Being Present to Nature’s Summons

Brown tipped reeds gently wave in the pond
Blackbirds silently fly in retreat
Winds mildly gusting from the Artic north
Leaves softly trembling in the Fall:
Seasons pass through their rebirth cycles
But not the old man at the edge of the pond

Winter’s blasts in wind and rain
Will purge the earth it replenishes
As naked trees stand firm on guard
Waiting the sun’s undoubted return
Burrowing roots to nurture new life
But not the old man at the door of death

Spring will warm the slumbering roots
Burst the seeds that were scattered in Winter
Nurture fresh fledglings in far flung beds
As they’re born from the womb of earth
To service nature’s quest for rebirth
But not the old man whose future is barren

Red winged blackbirds nest
Filling the pond with song
Heralding the reeds green shoots
Welcoming Summer’s awakening
But not the old man’s reckoning
Of days left without renewal.

Born of the stars in the cauldron of the sun
Sprung from earth’s dust both alive and aware
Humans are each moment beware
Of passing into eternity
While contemplating the mystery
Of being present to nature’s summons.

_____________________________________
AJD 9/19/2017

What is Politically Correct?

On August 14th, our President gave the most politically correct speech since he came into office. And it violated the most sacred promise of his candidacy in a feeble attempt to adhere to his oath of office. How so? To answer this question, I must review the President’s several remarks on the Charlottesville protests, the relevance of political correctness to duplicity, and the words of George Harrison.

Let’s begin with the President’s remarks on the violent clash between opposing demonstrations in Charlottesville. Initially, he condemned the violence “on many sides,” implying two equal parties in the clash. Of course, when only one side comes armed for battle, it is hard to make the case that both sides had either the intent or the expectation of a violent encounter. Moreover, when only one side displays signs and banners with hateful and provocative language, it is impossible to misinterpret their presumptive meaning. And, finally, if only one side is led by bigoted organizations and racists leaders, it is doubtful that the impetus for protest was anything other than hate, anger, and an eagerness for violence. The history of the Neo-Confederates, white supremacists, Neo-Nazis, and the Ku Klux Klan admits no other interpretation. It has been proposed that the President’s initial remarks were “ad lib” and pertained to violent ideologs of all kinds. But he was specifically addressing the violence in Charlottesville. His statement created a false equivalency between a gang of racist, bigoted thugs and anti-bias, initially peaceful counter-protesters. In effect, he was excusing the instigators of the resulting violence. But, two days later, he read a statement that corrected the implications of this initial statement. He denounced the instigators by name and called the country to join him in renouncing racism and violence and to come together in mutual respect and love. Previously, as the President Elect, he would have called this statement “politically correct.”

But Donald Trump’s supporters have always loved him for being “politically incorrect,” which they interpreted as “speaking his mind.” They were never offended by his off-the-cuff remarks, even when he was crass and offensive. On many occasions, he showed his ignorance of American history, government, and founding documents. Nevertheless, his supporters found no fault in his pursuit of the highest office in the land. They loved the fact that he might shake up the smug elites that showed little regard for their welfare. Perhaps mindful of these supporters, the President sounded a different tone the following day, reverting to his initial pronouncement on the Charlottesville tragedy, calling out both sides for their part in the violence. Perhaps he was incensed by the criticism hurled at him—that he took too long to condemn the perpetrators or that his “second take” failed to disassociate them from his supporters. Whatever his motivation, he clearly reestablished his credentials as “politically incorrect.” But, on this occasion, he went much further.

Both in his recent West Virginia rally and in his Charlottesville commentary, President Trump has taken his “politically incorrect” brand to a very un-American place. Until now, no American President has incited insurrection, as he did in West Virginia, or a counter revolution against American values, as he did in his assessment of the Charlottesville violence. He may have begun his campaign for the White House with dubious facts and duplicitous intent. But his attempt to legitimize a hateful, violence-prone protest that resulted in the death of one and injury to many reveals more than the incorrectness of his political persona. It reveals his character: it reveals him.

Why would anyone in politics want to be “politically incorrect?” Most, if not all, politicians attempt to be politically correct in the sense that they try to follow certain norms of behavior and speech that are not offensive to prospective constituents. The problem, of course, is that they do not always live up to those norms and can be duplicitous in behavior, speech, or both. Webster defines “duplicity” as “the belying of one’s true intensions by deceptive words or actions.” But before condemning all politicians as duplicitous, it should be noted that the perception of political correctness may not equate to duplicity. For example, is it duplicitous for a politician to pivot away from a question that might reveal ignorance, a partially formed and still unsubstantiated opinion, an untoward attack on a rival, or a premature announcement of a controversial position? In this instance, even Cicero would probably term this reticence as the art of a practiced politician. Avoiding a question is not necessarily the “belying of one’s true intensions.” It may show no more than being unprepared to give a lucid answer, or being wary of displaying stupidity, flippancy, offensiveness, or unnecessary controversy. Being politically correct can be how a politician maintains credibility with supporters. It may also illustrate how a politician can self-edit his/her words to win trust without offending others or exposing personal deficiencies and prejudices. This form of political correctness is often irritating, but it is seldom considered surprising or intolerable to voters. In an ideal world, as Senator Al Franken recently attested, “when asked a question, I was taught to answer it directly.” Imagine a world where our politicians felt they had the license to say, “I don’t know” or “I have to study the issues before I can give an honest opinion.” That world would leave no room for pivots or the doubletalk of taglines, spin, or “Party-line messaging.” Nevertheless, the clarity of that world would not distinguish political correctness from incorrectness. And the absence of clarity, as in a pivot, does not necessarily imply an absence of honesty or deception. It may be neutral and not, by definition, duplicitous. Therefore, how did it become identified pejoratively as “politically correct,” paradoxically implying duplicitous.

“Belying” involves intentional lying and using “deceptive words or actions” to justify the lie and disguise intent. For example, when a politician claims that undocumented immigrants are responsible for increased crime and job losses, he is misrepresenting facts to scare supporters and win their trust. He convinces them that only he can protect them by building a 2,000-mile impassable border wall. This misrepresentation of his intent and facts is an example of duplicity. Precisely because he makes “political correctness” a phony code word for duplicity in others, he becomes the poster child for the “political correctness” he so abhors. Nevertheless, Donald Trump claims the moniker of being “the most politically incorrect.” His claim, ironically, enhance his brand as a truth telling non-politician. But the only truth in his claim is that he is not a politician, for he is a lying demagogue. As such, he lies and distorts facts to create an illusion that supports his positions. Then he mislabels terms like “political correctness” to suit his purpose and create a scornful tagline for his supporters to use against his opponents. For example, the intent of his border wall proposal was to use fear and anger to convince voters that only he could save them from crazed hordes of undocumented immigrants. What this example from the last election clearly demonstrates is that the term “politically correct” is not well understood. Paradoxically, Donald Trump could proclaim as a virtue his so-called “political incorrectness” while displaying the worst example of what he decried as “political correctness.” While it is true that politicians have at times been guilty of duplicity, they are not politically “correct” as a result. A demagogue, by contrast, engages almost exclusively in duplicity. It is his stock and trade, though universally abhorrent in politics. But in the hands of a demagogue, its use can yet win the favor and support of an electorate unmindful of his lies.

History has never been kind to demagogues. Eventually, it exposes their lies. Regardless of how expressively or emotionally they proclaim their cause, their self-serving intent and deceptive self-justifications expose who they are. What others may mistakenly witness as authentic is just a glittering shell hiding a deep insecurity. That shell is the demagogues’ illusion that exists only as long as it can dupe a befuddled public with its brilliance. Their rhetoric, power, wealth, or status may cultivate the illusion. But, at their core, they lack the altruism gene. Demagogues are deficient in the honesty, integrity and selflessness we generally ascribe to character. They are just empty shells.

Once we see through a demagogue’s façade, it becomes impossible to believe in his words or connect with him as a person. When President Trump created the illusion of a false equivalency between repugnant racists and counter protestors—that is, between hate spewing bigots and their egalitarian opponents—he revealed his innermost self. He shattered the self-image he continually projects of the competent business man and “great deal maker” possessed of a “great mind” who “alone can make America great again.” Instead, we see the President as an imposter who is unable to support America’s 241 years effort to adhere to its founding principle that “all men are created equal.” How can we expect him to govern “with liberty and justice for all,” “to insure domestic tranquility,” and “promote the general welfare?” The divisiveness of his remarks in West Virginia and unsettling mischaracterization of the Charlottesville tragedy make it impossible for him to bring the country together or perform his Constitutional obligation “to form a more perfect union.” His words belie our trust.

Language is how we communicate and, more specifically, how we connect with each other. It is impossible to share our thoughts without a shared, mutually understood vocabulary. By contrast, this President spews diatribe, brands opponents with monikers like “lyin’ Ted” or “crooked Hillary,” and now disingenuously invents an “alt-left” as the scoundrels who attacked the good people who marched with the Neo-Nazis. His intent is not to share information or insights. His words serve only his interest, which is propaganda, not communication. Moreover, he does not share the life experience of most Americans. He was born into wealth and lives in a gilded tower. He finds it difficult to relate to subordinates who are not sycophants. He is incapable of projecting into our space, of connecting with our lives, our struggle for equality, or our historical heritage of diversity. But that disconnect is still not the most fundamental issue. The problem is that he is both our duly elected President and an alien in our midst. As Senator Coburn recently stated, “he does not understand the character of our nation.” His world is a self-reflecting shell that makes it impossible for him to relate to the experience of others—to immigrants, Muslims, the civil servants of the “deep state,” America’s allies, the press, elected officials who disagree with him, including fellow Republicans, and his own staff whom he regularly berates or fires. How could he be expected to empathize with his fellow Americans, even those who voted for him?

Frankly, it is sad to see a man so insecure in his own skin and so inept at normal human relationships. I can only pray that Congress will relieve him of his misery and us of his Presidency. Until then, we must try to maintain the values that define America and hold us together as one country. We cannot trust a President who speaks those values from a script while simultaneously stating his disbelief in them under the euphemism of being “politically incorrect.” Nor can we trust that his life’s experience overlaps with ours or that we can connect with him on any basic human level. He has not shown any evidence of personal empathy with others. As George Harrison explained in one of his lyrics:

“About the space between us all
And the people
Who hide themselves behind a wall of illusion
Never glimpse the truth…

We’re all one
And life flows on within you and without you.”

A Showman Stages an Accidental War

We just passed a significant date in U.S. history: August 7, 1964, the beginning of the Vietnam War. On that date, Congress enacted the Gulf of Tonkin Resolution, authorizing the President to conduct military action against North Vietnam. Congress acted quickly in response to the now infamous Gulf of Tonkin incident that allegedly occurred on August 4. Just two days before, there had been an exchange of fire between the USS Maddox and North Vietnamese patrol torpedo boats. On that occasion, the Maddox determined that the approaching patrol boats were threatening and unintentionally initiated the battle with warning shots across the bow. That warning, regrettably, was misinterpreted. The patrol boats launched torpedoes and were summarily destroyed or damaged. But the stage was set for the phantom attack on August 4, its erroneous report, and the resulting Congressional authorization to begin the Vietnam War.

I was caught up in that war. For many years, I suppressed its memory until I finally decided to confront the shadow that lurked deep in my soul. The novel that resulted from that decision— “A Culpable Innocence”—was a work of historical fiction, researched from many historical accounts and declassified documents. My research uncovered two startling facts. The first I just recounted: the incident that started the war never occurred. The second was the 1952 Geneva Treaty that called for an end to the Vietnamese-French conflict and a national election to presage a peaceful transfer of power to a reunified Vietnam. Although America negotiated this treaty, at the last minute the Eisenhower Administration pulled out of the agreement. The American government betrayed its own diplomatic effort to unify Vietnam and effectively laid the groundwork for the war that ensued.

Today, America just won a resounding diplomatic victory in the United Nations Security Council where all 15 participants voted to impose severe sanctions on North Korea for its continuing development of nuclear weapons and their ICBM delivery system. But instead of supporting this diplomatic breakthrough, the President seems intent on sabotaging it by inciting the North Korean leader into a war of threats and bluster: in the President’s own words, “fire and fury, the likes of which the world has never seen.” As a result, Kim Jong-un has responded by putting cruise missiles on patrol boats and by announcing an August 15 missile launch aimed in the direction of Guam. If he does so, how will America respond to a missile landing at or near one of its military bases. Even if the missile landed 300 miles away from Guam, how would the American military determine its intended target after traveling nearly 3,000 miles? Or how would America respond to a cruise missile shot across the bow of an American destroyer? What could possibly go wrong?

We lost more than 58,000 soldiers and over 250,000 wounded veterans in Vietnam. We killed over a million Vietnamese. If we now shortcut our diplomatic efforts with threats of “fire and fury” and stumble into a war over a chance or mistaken encounter, the result would make the Vietnam casualty figures appear miniscule. We have some 20,000+ American troops on the border facing a million-man army. There are ten times that number of American civilians living in South Korea, mostly in Seoul, only 60 miles from about a thousand enemy howitzers. Within 14 minutes, those howitzers would begin to rain shells on Seoul. Hundreds of thousand could die under that bombardment. If Kim Jong-un decided to use his nuclear arsenal, millions could die. Of course, North Korea would be devastated. There are some 70 trident missiles lurking offshore in American submarines. The President just ordered B1 bombers to Guam and already has authorized their North Korean overflights.

Listen, America, the President is not just threatening a nuclear holocaust, he is readying for a nuclear war.

Confronted with this possibility, the President just said, “it’s better we fight them over there, than here (a paraphrase).” How do you think our South Korean and Japanese allies feel about his priorities? If his real intent is just to distract Americans from the Russian collusion investigation or win public support for defending America from an insane dictator, then Congress should begin impeachment proceedings as soon as possible. If, instead, he believes North Korea presents an immediate and serious threat to the homeland, then he needs to present facts and figures to Congress and the American people to support his bellicosity. I am no military expert, but cruise missiles on patrol boats do not seem like much of a threat to the counter measures built into our Navy ships. And long-range missiles with no fins seem unlikely to hit any intended target thousands of miles away – except by accident.

Simply put, are we overreacting to ridiculous provocations? And to what purpose is the President rallying Americans with his war cry? If he undercuts his Administration’s attempts at diplomacy and blunders into a war, he will likely become the first wartime President in history to be impeached. But even his impeachment could never undo the shadow he would cast over future American generations.

World leaders are beginning to criticize our President for his language and warlike posture. Perhaps his supporters will applaud the emotions he elicits with his hyperbolic rhetoric. On whatever stage he occupies, he is ever the entertainer. But as a President on the international stage, he casts a very dark shadow. What happens when the curtain comes down on his circus act? He may be ludicrous and the gist of satire. But the flipside of the dark humor he inspires is a sickening feeling in the pit of the stomach. That feeling is repulsion—a mixture of anxiety, disgust, and moral outrage.

America desperately needs a real President, not a showman. Let’s remove this showman from the world stage before he brings the curtain down on an apocalyptic climax.

My Sock Drawer

My mother suffered the first signs of my initial problem with life. I can still remember the look of exasperation on her face when she surveyed the pile of socks and clothes her six-year-old son scattered over his bed. My problem, you see, began with my sock drawer, and metastasized from there. In fact, it encompassed a large part of my early years.

Like any first-generation Italian, my mother was matriarchal in the sense of being protective, nurturing, and almost smothering in her love. Caring for and worrying about me was her obsession. I was always well fed, clothed, cleaned, and “turned-out.” She even folded my freshly washed clothes and stacked them neatly in my drawers. But I rebelled. I wanted to impose my own order. And my sock drawer best illustrated the problem. My preferred stacking order demanded a rearrangement: separate stacks for patterned and solid colors; then a further distributive organization by color. In fact, putting things in order carried over into many areas of my childhood, including the furniture in my room, my pets, and the food on my plate. Apparently, I was taking my mother’s well-ordered household to a whole new level—a well ordered sock drawer became indicative of the well-ordered life I sought and presumed.

A well-ordered child, however, must pass through many crucibles of change. In elementary school, I encountered bullies and the chaotic competitiveness of team sports. For me, fitting into a juvenile social structure was like forcing a square peg in a round hole, somewhat awkwardly shaving the edges off my predisposition for orderliness, As I grew older, girls were especially adept at scrambling my emotional equilibrium. They did not follow my self-conceived precepts for order in relationships. I was learning that I could not impose my concept of order on others and that relationships require change in myself. How does one grow up without opening oneself to others, without connecting?

My increasingly less well-ordered childhood faced new challenges in secondary school and college. My studies were serious, well-intentioned, and disproportionately religious in nature. Perhaps the first shock came from classes in scriptural exegesis from Greek and Latin texts. I was aghast to discover that translations and transcriptions of these sacred writings were modified to account for various orthodox and heretical belief systems. This discovery was unsettling to my concept of order and trust in a religious belief system. If sacred texts fall prey to organized chicanery, is anything sacred?

As I grew older and wiser, I found solace in philosophy, history, and literature. The diversity of thought and experience presented in these studies was both overwhelming and exhilarating. But the more I delved into the basis for this diversity, I became increasingly aware of the fundamental disagreements we humans harbor over almost everything. For example, what proofs are there for the existence of a god? Is the replacement of theocracy with natural law a stable foundation for government? Is evolution solely explained by natural selection? Is there a human soul apart from the body? The answers to these and many other questions were diverse and often contradictory. They shook the underpinnings of my thoughts and elicited a yet more disturbing question. How can one rely on accepted truth?

Perhaps a bit wiser and much more cynical, I turned to science and began a career in technology. Surely, the scientific method would ground my understanding of reality. Besides, the technology that flowed from science would provide me the opportunity to make a difference in the real world. But then my queries into quantum physics and chaos theory jolted me out of my nascent comfort zone. Just as Newton’s concept of gravitational attraction between bodies gave way to Einstein’s gravitational field, quanta and fractals opened the door to many unanswered questions—perhaps even as bedeviling as the existence of God and His role in creation. Remember how “I AM that I AM” begged the question of the nature of God and existence itself. Well, the question of whether an electron/proton is a particle or a quantum of pure energy is just as unsettling and mysterious. Modern physics suddenly became metaphysics, questioning the very nature of being itself. Consequently, how can we say we really know what we know?

But knowledge is power, right? In fact, for us humans, it can become a mental aphrodisiac. It enables us to construct a world in our minds. And that mental construct can become the relative order we not only perceive but even project onto the external world. With assumed certainty, we name and classify the elements of that world. They and their relationships to each other become the fabric of our self-perceived truth. Some of those elements, however, bedevil our understanding so we identify them as mysteries. Science tries to unravel these mysteries by unmasking how they came to be. The unsolved mysteries become the impetus for analysis, theory, and experiment. If belief in the scientific method is absolute, then all mysteries will be resolved in time. But that faith cannot justify with absolute certainty everything science unravels and makes more explicit. Within the near future, our scientific understanding of time, space, and the nature of reality will likely evolve, perhaps akin to the revolution bequeathed us by the theories of relativity and quantum physics. Major scientific discoveries often serve as steppingstones to future discoveries. We should believe in and support scientific progress. But why would we accept every scientific fact as a definitive end state in our knowledge or as the final explanation of our world’s deeper mysteries?

Religious faith addresses life’s mysteries differently, sometimes even calling them sacred. Making something “sacred” is one way of categorizing a mystery and is essential to the creation of myths and the various forms of ritualistic sacrifice found in every religion. The Latin root of the word “sacrifice” literally means “to make sacred”—specifically, sacer, “holy” or “sacred” and facere, “to make.” (Oddly, sacer can also mean “curse,” which embraces a different type of religion or cult.) Regardless of the religion, the sacred usually refers to a mystery we can never truly comprehend, though myths give them meaning. Myths are stories that transcend formal logic. They account for the order we wistfully imagine through our miniscule eyelet into a vast universe. As such, they can verify whatever we perceive as stable and true in that universe and become that special reservoir of knowledge generally termed a belief system. But they still represent the incomprehensible. And, of course, the ultimate mystery many of our mythic stories identify as God or gods. The word “god” is not a sign representative of something in our universe, but a symbol, as Carl Jung defined it, of the wholly transcendent.

But that ultimate mystery is not beyond our reach. It is just beyond our understanding. The Hebrew “Yahweh” (“I AM that I AM”) was not a word the early Jews could speak. Its syntax is in the first person, i.e., the God person. So, Yahweh told Moses (Ex. 3:15) to tell his people that “he is has sent you.” The word for “he is,” comes from the Hebrew root haya which literally means “to be.” The ultimate mystery, then, is existence or simply being itself! That which is beyond our understanding but underlies all that is and all that we know is the most commonplace and intimate experience of our daily lives, our very existence. It is the primal element that both forms our individual lives and connects us to all we encounter. As such, it defines the very boundaries of order. Outside those boundaries, we have no guarantee of control. Nevertheless, it promises unlimited knowledge, unwavering truth, and a sacred enchantment within the scope of our individual lives. Even though we can become consciously oblivious to its constant presence, we can never deny that we feel its presence. Our individual existence is all there is, until it isn’t. The meaning of life is no more than being conscious of the feeling or experience of living within the context of our personal existence. That experience must become the touchstone of our lives. For the moment in which we become fully aware and participate in existence is when we touch Divinity within ourselves. As William Blake wrote, “If the doors of perception were cleansed, everything would appear to man as it is: Infinite.”

Today, I still maintain a well-ordered living space. Old habits are as comfortable as a well-worn sweater. But my sock drawer is not as well organized as that six-year old’s drawer once was. It no longer defines me. My life is not so closed; my relationships, not so anxious or judgmental; my thoughts, not so definitive or arrogant; my religion, not so orthodox. The experience of living is all. I am now like a flea riding high and fully exposed on the back of an elephant. At any moment, I may be brushed, blown, or washed away. But, by God, what a fantastic ride!

The Twistcon’s Collaboration with the Senate

Savvy, the Twistcon’s AI, has just interviewed several Administration operatives for the Senate Intelligence Committee. The Committee decided to employ Savvy after witnessing its success in a recent interview with the President. The following is a transcript of the interview:

Chairman: (sound of a gavel strike) This Committee is called to order. (Pause) Today we begin testimony by three of the President’s closest advisors and his Press Secretary. (Long pause as the Chairman prepares to address those called to give their testimony) Departing from our usual practice, the computer placed between us will conduct this interview. (Lights flash on the Twistcon’s panel, noticeably surprising the attendees) Please begin, Savvy . . . aah, that’s the AI’s name.
Savvy: Thank you Mr. Chairman. Savvy would like to begin with a question for Ms. Con Way.
Conway: Excuse me! My name is Kellyanne Conway, that is, “Conway,” one word, one name. You see the problem here: it’s word confusion . . . sends the wrong message. Like “collusion” is not “conclusion.” That’s what’s wrong right now: people are told there is collusion, but there’s no way you can reach that conclusion.
Savvy: Ms. Conway, are you aware of any contacts between Trump campaign officials and Russian government officials or other Russian nationals?
Conway: There it is! (addressing the Chairman) Just like I said, word confusion. “Allusion” becomes “delusion.” Your AI’s allusion about nonexistent contacts is its delusion. I hope my testimony can clear up this confusion.
Savvy: Ms. Conway, did you hear my question? If so, can you answer it?
Conway: I’m not deaf. But how can I affirm a negative? There’s nothing there. It’s just your deluded programmers drawing conclusions out of thin air. The President is busy fighting terrorists and keeping Americans safe, while the media talks “collusion.” Confusion pollution! I can’t be part of the media’s delusion. It’s all just fake news.
Savvy: Perhaps Savvy can get a response from Mr. Jar ed Kush nerd. Sir, can you answer the question I just posed to Ms. C o n w a y?
Kushner: My answer is the same as the Vice President’s: of course, not. (Attendees react with a collective exhale. Nobody had ever heard Kushner’s voice before.) And my last name is KushNER, without the “d.”
Savvy: Savvy will rephrase the question: have you personally associated with Russian government officials or other Russian nationals before or since the President’s inauguration?
Kushner: Yes, I have had associations with many people in the natural course of my business. Some may have been Russian.
Savvy: Savvy is questioning whether those associations occurred in your role as a trusted campaign advisor or senior counselor to the President.
Kushner: I have already disclosed those associations and have testified before Congress in that regard.
Savvy: But your disclosures came after your non-disclosed contacts appeared in the press. How do you explain your failures to disclose these contacts with Russian government officials?
Kushner: The government forms are confusing. My staff hit “enter” before I could complete the online security form.
Savvy: Many of the questions on your application for Top Security Clearance require a simple “yes” or “no” response. And they require you to hit “enter” many times. (pause) Also, Savvy must ask, why where 77 assets left off your application?
Kushner: My staff mistakenly overlooked a few assets. I have since corrected this misunderstanding. (Speaking to the Chairman) I have extensive assets. If further information is required, I would suggest talking to my lawyers.
Savvy: The assets not included on your application reportedly amount to one billion dollars. (pause) One of your associations not on your initial application was with the Russian Ambassador. According to a leaked intelligence report, you requested use of the Kremlin’s secure communication facility. Why did you make this request and what secret communique did you want to send to Moscow?
Kushner: That press reported leak is wrong—just another example of fake news. I merely asked to speak to Russia directly, rather than through an intermediary. “Backdoor” communication between governments is not unusual. But it would not be appropriate for me to speak to any spurious “intelligence” allegedly leaked by an anonymous source. These leaks undermine our President and our American institutions. We should not give them any credence. So, I have no further comment on this subject.
Savvy: At the time, you were working for the President Elect. You were not a government official and had no authority to engage directly with the Russians. What would justify this request for secret communication with a foreign adversary? (Kushner looks past the Twistcon in silence.) Savvy understands that you have no further comment. Mr. Sean D. Spite, can you, sir, explain these undisclosed contacts with Russians by the President’s closest advisors? Most especially, how can you justify the President’s son welcoming damaging information against his father’s campaign rival from an agent of the Russian government?
Spicer: Whoever programmed you—errr, Savvy, or whatever entity name you go by—must have been a Democrat or part of the fake news conspiracy. “Despite” your rogue programmers, I go by the name of Sean S p i c e r, and without your middle “d”. This disrespect shown to me, my team, and, worse, to the President is beyond bounds. As far as the President’s son, he was very transparent in reporting on his meeting with a Russian lawyer about American adoptions of Russian orphans. And with respect to Jared, he has been very forthcoming about the accidental omissions on his top-secret security application. There is nothing here! We keep trying to correct this bad reporting. It’s all just fake news.
Savvy: If you cannot explain why these Russian contacts were not disclosed, maybe you can comment on the nature of those contacts. What would justify any American to request the use of a clandestine Russian spy network to communicate with the Kremlin? Or what would justify any American to welcome Russian interference in our democratic election campaign?
Spicer: Asking me to address matters of intelligence is a good try. I won’t get into word games with you. But I would refer you to the intelligence agencies. The press’ spin is obviously another example of fake news.
Savvy: Perhaps Savvy would do better to address a question to Mr. Stĕv Bandit.
Bannon: Ridiculous! Is this an inquisition by the deep state? Whoever programmed this idiot machine is biased. Your rogue programmers know who I am. I’m Stēve B A N N O N.
Savvy: The probability of error is .16721%. Savvy does, however, make note of any possible error for the programming team’s review and apologizes for any deficiency in its code. Now, may Savvy ask you, Mr. B a n n o n, a question. What is the deep state?
Bannon: The deep state is that body of entrenched public service parasites who are dedicated to preserving the status quo without recognizing the forces that threaten to destroy our way of life.
Savvy: What threatens our way of life?
Bannon: The deep state is blind to the threats from Islamic terrorism, globalization, godless internationalism, and the lame liberalism of cults that cultivate the racially diverse and sexually perverse. Our Judeo-Christian heritage is at risk. America is in a war between civilizations. It must arm itself both ideologically and militarily against this evil.
Savvy: Did you prompt the President’s criticism of Pope Francis who stated that Christianity is about building bridges not walls?
Bannon: As the President said, the Pope should stick to religion, not politics.
Savvy: The Pope seems not to agree with you. Two of his closest confidantes just recently published an article in a Jesuit publication, La Civitá Catholica, in which both you and the President were labeled as “evangelical fundamentalists.” As such, the article claims you adhere to a strange ecumenism, justified by misinterpreted Bible quotes and dreams of a theocratic state and characterized by xenophobia and islamophobia. Is it fair to say that your vision for America demands the building of a border wall to keep out Latinos escaping poverty and war, the banning of Islamic or Muslim travelers and refugees, and the mass deporting of undocumented immigrants already living and working in America?
Bannon: You’re damn right! And I don’t like Jesuits either. But my vision is about the only thing they got right. America is the last hope for Christianity and Western Civilization.
Savvy: You seem intelligent enough to recognize that your world vision reduces all politics and diplomacy to a battle between good and evil where all measures, including war, are justified.
Bannon: So?
Savvy: Then do you admit, as the Vatican article states, that you are a “supporter of an apocalyptic geopolitics.”
Bannon: Not my words. But, yes, we are in a mortal struggle against evil. And we must win at all costs.
Savvy: Then you have the same beliefs as Daesh or ISIS, just on the opposite side.
Bannon: That’s a characterization deserving of the press. Congratulations, Twistcon programmers, you’re worthy of the same spin machine as the fake press.
Savvy: (addressing all four testifiers) To many Americans, including the press you all vilify, it appears possible that there was collusion with the Russians to influence the results of our election. Can either of you explain or justify the non-disclosure, disclaimers, or lies that surround these Russian contacts? Was there collusion?
Conway: Collusion confusion.
Spicer: It’s a nothing burger!
Bannon: Your question is proof of a deep state conspiracy.
(Kushner silently rises from his seat and leaves.)
Savvy: Mr. Chairman, Savvy concludes that these testimonies speak for themselves, even though they failed to answer any of Savvy’s questions.
Chairman: Very well, then, I would like to thank the programming staff that gave us this non-partisan session. My Democratic colleagues would likely have had more wry comments than questions. And my fellow Republicans would have preferred to ask about Hillary Clinton’s Russian ties. At least this committee has tried to get unbiased answers. Thanks to all participants. (he gavels the session closed)

Meanwhile, in the back of the room, a small group of programmers linger. They appear quite bewildered . . . perhaps as much as the American people.

The World We Live In

Egocentrism is a term generally used as a pejorative. But, every human is born into a world that exists only within the self. A baby reaches out to touch a parent’s face and discovers another. His/her existence for the next several years involves many such discoveries. At some point, normally before pre-school, the outside world that seems to revolve around the infant reveals the most intimate and important experience of all: he/she is not only separate, but a subject or conscious agent in this world. Unfortunately, this revelation does not prepare that infant to deal with this outside world. For the next several years, the child will explore his/her ability to interact, to change, to build or destroy the things in this world. More significantly, he/she will learn to connect and communicate with parents, other children, and adults, mostly patterning behavior learned from the home environment. As the child grows into adolescence and adulthood, knowledge of both the physical and social world expands. But, at every point in human development, perception of the outside world is relative. In fact, that perception gradually becomes an ever-expanding network that exists only in the individual, not in the world that exists outside of the veil of his/her perception. It is only when we discover our personal isolation that we begin to understand our limitations and the only path to maturity.

Egocentrism is the albatross that warns us of the storm on the horizon. It tells us that we are not safe at sea, unless we attempt to steer free of the storm. Development of an ego, in psychological terms, is an escape from the id. But it can be its own prison. In fact, we can never escape our personal perspective, but we can expand it to include other perspectives. This expansion is the pivotal experience of surviving in a world that exists with or without any one of us. It is keyed by a personal decision to be open to what the world and others can teach us. But that openness is not a matter of rote learning or of acquiring control over people and things in the service of personal status and ego. Egocentrism may be a birthright, but it need not be a life sentence.

My wife is an elementary school teacher. When I relate to her my blog topics, she often sees them in the context of her children. What she recognizes is my humble attempt to describe a petulant resistance to facts and verifiable evidence—in effect, an inability to deal with the world outside of one’s personal, limited perspective. For example, the first step in conflict resolution is the attempt to understand an opposing perspective. A child who misbehaves in the classroom often has an unresolved grievance. Discovering the nature of that grievance is usually the first step in correcting the misbehavior. On a world stage, consider Vladimir Putin’s grievance with the West. Is his reaction to NATO’s ever closer deployment at Russia’s border different in kind from John Kennedy’s reaction to Soviet missiles in Cuba? The tactical nuclear weapons presently deployed in Eastern Europe are comparable to the destructive power of their less sophisticated predecessors positioned in Cuba fifty-five years ago. Granted it may not be possible to dissuade Putin, but the first step in de-escalating this current adversarial contest is an attempt to demilitarize both sides of the Eastern European border. Major breakthroughs in world diplomacy have almost always resulted from a recognition of another’s perspective. Certainly, the American led Iran Nuclear Deal is an example. For those few of us who read the agreement, the long list of appendix items reveals to what extent both parties went to recognize each other’s concerns and needs.

Closer to home, another example of egocentrism is what I will term “political validation.” The Republicans have fallen into the trap of validating their previous political promise of repealing Obamacare without considering whether it is the right thing to do. Yesterday, our President called a meeting of Senate Republicans to encourage them to repeal Obamacare now and develop its replacement over the next two years. He promised as much to his electorate. Apparently, he wants to validate an ill-conceived political promise. Meanwhile, many who voted for him reportedly (if you believe the polls) say they still support him. Considering that many of them will lose their healthcare, they unhappily demonstrate how political validation of their vote can take precedence over what is right – even at their personal detriment. It is usually considered heroic to put one’s personal welfare at risk for a cause greater than oneself. In this instance, it seems personal risk serves only personal pride. Such is the price of political validation. It’s like the child who refuses to recognize that recalcitrant behavior earns expulsion from the class. That child would rather be punished than change behavior.

My personal world is as limited and egocentric as anybody’s. But whatever I have learned and whatever maturity I have gained derive solely from my reflections on the borders of my own perception. At those borders rest the barriers to connection with others and the outside world. Every time I crossed one of my barriers, I learned something—both about another perspective and about myself. It is that connection that builds relationships, begins to overlay differences with empathy, and creates communities. It also allows us to share a common understanding of the world. Without these relationships and common understanding, we would find ourselves isolated and insecure. Our only solace might be a feeble attempt to project our personal perspective on everything and everyone. In effect, we would either expect others to share our childlike fantasy or, if circumstances permitted, compel them to accept it. Who amongst us would choose to live so?

I choose to live in the real world. And I wish the same for you, my readers.

The Republican Path to Healthcare

Is healthcare in America a right or a privilege? In order to answer this question, we need to understand the path America has taken towards the concept of universal healthcare. That path could have started with the Declaration of Independence where certain rights were considered “unalienable,” such as “life, liberty, and the pursuit of happiness.” But, of course, in the context of the time, the right to life did not include the primitive healthcare then available. Early Americans survived or died without the lifesaving treatments medical science provides today.

In the Eighteenth and Nineteenth Centuries, our modern concept of medicine and healthcare was still unimaginable. When settlers moved west, their covered wagon migrations rarely included doctors. People learned to take care of themselves with well-worn practices passed down through generations. Many died in transit. Though medical science advanced a great deal during the early Twentieth Century, it was not readily available to most Americans. By midcentury, most Americans still subscribed to well-established home remedies and “old wives’ tale” preventative measures. As a child, I still remember the foul taste of castor oil. It was the universal remedy for many ailments and required no doctor’s prescription. When my dearly beloved canine friend pulled me to the ground, no doctor sewed up the deep cut on my knee. Spot was more interested in a cat than my five-year old ability to hold onto his collar. But neighbors came to my rescue and staunched the bleeding until my mother could close the wound with kitchen tape. Today, my knee still displays a gash with scar tissue as wide as the original length of the cut. But my experience was not unique for that post-war period.

Although health insurance was introduced after the war, its availability was limited to those who could afford it or whose employer could provide it. Gradually, more and more companies offered this insurance to their employees as an additional job enticement. But the unemployed had no access to this insurance; and the retired had no assurance of health insurance in their retirement. From 1958 to 1965, Congress considered various amendments to the Social Security program to address healthcare for the aged, the poor, and the disabled. Senator John Kennedy had worked with Senators of both parties to advance his healthcare proposal. As President, he sponsored a Social Security amendment to extend healthcare to more Americans. But it was his successor, President Johnson, who negotiated this amendment through a barrage of adopted and deleted provisions in both House and Senate committees. Finally, on July 27th, the House passed the Social Security Amendment by a vote of 307 to 116. The Senate overwhelming supported the final bill by a vote of 70 to 24. The President signed it into law three days later, thereby establishing both Medicare and Medicaid. The new law allowed every worker to pay into a system that would assure him/her access to medical care after retirement. In a sense, this new “entitlement” program recognized both aspects of individual healthcare: personal responsibility and a social obligation. The former required every worker to pay into Medicare; the latter assured healthcare for all workers in retirement. Moreover, this new law established Medicaid which, together with Medicare, would operate equally in all States by addressing “the failure of some states to implement (healthcare) to the extent anticipated and thus the existing program is inadequate to solve the problem” (quoted from the Congressional Bulletin, September 1965, p. 6). Congress seemed to recognize the need for healthcare to meet basic expectations and to treat all citizens equally. Its non-partisan votes created the first nationwide standard for healthcare and established the entitlement programs we have come to accept as a basic right.

Nearly a generation later, President Reagan enacted the law that forced hospital emergency rooms to treat patients who could not pay for their treatment. Before he did so, critically ill patients could be turned away from medical care. I can remember that the only time I saw a doctor as a child was when my life was at risk. One such memory was of my father threatening a doctor on such an occasion. He demanded the doctor save his son or risk physical retribution. My father’s desperation was not unusual for the time. In these extraordinary, often life-threatening, situations, a Republican administration recognized that urgent medical treatment was morally required, regardless of the patient’s ability to pay for it. While ongoing medical treatment and “preventative care” were still not pervasive practices, emergency medical treatment was made an individual right for all Americans.

Today, modern medical treatment has progressed far beyond the ER and care for the elderly, the poor, and the disabled. It provides drugs and therapies that help millions of otherwise “healthy” Americans to live active and productive lives. And it can extend the lives of those suffering from heart disease, cancer, bacterial or flu epidemics, bone shattering or organ damaging accidents, and so much more. Babies used to die in the womb and at birth at an alarming rate, but not anymore. Women suffered more during pregnancy and died during child birth much more frequently than today. Preventive medical measures can keep us healthy and active for a much longer portion of our adult lives: colonoscopies, mammograms, annual blood tests, maternity care, and annual health examinations help us keep our jobs and personal lifestyles. Of course, these advancements in medical treatment are costly—in fact, medical expenditures now account for one sixth of our economy. And they raise two urgent questions: does every American have a right to the healthcare the medical community can now offer; and, if so, how can we provide that healthcare or, more simply, how can we afford it?

The Affordable Care Act (ACA), or so-called Obamacare, made possible the expansion of the existing state run Medicaid program, significantly extended the financial viability of Medicare, established competitive healthcare exchanges for purchasing private health insurance, and regulated the insurance market by capping insurance company profits and by standardizing coverage to assure preventive care for all insured, to allow children to remain on their parents’ plan until the age of 26, to remove lifetime insurance caps, to eliminate gender discrimination in premium costs, and to eliminate the practice of refusing coverage based upon previous conditions. For those who could not afford the costs of private insurance, the ACA provided subsidies. These changes were paid for by various fees and taxes paid by insurance issuers, by sponsors of fully funded health plans (large businesses), and by high earners. These high-income earners must pay an additional Medicare wage tax of .9% on incomes over $200,000 ($250,000 as a family) and a securities income tax of 3.8% tax on investment incomes over $200,000 ($250,000 as a family). The latter tax targets individuals with massive holdings in stocks, mainly millionaires and billionaires. The ACA does in fact represent a modest shift in wealth whereby tax revenue drawn from the rich is reallocated to subsidize health insurance for the less fortunate. For example, it was recently reported that 400 families in the richest 1% of the population in effect subsidize healthcare for about 750,000 enrollees in the exchanges. As a matter of public policy, the ACA also reoriented America in the direction of universal healthcare. Its basic assumption is that healthcare is one of those Jeffersonian unalienable rights, specifically, “that among these are Life . . .”

The ACA was passed in Congress by a Democratic majority. Though individual Republicans offered 143 amendments to the legislation during its nearly yearlong debates, committee mark-ups, and hearings, no Republican voted for it. Both Parties politicized their opposing positions to the point of absurdity. My first blog on this subject, entitled “Subtlety and Bombast,” attempted to find a baseline of facts amid the exaggerated claims and criticisms. (That blog seemed to have touched a cord and triggered a surge in readership, leading eventually to 8,000+ new subscribers.) It quoted the Congressional Budget Office to undermine the extreme positions taken by both Parties, that is, a trillion-dollar savings versus a trillion-dollar deficit in the Federal budget. It also explained the Parties’ differences on philosophical grounds, naively intimating that the financial argument might be no more than political hyperbole. Today, their differences expose a more realistic explanation of this partisan divide, specifically the Republican opposition to the ACA. For we can now see more clearly what this current version of Republicanism has been reluctant to reveal until now.

Recent antagonism against the ACA reveals the underlying truth behind Republican opposition. While the financial argument is and always has been the core Republican issue, the Party has deflected Americans from its real intent. First, it complained about the “trillion-dollar deficit,” then “the rising cost of healthcare,” and now “the death spiral.” But the ACA has not caused deficits or a self-induced devolution. In fact, America has reduced by two thirds the trillion-dollar deficits it incurred from Middle Eastern wars and the Great Recession, while it has simultaneously extended the solvency of Medicare and enrolled an additional 24 million people in health insurance. Healthcare is one of the two fastest growing segments of our economy and now accounts for one sixth of our GDP. Its 3.9% inflation rate, though nearly double the country’s growth rate of GDP, is still a relief from the double-digit inflation rates of prior decades. The real Republican issue with the ACA IS financial in nature, but NOT about deficits, inflation, or its financial instability. The real Republican issue is and always has been about the taxes that support the ACA, specifically, the .9% wage tax for individuals earning more than $200,000 and the 3.8% income tax for individuals earning more than $200,000 from securities. Republicans simply cannot justify taxing the well-off in behalf of universal healthcare. Could it be that they think the wealthy cannot afford to pay more to support the less fortunate among us? No, they just cannot accept healthcare as an unalienable right. If they did, they would have acted accordingly.

I must emphasize the fact that the current Republican Party is not representative of Republicanism or conservatism. Prior iterations of the Party gave full throated support for the creation of Medicare and Medicaid, as witnessed in the Sixties. Moreover, President Reagan defined conservatism to include emergency medical care for everybody. The Party has been well on the path to universal healthcare, until now. The current Party leadership is, by contrast, radically regressive and bears little resemblance to our forefathers’ Republican Party or to its own historical roots. But we do have individual Republicans who are or can be profiles in courage. They can lead America down a different path. But they must begin by stopping the despicable steps taken to dismantle the ACA and leave so many Americans without healthcare. Since the ACA was passed, Republicans have done whatever they could to discourage enrollment in the exchanges and force insurers out of the exchange market. Their assault now encompasses defunding the healthcare safety net former Congresses worked so hard to establish. Today, a Republican Congress and Administration have tried to undermine the ACA and the 52-year-old healthcare programs that insure half of our children, the disabled, the elderly, women, and low-income Americans. Let’s review what Republicans are doing versus what they could be doing to support healthcare for all Americans:

Republicans have tried to make the ACA less affordable. The Party has filed several lawsuits that attempt to freeze subsidies or CSRs (Cost Savings Reductions). One such lawsuit attempted to put a hold on reimbursements for certain high deductibles, affecting seven million people and likely pricing them out of the healthcare market. At this time, those subsidies continue while the court allows time for the appeal process.
Versus: The President could order the Justice Department to defend this suit, but he has not done so. Congress could implement Section 1402 of the ACA, but it has not done so. Or it could just appropriate funds for these reimbursements, rather than sit on their hands while 7 million Americans face the possibility of losing their healthcare.
The President has caused ACA premiums to increase in 2018. He has ordered Health and Human Services (HHS) to levy a 19% tax on ACA premiums. While the President’s order allows him to claim a significant increase in ACA premiums, 80-85% of the insureds will be reimbursed by tax credits via the ACA subsidies. For most, then, their effective premium expense will be unchanged. In other words, the President is willing to waste tax dollars to prove a point, i.e., that premiums are going up in the exchanges. Fortunately, our free press noticed his ploy—disingenuous at best, malicious at worst.
Versus: The President could rescind his scheme to artificially increase future premiums and subsidies.
The President has ordered the IRS not to enforce the individual mandate. In effect, he is deliberately cutting off a source for ACA funding to make another political point—specifically, that it is no longer self-sustaining, but in a “death spiral.”
Versus: Instead of eliminating the individual mandate, Congress and the President should be reviewing ways to make it more enforceable and fairer. Its fees might be recalibrated to income. Or, as some Republican legislators suggested, non-compliance with the mandate might be penalized by higher premiums for any future private insurance application.
The President’s budget defunds ACA marketing and future upgrades to its exchange websites. In other words, the President’s HHS will not advocate for the ACA or make any online improvements.
Versus: Obviously, the President must administer the government programs Congress establishes, whether he agrees with it or not. He can veto or propose legislation. But he should not sabotage legally functioning programs his office is obligated to administer. No President is above the law.
The President’s HHS has attempted to shorten the ACA enrollment period. Coupled with not advertising for enrollment, this action by the President’s HHS attempts to suppress enrollments and thereby the number of healthcare recipients.
Versus: HHS should be encouraging enrollments for they entice more insurers into the exchanges, encourage price competition, and progress America further along the path to universal healthcare, one of the major goals of the ACA.
The President’s HHS has needlessly increased paperwork for ACA consumers. It appears that HHS believes cumbersome paperwork will convince potential consumers that enrolling is not worth the effort.
Versus: Obviously, HHS should not be discouraging enrollments. Given the purpose of HHS and the ACA, this pointless obstructionism is oxymoronic.
Republicans have loudly and consistently discouraged insurance companies from participating in the exchanges. Some Republican governors and congressional representatives have touted the “death spiral” tagline even though the 2017 enrollment surpassed expectations. Instead, they mention extreme premium increases in Arizona and Colorado or the number of counties with only one insurer in Pennsylvania and Ohio. They never explain these problems in the broader context which includes more than 12 million enrollees through the ACA exchanges.
Versus: A Republican Congress and Administration must address the fundamental issues that explain why premiums are costlier in some markets than in others and why insurance companies are pulling out of many exchanges. First, they will discover they need to stop the anti-ACA political campaign which includes lawsuits, threats to curtail subsidies, and legislation to rattle the insurance market’s risk sharing. Secondly, instead of justifying past political positions, they need to work across the aisle with Democrats for a common goal, i.e., better and affordable healthcare for all Americans.
The President and Congress have now decided to defund the ACA instead of repealing it altogether. By eliminating its tax supporting structure, they not only reduce the private insurance subsidies and eliminate the Medicaid expansion, but also roll back the 52-year-old Medicaid program and potentially impact Medicare costs as well.
Versus: The current American Health Care Act (AHCA) is a tax bill masquerading as a healthcare bill. If Republicans truly wanted to create healthcare legislation, they would build on what the ACA has accomplished. Instead they are eviscerating it to fund tax breaks for the wealthiest among us.
Republicans are destabilizing the healthcare insurance market by eliminating the risk corridors. Senator Mark Rubio added an amendment to a 2015 spending bill that limited the government’s ability to fund shortfalls in the risk sharing fund. Insurers paid $362 million into the risk pool, far short of the $2.87 billion needed for the first year of the ACA. The purpose of the fund was to stabilize the insurance market during the first few years of the exchanges. The fund, established in Section 1342 of the ACA, phases out in 2020 by design. Legislating its early demise allows Congress to drive insurance companies out of the exchanges prematurely, before they can establish a firm foothold. Of course, Republicans understand the need to stabilize the insurance market. Their proposed AHCA includes funding for risk pools in each state. They fully know how to aim an arrow at a bullseye in the kill zone.
Versus: Instead of eliminating the ACA’s risk sharing, Republicans should have reviewed its effectiveness and shored it up. Because of their actions, many insurers have dropped out of the exchanges. In effect, their claim of an ACA “death spiral” was never an accurate assessment. It was their promise and mission. But it is not too late to re-establish the risk corridors and perhaps extend it beyond its original 2020 expiration to remedy the damage already done by Congress.

My previous blog on this subject (“Why Repeal and Replace Obamacare?) delved into many areas where the ACA could be enhanced. Although it focused on providing healthcare to more Americans, it also accomplished better healthcare outcomes by promulgating preventative care and standardizing more effective treatment options. These benefits may in part account for a significant reduction in the healthcare costs inflation rate. But the fact remains that Americans pay more per capita for healthcare than any other developed nation.

It is true that we have many of the most advanced medical facilities and research centers in the world. People from around the world come to America for leading edge treatment for conditions such as cancer and diabetes. However, for most Americans, high end medical treatment is either not available or not required. In terms of the medical outcomes most desired and anticipated—such as successful birthrates, long life expectancy, timeliness of non-emergency care, and other commonplace treatments for infections, workplace injuries, and so on—America is last among the other eleven developed nations evaluated. The obvious conclusion is that we are paying more for less.

My personal belief is that the ACA not only moved America well along the path to universal healthcare—its primary goal—but also pushed our medical community in the direction of lower costs and better outcomes. Regarding the latter, HHS has tracked an upswing in treatment successes. In part that success can be attributed to better preventative care. But it is also the result of the HHS empowering its innovation center, identifying best practices, critiquing hospital death rates, funding medical research, and propagating its centralized learning throughout America’s healthcare system. More successful treatment outcomes and less visits to the ER have also accounted for the decrease in medical cost inflation. Incapacitating the innovation center or the other functions of HHS by defunding them will not reduce healthcare costs, as the current Republican Administration seems intent on accomplishing. We would be pulling the plug not only on the healthcare improvements the ACA has afforded us but also on the cost savings it has sustained.

The ACA did not address, however, the price structure that still exists within the American medical community. Reversing some of the Republican political positions listed above will help lower costs and stop the Party’s attempts to increase it further. But there are more specific cost saving measures that may be taken and that the ACA did not address. The following are a few suggestions:

Eliminate the “charge master” used by nearly all U.S. hospitals. At best, insurers negotiate prices that on average are only 40% of the ridiculously high charge master price structure. That charge master price is pegged as much as forty times the actual costs. It is an arbitrary number that differs from hospital to hospital across the country. By contrast, Medicare bases the cost of medical services on actual costs plus a reasonable profit margin to pay for hospital operations and innovation. The result is that insurers often pay 10x (the “x” here is an exponent, not a factor, please forgive the rendering limitation) times more than Medicare for the same service. If Congress proposed some form of price control on medical services—perhaps using Medicare pricing as a starting point—it would significantly bring down healthcare costs and, therefore, premium costs.
Allow the government, perhaps via Medicare or the Veterans Administration, to negotiate with the pharmaceutical industry on the pricing structure for all drugs sold to Americans. If the U.S. paid what other countries pay for pharmaceuticals, for example, drugs would be 40% cheaper; and insurance premiums would be 6 to 8 percent cheaper.
Adjust the income threshold between upper income eligibility for ACA subsidy to include those who can’t afford private insurance. One of the issues with the ACA is this threshold which affects people who have more income than four times the poverty rate. Their premium costs for private insurance is often much more than they can afford. But Congress could adjust the sliding scale currently used for subsidies to include those currently trapped in this zone of unaffordability. For those so affected, their healthcare costs would decrease. Admittedly, it is not clear whether overall healthcare costs would do likewise. The CBO would have to weigh many factors, such as, improved healthcare outcomes, the insurers’ premium adjustments on other offerings, increased costs for ACA subsidies, and, of course, unforeseen consequences. For example, what do we know of this affected class who are forced into high priced private insurance? Are they near retirement? Are they families with children who might qualify for CHIP? You see, healthcare really is complicated.
Finally, the ACA-caused shift to larger healthcare institutions raises the issue of uncontrolled profits in these institutions, including non-profits. For example, some highly successful hospitals, like the Cleveland Clinic and the Mayo Clinic, are multi-billion-dollar corporations with hospital outlets in many locations. Of course, these are highly regarded institutions. But they are also publicly regulated. Can we be assured that their profits are reinvested in the best interest of the public they serve?

I have yet to meet a fellow citizen who is thrilled about paying taxes. Most of us want assurances that justify what our taxes buy in the way of public services and security. For example, recently the President christened the most expensive ship ever built, the USS Gerald R. Ford aircraft carrier. It costs 13 billion-dollars. The President promised to spend an estimated 43 billion-dollars to build three more such behemoths. My question: are we really willing to spend our national treasure in preparation for the last war? The next war, if there is one, will begin in space and on the internet. It will include laser guided missiles and radar cloaked planes. One such device could destroy the USS Gerald R. Ford and its forty thousand sailors in just one pass. Now I imagine there are arguments that can rebut these comments. But should we not weigh the benefits of stabilizing the ACA risk pool with a public expenditure less than half the cost of one of these aircraft carriers? American healthcare is an immediate concern. How do we balance that concern against an exorbitantly expensive weapon that may be obsolete in a future attack? But, aside from practical considerations, we should be considering what motivates us as Americans: is it fear of future threats or the will to live our values?

Universal and affordable healthcare is a right that makes our ongoing fight for “life, liberty, and the pursuit of happiness” possible. Without those values, what would be fighting for?