brain washed or just plain stupid?

Only 66% of the population of the great state of Texas has full health insurance. Over one fifth of children there have no cover at all. Yet the opposition to health care reform in Texas runs at 87%. Texans apparently believe the legislation is socialist, godless, and a step on the road to a police state. Why they would have such ridiculous and outrageous ideas is anyone's guess.

It is not often that one finds people so determined to vote against what is to their immediate personal benefit. In this age of smart phones, smart bombs and smart cars, it seems we are left with a whole lot of dumb people.

According to Drew West, in his book Political Brain, people are not stupid. He argues the reason why people vote against their own interests is not because they do not understand what that interest is, or have not had it explained to them. It is apparently because they consider having their interests decided for them by politicians who think they know better is seen as a betrayal.

Let me get that straight. If a politician were to offer you $100,000 cash -I think that is an underestimate of what good health insurance is worth, but so be it- you would say no because you felt that having someone else, who acts like they know better, decide what is best for you is a betrayal?

I agree that the reasoning sounds really smart, but I doubt that anyone would say no to a $100,000 check. No matter how much they hate being treated like idiots. Because idiots is what they are. If they can't see that this healthcare reform is directly going to benefit them, they must be idiots.

Let me offer an explanation that makes a bit more sense. First of all, these people are not too bright. I know one is never supposed to say that and it threatens to derail a good argument and prevents people from listening to me, but I would say it needs to be said. These people are not too smart.

Second, and because they are not too smart, they are very suspicious. That too is quite common. People who aren't too bright are often taken advantage of and all of them must have lots of painful childhood memories where smart looking people got the better of them. That has fueled a strong aversion towards sweet talkers. And what better sweet talkers than politicians? It is obvious these people are unlikely to listen to politicians. But Europe has lots of dumb people too and that has not prevented them from acting this way. So there is more.

Apart from being suspicious, the not-so-bright are also paranoid. They are afraid, and they are very susceptible to the Harry and Louise type ads. Those types of ads never aired in Europe and Europeans had good healthcare long before TV ads could brainwash them.

These ads play on important fears: -that one will not have access to the best doctors. Note that none of these people has access to such doctors now, because they cannot afford to go there.

-that care will be denied to save money for the government. Note once again that these same people are now barred from care because they cannot afford it or because their insurance company will not pay or threatens to dump them.

-that government bureaucrats will make decisions for them. Note that company bureaucrats already do so for insured Americans. There is no equivalent of that in Europe.

-that the country will turn to communism. This one is for the patriots. Note that all Western democracies except the US have solid healthcare systems without being communists.

-that the deficit will skyrocket. This one is for the more sophisticated among the dummies. The ones who want to show off to their kids and peers by pretending they are Wall Street tycoons. The ones who think they can afford to be worried about the debt burden.

massachusetts

Much has been said and will be said about the senate vote in Massachusetts, but in reality the outcome was not unexpected. Especially not in light of what happened earlier in Virginia and New Jersey. And even less so when you hear the talk inside the beltway. Democrats are bracing for a loss of up to 30 seats in midterm elections. Clearly they know something is up. Some of the more prominent ones have already preempted a defeat by declaring they won't run again.

There is no doubt that this string of losses is a rebuke to Obama. The new president's popularity is low compared to that of his predecessors. He barely tops Carter and comparisons with Carter are sure to follow. Unfortunately a lot of it is of his own doing.

The keys to defeat lie in the unrealistic expectations that were only topped by the even more unrealistically high fundraising. Both are coming home to roost.

I agree with Krugman at the NY Times that Obama made serious mistakes. The stimulus was too small and it did not reach the intended beneficiaries. The bankers got bailed out without so much as a slap on the wrist, while middle class families are losing their homes, their retirement, and their savings. It is obvious Obama is in bed with Wall Street. I pointed this out before and predicted it would cause major problems.

I also agree with the Rutten at the LA Times that the administration did not do a good job explaining healthcare. While it addresses the 30 million uninsured, it appears to offer little or nothing to the 270 million who have insurance. All they can see is more deficits that they know they will have to pay for. Never mind that their coverage could lapse, that they might be bumped when they need it, or that they will find out it does not cover their expenses. For now it appears to them that things are OK.

But Rutten goes further. He points to the anger that he says is due to the fact that American middle class families are worse off than their parents. Some of that may be a factor. The American economy is not so much a wealth creator as it is a wealth shifter. It has shifted massive amounts of wealth from the poor and the middle class into the hands of the few. In doing so it has bankrupted over half the population. The shifting is running out of resources to shift.

Everything was done by deceptive means. US style capitalism appeals to people's worst behaviors such as greed, lust, pride, envy and gluttony while making fun of altruism, cooperation, and moderation. It pits people against their friends and neighbors. It uses fear and anger and preys on feelings of inadequacy and inferiority. It relies on illegal immigrants and workers on job-related visas that have no bargaining power and can be used to undercut the wages those who seek a decent living. It uses layoffs to boost quarterly earnings, and promote job-insecurity in workers.

It has promoted women, not because it believes in feminism, but because additional lower paid workers helped create an environment that is aversive to organizing, unionizing, and bargaining power. It also helped create a false sense of wealth and that drove more consumption.

It uses open markets and tax payer subsidized oil to bring in items from abroad, where labor laws are lax and environmental issues of no concern. It treats many parts of the world as colonies to be stripped of resources and valuables.

Furthermore, the unfortunate situation is leading to a country that is becoming ungovernable. The State of California has already reached that impasse. Soon the nation will follow. Like Rome before it, the American republic may soon become a dictatorship or go down in anarchy.

health care issues

Today we read in the NY Times, "Mammologists wanted" that delayed diagnosis of breast cancer is the most common and second most costly claim against American doctors. And therein lies a big problem. First of all, I disagree with the consensus that early diagnosis improves survival in breast cancer (or almost any cancer for that matter). Although it sounds plausible enough, this idea is based on a faulty hypothesis about the way cancer develops, spreads and kills. It is also caused by warped statistics and the fact that we do not know the natural history of malignant looking lesions.

So here is the first issue. American doctors, eager to help patients, and esp. militant patients as one finds in breast cancer, have popularized the notion that early detection is key. That it saves lives. Several agencies and scientific bodies have lent credibility to this nonsense and it is now generally accepted that early detection is necessary.

The second issue is even more daunting. And once again it rests on a faulty assumption. And that assumption is that cancer grows locally until it hits a certain size, at which point it will start spreading. But many cancers do not evolve that way. In many cases, finding the early lesion is not trivial. But it is rather easy to go back (hindsight is 20/20 as they say) and "find" the earlier lesion that -now by definition- someone must have "overlooked." I.e. a vague shadow may not be identifiable when you look but when you come back months later and know it is there, well that is a different story. Now that you know the right answer, interpretation is easy.

Can you see where this is going? We treat too many people who then survive, but would have survived anyways. These people add to the statistics and make it more plausible that we should think early detection is key. Now lots of women whose cancers are found "late" start complaining that their lesions were overlooked and go see "legal help." Enter the lawyers, another highly paid profession that has no business in medicine or healthcare. Someone has to pay these lawyers, and the exorbitant fees they charge and the even more ridiculous and exorbitant "settlements" they get.

Once the lawyers are in, the docs start practicing more "defensive medicine," doing even more tests and more procedures so as to make sure nobody can come after them later. Before you know it the whole system is dangerously and expensively out of whack. Ironically enough nobody benefits from this, certainly not the patients. Many more of them suffer complications, while others are told they have "cancer" and need expensive treatment and lots of anxiety for lesions that would regress naturally if left alone. These people not only suffer tremendous mental anguish, they also undergo needless chemo -and some die or get very ill- and they no longer qualify for most healthcare after that. Not to mention all the extra economic hardship they suffer.

And who pays for all this? Your healthcare system. Your premiums.
You pay for unnecessary treatment, for longer than necessary treatment, for high malpractice insurance fees, for experts and more experts to read and re-read xrays, etc. etc.

And what does it buy you? Has survival improved? Except for a few cases, it hasn't. If you include the iatrogenic morbidity the end result is probably zero. That is the long and short of it.

health care reform

It looks as if Health Care Reform will die a slow death. That is to be expected when powerful for profit forces with ample media access stand to lose their lucrative honey pot. Health Care will forever be a problem in America because both parties stand in the way of meaningful reform.

First one would need to take the lawyers out of the picture. We need to end the malpractice lawsuits and the punitive damages. These things accomplish nothing and they cost each and everyone of us a fortune. They cost us in more ways than one. We are denied simple things because people are afraid of being sued, and we pay through the nose for other equally simple things because the liability insurance is so high. We have to fill out tons of paperwork and stand in long lines before we can participate in everyday routine activities.

Unfortunately, the lawyers are a major force in the Democratic party so don't expect anything here. And if the Republicans want to take on the lawyers, they only do so to enlarge the already excessive profit margins of the major players.

Second, we need price controls on drugs, and we need competition for private health insurers. Better would be to get rid of private insurance but that is another matter. Both of these groups are ardent Republican supporters so here is another impossible roadblock towards reform.

The problem is simply this: health care is so full of conflicts of interest that even without a profit motive, it is hard to ensure fairness and equity. If you add in profits, everything goes to hell. If your doctor stands to gain from procedures, he will perform more of them. If the drug company stands to gain from selling pills, they will sell them to everyone regardless of need.

It costs us and it costs us in many ways. We pay for it over and over again, not just directly, but also indirectly. And we get very little value in return. No American Health Plan comes even close to what Europeans take for granted.

Even the wealthy with unlimited access suffer as the profit incentives force them into unnecessary tests and procedures. And the liability issues make it so their doctors and providers practice defensive care (i.e. another incentive to do even more tests). No test or procedure comes free of risk and in most cases the cost benefit is simply not there.

Now you say, but isn't our long life expectancy proof that we have great healthcare?

Unfortunately longevity is not a good measure of success. Longevity correlates well with wealth because good food, clean water, good sewers and an ability to stay away from dangerous (job) situations promote longevity. Anything that brings you closer to a doctor or hospital on the other hand is likely to reduce your quality of life or artificially extend the duration of it in ways that are unsuited for a dog, let alone a human. Every Terry Schiavo does wonders for longevity statistics.

Apart from party politics, one other bipartisan hurdle remains: the moralists. A key benefit of medicine is pain relief. And not surprisingly, pain is grossly under-treated in this country. Not because we don't have good drugs, but because a handful of moralists feel it is imperative to prevent drug addiction. Heaven forbid that a terminal cancer patient should become addicted to morphine! For that simple reason we all have to suffer. And suffer we will, because modern medicine will make sure we don't die a quick death. Euthanasia is out of the question, even if one's condition is hopeless and one's suffering unending. How's that for first do no harm?

Death panels

I am sure you are all aware of the fact that the President's healthcare reform plan will not only bring socialism to our country, but it will also encourage embryo-factories, where embryos will be grown to be used for stem cell research, abortion clinics, where young women will be forced to undergo unwanted abortions, condoms and birth control pills in schools so pupils engage in early sexual activity, and death panels, where experts will decide who will live and who will die.

Yes you got it! It is all part of the master plan devised at the UN to make America weak and to undermine religion and family values. Obama is really a UN spy in disguise, who wasn't even born in this country and illegitimately claimed the presidency so he could sell us all out to atheist aliens.

Fortunately for all of us however, the healthcare plan will be administered by the government. That means it will be so inefficient and wasteful we won't have to worry about it. We will just pay higher taxes, but none of the bad things will happen because bureaucrats in Washington won't be able to make decisions in a timely manner.

And so you see, it all balances out in the end!