DERANGED

You’re a radical.

I’m a radical.

We used to be normal, but we’ve been labeled. There are only two sides: violent, bigoted, militaristic conservatives, friend of CEOs and Big Business, and liberal/progressive unwashed, tie-died communist progressive liberals who want no borders and more taxes from the rich.

The Bush Derangement Syndrome has become the Obama Derangement Syndrome. Bush was a dumb cowboy who dragged us into a war for oil on a specious pretext to benefit his wealthy friends. Obama wants to destroy the country, erase the borders, and make us the Europe of the West.

It’s time we put a stop to it. When we talk in hyperbole, we can’t talk at all. We’ve allowed the far right and the far left to distract us for too long.

No, I’m not going to become progressive. The ideology has become foreign to me. But I don’t believe Barack Obama is itching to destroy America. I believe he’s walking down a road that he believes is best for our country (or perhaps the world), that will ultimately hasten America’s downfall if we don’t reverse course. I believe he’s obsessively political due to his Chicago machine roots and has a narcissistic, arrogant streak. But he’s not Satan. He loves his wife and family and succumbs easily to a misguided charity for the “downtrodden.”

George Bush the younger was not Satan, either. I believe he is best characterized as a naïve idealist. He used the pretext of WMDs in Iraq (which he and the left at the time believed to be a real threat) as an excuse to nation build, with the ingenuous belief that everyone, given the chance, would risk their lives in the name of freedom, as our ancestors did and our brave warriors continue to do today. He believed another democracy besides Israel the in the cauldron that is the Middle East would be a game changer and establish his legacy. Events appear to have proven him very wrong.

We need to move away from stereotypes, see the true radicals for who they are, and start talking. There is a common ground. For instance, many on the left are economically conservative and socially liberal (yes, there is a Tea Party side to many mainstream liberals). We need to reexamine the principles upon which the country was founded and start strengthening them. We need to quarantine the race-mongers like Jesse Jackson and Al Sharpton. We need to take hotbed issues that divide us and keep us from solving problems, like abortion and gay marriage, off the national agenda and return them to the states. And we need to stop overspending and leaving trillions of dollars in debt for our children and generations to come.

Radical thoughts, I know.

THE RIGHT TO BE UNCIVIL

A few months ago a dinner discussion with a friend triggered a reference to Barry Goldwater, the late senator and presidential contender who lost to Lyndon Johnson in 1964. I was 12 at the time and apolitical but recall him being portrayed as a racist by the New York media. My friend, who is neither stupid nor racist, shocked me with the comment that he agreed with Goldwater’s vote against the 1964 Civil Rights Act.

The fact that Goldwater’s dissent had nothing to do with racism is beside the point. My friend’s argument distilled to the libertarian belief that the government shouldn’t be legislating against people’s prejudices of any kind, no matter how appalling. Coincidentally, this discussion occurred at a time when I’d been thinking quite a bit about the evils of racism. Also coincidentally, I was in the process of reading a book by Lawrence Hill, Someone Knows My Name. This historical novel reconstructed in distressingly graphic detail the slave trade of the late 18th century, chronicling the life of one extraordinary black woman.

At dinner, after vehemently denying the validity of my friend’s argument, I got to thinking why a reasonable, intelligent person would even debate the issue. And I realized it merited some thoughtful analysis.

We discriminate all the time: what clothes we wear, what food we eat, the colors we paint our walls … with whom we chose to eat dinner. People often use the terms discrimination and prejudice interchangeably. Discrimination is nothing more than choosing according to one’s preferences. Prejudice, on the other hand, involves prejudging a person, thing or idea based on criteria that may or may not be valid. Things become more complicated when the actions are applied to race, religion and sexual preference.

In some ways the third category is the thorniest. In September of last year, a photographer lost her court battle after refusing to take a job at a gay wedding. In a separate incident, a baker closed his doors after being targeted legally by a lesbian couple for refusing to sell them a wedding cake. In both cases, the accused cited moral opposition and their right to free expression.

To prevent injustice, our laws have delineated certain protected groups that are excluded from our right to discriminate, regardless of whether this is motivated by prejudice. My friend believes that the marketplace should be allowed to mete out the consequences. For instance, businesses that engage in racial discrimination would have less patronage and might be driven from the marketplace by censure. In a perfect world, this argument might have validity (although I would argue that in a perfect world racial discrimination wouldn’t exist). His argument fails to take into account the concept of tyranny of the majority.

Our Founding Fathers feared this enough (otherwise known as “mob rule”) to make this country a democratic republic, not a democracy. If we were to remove the prohibition on racial discrimination, what protection would a minority have against local majorities recreating the Jim Crow laws of the early part of the twentieth century?

With the deinstitutionalization of racism over the last few decades (which is not equivalent to its absolute abolition) one might argue that there is now a substantial economic cost to racial discrimination and segregation that might validate my friend’s argument. We must not forget, however, that this economic incentive to “do good” was not operative in the relatively recent past, when these detestable practices were not only permitted, but condoned and even encouraged in some parts of the nation. It’s conceivable that pockets of like-minded bigotry could coalesce to create regional monopolies that would, in essence, impede market corrections, forcing the subjugated minorities to flee to locations distant enough to uproot them. The reprehensible nature and the consequences of this behavior, in my opinion, make it a moral imperative to act more quickly than market forces can to correct it; we need laws to preempt it. Freedom to discriminate is, in a sense, like freedom of speech. Yelling “fire!” in a crowded theater is as taboo as the freedom to subjugate.

Libertarianism without limits turns liberty into anarchy.

IMAGINE

Forty-three years ago the words of John Lennon’s famous opus greeted us from the speakers of our transistor radios and turntables, vinyl discs spinning at 33 or 45 revolutions per minute, oblivious to their eventual reincarnation on little silver digital platters and magnetic discs whirling at 7200 rpms, or codified on tiny silicone chips. They were, and remain, a plea from a young, idealistic mind, and appeal today to the innocent child in all of us. And they should, like the movies Shrek and Toy Story. They only become dangerous if you believe them.

“Imagine” constructs a (supposed) utopia without heaven or hell, “nothing to kill or die for and no religion….” People living in peace. No possessions, greed or hunger—“a brotherhood of man.” The sentiment comes from a good place, but, like all fairy tales, has a dark side.

By inventing a mythical human nature, it creates a world that, if implemented literally, would destroy the very souls it wants to help. By denigrating religion, it fails to understand the fundamentals of what religion is—a human tool. Just as a gun can be used for good or evil intent, so can religion. In the Middle Ages, Christianity committed atrocities in God’s name, and today the Islamists have hijacked the religion of billions of Muslims and done the same. If the evil that coexists with the nobility in the human spirit just vanished (imagine—it’s easy if you try), then perhaps there would be no need for religion. (No need for faith in God is a larger, more complex issue, however.)

Nothing to kill for may be laudable, but nothing worth dying for … well, that might be a recipe for an empty existence. In Lennon’s utopia there’s no need for countries. In our world, nothing could be farther from the truth. I shudder to think what our planet would be like if the American experiment in freedom, starting to erode at the edges in my lifetime, had failed.

So continue to imagine an existence without greed, without evil, “a brotherhood of man.” But don’t for an instant let your fantasies convince you that we have no need of a strong country—one grounded in principles of human liberty with as fervent a belief in the God that teaches us to “do unto others” as those that want to destroy us believe in a power that tells them to kill anyone who deigns to choose freedom over subjugation.

Don’t be a dreamer.

A TAXING SUBJECT

Some say taxes are our civic responsibility. Some say it’s institutionalized theft. Both are right.

Our obligation to the governments extends to the limits of the services they provide to us. This includes public defense (military, police, intelligence), infrastructure development and maintenance (roads, bridges), security (borders, passports and the like) and safety (regulating air, water, food production, etc.). You may be able to find a few other niches  such as education (which I believe should be at the lower levels of government), but the idea is to pay for what public services are needed for the public welfare and a reasonably ordered existence.

More recently in our history, the governments have increasingly taken on the responsibility of providing for those least able to help themselves, on the surface a laudable goal. In the past, this was termed charity, and the institutions that provided it were, from the bottom up, family and friends, secular and religious community organizations, and local, county/state and federal governments. With the greater institutionalization of charity, it began to move further and further away from the recipient and, I posit, becomes less and less “charity” at all. Charity, by definition, comes from the heart, not at the end of a shotgun barrel.

The liberal view, which hinges on the tenets of larger government and more structured “giving” (necessarily requiring “taking”) implies a belief that, of their own volition, people would not provide enough for the needy. One might conclude that, therefore, the progressive ideology is linked to a more pessimistic assessment to human nature, but that is beyond the scope of the present discussion. More pertinent is one of the fundamental differences between conservatives and progressives: where the line is drawn. In other words, determining the definitions of “enough” and “needy.”

So where should the safety net be placed? Those on the left like to characterize the right’s reluctance to redistribute wealth with callousness, minimizing the well-documented unintended consequences of overdoing welfare that has historically caused empires to implode. They cite the maldistribution of wealth inherent in a capitalist economy, emphasizing the widely publicized malfeasance and distortion of the free market by private entities that will always be present, to bolter their arguments. Corruption of the system by the government through crony capitalism often gets less play on both sides of the divide.

The bottom line, for me, is that the further you stray from the social structure closest to those in need, the greater the risk of corruption and incompetence and funds being disbursed inappropriately. And the larger the group we define as needy, the more we rob the population of the incentive to produce and the incentive to give.

The next time congress convenes to legislate the newest tax hike it behooves them to remember one fundamental imperative:  Taxing hardens the heart; charity enriches it.

DOC-IN-A-BOX

A small study, unlikely to garner much media attention, may be one of the first salvos in the war against medical waste.

Recently published in Circulation: Cardiovascular Imaging, the trial studied the impact a web-based computer program might have on decision-making in the emergency room. About 500 patients presenting with chest pain or a sensation of shortness of breath, something doctors call dyspnea, were randomized to an active group that had a computer gauge their medical risk and prescribe the necessary testing. The doctors in the control group decided in the usual fashion, without computer help. The investigators found that the program lowered the patients’ radiation exposure (i.e., fewer tests) without a significant difference in the rate of return to the emergency department for care or occurrence of adverse events.

Watching the geometric progression of technological evolution, it seems inevitable that someday the line will be crossed where computers become more accurate diagnosticians than people. Whether you believe that day is 25 years away, 50, or 100, is irrelevant. The importance of this study lies in the fact that, properly applied, even present-day computer programs have the potential to cut waste (and increase patient safety).

Whatever your view of Obamacare, it is evident that universal coverage and no exclusions for pre-existing conditions are good things. It is also evident that good things come at a cost. The only immediate way to get a good thing at no cost is by removing fraud and waste. Having practiced in the medical field for decades, my impression is that there’s probably a lot more waste than fraud. Figures of 20-30% of our medical care dollars have been bandied about, which jives with my admittedly subjective impression.

Eventually, the march of technology and knowledge will lower costs in other ways, by allowing more effective treatments and perhaps even curing chronic illnesses that, at present, we can only effectively manage to the point of bankrupting the health care system. In the meantime, it behooves us to put a lot more effort into studies like the one above, the primordial germ of artificial intelligence, that will ultimately make my job obsolete.

Someday, perhaps sooner than we think, the only “doc-in-the-box” you’ll ever need will be attached to a touchscreen with circuits linked to what is now known as the “cloud.”

THE RED LINE AND THE RED, WHITE AND BLUE

The issue of targeted attacks on Syria for the used of chemical weapons has faded from the headlines in the wake of domestic issues and Vladimir Putin’s politically savvy maneuvering to portray himself as savior of the moment, brokering a reputed deal for verifiable destruction of Assad’s cache of chemical weapons.

Central to the debate is whether we believe there is a real distinction between use of conventional weapons and biological and chemical ones? I think there is. The use of these agents makes it easier to target noncombatants and children, and the ability to leave the infrastructure intact potentially encourages the expansion of this particularly obscene form of warfare. And biological weapons have the chilling potential to move beyond the control of the attacker.

Still, there were many cogent arguments voiced for not taking military retribution against Syria’s Assad for the use of chemical weapons on his people: An action for a few hundred lives against the backdrop of 100,000 with conventional weapons makes no sense. It’s their civil war, not ours, and we can no longer afford to be the world’s policeman. It’s a battle of our enemies against our enemies, and the Muslims should take the lead. And, if the world as a whole is unwilling to act, why should we paint an even bigger target on our backs? Despite all of this, our inaction, as logical as it appears on so many fronts, points to a change that should bother us as Americans.

In 1999, you may recall, President Clinton took action in Kosovo on humanitarian grounds. The unfortunate bottom line is that we are no longer in a position of strength to enforce the “red line.” In the past, just our threat would carry weight. Now, our enemies know we’re indebted and war-weary. And the world seems to have neither sufficient moral outrage nor the appetite to support a unified action beyond speeches and resolutions.

If we had a strong, competent leader, one of two tacks might have been taken: quick, decisive military action after covert discussion with our allies, or a concerted effort after the “red line” speech a year ago to get all the ducks in a row, with commitments from the Western nations and the Muslim states to a course of action should the line be crossed. Instead, this second path was taken belatedly, from a position of weakness, granting Assad time to prepare for attack and relocate the weapons of mass distraction. Our president was forced to embrace this turn of events in the face of underwhelming support for what Secretary of State Kerry stated would be an “unbelievably small” action. Obama’s claim that the threat of force is what spurred Putin and Assad to act, which may have a kernel of truth to it, was viewed as a lame excuse in the face of perceived weakness and Congressional dissent. It’s hard to see how our president could be viewed throughout the world as leading, except with his jaw.

I wish we could still be the moral policeman when it comes to issues of the magnitude of chemical weapons, as there is no one to take that role any more, but we’ve been beaten and bruised by long wars and loss of too much blood and treasure. Our new colors are the red, black and blue.

GENERATIONAL PONZI SCHEME

Pretty soon the elephants and donkeys that run the zoo we call the federal government are going to lock horns (tusks? hooves?) again over raising the debt limit. The elephants will make a big show about closing part or all of the zoo down and will eventually cave to the donkeys. We’ve seen it all before.

We, the monkeys, will grin and chitter, as we’ve done before. The government will print more money and borrow the shortfall and the zoo will stay open—for a while.

If it were a one-sided deal, perhaps we could push the debt off forever. After all, we have children, who will presumably have more children, and so on and so forth. Three generations from now, the great-grandchildren can hand off the, say, $170 trillion to their kids. The fly in the ointment, unfortunately, is that we have to have—darn it!—people willing to take our dollars. And a growing number of experts are warning of signs that the tenure of our greenbacks as the world’s reserve currency is coming to a close.

We could reverse course, start living within our means, pen a real budget, tighten our belts and begin the slow, painful road to recovery. But, as we’ve seen with the elephant-donkey wrangling over the sequester, which was simply a reduction in the continued growth of spending, this is not going to happen.

We could, as I’ve pointed out in a previous blog, become the world’s foremost oil producer with our new-found fracking abilities and vast shale oil reserves, continue with out current rate of unbridled spending growth, and perhaps even have enough left over to slowly pay down the debt. This could buy us more than a century of wanton progressivism—perhaps even pay for full-fledged socialism. That assumes our entry into the marketplace doesn’t further destabilize the Middle East, which largely depends on oil as its source of income.

In the meantime, though, we’ll print and borrow for as long as we can.

Generational theft is a crime not punishable by law, only God.

ROYAL PAIN IN THE ….

I have a headache. I can’t turn on the TV without semi-hourly updates on apparently one of the burgeoning issues of our time: Kate Middleton’s womb.

Newsroom chiefs are so convinced that we share their pins-and-needles anticipation that they’ve sent their reporters in droves across the pond to watch and wait breathlessly on our behalf. And since nothing happens until it happens, they have ample time to breathlessly speculate on the royalty-in-utero’s name and gender (forgive me, I’ve put the royal carriage before the horse); gender and name. Perhaps the media mavens know the foibles of the public better than I; if so, the irony is, indeed, royal in its proportions.

There is no question we Americans have a penchant for celebrity worship. And I harbor no ill-will toward those that are able to engender wide-eyed adoration in millions of fans who freely choose to share their time and hard-earned greenbacks with them because of their exceptional talent, intellect or beauty. But the Royal Family? They’re granted fame and fortune based on their lineage; no ability or achievement required. The antithesis of the values our nation was founded upon. It’s even more ironic when you think that most of past royalty, when they had actual power, plundered and stole from the hard-working masses—because they could. And we fled them, fought with them and liberated ourselves from them. As an individual, no one can argue that Prince William, who served bravely as an RAF pilot, doesn’t deserve the same respect as anyone who puts himself in harm’s way to help others. But the concept of revering the institution of aristocracy in a meritocracy such as ours reviles me.

Some will say I’m just being an old stick-in-the-mud. This is nothing more than a welcome escape from the harsh realities of a tumultuous world; a real-life fairly tale: Commoner meets her Prince Charming, they fall in love, marry, have a little prince or princess and live happily ever after. After all, modern British royalty no longer have any real political power. They will say I’m no different than the zealots that won’t let their kids trick-or-treat on Halloween because it started out as a pagan holiday.

Maybe I should lighten up.

Then I turn on the TV and this royal headache starts in again.

FAST BIRDS, FALLING SAFES, AND EMPTY EMERGENCY ROOMS

Now that all the world’s problems have been put to bed, the economy’s been quantitatively eased, Obamacares for the ill, the Middle East has had its Arab spring, and now fall, winter and summer, it’s time to move on to weightier matters—violence in Hollywood.

I’ve kept silent long enough. There is a growing epidemic of, for want of a better term, cartoon violence in our action-adventure cinema, and it’s got to stop. No one talks of it, neither conservatives, progressives, ethnic groups or the increasingly vocal LGBT community, so I must.

It didn’t start with the street fight in Rocky 5, I’m sure, but that’s when it first came to my consciousness. Venerable action heroes like Chuck Norris didn’t stoop to it. When he hit someone, they stayed down. A bone-crushing, jaw-mangling, tooth-extracting blow did what was intended. Bodies collapsed, emergency rooms and trauma centers filled—doctors had work to do.

Then, somewhere along the line things began to change. Perhaps plot lines were getting thinner and more air time had to be filled. Perhaps the video game demographic became just too large to ignore. In any case, one after another, movies filled the big screen like so many “real life” reenactments of Roadrunner episodes.

Have you seen the latest addition to the “Die Hard” franchise? Never have so many absorbed so much with so little trauma. Yes, the son of aging hero Willis’ character did wince when the metal object skewered his belly. But a little thing like that doesn’t slow a hero down. No need to invoke special powers or a Kryptonian upbringing to explain it. Long, drawn-out battles, trading one lethal blow after another, are just extensions of the “suspension of disbelief” you learned about in grade school English. Excitement trumps plausibility every time.

Perhaps it’s a sign of aging, but my love for Roadrunner (meep-meep!) faded somewhere in the depths of time along with my patience for the cinematic equivalent of the Ajax safe falling on Wiley Coyote’s head in grade B after grade B me-too action flicks. It must stop. So I ask you, dear reader, to rise up and join me in protest. Don’t patronize any production that allows this kind of cartoon violence unless the recipient is wearing tights, a cape, a hood, carrying a hammer or trident, or is able to hit a dime with an arrow at 200 yards.

It’s just not believable.

SICK AND TIRED

I recently cared for a patient who was gainfully employed who is now, unfortunately, in the throes of a serious and expensive illness. In providing emergency hospital care, physicians, myself included, do not routinely ask questions about insurance coverage. However, since this individual required specialized care that would require a hospital-to-hospital transfer, I gave a couple of options, knowing that  insurance coverage can be an issue. His response, that he hadn’t bought health insurance because he was waiting for Obamacare to kick in for him in a year, triggered a visceral reaction in me.

I’m sick, too. I’m sick and tired of paying, in addition to my federal and state income taxes, a burgeoning array of fees and surcharges including property taxes, car registration fees, sales tax, a slew of new local fees, the hidden tax that goes unrecognized and unmentioned in my kids’ college tuitions to cover the people who pay no tuition … it goes on and on. And the ones demanding it all are still going broke. So they want, and will take, more, even as the cost of living steadily rises.

I’m sick of paying for the myriads who work under the table, reporting only a fraction of their income, poor on paper and earning almost twice as much per hour as their tax-paying compatriots while collecting subsidies and benefits. Although I have to admit I sympathize with their desire to avoid giving their hard-earned cash to overgrown, corrupt, governments at every level that spend the largesse like funny-money. I’m sick of being bombarded with yet the next silly video and lavish meeting I’ve shelled out for. And these are only the instances we’ve uncovered.

I also sympathize with the millions of honest, hard-working government employees who are frugally going about their business, painted as they are by association with the same scandalous brush as the rotten apples. I don’t know, and doubt anyone does, how many tainted apples are in the barrel. I only know government is too big a part of the economy and, operating outside the checks and balances of the real world, is making a big problem bigger.

I’m sick of the safety net being continuously raised so that more and more people find it acceptable to be on some flavor of welfare.

I’m sick of having my charity stolen by people who feel they are better qualified than me to decide where my hard-earned dollars should go.

Will the poor patient referenced above be bankrupted by medical expenses due to an unwise gamble? I hope not, for his sake—and mine, as a taxpayer, a health care provider … and a human being. I’ve worked hard for what I have, but have also had help along the way, from family and, to a lesser extent, government assistance. So I’m happy to give back. But I must say, the line has shifted in my lifetime from providing a helping hand to becoming the hand that provides, through an intermediary known as Big Government that’s grown beyond its ability to sensibly sustain itself.

It’s enough to make you sick.