Thursday, July 16, 2009


Our current system for providing and paying for health care as it looks to a rational outsider (I'm talking to you, Canada!)

Dear Editor:

For the first time I can recall, I agreed with both the USA Today editorial and the opposing view (from the Chamber of Commerce) on a subject- in this case, the health care reform efforts underway in Congress. However, although the editorial board's comment that "no one ever thought [health care reform] bills would be works of elegance or simplicity" is accurate, that doesn't mean that complexity is better in this context. True reform would be a work of simplicity, but it would take courage and leadership, qualities presently lacking in both the White House and the Congress. There are reforms available which would vastly reduce costs to the government, to the consumer, and to the medical industry, but politicians so far have lacked the guts to cut the Gordian knot. Here are three suggestions that would accomplish the goals of a better system for all while reducing costs:

(1) End the multi-tiered system of paying for services, which at present includes government funded Medicare, Medicaid, and the Veterans Administration, private funded insurance, and no insurance-no pay patients funded by the general public. Replace all of those with a government funded catastrophic insurance which would pay all annual medical expenses for each person which exceed $2,400 a year ($200 a month). In addition, provide free pre-natal care and free pediatric care for all children under 12, and free preventive medicine for all. Fund these programs with a national sales tax that would be less than five percent. Ending Medicare and Medicaid programs and substituting the foregoing will save hundreds of billions of dollars starting on day one. Using a national sales tax will equitably share costs without burdening any businesses, large or small, or unfairly piling the costs onto wage earners or the super rich. Ending employer provided health insurance will reduce overhead and make all American businesses more competitive with foreign companies whose workers have a national health insurance. Providing government funded catastrophic insurance will allow Americans to switch jobs regardless of pre-existing conditions or availability of health insurance, and it would end the sad state of affairs where too many parents of diseased children are literally begging for donations in penny jars put out in retail stores to pay for life saving operations. Having the system paid for in full by a national sales tax (the percentage will be adjusted as the costs are calculated and re-adjusted over the years) will ensure fairness, including the fairness of having foreign residents, the retired rich, and illegal aliens all helping fund the program.

(2) End all medical malpractice insurance costs by replacing the system with a no-fault system similar to worker's compensation programs that do not require lawsuits or lawyers for recovery. Any person injured by any medical product or medical procedure will be entitled to recover set amounts based on the degree of injury, without regard to fault. This provision will save tens of billions of dollars in overhead for all physicians, hospitals, and pharmaceutical and medical equipment companies, both directly in the form of insurance premiums and indirectly in reducing the amount of defensive medicine. And a no-fault system will compensate far more injured patients than the current tort system which requires expensive lawsuits available only to the few who have suffered serious injuries or death.

(3) Require all medical providers to publicly post the following information: all costs for all procedures, services, and products. Currently, the average patient never sees a specific cost for anything until long after the service is provided- and sometimes never in the case of patients with good insurance. Also, require all recoveries under the no-fault system to be publicly posted (on the internet and elsewhere) with names and identifiers of patients removed to protect their privacy. This will inform and alert the public to defective products or bad doctors far more effectively than the occasional malpractice lawsuit, many of which result in confidential settlements. These public disclosure requirements will allow price shopping among patients, promote price competition between doctors and between hospitals, while allowing patients to avoid dangerous doctors, dangerous hospitals, and dangerous drugs. This proposal would be an adjunct to FDA regulations and inspections and state licensing agencies for physicians and hospitals which are already in place and already supposed to protect medical consumers.

So the ideas exist. They are elegant, simple, would cut government costs, patient costs, and costs of the medical industry, all while improving services to all. Now who has the courage to see that they are enacted?

Sunday, July 05, 2009


Dear Editor:

The essay "Not Just for Kids" by Mark Hyman makes some excellent points about adults abusing children's organized sports. But any organized activity is subject to abuse, and Little League baseball and Pop Warner football aren't intrinsically evil or inevitably devastating to the children who sign up to play. My experiences in 50 years as a player and as a coach in youth sports have taught me that the key in allowing the participants in organized sports to have positive experiences is in having program administrators who understand what's important and who clearly communicate that to coaches and parents.

I first coached an organized team 45 years ago, when I was a 12 year old Little League player (we won the championship that year, and the baseball signed by my teammates after that game still sits on display in my office), and I was asked to coach 10 year olds in a lower division when the league couldn't find a coach for their team (we won that championship, too, so I had a rare double at an early age). But my peers and I also played pick up baseball or whiffle ball every day during the summer when I didn't have a game scheduled, and the experiences were vastly different. There is simply no comparison between the emotional involvement in a pick up game in a neighbor's backyard and pitching in a ball park for a team in uniform with a championship on the line. The pressures that existed came not from our parents, but from ourselves, and the characters that were forged- or, in some cases, revealed- in the crucible of competition could not have been replicated if my only athletic experiences growing up had been unorganized.

As an adult I've coached youth sports on and off for over 24 years, starting when my son was six years old and the local YMCA needed a coach for his soccer team. That was my one and only year coaching soccer- a sport I barely understood- and later on I coached youth sports in baseball and basketball, two sports with which I was much more familiar, one of which (basketball) I still play. At the beginning of every season, at the first team practice, I tell the kids that we have three goals: to have fun, to improve their skills regardless of what ability they had at the start of the season, and to learn to play together with teammates. The YMCA leagues in which I have coached have made it very clear in the rule sheets that participation trumps winning, and coaches must play every player at least half of the game. At the end of every game, the kids line up and shake hands with every member and coach of the opposing team. Parents and spectators are actively discouraged from injecting themselves into the competition, and verbal abuse is not tolerated. As a coach during and after games I've always made it a point never to criticize a child's performance, but instead to focus on giving praise when they do well and mentally noting the areas they need to practice when they falter. And win or lose, I have also made a point of congratulating officials after the game while refraining from complaining about calls in the heat of competition.

Of course there are abuses in organized youth sports, and every week the local paper has an anonymous complaint or three from parents about favoritism in local baseball leagues (basketball, not so much) where parent-coaches favor their sons or their friends' sons. Other abuses have occurred nationally with the rise of travel teams, expensive sports based summer camps, and over the top college recruiting permeating and affecting the lives of impressionable youths down to middle school (a recent news report disclosed a 13 year old who has already committed to University of Tennessee football, where his older brother plays).

But even while unorganized casual pick up games have declined in every sport except basketball, there are now far more opportunities to participate in organized sports than existed when I was growing up in Western Pennsylvania. Soccer leagues didn't exist anywhere I knew of in the '60's, high school girls basketball was still shackled by the old Iowa rules (6 girls, only 2 of whom could roam full court), girls softball didn't exist, and outside of a few church leagues for high schoolers, organized basketball didn't exist outside of interscholastic competition. I agree that taking competition outside the local level- all star teams, Little League World Series on ESPN, travel teams- is a bad idea for children, and the focus instead should be on participation, acquisition of skills, and fun. And I'll never forget the words of wisdom I imparted to my 11 and 12 year olds during a time out with the game tied and 1 minute to play in a YMCA playoff game a few years ago: "Are you having fun yet?" Then I sent them back on the court to enjoy the moment.

James Finkelstein, College 1973

P. S. I earned a letter at Penn on the Golf Team, which won the Eastern Collegiate Athletic Conference Championship (ECAC) at Cooperstown, New York in 1972. We beat Harvard by a stroke.

Saturday, July 04, 2009

The real question is: why do so many intelligent Republicans (yes, I know that's pretty much of an oxymoron) slobber over her?

Rich Lowry after watching the VP debate last year:

Via TNR, National Review's Rich Lowry gives Sarah Palin's debate winks a rave review:
I'm sure I'm not the only male in America who, when Palin dropped her first wink, sat up a little straighter on the couch and said, "Hey, I think she just winked at me." And her smile. By the end, when she clearly knew she was doing well, it was so sparkling it was almost mesmerizing. It sent little starbursts through the screen and ricocheting around the living rooms of America. This is a quality that can't be learned; it's either something you have or you don't, and man, she's got it.

Rich Lowry today:

Friday, July 03, 2009

Palin Today [Rich Lowry]

I think I have pretty well-established credentials when it comes to being charmed by Sarah Palin, but that statement, as a statement, was simply terrible. Rambling and not at all persuasive as an argument for her decision. More Gibson/Couric than GOP convention speech. She shouldn't have said a thing without getting Matt Scully — or some similarly talented speechwriter — on the case first

The annotated Sarah Palin resignation speech:

2008 photo from video of Alaska Governor Sarah Palin, former running mate to John McCain in the 2008 presidential election, giving Thanksgiving speech as live turkeys are slaughtered behind her, epitomizing her cluelessness on a cosmic scale.

Following are excerpts from the July 3, 2009, resignation speech of Alaska Governor Sarah Palin, who announced in a rambling 20 minute address to reporters that she is resigning, effective in "a few weeks."

PALIN: "... a member of President Abe Lincoln's cabinet, William Seward, providentially saw in this great land, vast riches, beauty, strategic placement on the globe, and opportunity. He boldly looked "North to the Future". But he endured such ridicule and mocking for his vision for Alaska, remember the adversaries scoffed, calling this "Seward's Folly"."

FACT: Lincoln was assassinated April 14, 1865, and was succeeded by his Vice President, Andrew Johnson.

FACT: Seward's most famous achievement as Secretary of State was his successful acquisition of Alaska from Russia. On March 30, 1867, he completed negotiations for the territory, which involved the purchase of 586,412 square miles (1,518,800 km²) of territory (more than twice the size of Texas) for $7,200,000, or approximately 2 cents per acre (equivalent to US$95 million in 2005). The purchase of this frontier land was alternately mocked by the public as "Seward's Folly," "Seward's Icebox," and Andrew Johnson's "polar bear garden." Alaska celebrates the purchase on Seward's Day, the last Monday of March.

PALIN: "Let me go back to a comfortable analogy for me – sports… basketball. I use it because you’re naïve if you don’t see the national full-court press picking away right now: A good point guard drives through a full court press, protecting the ball, keeping her eye on the basket… and she knows exactly when to pass the ball so that the team can WIN. And I’m doing that – keeping our eye on the ball that represents sound priorities – smaller government, energy independence, national security, freedom! And I know when it’s time to pass the ball – for victory.

FACT: A point guard in basketball does not leave the floor after passing the ball to a team mate, but continues playing until the coach removes him or her from the game or the game ends.

PALIN: In the words of General MacArthur said, “We are not retreating. We are advancing in another direction.”

FACT: MacArthur never made the statement and the quotation actually uttered by a Marine Corps general (O. P. Smith), has never been mistakenly attributed to him- until now. During the Korean War, in November of 1950, U.S. forces were surrounded by Chinese troops in the area of the Chosin Reservoir in what is now North Korea. When asked if the Marines were retreating, Major General O.P. Smith, commander of the 1st Marine Division and associated forces in the Chosin area explained that their fighting withdrawal through Chinese lines did not constitute a retreat. His explanation was abbreviated into the famous misquote, "Retreat? Hell, we're attacking in a different direction!"

PALIN: "And one chooses how to react to circumstances. You can choose to engage in things that tear down, or build up. I choose to work very hard on a path for fruitfulness and productivity. I choose NOT to tear down and waste precious time; but to build UP this state and our country, and her industrious, generous, patriotic, free people!

Life is too short to compromise time and resources... it may be tempting and more comfortable to just keep your head down, plod along, and appease those who demand: "Sit down and shut up", but that's the worthless, easy path; that's a quitter's way out. And a problem in our country today is apathy. It would be apathetic to just hunker down and “go with the flow”.

Nah, only dead fish "go with the flow".

"I've never believed that I, nor anyone else, needs a title to do this - to make a difference... to HELP people. So I choose, for my State and my family, more "freedom" to progress, all the way around... so that Alaska may progress... I will not seek re-election as Governor."

FACT: Governor Palin was not just announcing that she would not seek re-election in 2011 (her term ends in two more years), but quitting her job as governor, with her resignation effective this month.

PALIN: "And so as I thought about this announcement that I wouldn’t run for re-election and what it means for Alaska, I thought about how much fun some governors have as lame ducks… travel around the state, to the Lower 48 (maybe), overseas on international trade – as so many politicians do. And then I thought – that’s what’s wrong – many just accept that lame duck status, hit the road, draw the paycheck, and “milk it”. I’m not putting Alaska through that – I promised efficiencies and effectiveness! ? That’s not how I am wired. I am not wired to operate under the same old “politics as usual.” I promised that four years ago – and I meant it.

It’s not what is best for Alaska."

FACT: There is no requirement that Alaska's governor must stop doing her job, must "milk it" while drawing a paycheck, and must start making travel junkets at State expense rather than performing her official duties.

PALIN: I have given my reasons candidly and truthfully..."

FACT: Here are the reasons, in quotes, she gave for quitting now instead of serving out her term:

"... nothing's more important to me than our beloved Alaska. Serving her people is the greatest honor I could imagine."

"Political operatives descended on Alaska last August, digging for dirt. The ethics law I championed became their weapon of choice. Over the past nine months I've been accused of all sorts of frivolous ethics violations – such as holding a fish in a photograph, wearing a jacket with a logo on it, and answering reporters’ questions.

Every one – all 15 of the ethics complaints have been dismissed. We’ve won! But it hasn't been cheap - the State has wasted THOUSANDS of hours of YOUR time and shelled out some two million of YOUR dollars to respond to “opposition research” – that’s money NOT going to fund teachers or troopers – or safer roads. And this political absurdity, the “politics of personal destruction” … Todd and I are looking at more than half a million dollars in legal bills in order to set the record straight. And what about the people who offer up these silly accusations? It doesn’t cost them a dime so they’re not going to stop draining public resources – spending other peoples’ money in their game.

It’s pretty insane – my staff and I spend most of our day dealing with THIS instead of progressing our state now. I know I promised no more “politics as usual,” but THIS isn’t what anyone had in mind for ALASKA. "

FACT: Governor Palin was found by an official investigation to have violated State ethical rules when she and her husband pressured the head of Alaska's Department of Public Safety to fire a state trooper who was Governor Palin's former brother-in-law and who had been embroiled in a bitter child custody dispute with the governor's sister.

Palin dismissed Public Safety Commissioner Walt Monegan on July 11, 2008, citing performance-related issues, such as not being "a team player on budgeting issues." Monegan said that he had resisted persistent pressure from the Governor, her husband, and her staff, including State Attorney General Talis Colberg, to fire Palin’s ex-brother-in-law, state trooper Mike Wooten; Wooten was involved in a child custody battle with Palin’s sister that included an alleged death threat against Palin's father. Monegan stated that he learned an internal investigation had found all but two of the allegations to be unsubstantiated, and Wooten had been disciplined for the others—an illegal moose killing and the tasering of an 11-year-old. He told the Palins that there was nothing he could do because the matter was closed. When contacted by the press for comment, Monegan first acknowledged pressure to fire Wooten but said that he could not be certain that his own firing was connected to that issue. He later asserted that the dispute over Wooten was a major reason for his firing. Palin stated on July 17 that Monegan was not pressured to fire Wooten, nor dismissed for not doing so

On October 10, 2008, the Alaska Legislative Council unanimously voted to release the Branchflower Report, in which investigator Stephen Branchflower found that firing Monegan "was a proper and lawful exercise of her constitutional and statutory authority," but that Palin abused her power as governor and violated the state's Executive Branch Ethics Act when her office pressured Monegan to fire Wooten . The report stated that "Governor Palin knowingly permitted a situation to continue where impermissible pressure was placed on several subordinates in order to advance a personal agenda, to wit: to get Trooper Michael Wooten fired." The report also said that Palin "permitted Todd Palin to use the Governor's office [...] to continue to contact subordinate state employees in an effort to find some way to get Trooper Wooten fired.

PALIN: "My choice is to take a stand and effect change"

"In fact, this decision comes after much consideration, and finally polling the most important people in my life - my children, where the count was unanimous... well, in response to asking: "Want me to make a positive difference and fight for ALL our children's future from OUTSIDE the Governor's office?" It was four "yes's" and one "hell yeah!" The "hell yeah" sealed it - and someday I'll talk about the details of that... I think much of it had to do with the kids seeing their baby brother Trig mocked by some pretty mean-spirited adults recently."

FACT: Many of wounds on the Palin family were self inflicted. The media focus on the Palin family resulted from their injection of family members, including her then pregnant 17 year old daughter Bristol, Levi Johnson, the father of Bristol's baby, and, later on, the baby (Tripp), into the national spotlight during and after the 2008 presidential campaign.

FACT: In 2008 the governor posted a statement at her official website saying, ""The road ahead for this young couple will not be easy, but nothing worthwhile is ever easy. .. When Bristol and Levi first told us the shocking news that she was pregnant, to be honest, we all at first looked at the situation with some fear and a bit of despair. Isn't it just like God to turn those circumstances into such an amazing, joyful blessing when you ask Him to help you through?"

FACT: On January 2, 2009, media reports surfaced that Governor Palin had called numerous national news organizations to complain about coverage of her daughter and the daughter's former boyfriend/fiance:

"Alaska Governor Sarah Palin has gone on the attack to defend her daughter Bristol against charges of being a high school dropout.

CBS reports that Palin has "personally contacted People Magazine, the Associated Press, and the Anchorage Daily News" to complain that they are publishing "erroneous information" about her daughter and Bristol's boyfriend Levi Johnson.

Palin even left a personal phone message with People on New Year's Eve, stating, "You need to know that both Levi and Bristol are working their butts off to parent and going to school and working at the same time. They are certainly not high school dropouts.""

FACT: from an April 05, 2009, news story titled "Palin camp responds to Levi Johnston"

Bristol Palin's ex boyfriend and father of her baby, Tripp, went on the Tyra Banks show this week and spilled secrets, including that he thinks Sarah Palin knew the two were together in the biblical sense. This, obviously, did not go over well with the Palin camp who released the following:

"Bristol did not even know Levi was going on the show. We're disappointed that Levi and his family, in a quest for fame, attention, and fortune, are engaging in flat-out lies, gross exaggeration, and even distortion of their relationship," says the statement from the Palin family rep, Meghan Stapleton.

"Bristol's focus will remain on raising Tripp, completing her education, and advocating abstinence," the statement continues. "It is unfortunate that Levi finds it more appealing to exploit his previous relationship with Bristol than to contribute to the well being of the child."

The statement ends, saying, "Bristol realizes now that she made a mistake in her relationship and is the one taking responsibility for their actions."

FACT: from an interview with Levi Johnson followed by related news stories:

When asked by Rodriguez what the biggest misconception about his family is, Levi replied with,

"Probably that my family's white trash."

Both Bristol Palin and Levi Johnson made national news on the issue of abstinence from sex for teenagers, with Bristol Palin endorsing it and Johnson dismissing it as

On the Palins' 'snobbery' regarding Bristol Palin's child with Levi: "I mean, look what they're doing. They're lying, trying to save theirselves. And they're the one that asked for it. They brought [Tripp] to the campaign. They should have known what was coming. They can't, you know, turn around and try to take it back now."

And what about Sarah Palin's denial that Levi ever lived with the family?

Says the father of Tripp: "They said I didn't live there. I stayed there. I was like, OK, well, whatever you want to call it. I had my stuff there. So, if you want to call it staying there, that's fine, but…"

"He was living there. I didn't see him for two months. He lived there. They can't say, oh, no, he just stayed. That's an absolute lie," Johnston's sister added.

While Bristol Palin has recently paired with young Hollywood’s Hayden Pannettiere to promote abstinence, Johnston calls the “just-say-no” approach to birth control “unrealistic” in the article. And he also has some harsh words for his ex-girlfriend’s family.

“I know that her parents didn’t want us together. I really don’t think they did,” Johnston told the magazine. “So they probably put a little pressure on her.” He even revealed that Todd Palin offered to buy his daughter a new car if she’d dump Johnston--numerous times.

At this point, Johnston says he doesn’t think he’ll ever get back together with his son’s mother, adding that visiting the Palins’ house “makes me pretty damn uncomfortable.”