at least to me that the politics of such a thing would be a disaster.

As our economy is torn apart by waves of Decepticons, people are content to watch their metal cousins engage in WWF-type slamdowns on the big screen. Whatever message might have been buried in the film it is so deep that even alien powers would be challenged to retrieve it. In fact, I couldn’t help but think that in this summer of “Debt Ceiling Chicken,” the newest game being played in our nation’s Capitol, Transformers was indeed the perfect film. It has been a point of curiosity for me exactly what Americans would sit still for. Now I know.

Book Burning

On May 10, 1933 and other dates shortly thereafter German students in coordination with the office of Reichspropaganda Minister Josef Goebbels burned mountains of books considered un-German. The American reaction was swift and strong and, although it did not include the physical intimidation or murder of Germans and the destruction of symbols of German culture, the displeasure of the American public was amply made manifest.

On March 20, 2011, following an earlier promise he had made for September 11, 2010, Terry Jones, an evangelical minister in Gainesville, Florida had ignited a copy of the Koran. The book had been soaking in kerosene and burned for about 10 minutes. Before the date of his first planned burning, he had been warned by high officials both within and without the United States that such an act conducted in public would most likely cause a firestorm in reaction in Muslim countries where American troops are engaged in military actions and need the cooperation of local populations. Terry Jones only relented after supposedly receiving a promise that the Islamic Center slated for construction a few blocks from Ground Zero in Manhattan would be moved. Since it has become apparent that the plans for the Center’s construction have not changed, Jones felt it was necessary to make the original point he had intended. So in his church where about 30 were in attendance, a trial was held to establish the “guilt” of the Koran and then a punishment was executed.

Unfortunately, as predicted, parts of the Muslim world exploded in rage. In particular, in Afghanistan as of April 3, 2011 24 people have been killed, including 7 United Nations staffers overrun by an hysterical crowd. The number of wounded is over 100. Even in the best of times, Christian minorities are at risk throughout that region and after this provocation, one can only assume that the lives of Christians and Westerners are at greater risk. Is it fair to bring this episode into the context of Nazi bookburning? I believe so. When the Nazis burned books we as American reacted. When the holiest of Muslim texts is burned, the Muslim world reacted, each of course in an entirely different fashion.

Let us engage in a mind experiment. Suppose a crowd in Kandahar (Afghanistan) or Peshawar (Pakistan) burned copies of our Constitution or Declaration of Independence. Would we be thrown into a murderous rage? Probably not. The hypothetical scenario seems somewhat hilarious to a degree because it appears on one level to be a sandbox conflict. “Are too!” “Am not.” We are more sophisticated than to imagine that any real insult could be leveled against us merely by burning pieces of paper. Great parts of the Muslim world are still living in an age where symbols still count for something. What in fact would get our dander up to the point that we lose our self control and commit acts of mayhem and murder? Well, we use our armed forces when the “interests” of the United States are at stake. And when is that? Here I inject a subjective response. Those interests are really commercial interests. If attempts are made to compete with us in markets we deem sole access to or if threats are made to strategic resources such as oil or natural gas, bullets will surely fly. Some might ask – isn’t the mission to bring democracy and prosperity to the deprived of the earth. Looking at the record, our elites seem quite content to do business with ruinous and bloody dictators as long as they secure those commercial interests. As inhabitants of the quite daffy 21st century, we have our priorities straight, don’t we?

Of course, there are those in this country who think that Terry Jones did a noble thing by taking a match to helpless paper. That is because they belong to a segment of American opinion that has substituted magical thinking for reason and meaningless display for analysis and dialogue. There are entire broadcast networks devoted to a non-stop form of figurative bookburning, giving to the American people the kind of satisfaction found by the crowds on the streets of parts of the Muslim world. The Nazis were smarter and stronger and see how far their bookburning got them.

The Supreme Court Conducts a Military Funeral

When they finally posted Snyder v. Phelps, a recent Supreme Court decision, I threw away one hour of my life poring over the metaphysical cogitations of that most arcane of government committees on the subject of free speech and funerals. You already know (or maybe not) that I am a professor of sociology and that one of the subjects with which I get to badger crowds of twenty-somethings is the sociology of law. So, Supreme Court decisions, their illogic, their inanities, and their language, as distanced from real human life as if written by Martian invaders taking a sardonic turn about the room, are nothing new to me. However, this decision did manage to get my hackles up enough to write a short diatribe. What is all this about?

The Westboro Baptist Church (Baptist? a Church?) was up to its old hijinks in that on March 10, 2006 it again picketed another funeral, that of Matthew Snyder, a 21-year old Marine who gave his life for his country in Iraq. For those of you who need catching up, Westboro is an outfit founded and run by a religious maniac named Fred Phelps who claims that the deaths of American soldiers in battle are a result of the toleration of homosexuality that exists in American society. He and his small band of malicious fanatics (all relatives of the same Phelps) travel about the country picketing funerals. The signs above should provide a sense of the wackiness these servants of the Lord feel it incumbent upon them to wave about at military funerals. It should be noted that Matthew Snyder was not gay, was Catholic (another group Westboro merrily defames) and was a private person who had no part in this debate nor did any of his family.

On the day of the funeral, the group from Westboro was picketing at a distance in conformity with Maryland law. Albert Snyder, the father of the fallen Marine, saw only the tops of the signs and learned what they said after the funeral. Nonetheless, he suffered traumatic health consequences from this episode and sued Phelps and Westboro in Federal District Court in Maryland for intentional infliction of emotional distress, among other things. The District (or trial) Court decided in favor of Snyder on some of the state tort issues and awarded him $5 million in damages. The church appealed and the Fourth Circuit reversed the District Court’s decision. The case came to the United States Supreme Court on this basis. The Supreme would have to decide if the District Court or the Appellate Court was correct.

Of course, the decision in any court rests on the way that the law is construed by the courts. Since intentional infliction of emotion distress was an issue, it had to be decided if the trauma experienced by Albert Snyder was of such an extreme kind that freedom of speech itself could be held in check to protect him from experiencing it. Any reasonable person should be able to appreciate the highly emotional nature of a funeral and that it is one of the most, and maybe the most, sacred and respectful actions taken by any civilized society. Surprisingly, the only mention of funerals or their particularly profound nature made by the Supreme Court in upholding the decision of the Appellate Court is to pontificate that the character of funerals does not place them outside the orbit of the requirements of free speech doctrines. Why shouldn’t you be treated to some of the Supremes’ verbiage:

"Westboro’s choice to convey its views in conjunction with Matthew Snyder’s funeral made the expression of those views particularly hurtful to many, especially to Matthew’s father. The record makes clear that the applicable legal term—“emotional distress”—fails to capture fully the anguish Westboro’s choice added to Mr. Snyder’s already incalculable grief. But Westboro conducted its picketing peacefully on matters of public concern at a public place adjacent to a public street. Such space occupies a “special position in terms of First Amendment protection.” United States v. Grace, 461 U. S. 171, 180 (1983). “[W]e have repeatedly referred to public streets as the archetype of a traditional public forum,” noting that “‘[t]ime out of mind’ public streets and sidewalks have been used for public assembly and debate.” Frisby v. Schultz, 487 U. S. 474."

Here is where law tends to go off the rails. Yes, the picketers were on a public street, peacefully protesting, but they were protesting at a FUNERAL. Context must make some difference. You are free to shout “FIRE!” but not in a crowded theatre unless there is a fire. The decision if you read it, and I recommend that you do (just follow the link) has implicit within it the notion that the law is concerned with its own internal logic and sense despite what havoc they may cause to us mortals. But there are other considerations that the logical-rational operation of Western law considers vital. The Kantian categorical imperative must be part and parcel of the law. Its prescriptions and proscriptions are universal. What is good for one is good for all. The Court could just as easily have said that the exercise of free speech stops at the horizon of the funeral. Westboro, as the only dissent by Judge Alito made plain, has a thousand other venues to express its odious opinions. I am not suggesting that Phelps and his ilk should be censored. They can shout their line from the housetops for all I care. But, for every street corner rendered unusable by the presence of a funeral, there are 10,000 other street corners where picketers are free to purvey the same filth, some of them more trafficked and more likely to get attention. There are newspapers and the Internet and so on. Just because they happen to strike upon the name of Matthew Snyder and in their maniacal logic deem his death worthy of opprobrium does not mean that they should be able to render the occasion of his funeral a subject of national discussion and personal anguish. But that is exactly what the Court has said. They blithely acknowledge attempts of states to prohibit all funeral picketing, but by the tone of that acknowledgement I am not encouraged what that future decision might be. In fact, it would seem to me that those who picket funerals should be open on principle to the torts of which Westboro was accused. That would be a much better way to control the situation than trying to solve the problem on a free speech basis or a basis of location.

The principle that the court has established is as insane as the activities of Westboro itself. (Recent news story quotes members of Westboro promising to quadruple the number of funeral protests in the wake of the Court’s decision.) The Court seems to suggest that if some group of people believes that the decision of the Court in this case is sacrilegious, it can picket the funerals of Supreme Court judges and their children with signs that say “God Punishes Disrespect” and “Families Go To Hell who Cannot Tell the Difference Between Right and Wrong” or “American Soldiers Die Because Funerals Unprotected.” Let the funeral combat begin according to the Supreme Court. Speech is such a sacred value that even respect for the dead shall not be allowed to trump it. Of course, who is kidding whom? The very wealthy could easily shield themselves from any unpleasantness, leaving the rest of us to run a gauntlet of picketers at one of life’s most trying and tender moments. In fact, a movement protesting at the funerals of the wealthy, especially bankers and stock brokers would be most apropos. My sign – “Thieves Go to Hell.” Now there’s a sentiment that meets the Court’s test for speech concerning “broad public issues.”

One last thing. Roberto Mangabeira Unger, one of the founders of Critical Legal Theory, suggests that courts can provide the necessary legal logic to justify any result. One can only wonder what the Supreme Court was thinking when it almost unanimously ratified picketing at funerals as something found within the “free exercise clause.” The conservatives on the Court probably identified with the rank homophobia of Westboro itself, and the liberals on the court salivate like Pavlov’s dog when they hear the word “speech.” One can only wonder what kind of horse trading or discussion went on in order to get to this result. This decision is either puerile or vicious, or a little of both. Two hundred thirty years of civilization and our courts cannot even protect a simple military funeral. After all is said and done, whose funeral is it?

Visual Aids for Politically-Challenged Americans

This is the coronation portrait of King George III which has had a face lift; that is, the face of that (in)famous king has been removed and replaced with the face of Hosni Mubarak, President of Egypt. I have done this specifically to assist Americans who are having difficulty following the events that are going on in Egypt. The Egyptian people have had to contend with the “tyrannies,” “usurpations” and “abuses” by Mubarak and his regime for thirty years and even longer if former regimes are brought into the equation. These terms are used in our Declaration of Independence to refer to the actions of George III in order to justify the extreme step that our revolutionaries took in taking up arms against that king. Looking back today, of course, George III appears a kindly gentleman in a wig who had some bad advice and even worse public relations. But whatever he was guilty of, the American revolutionaries turned those abuses into the basis for a rhetorical flourish that to this day has left us both wonderfully inspired and terribly confused. On the one hand, the Declaration of Independence establishes the equality of all persons (using the term “men” to mean persons, we think) and yet countenances the continuation of slavery on the other. Be that as it may, what has this to do with Egypt?

The Egyptian people today are fighting an even graver battle against a dictator and regime certainly as ruthless and brutal as the redcoats of almost 250 years ago. Americans supposedly have been committed to the principles of freedom and democracy by virtue of the way that the United States came into existence. Shouldn’t the Egyptian people, or any people for that matter, have our sympathy and support when they seek the same freedom? There are, however, unfortunate barriers preventing this simple logic from operating. Those barriers include a distance in religion, ethnicity and even race, coupled with a sorry apathy among Americans that extends even to their own political and economic situation. It is my firm belief that what is going on in Egypt is a watershed moment, not only in the history of the Middle East, but in the history of the post-modern world.

The scenes out of Egypt over the past two weeks have exploded a narrative that has held sway until now without successful challenge. It includes the idea that Arabs are incapable of understanding democracy or the institutions that support it and that their Muslim faith is antagonistic to those institutions. What we witness instead is a generation of tech savvy people coming from all walks of life, from all faiths and degrees of faith, from various political shades of opinion, from all socio-economic strata, of all ages, men and women, together in a form of solidarity that is impressive by any sociological standard. The energy that we witness on the streets of Cairo and other cities wants its chance to affect events in Egypt and the world beyond through a democratic process. You hear calls for social justice because Egypt is a country with social inequalities even greater than those in the United States, and those inequalities are something with which it is difficult to compete.

Another part of this exploded narrative concerns the proclivity of Arab populations to engage in violence and terror to secure change. Concomitantly, the Muslim world has been taunted after 9/11 for calls to demonstrate that it contains moderate masses, disconcerted by the violent events in the world. Well, here is an eloquent demonstration of non-violent Muslim, even Arab, masses laying down their lives in the name of freedom. The tables are now turned. Where are the Western masses raising their voices in concern and support? Where are the Western voices taking responsibility for supporting for thirty years a regime and security service that engaged in every form of brutality? Where are the Western voices acknowledging that the Egyptian regime was a handy client who provided a venue for torture and mischief that could not be conducted on the soil of supposedly more civilized environments? Those voices until now seem rather silent.

Egypt is a nation of great contrasts and difficulties and the road to democracy is not going to be an easy one. The Muslim Brotherhood has its eye on capturing events for its benefit. But why is the Muslim Brotherhood any more dangerous than the “Christian Brotherhood” which operates under a hundred different names in the United States, is as retrograde and which supports violence against its “enemies.” Right now, we witness events which should fill us with hope and inspiration. If good people on all sides of the various divides in the world make common cause on those things with which they agree, maybe the divisions will seem less important. There are too many critical problems that need a remedy. Inflaming sectarian passions certainly is not a solution. Fostering democracy and eliminating injustice seems more apt to move us in that positive direction.

POLITE SOCIETY

In today’s New York Times, there were two editorial columns concerning the connection between the shooting in Arizona last weekend seriously wounding Congresswoman Giffords (which involved the death of six people, including a federal judge) and the violently inflammatory rhetoric that the coddling of the political right has permitted. The column by Bob Herbert hit all the right notes. The column by David Brooks was shameful, but in a career of expressing shameful opinions this was no surprise.

The sorrowful Mr. Brooks is unhappy that the media, the monolithic left wing media, has the audacity to link the actions of a maniac in Arizona with the rantings of numerous political maniacs from his side of the political spectrum. After Sarah Palin, that strong frontierswoman in Gucci, was able to publish a map with the locations of left leaning Congresspersons placed in “cross-hairs” of a gun site and still be found on the crosshairs of the political radar, speaks volumes about the level of our moral sensitivity. It is incomprehensible to me that any candidate aspiring to national political office would not have been hounded off the political stage just a few short years ago for such a gesture and shows how far down the road to political oblivion we have gone. The tactic of the old right was to scare the public with minority violence. Remember the first Bush campaign and his smearing of Governor Dukakis with the likes of Willy Horton? They have graduated from deploring the violence to encouraging it. But the accusation Mr. Brooks is making is more profound than his acting the flack for an airhead cheerleader from a backward state with gun-sized fantasies.

He wants to decouple the act of Jared Loughner, the young man who brought a gun to a political meeting in Tucson and opened fire on an innocent crowd, almost assassinating a member of Congress, from all the political gun talk and violence talk that the right wing has been so free to cast about at least for the past ten years. Sorry, Mr. Brooks, your efforts are not only wasted, they are demeaning. Having taught a class in Holocaust studies and published in that area for twenty years, his column immediately made me think of another kind of decoupling that many, particularly on the right, also attempt. That is the decoupling of anti-semitism and the Holocaust. Two thousand years of vitriolic talk and accusation mounted by church and throne in Europe and somehow there is little or no connection between the murder of millions of Jews and all that rhetoric. While we are decoupling political rhetoric from violent acts, maybe 9/11 was actually the end product of a joyride that a few dozen crazy men decided to take in order to get their names in the history books. Forget all the hate and violent talk spewed into their heads by their local Sarah Palins. What an image – the lovely and demure Ms. Palin among bearded and wild-eyed imams. At least, they are the genuine article. She is a cardboard figurine propped up by a cadre of amoral flacks and now we can add David Brooks to that list.

The $2.3 Trillion Magical Misery Tour

This coming semester (Spring 2011) I am again going to teach Medical Sociology. This is both an exciting opportunity to orient students to a fascinating field and a sobering occasion indeed. During the next five months I will have to live and breathe the grim statistics and sobering tales of the American health care (non)system. I have written about this subject on a number of occasions before and do not want to repeat myself; however, repeating oneself is surely one of the greatest pleasures life can afford.

This time I want to get personal with a number of tales that would surely provide enough fright for any number of juveniles arrayed before the campfire during dead of night. It all started a number of weeks ago when my endocrinologist (yes, I have one - he monitors my levels) suggested that I call my regular physician and set up a schedule of appointments in such a way that either one or the other saw me every six months. That sounded like a plan and last week I called my regular physician at St. John’s Clinic here in Springfield to complete the arrangements. Seems like a fairly simple transaction, no? Well, no.

The phone rang a couple of times and the cyborg on the other end quickly asked if I could be put on hold. No sooner had my internal assent been translated by my vocal cords, before I was enjoying music composed by the same folks who are subcontracted to build penitentiaries. My sentence, however, was not commuted as the few minutes turned into an eternity of anguished anticipation. In such circumstances, I never hold for more than a minute or two. I redialed immediately and cyborg gave me the identical greeting, asked the same question, and I foolishly gave the same assent, but with the proviso that, “I will not stay on hold forever.” Forever was definitely the key word. In fact, forever in some religious dispensations promises salvation, albeit at some indefinite time, but in this case salvation never came. I hung up and redialed and this time said in a rather stern and demanding tone that I would give cyborg my name and number and when the gracious moment arrived, I would be sitting anxiously by the phone awaiting undeserved condescension. Cyborg, however, would hear of no such arrangement, and again came the dreaded request: hold! At this point, I was enraged beyond description, filled with such emotion that my health was certainly not a beneficiary of the circumstance. But the health care system does not function to preserve YOUR health. It is the health of the system that is the subject of its prime directive. I was about to call St. John’s administration when I gave cyborg one more chance. This time through gritted teeth I said, “If you don’t take my name and number, the next call I make will be to St. John’s administration.” Wonder of wonders. Cyborg said, “How can we help you?” I was nonplussed. A few seconds ago cyborg was so busy that there was no time to jot down my name. Now we are all ears. The appointment made, I hung up thinking that with such genius in charge of the system what could possibly give us a second thought about the quality of our health care.

Coincidentally, a few days later something happened to create that second thought. The billing office of St. John’s Clinic called and wanted to discuss an outstanding bill in the amount of $115.14. I immediately opened my checkbook and found that I had written a check for that amount at the beginning of November. Billing office cyborg stated that, yes, the payment was received but that other amounts due had claimed it. I asked what amounts those were. In fact, they were the amounts created by the lab tests and my routine check by my endocrinologist. Those had happened a number of weeks after the payment had been mailed so I asked how the payment could have been misapplied. Cyborg became silent and had an “Er. . .” moment when it then became clear that the later amounts had not even been billed to me yet. So, when I asked what amount was outstanding, it turned out that nothing was outstanding. All of this was from a call placed to my home after 7:30 P.M. from a hospital billing office which had informed me during the course of this Kafkaesque dialogue that St. John’s gives patients only 20 days to pay all accounts in full unless other arrangements are made. Ah yes, nothing can beat the charity of a Catholic hospital system.

In this country we spend $2.3 trillion (and more given that figure is from 2008) for a really first crass health system. A little anesthesia never hurt when you are picking someone’s pocket.

LESS GOVERNMENT?

Less Government!!!! This is an idiot’s mantra shouted from housetops and on the lips of many a hysteric. In fact, in a recent editorial in the local Springfield paper, a comment was made about a politician that for whatever other flaws he might have, at least he advocated less government. This betrays an appalling lack of understanding of history and/or politics. Embedded within this complaint are elements that are partly true but mostly false.

First, a bit of humor. Those who have seen the movie Amadeus which showcases the life of Mozart might remember a scene when a small minded minister convinces the Austrian emperor that Mozart’s music is wonderful but contains “too many notes.” The theory proposed was that there are only so many notes the human ear can assimilate. So the emperor orders Mozart to reduce the number of notes in his music. Mozart replies something to the effect that there are just as many notes as he requires and asks in frustration which notes should be sacrificed.

Similarly, with the argument about the size of government, less government as a political slogan is mindless. There should be just as much government as needed to conduct public business. You might then ask: what is its business? Well, for starters we all assume that the government will ensure a safe supply of drinking water, a police force, schools, firemen, libraries, roads, bridges and sidewalks, courts and legislatures, elaborate systems of record keeping, enforcement of regulations to ensure the safety of food, consumer products, and the conditions in restaurants, etc. In a modern, fast-paced and complex society, the list is quite long. The services provided and the rights safeguarded are many. So which of these are you willing to forego? None you say. That isn’t the issue you say. We want all these things and more but we want them delivered more efficiently with less waste of our precious tax dollars. Now that is certainly an intelligent complaint. Why not “Honest Government” or “Efficient Government” as a demand? Most of us could get behind that.

Calls for “less government” are as sensible as children calling for “less parenting” or felons calling for “less justice.” Remember, the author of that 18th century riddle “Government governs best that governs least” was Thomas Paine, probably the most radical of American revolutionaries. Paine denounced religion as a human invention and supported the French revolution. How about “less cherrypicking” the quotes of 18th century radicals.

It is not too hard to find the motive behind these calls for less government.  Cui Bono - to whom the good? - is still the best question to ask when wanting to get to the bottom of something.  Those who do not wish to be regulated, those not wishing to pay their fair share, those who think that in the delirium caused by starving government of power their fondest wishes will come to pass.  They are playing a fool's game.  All that will be achieved will be the creation of a momentary vacuum which will be filled by an increased power and sovereign entity even more difficult to control.  But it is obvious that were we to judge the efficiency of government by the general level of public education and sophistication, those presently in charge of providing that basic service have much to answer for. 

Nuts on a Velvet Cushion

OK. There is something creative and kinky about wearing hardware as a fashion statement. The Today Show this morning (September 9, 2010) had a short segment about women creating jewelry from some of your favorite items in the hardware aisle. My favorite accessory in the “DIY Haute Couture” line was a belt made of out of a pulley and rope. Of course, there is nothing intrinsically wrong with giving Home Depot a seat at the fashion runway, but is simple youthful exuberance all that is going on here?

The American Middle Class, bless its plaque filled heart, is being further softened up for what MadTV brilliantly satirized as “Lowered Expectations.” Over the past 20 years, the productivity of the American worker has increased but real wages have declined. Now that the biggest bubble of those last 20 years has burst (in real estate), the economy has hit the skids, at least for those in the bottom 80%. Those at the top have never had it so good. The levees of our economy have collapsed and, except for those who live in the most exclusive neighborhoods, we are all trying to keep our heads above water.

Thus, our friends at NBC are there making life a little more pleasant by demonstrating that as every penny of savings and equity are eaten up, women do not have to go about unadorned. They can galvanize their admirers with items that are themselves galvanized. The hardware store is replete with all kinds of rings, chains, spokes and spools in many sizes and shapes. Minnie Pearl step aside. Your dowdy image is in for some stiff and steely competition.

Doesn’t anyone else find this depressing? I thought diamonds were a girl’s best friend. Turns out that all along those blokes who worked themselves into a lather mortgaging their sweat for that matrimonial rock, could have saved a great deal of trouble. All they needed to do for their true love was trot down to True Value and buy their baubles by the pound.

However, the big surprise comes much later. Get ready all you little tykes. When your grandma loses her last little bit of private health insurance and slips off to those faux pearly gates, your inheritance is going to be one large screw.

The 14th Amendment – Racial and Political from the Start

14th Amendment to the U.S. Constitution. Section 1. All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside. No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.

Ah, you gotta love the Republicans. The 14th Amendment was passed by the required 2/3 vote by an overwhelmingly Republican Congress in 1866. The Civil War having concluded with the defeat of the South, that defeat put the slavery question to rest and should have also put to rest the relative constitutional position of the states vis-à-vis the federal government. Alas, some bad ideas never die even when they are buried under the bodies of 600,000 slain soldiers.

So, the present Republican leadership in our Congress, playing on racial and ethnic prejudices, wants to reverse the impact of the citizenship clause of the 14th Amendment as that has been understood for 150 years, this, ostensibly, as a remedy for “furriners” coming to this country and having children who immediately qualify as American citizens. Illegal immigration is certainly a problem with which the federal government needs to deal; however, for the past 30 years administrations both Democrat and Republican have feared the electoral repercussions of offending one or another voting bloc and left the situation to deteriorate. Reagan did attempt some reform and in the process gave amnesty to 6 million people who had entered the country illegally at that time. Amnesty is no longer a viable option because Republicans have recognized that their racist postures over these 30 years have so alienated many groups that the future does not bode well for their electoral prospects as the racial and ethnic composition of the U.S. will shift over the next 40 years.

Of course, when the amendment first passed the freed slaves were grateful to Lincoln and his party and that gratitude was expressed in voting patterns well into the 20th century, until the Great Depression and the emergence of the New Deal. Those polarities have reversed. African-Americans have been abandoned by the party of Lincoln, which has bleached itself of every progressive element that it may have ever contained to become the spokesparty for plutocrats, the avaricious and the retrograde. The 14th Amendment was passed to guarantee the civil rights of slaves who had been freed and were subject to imposition of disabilities that would have reduced them once again to a kind of functional slavery. It should not be forgotten that generations of slaves born in the United States were not considered citizens, their lives and labor forfeit to generations of people who believed owning other people was perfectly consistent with the idea that “all men are created equal endowed by their Creator with certain inalienable rights.”

Why is this attempt to undo the spirit of the American ethos such vile hypocrisy? For two basic reasons. First, the vast majority of Americans living today are citizens by virtue of the fact that their immigrant forebears, both legal and illegal, gave birth to children on this soil automatically making those children and their progeny American citizens. That was their dream and apparently the dream is still alive. The argument that terrorists are exploiting one of this country’s virtues is laughable. 10,000 people are killed by guns in this country every year. All Osama needs to do is make large contributions to the NRA, sit back, and watch the fireworks. Second, this attempt on the part of Republicans to rewrite the Constitution for their electoral convenience smells to high heaven because it is consistent with their attempt to disenfranchise certain groups in general. So many African-American men are in prison (11% of all African-American men between the ages of 30-34) that disqualifying felons from voting can be the difference between victory and defeat in many political races in this country. It is not that felons ought to vote. Elections can just as easily be stolen by trolling voter registration lists for felons and then disqualifying many eligible voters in the process. (That exactly this tactic was used in the Presidential elections of 2000 and 2004 is easily documented.) What Republicans are doing in this recent maneuver is an attempt to disqualify voters at a more strategic juncture – the very point of citizenship itself.

See Also: http://www.truth-out.org/connie-schultz-blame-babies62011

Sweden - Socialist Paradise?

I have been in Sweden for a week and a half and am about to depart in the morning. The purpose of this trip was attendance at the International Sociological Association meetings where I gave two papers and otherwise hobnobbed with my fellow wizards. But the experience of Sweden and, in particular, Göteburg, is what I wish to discuss.

Sweden has a bad rap in the United States for being too heavily taxed and the prime suspect in that crime known as “social democracy.” It is true that taxes here are high. Not only taxes, but prices for a middle-class sociology professor like myself are just about astronomical. A Caesar salad at any decent restaurant is going to cost the equivalent of about $20.00 and bottled beer goes for about $7.00. One ride on the tram is almost $3.00, at least 30% more than comparable cities in Germany, for example. One supposes that the high prices are a result of the tax structure. The lovely proprietor of a shop selling Indian goods told me that she had to pay 25% off the top from every transaction she made as tax.

On the other hand, the streets are clean and street crime is a non-issue. What is more the people enjoy a very healthy lifestyle and few are as extremely obese as Americans. Coming in by train from Copenhagen, I faced across from a Swedish professional woman who was quick to praise the many social services that were available to people in the country, especially child care. She had children who were in kindergarten which had a very active program and which could keep children until she got off work. In addition, the children were fed two nutritious meals. A woman came in every day and cooked for the class and prepared homemade bread and rolls. Her child does not eat prepackaged meals filled with preservatives and additives, but homecooking and that in a public facility. She beamed when she told me this and that childcare was a worry with which she did not have to contend. Children in the country receive the equivalent of $200 per month from the state paid to the parents and when they reach age 16, the money is paid to them directly. University education is basically free if a student can qualify.

Politically, Sweden is a neutral country so its politics are unusual. The defense budget of the country would not be nearly as burdensome as is that of the United States. Since crime is so low, there are few people in prison taking that burden off the budget as well. In fact, Sweden incarcerates 75 out of every 100,000 people, while the United States incarcerates approximately 750 out of every 100,000 people, ten times as many proportionately. There is an increasing amount of racial and ethnic diversity since Sweden welcomes immigrants from Africa and many foreign nations making its mix something fairly interesting.

Göteburg is a medium sized city (350,000) on the western coast of Sweden and is the second largest city after Stockholm, the capital. People are friendly and the extensive public transportation system makes getting around very easy. I heartily encourage a visit to this interesting place, but save your pennies because it is not inexpensive, especially for Americans who will find that as time goes on their money may not go as far overseas as it has in the past (nor will it at home). Sweden is an example of a working social democracy which is feeling the same pressures that all nations are contending with during the world-wide economic crisis. Forces in this world are attempting to dismantle every bit of human connectedness and feeling, but if people are aware that this happening, possibly they can take steps to prevent it.

Spilled Ink

It is a metaphor for so much of what is wrong with our society: a deeply embedded structural flaw is hemorrhaging national treasure, but, instead of providing any benefit, it is fouling the landscape. The ongoing calamity, the oil leak in the Gulf of Mexico resulting from the explosion and sinking of the rig Deepwater Horizon, demonstrates every day that the Obama administration is not in control of events and that the American people are not in control of their government. As of this writing, British Petroleum has “slowed the leak” but work continues. Up to this point, the term “leak” does not do justice to the colossal scale of the environmental catastrophe that already has taken place and which may be further exacerbated. Estimates run as high as 70,000 barrels of oil a day gushing out of that mechanical wound. At the higher end of the estimate, it would be an Exxon Valdez sized oil spill every four days. Even moderate figures mean millions of barrels of oil fouling the Gulf.

The response of the government provides an opportunity to evaluate its priorities and the credulity of the American people. We live with a legitimating legal dispensation that finds it entirely proper to invade foreign nations, bomb villages with mechanical drones sometimes killing dozens of innocent civilians, waterboard foreign nationals without any legal process, incarcerate its own citizens to the point where even a small quantity of illegal drugs can result in twenty year sentences creating the largest prison system in the world, foreclose on hundreds of thousands of homeowners pushing them into the street, deny veterans the medical care they have earned and so desperately need – all this and yet –

Our government is incapable of reflecting the outrage of the populace when a foreign oil company plays fast and loose with American lives and America’s landscape. Now we know what it feels like to live in a banana republic, helpless before the dictates of foreign corporations. Where is a Congress that sweeps into action denouncing these smug, self-satisfied CEOS who care nothing about life, limb or property? Here is a little action plan for Congress. Pass legislation sequestering every bit of profit made by British Petroleum as a fund against which to pay for any clean-up and continue withholding that profit until every penny in damages is recovered. If that had been done in the first week, the hole in that dyke would have been plugged then and there even if the fat-faced Board of Directors had to go deep sea diving to do it themselves. Instead of outrage we get tears. Congressman Melancon of Louisiana got emotional when thinking about the catastrophic damage done to the natural beauty of his home state. Our sympathy is with him but it is not tears of sympathy that are needed now. Nothing will wash that black stain out of the Gulf for quite some time to come. Unfortunately, it is small compared to the stain on America’s honor and intelligence which this episode has so sadly revealed.

Medical Soviet - Part II

A story recently turned up in the Orlando Sentinel that describes a urologist in that area who has posted a sign on his door that attempts to turn away from medical care in that practice anyone who voted for Obama or supports his health care reform. The story goes on to describe the ethical dereliction that this piece of professional arrogance represents. I suggest that if there are any firefighters in that area who disagree with the good doctor they should refrain from putting out any fires at his home. The pathologically anti-social nature of the sign on his door should deter anyone with any sense from putting themselves in the hands of such an ethical monster.

Unfortunately, the medical establishment in this country has been heavily colonized by this kind of sensibility. There is an interesting work by E. Richard Brown entitled Rockefeller Medicine Men: Medicine and Capitalism in America which provides an excellent introduction to the impact that both medicine has had on capitalism and vice-versa. (It should be noted that the entire work can be downloaded on the Internet at the site which has been hot-buttoned). There is little doubt that medicine as practiced in this country has been an auxiliary to the Fordist and Taylorist practices that have until recently organized the time, minds, bodies of the great masses of American humanity. In return for their faithful service, physicians have received an almost sacred status and the highest medical salaries in the world, although the impact of medical care on gross measures of health do not bear out any great return from all this expense.

It is high time that Americans freed themselves from mystifications of all kinds, but a good start would be the professional mystifications that abound in almost every area of life. Medical mystifications are some of the most durable, most resistant to being dispelled. This is not difficult to understand because we are all wary of criticizing the very people upon whom we rely for the maintenance of our health and the health of our loved ones. Thus, it becomes doubly important that the individuals who operate within that arena of activity, the medical/health care arena, do so on the most disinterested basis that can be arranged. Those who aspire to practice medicine must bring with them a strong sense of social responsibility as well as a basic humanity that transcends politics or economics. Physicians whose lives are taken up with entirely venal considerations are no better than priests who abuse the worshippers in their charge.

But our civilization has given itself over to the idea that we should recognize self-interest as the only worthy motive of action and competition as the engine providing the organizing principle of human relations. The result of this has been the perversion of human values and the transformation of American society into a version of ultimate cage fighting. Winning is everything and your opponent is an object to be eliminated in the pursuit of your goals. Religion, morality, education and even medicine, all these institutions are insidiously transformed to support this shift in values. In fact, there are some who would replace the book held by the Statue of Liberty that has carved into it “July 4, 1776” with something similar to the sign on the doctor’s door: Stay Out – Survival of the Fittest Rules!

The Medical Soviet - Part 1

Today’s comments do not have so much to do with medicine as they have to do with the various twisted ideas that come out of those witches Sabbaths of stupidity and hypocrisy known as “tea parties.” That tea parties are anything more than a collection of disaffected white racists who bemoan their perceived loss of privilege is a difficult position to defend. However, through the vulgar taunts and the vicious looks comes a number of complaints that have a pedigree pre-dating the Obama presidency and which have held together the right wing consensus through a number of presidential administrations. Some of those complaints emerge from a theory of society and economics. That theory maintains that government action, or any collective action for that matter, which stymies the free working of “the market” is illegitimate and guaranteed not only to fail as economics but also to undermine the sacred values of a democratic state.

Unfortunately, there is no easy way to distinguish between one set of regulations and another. To bring medicine back into the conversation, if the principle of open competition were to operate freely in the medical sphere, as I, for one, believe it should at least to a greater degree than it does, state regulation of physicians would be an unacceptable encroachment on freedom of choice. If I want to consult a physician who treats on the basis of the latest nutritional and herbal knowledge, why should I be denied the freedom of doing so? Considering the vast uncertainties upon which medicine is based, it is curious that there are not more disagreements among medical professionals. But medicine as conducted in this country is a series of closely monitored practices based on what is considered to be the best science. Even so, science, if it is science and not dogma, must be an open-ended practice ever laboring toward new paradigms. However, the track record of American medicine has not been one of toleration for alternative views or practices. All one needs to do is consult the history of chiropractic or the oppression suffered by lay midwives. The only way that medicine is able to exert any power is through the monopoly granted it by the state. But if competition effectively sorts between those who succeed and those who fail, why not allow the market to decide who stays in business practicing medicine and who does not?

Of course, to a degree I am playing the devil’s advocate. I suppose even hounds of the tea party breed would bark loudly and lustily if it was suggested that the state cease licensing and regulating the practice of medicine. But why? Well, I suppose it might be argued that some things are so well settled that it only stands to reason that the state has an obvious basis for intervening. The fact that this last insight should be applied to medicine and should not be applied to the provision of medicine would seem to me to be a failure of imagination. Reasonable people can come together and through their consensus determine that some things will not be subject to the whim of fate. “The market” in reality is only another way of saying “fate” or “chance.” At the risk of offending some religious believers, an analogy could be made between this fear of regulation and the refusal of some individuals to accept medical treatment on the basis that it upsets “God’s plan.” Medical treatment may not work and some social regulation may be misconceived and fail to produce its purpose. Neither of those two possibilities should mean that we avoid taking the most advantageous action when the opportunity arises. If the tea parties were operating out of a sense of wisdom and not vitriol, their medicine would be a lot easier to swallow.

Good to the Last Drop!

Hooray! As per a new study out in the last few days, not only has coffee been rehabilitated heart-wise, it is now touted as being heart protective. The new study (funded by the Robert Wood Johnson Foundation and Kaiser Permanente) suggests that dangerous heart arrhythmias are found to occur less often in people who are the heavier coffee drinkers. Of course, media reports of the study do not tell you which kind of coffee to drink, what time of the day to drink it or whether or not it operates the same way if you are taking it with Beta Blockers or whipped cream. Long ago my cynicism reached its now epic proportions concerning medical pronouncements when it became obvious from the conflicting studies that appeared on a regular basis in the media that all one needed to do was wait. You like to indulge in fried pig’s livers but were told that this is a death sentence for your circulatory system? Wait a few days and a new study may appear that will not only clear those livers of all harm but will exalt them to such a height they will be given their own float in the Rose Parade.

Don’t get me wrong. I love coffee, especially the kind that comes mit schlag in the wonderful cafes scattered so conveniently about the city of Vienna. When it was partially vilified by earlier studies, I continued to drink it. Now that coffee has been fussed over yet again by the medical establishment, my love for it has not increased. I drank it before, drink it now and will continue to drink it. Why? Because it tastes good (to me), has not caused any fatal complications as of yet and has a sophisticated complex of flavors and sensations that are appealing. That appeal is ancient and when coffee finally made its way into European salons it took off like a shot. There seems to be little or no evidence that its allure is fading anytime soon. Of course, everything needs to be approached sensibly, but that seems beyond the ken of our modern sawbones. Now that this study has given a green light to coffee drinking, I expect that Americans will put the pedal to the metal and start guzzling coffee like Ponce de Leon at the Fountain of Youth.

But isn’t this exactly the problem with the way that medicine is practiced? Physicians prescribe literally billions of drugs per year to Americans (see Greg Critser) but can only tell in the most general fashion who will suffer serious or even fatal side effects. Everything is a matter of percentage risk. Of course, herbs, teas, natural foods are off limits for most physicians to discuss with their patients because they cannot find “studies” which provide the probabilities of risk. Now that coffee has been the subject of a study and the numbers are in, their confidence swells like Tarzan’s pecs. What about the old studies? What all this is about is a professional narrative that medicine, especially American medicine, would like to have believed. That narrative is simple – we knew nothing before modern medicine came on the scene and we all owe our lives (and most of our fortunes) to the good doctors for the great benefits they have brought us. They have brought us great benefits indeed, but those need to be kept in perspective. Drugs which are enthusiastically marketed at one moment, become a deadly menace the next. Medical errors cost tens of thousands of lives a year. One cannot fault the medical profession entirely. It is really the American public that needs a good hiding for forgetting the simple lessons of their great-grandparents. With medicine, less is more.

Old Duffer responds to News-Leader Blog

The editorial I wrote in response to Dr. Lilly’s article in the Springfield News-Leader has generated a host of comments on the News-Leader site, many of them quite diverting, both in the sense they are funny and that they avoid the issue. In one I am called an “old duffer” to which I take some exception. Please, allow me to be a middle-aged duffer. My duffer-hood has only recently begun. Also, there was reference to my inflated salary, supposedly one of six figures. It is obvious that these posters do not know how to use the Internet because the State of Missouri makes public the salary of all its employees. This is a cruel exaggeration. When I came to Missouri State they hired me in at $29,000 a year, hardly six figures. But people who make such charges do so because they are resentful not only that the state employs people who do mind-work but also because such work may be beyond their understanding. Finally, a suggestion was made that professors be paid $20.00 per student per week, that figure chosen, one supposes, as a disparagement of the education process. In my case, that would mean a salary of more than $160,000. Please, write your representatives and actively work to make this scheme a reality.

As for the health care issues, it was interesting for me to see that there were actually comments made that attempted to downplay the well-known statistical evidence that health care in this country is not what it might be. Life expectancy and infant mortality rates are not the whole picture and present more than a few difficulties when being used to judge the adequacy of a health care system. However, coupled with the amount of money being spent and the lack of access to health care by millions in the population, the picture becomes rather bleak indeed. Dr. Lilly’s powerpoint is not persuasive. The problem lies not in the narrative itself, although there are issues that could be taken with certain points he makes, but the interpretation of the picture that he paints. Yes, third party insurance was abused just like illegal drugs are abused. But without pushers the problem of drug abuse would change considerably. Similarly, where were the AMA and the medical profession in general while all this was going on? They were doing what the hospitals, the insurance companies, the medical device companies and the pharmaceutical companies were doing – coining money. Let him produce the great campaigns that doctors undertook to convince the public that medicine was being oversold. If there were any, they were few and far between. If today, you should suggest that cost is a factor in the health care debate, the very same individuals who complain about the costs start shouting “death panels.”

One of the snide comments on the News-Leader blog concerned the fact that doctors pay so much for their education. In many nations around the world, medical school like university education in general, is either much less expensive than in the U.S. or is funded by the state. Imagine, physicians graduating without having to pay back enormous debts right out of the gate. Physicians today are the highest paid profession in the United States, earning considerably more than physicians in most other industrialized nations. Even so, physician salaries are only about 20-25% of total health care expenditures. None of this truly matters, unless we get the debate under control. This apparently is not within the capacity of a certain segment of our population. Some physicians are going to work hard to keep the present system intact or even to eliminate the government health care programs that now exist in the name of some free-market hokum (although there are more than a few physicians working for positive change). This will continue to allow them to reap enormous profits off the backs of frightened Americans who imagine that they need to throw a sacrifice of their virgin dollars into the health care volcano in order to protect themselves and their loved ones. This strategy does not seem to be working and a fiscal reckoning is approaching when some hard decisions will have to be made. The medicine may not taste very good but ultimately we may have to take it. Either we will realize that human decency requires that we extend health care coverage to everyone, or that we allow people to sicken and die because they are too poor to afford care, which, in fact, is happening already.