Sunday, December 29, 2013

Senator Coons, Too Many Cooks In The Iran Kitchen

Originally posted in Delaware Liberal by Progressive Populists on December 28.

Well, maybe living in a Blue state is not all its cracked up to be after all.  I now read that Senator Coons has signed onto the Menendez bill with some of the worst the Republican party has to offer to mess with the Iran peace/nuke disarmament recipe.
I was taught that Congress has an advice and consent role with foreign policy, not a micro-management involvement.  Yes, he's a member of the Foreign Affairs Committee.  But after President Obama and Secretary Kerry have come up with the first potential breakthrough in our troubled relationship with Iran, he feels they need extra help?  Come on now, they've done amazing work here after years of "Bomb, Bomb, Bomb Iran"  refrains emitted from the mouths of the all too meddling Republican party.
Let the Administration do its work.  Let them play out this welcomed initiative before you and your kitchen mates foul up the recipe.  Those of us who served our country in the military don't need this ill timed coupe you're engaged in to cause the new regime in Iran to wonder who is in charge of negotiations from the U.S.A, empowering our own war mongers to go for a kill here.
Iranians have plenty of evidence of historical confusion about U.S. policy with them.  They well remember our CIA's role in the 50's in overthrowing their hard earned first attempts at democracy.  Again in the 70's they remember our invitation to the Shah and his court who pillaged Iran's  coffers, to live out his last days in the U.S. after being ousted.  And again in the 80's when Republicans sabotaged  President Carter's peaceful efforts to retrieve our hostages for Reagan to win the U.S. Presidency.  Not also to forget the Iran/Contra crime by the Reagan administration.  Not a great track record, eh?  They really are wondering who is running the kitchen here and now you and your R buddies are about to screw it up again.
The sanctions we have going there, relaxed a bit for these breakthrough negotiations,  are for policy change aims in Iran, not punishment.  Menendez wants to reduce further Iranian oil sales with a global oil boycott in 2015.  And, institute bans in engineering, mining and construction industries, all of which is fuel for the modernization of their economy.   Tell me this, Senator Coons.  What do international oil politics have to do with these proposed sanctions?  You are well aware of Iran's designs for gas pipelines across the middle east in competition with Bush's buddies, the Saudis.
Also other trade politics figure in here including Iran's enhancing its relationship with India and Iraq.  Iran can be positioned through a peace/nuke disarmament deal to become a much bigger power in the middle east and Af/Pak region, further diminishing the house of Saud.
Or is it AIPAC's and Israel's justified paranoia about Iranian nuclear weapon's development ?  It appears your President and Secretary of State have a pretty good handle on stemming that threat through these negotiations.  And certainly Israel's paranoia is informed by their own undisclosed nuclear weapons stockpile, somehow being exempt from the world's nuke disarmament movement.
So, Senator, give us the real rationale behind your recipe for spoiling the Iranian peace broth.

Wednesday, December 18, 2013

Eliz. Warren Gets It Right On Credit Score Bullies

This blog was published in Delaware Liberal on December 18

I read with interest that Sen. Elizabeth Warren is submitting legislation to regulate and rein in consumer credit scoring companies on their abuse of our citizens.  This warms my populist heart.  It mainly aims at employer's use of this unreliable and often inaccurate information but at least it is a start for us consumers/job applicants.
When I first retired, I decided I'd finally have the time to check out my credit reports and make sure they were in order.  I'd had no particular problem with getting credit having done some modest real estate investing requiring loans.  Also, I had then a friendly community banker who gave me a heads up on my credit reports.  I noticed then an erroneous item on a mortgage I'd had years earlier and decided to check further, though it seemed  not to impede my qualifying for more current loans.
To my amazement, these companies, Experian, TransUnion and Equifax had attained enormous power over consumers beyond credit and bank loans;  employers were using their data on a massive scale to check out job applicants for "character flaws" and risk issues.
As I got into the process I learned the power these bureaus hold over those persons on whom they report.  They claim no responsibility for accuracy, fading the heat back to the source of the transaction information they receive from their information sources on you and offer little or no help in correcting inaccurate information send to them by retail stores, credit card companies, auto and home loan lenders.  Further, it is on you, not them, to go back to the original source for corrections or modification of their reports to the bureaus.  But, their accuracy is taken for granted by employers it seems.
In my case, I had two issues to "clean up"; an erroneously reported late payment on a mortgage I'd had 15 years earlier and long since paid off and an non-existent late payment on a credit card account of about the same vintage.
Net, net, it took months, about 6 in total, to address these error laden reports and with no help from the bureaus.   I had to go back to the sources, the mortgage company and credit card company, via snail mail at their demand, to provide challenging and correcting information.  Back and forth with endless exchanges until they acknowledged their errors and then documented their errors back to the three bureaus.  Now imagine if I was having to do this in conjunction with a job application or potential employer?  6 months?  I'd be blown out of the water on the job before the correct information was finally documented in the credit reports read by the employers.
The fact is that these bureaus are data base managers of information provided by credit and money lenders and your information depends, in part, on the accuracy of the data entry staffer with the bureau as well as the accuracy of the lenders/credit issuers in their data entry and reporting.  And you have no power over either.  But your job or loan hangs in balance based on their accuracy or correct reporting.  And they, the sources and the bureaus won't help you correct the information or explain the mitigating circumstances.  You're all on your own here and you'd damned well better have the time, persistence and energy to root out the errors and with some luck and minimal cooperation from them, get the record corrected. Often, the result is just permission to write and publish on their reports a brief statement from you on the mitigating circumstances, not a full retraction, deletion of erroneous information or complete correction of the record.  At least, not unless you're in a position to hire an attorney.
So, thank you Senator Warren for standing up for the little guy or gal.  And, Senators Coons and Carper, are you on board with justice for consumers in this case?  Will you sign on?  Why aren't you co-sponsors?

Wednesday, December 11, 2013

Meet The Best Health Care, The VA

Published in Delaware Liberal by ProgressivePopulist on Dec. 11

Yes, the best health care in the USA is the VA.  Not private, for profit care but the system owned and run by the people of the United States, via the federal government.  Yes, government healthcare that is essentially socialized medicine.
How do I know?  I've been under their care for about 15 years and have some basis of comparison having had a career in health care marketing for an equal number of years, working on a strategic level with managements of some of the largest health systems across the USA.  Hands on and very much in touch with the measures by which this field judges its quality.
My own care was with the VA hospital and clinics in Houston and more recently right here in Wilmington, DE up off the Kirkwood Highway.  Issues?  Age (over 70), 35 years of blood pressure treatment, atrial fibrillation, runners knees, eye surgery to correct stigmatism and cataracts, diabetes and a one time cancer scare. Countless clinic visits and tons of meds to deal with the issues above.
A buddy gave me a heads up on the VA years ago  when I was lamenting the shitty care and systems I was receiving from a recently opened huge clinic my then wife's HMO health plan assigned us to.  A real architectural monument with all the external flourishes they taught at architecture school.  Only problem, they ran out of money after paying the architects and failed to bring their patient records and computer systems up to any kind of reasonable standard.  One department's IT system would not talk the the one next door down the hall.  So it was endless refilling out of forms by patients and staff, stop by stop down the hall.   I fired them and went to the VA down the street at the Texas Medical Center when approved.  It took them three months to transfer my medical records to the VA by courier after I hounded them repeatedly to do so.
Anyway, the first sight on my first visit to the VA waiting room filled will fellow geezers made me wonder if I'd made the biggest mistake of my life.  Turns out, they had a system of moving people through their appointments, blood work et al administered by the friendliest desk staffers I'd ever encountered as both a patient and consultant to hospitals and clinics.  Boom, they got it done with smiles, efficiency and compassion like I'd never experienced in the private sector.
Oh, and did I mention cost?  Co-pays for visits about $25 bucks and a list of meds that would choke a horse that cost a fraction, literally, compared to private sector meds pricing. A few hundred a year for about half a dozen meds taken daily.  My rates are based on my income; some pay less, some other low income vets pay nothing.
Systems?  While the rest of health care was debating whether to convert from paper to electronic medical records ad nauseum (they still are debating),  the VA created a system using open source that became the envy of the health care field.  The rest of the world is still catching up.  Records, physician notes, RX regimes, diagnostic results and the images from MRI, Xray, etc. all securely stored and pulled up with lightening speed by the providers.
The actual care delivery?  Primary care by salaried physicians, PA's and Nurse practitioners.  Turns out, the profession has discovered that routine primary care doesn't  need an MD, but these other folks with MD's on staff to consult with patient and them as needed.  Efficient as hell.  Cost efficient too.  So, into one room for labs/blood work, wham.  Out over to the clinic waiting room.  Wham again, visit complete with tons of info, smiles and good history/records update done by the clinician themselves.  Rx refills. Done online and either pick up down the hall in 20 minutes or mailed  to home more often than not. When specialists are needed, often this is provided by local medical school faculty and MD's in training on contract  who come to the VA to provide their expertise.  I've always sought out providers active with medical school faculties for their expertise on current research, not usually acquired on cruises by your friendly pharma or med-technology manufacturers.
And just in the past year, my records were flawlessly transferred electronically from Houston to Wilmington, where I met them with my new MD for intro and review with an appointment made before leaving Houston.  Now, on a smaller scale, the same friendly and efficient clinic visits, labs et al.
And, just introduced in the past year, a fantastic online resource called where I can reorder meds, schedule or change appointments, email questions to my nurse or MD and get same day answers or info.  I can review my meds list on it and can go in an read my medical records and recent visit Dr. or PA notes on my care, situation, etc.  Seamless and secure.
Yes, I am acutely aware of the terrible backlog the VA is fighting to process in new patients. No excuses are suitable for this travesty but sadly, the nation, congress, appropriations committees  et al either did not anticipate the Republican-driven consequences of two unfunded wars and the millions returning damaged forever by amputations, PTSD and other psychological damage wrought on young lives by these obscene misuses of our military. These young people have earned this care and deserve immediate attention, even if it has to be provided temporarily by the private health care sector under contract until the VA can be expanded to do their amazing work for this need breed of veteran.
Results of VA care ?  A 2010 study of available clinical literature on key quality measures concluded:
"Overall, the available literature suggests that the care provided in the VA compares favorably to non-VA care systems, albeit with some caveats. Studies that used accepted process of care measures and intermediate outcomes measures, such as control of blood pressure or hemoglobin A1c, for quality measurements almost always found VA performed better than non-VA comparison groups. Studies looking at risk-adjusted outcomes generally have found no differences between VA and non-VA care, with some reports of better outcomes in VA and a few reports of worse outcomes in VA, compared to non-VA care. The studies of processes of care are mostly those about medical conditions, while the studies of outcomes are mostly about surgical conditions and interventional procedures."
From another source, Phillip Longman of the New America Foundation : see "The Best Care Anywhere," Washington Monthly, January/February 2005), the VA also comes out on top of virtually every study ranking the quality, safety, efficiency, and cost-effectiveness of U.S. health care providers.
Mr. Longman updated his 2005 published work in 2010 with comparable claims.
Doug Waller of Time Magazine, in 2006 wrote this:
"For the sixth year in a row, VA hospitals last year scored higher than private facilities on the University of Michigan's American Customer Satisfaction Index... Males 65 years and older receiving VA care had about a 40% lower risk of death than those enrolled in Medicare Advantage, whose care is provided through private health plans or HMOs... Harvard University just gave the VA its Innovations in American Government Award for the agency's work in computerizing patient records."
Hospital inflation data suggests that during a recent 10 year period, VA costs remained static, with dramatically reduced staffing compared to private sector hospitals whose costs rose 40%.  I'll be writing more about these costs in future blogs.

Thursday, November 14, 2013

Anybody Else Longing for Single Payer?

Published by Delaware Liberal Blog, Progressive Populist:

Ok, now I am more than totally befuddled about our so called health care reform.  Today the President announced  that if you liked your piece of shit so called catastrophic health policy that covers practically nothing and leads you to bankruptcy court, you can keep it.  If only the insurance companies will willingly volunteer to restore their pieces of shit policies. In the name of good citizenship.
Of course, there's no certainty that the insurance companies can turn around on a dime and rescind cancellation notices they've sent out and reinstate these policies in about a 30 day window.  Have you ever seen an insurance company pay any settlements in 30 days (excepting Medicare which turns around reimbursements on a dime)?  Let alone retool suspended policies, write and mail out letters to policy holders explaining that the policy you thought they cancelled was in fact a piece of shit and compare the piece of shit option to a real policy you might, just might be able to buy on the Obamacare Exchange, if you're lucky, persistent and unbusy enough to get into the site. Yea, I know, that last sentence needs some punctuation.
Yup.  I caved and gave up on pushing my Party to give us a public option or a Medicare For all program and accepted the reality that wall street pushed and bribed our party of the people to subsidize the insurance industry to do the right thing and give us things like no preexisting condition, not cancel us when we really needed the insurance for illness or accident and so on and so forth.   I caved with no illusions held by some in my Party that the Republicans would show love for our supporting one of the worst and ethics free sectors of our capitalist economy, the health insurance industry.  I kinda knew they'd figure out a way to game us and sure enough, we're here.
So, here we are stuck with this Rube Goldberg machine of a payer system.  Let's just hope the gears are well oiled and don't further freeze up on us.  At least until America comes to its senses and we replace all this claptrap with Single Payer.

Sunday, November 10, 2013

So, Where Was The Republican Outrage On Insurance Ethics Pre-Obamacare?

This post appeared in DelawareLiberal Blog from Progressive Populist.
Upfront, let me tell you I was hugely disappointed when the public option and/or single payer got shelved in the formation of Obamacare.  And as one in the health care industry I was amazed that candidate Obama was willing to trust the health insurance industry to do the right thing for a revamped health insurance  public policy, having  seen them in action up close and professionally.  But, I hung in there, reluctantly, as health policy got formulated by my President's new administration and our Party in congress.
But, how quickly we forget the outrageous ethics of the insurance industry in their non-coverage of so called pre-existing conditions, cancellation of policies when people got sick and non-renewal of policies for families with high risk.  This was routine corporate behavior back in the day.  Did we hear anything from Republican policy makers about complete lack of ethics from this industry regarding such treatment of the 85% of the American public covered by so-called high end, employer based insurance?  Hell no.  Not one word.  For that matter, not much either from corporate conservadems.
So, now, candidate Obama is pilloried by these clowns for having made a perfectly reasonable generalization, aimed at the vast 85% majority of the electorate who were employer insured, that they would keep their insurance under his plan.  He even advocated building in a grandfathering protection for those not so covered who relied on their own privately purchased policies that were known to be pieces of shit, coverage wise.   Yes, if you wanted to keep your piece of shit policy, you dumb ass, you could.
This whole discussion now should be not about what candidate and now twice elected President Obama said back in the day, but the ethics and social responsibility of this so called industry.  Their ethics then and their ethics now, manipulating the system, squeezing through loopholes and laying blame on public policy for their outrageous practices and ethics free behavior.
Let's have that debate, that discussion as we now seriously reconsider how we offer the citizens of America a public option/Medicare for all protection against the serial unethical culture of the private health insurance industry.  Their immorality is uncurable.  Let's put them out of their misery.

Wednesday, October 30, 2013

NSA Is Out Of Control. Time To Rein It In.

As published in Delaware Liberal Blog by Progressive Populist.

 James Clapper, the Obama Administration’s Director of National Intelligence has said NSA does not “wittingly” collect data on citizens.  General Keith Alexander, NSA’s Director as well as his predecessor have testified that NSA is not spying on or collecting data on citizens.  Even the Chair of the House Intelligence Committee has told the media that the American intelligence community is not intrusively monitoring the communications of our citizens without a warrant.

So the House Intelligence Committee is clearly in the pocket of the government institutions whose activities it is supposed to be monitoring on behalf of the American people.  With the revelations provided by  Eric Snowden and Glenn Greenwald and other journalists and whistleblowers, we know the opposite is the truth.  We are now living in the Surveillance State many of us once feared would reappear after the Senator Frank Church hearings in 1975, which resulted in legislation to get a rogue intelligence apparatus under control.  Sure enough, here it is again.

Finally we hear from Senator Feinstein, who recently stated that intelligence data collection was no different from the functioning of local grand juries.  Now she acknowledges that unaccountable monitoring of phone conversations of many of our allies is a breach of trust and an impediment to our ally relationships.  Even hawkish former California congresswoman Jane Harmon now advocates reforms to rein in our intelligence apparatus.
It seems to me that there are at least two major criteria on which to evaluate the massive scale of surveillance being undertaken by NSA, as well as the various intelligence missioned agencies they service.  First, the damage being done to trust in our government by our citizens as a result of the infringement of our civil liberties by our post 9-11 Patriot Act.  Second, the results produced by NSA and other intelligence/counterintelligence activities as a result of the massive ramping up of domestic surveillance.

Various polls and studies are widely disseminated by the media showing public trust of our federal government at an all time rock bottom. The damage is clear.  Very similar in fact to the post Watergate period.  In the surveillance arena, the Church Commission did a major service to our democracy with the reforms instituted then to enhance oversight and transparency.  Over time, public trust greatly improved.

We can do it again through congressional work on Patriot Act reforms and aggressive oversight of our intelligence apparatus.  The mission of NSA, originally focused on foreign signal intelligence, needs to be significantly reviewed and clarified.  The FISA court process currently does not involve advocacy of citizen civil liberties and should, according to former Senator Gary Hart and others he is working with on the due process component to our surveillance policy.   In addition, House and Senate congressional oversight needs revitalization, as do their security clearance policies which deny key leaders needed  information on intelligence operations.

Rep. Alan Grayson points out that non-Intelligence Committee members are routinely denied information from both the committee and the intelligence agencies they need to properly advocate for the privacy and civil liberties of their constituents due to absurd policies on security clearances.  Further, he argues that he and his peers are routinely lied to and misled about intelligence matters impacting their constituents they are elected to serve, in the name of “security”.  He argues that the Intelligence Committee is complicit with the agencies in misleading and denying access.

In the results area, there are already some distressing indications that the disproportionately huge increases in our domestic surveillance are not yielding huge results.  In fact, the results are miniscule. NSA has reported that 54 terror attacks have been thwarted; 25 in Europe, 11 in Asia, 5 in Africa and an underwhelming 13 in the USA.

42 of these 54 were interrupted plots and 12 involved terrorist activities of material support.  Surveillance of foreigners, ours and that of foreign governments,  yielded 1/2 of these.  Four plots have been detailed by intelligence agencies,  including a San Diego terror supporter sending money to Al Shabab in Somalia, a NYC subway plot foiled, a Chicago supporter of terror providing support for the unfoiled Mumbai attack and a plot against the NY Stock Exchange foiled.

Senator Ron Wyden pointed out that of these four terror projects, only two were significantly impacted by  Federal surveillance.  He also pointed out that of the 54  plots, the evidence suggests the overwhelming majority were foiled not by surveillance but by traditional  informant help.

Peter Bergen of CNN estimated that of 33  terror plots derailed he studied, the evidence showed that of 29 were stopped not by surveillance but tips and informants.
Are we getting any kind of a reasonable return on investment in our surveillance of our own people in conjunction with both the massive  human and financial commitment of national resources ?  It sure doesn’t appear so to me.  A tough minded audit of results and payback are imperative.

Of course the American public would and should not have privy to much of the how-to of our surveillance and intelligence gathering process for obvious reasons.  But through our representative democracy process, our elected law and policy makers must have much more hands on oversight of NSA and other agencies who have, as history has shown,  the natural inclination to overreach and deny access to those who are charged with both maintaining our security as well as our civil liberties.

Tuesday, October 15, 2013

Vet To Cruz: Keep Your Slimy Hands Off My Monuments

This post first appeared in Delaware Liberal on 3/14.

Ted Cruz, you dishonor your title, Senator.  You do not deserve it.  You dishonor all U.S. military veterans and the monuments built to honor us.  Yes, I say us.  I am the third generation in my family to serve as an officer in the U.S. Army.  My father served in WWII and Korea.  His father served in WWI.  The monument you visited with your merry band of nut cases over the weekend was built to honor our brothers and sisters who served the UNITED States of America.  Get it?  They served and many gave their lives not just for Texas or Alaska, but all the United States, every damned one of them and all of them together.  Why do I mention Alaska?  Because your insulting, hypocritical visit to these memorials included your evil twin sister, Sarah Palin.
You two represented the leadership of your seccessionist tribe of teabaggers who stand for the neoconfederacy you advocate to replace our United States.  You argue for the un-uniting of our nation-state, yet you visit shrines built to memorialize those who stood for preserving our United States against external threats to our existence.  You two represent an internal threat to our unity and existence.
To add to the insult you made by visiting the WWII Memorial, you and your tribe carried the battle flag of the confederacy.  What a cruel irony.  The flag representing the seccessionist southern army which fought for and lost the cause of taking our nation apart for a thoroughly dishonorable objective.
Here's another cruel irony.  Your father sought refuge in this United States of America for his family on the premise of a better life than he thought you might have faced in Cuba.  You all immigrated to and sought citizenship in the USA.  Now you advocate tearing it apart.
Shame on you.  As a proud veteran I demand you demean yourself in some other venue.  Take your hypocritical presence to a more appropriate memorial...perhaps memorializing the now dead confederacy you are trying to revive.

Thursday, October 10, 2013

Let Me Count The Ways The Tea Party Loves Us

35 by my count.  Maybe you can add to the list.  Not satisfied that there are thousands of varieties of teas they can throw overboard, they have voiced at least 35 issues they want the President to “have a conversation” about to end the shutdown and/or the debt ceiling crisis.

Here they are: Repeal O-care, defer O-care, end the O-care individual mandate, delay O-care, mitigate O-care damage, repeal the medical device tax, reduce government spending, no new taxes, cut federal benefits (except their own), cut the deficit, fund FEMA, fund the National Weather Service, fund Head Start, back pay for furloughed Federal employees, fund veterans benefits, fund the National Parks, fund D.C., fund the military, fund air traffic controllers, “get something out of this”, meet on a budget, create a conference committee, create a committee of twenty, approve the Keystone pipeline,  fund military death benefits, reform the tax code, energy regulatory reform, a one year debt limit waiver, block net neutrality, end Dodd-Frank, means testing for Medicare, tort reform, repeal the public health trust fund, end coal ash regulations,  end EPA carbon regulations, end Social Security block grants…..I’m sure more have been raised since I started typing this list.

In sum total, replace the Democratic Party/Obama agenda which won by a margin of 5 million votes  with the failed Romney campaign platform.