Wednesday, December 15, 2010

A Spanish Wedding

I am not sure what I expected a Spanish wedding to be like. I suppose I had conjured up an image of traditional Spanish dancers with black vails and patent leather shoes. I also anticipated much pomp and circumstance. Whatever image I may have had, it was shattered by reality.

Monty and I flew into Madrid where we met Teodoro Nieto, an artist Monty represents and a long time friend, along with Franz and Laura Reinart. Franz is German born but had migrated to Mexico where he met and married Laura, who is a native born Mexican. They live in San Diego, but most of their business interests are located in Mexico. Laura serves as a North American representative for Teodoro.

We rented a car and drove with the Nieto entourage to Ayllon, a small town of about twenty five hundred residents located about eighty miles from Madrid. Although Teodoro has worked and lived for most of his adult life in Madrid, he has maintained strong ties with Ayllon, where he was born and now owns significant properties. The great majority of his landscapes portray Ayllon.

Allyon, Spain
View Ayllon, Spain in a larger map

The wedding took place in a small community was about five miles from Ayllon. Oscar Ramirez, the groom, lived in that small town of about 500 people and was its mayor. He owned and operated a vineyard nearby. The bride named Lorena was Teodoro’s daughter. She ran a restaurant in Ayllon, which her father owned.

Our group arrived at the little country church about five minutes before noon, when the wedding ceremony was supposed to begin. I was fearful that we would be late. After all, we usually show up a half an hour in advance for Birmingham weddings. To my surprise, although there was an enormous crowd in front of the church, no one had gone inside. The church could seat no more than about one hundred people but two hundred had been invited.. It appeared that all the invitees had come. Therefore not all the guests could be seated in the church.

We entered the church in order to get a good seat, which was no particular problem because no one else seemed to be in a hurry to go inside. The bride and groom arrived separately and fashionably late. I expected to see a procession with bridesmaids, ushers and the grand entrance of the family, but it did not happen that way. The bride and groom ambled in with the rest of the crowd. Lorena was wearing a long green dress, but it hardly appeared to be what we would consider a wedding dress. A band consisting of a flute, drum, tambourine and a couple of horns began playing music which was joyful and loud, but not very religious to my ear. The entrance of the bride and groom appeared to be quite similar to that of a politician entering a rally.

Lorena and Oscar took their seats at the altar accompanied by Teodoro, the father of the bride, and the mother of the groom. Henar, the mother of the bride, sat somewhere near the front.

Hollywood could not have found a more appropriate priest for the occasion. He was probably no more than about 30 years old. He stood about five foot five inches tall. Despite his youth and short stature, he had already acquired the demeanor of a parish priest, with an angelic look and a broad comforting smile.

The guests began to file in occupying all the seats, packing the aisles and slipping into every available nook and cranny. So much for our great seats. Our main view was of the back of the necks of persons who were standing in the aisles. Still others who could not find space stayed outside looking in through open doorway.

The service went on for at least and hour and a half. Since it was mostly spoken in Spanish, we could not follow what was being said most of the time. Monty detected at one point that the priest was repeating the Apostles Creed.

At another point, the priest seemed to using the word “bambino” frequently. I have known that Catholic priests encourage the couple to have children early and often, but his instruction in that regard seemed a bit superfluous in this instance. Lorena was already carrying a baby. She was about four months along and clearly showing. There was no shame or embarrassment, though. She was happy, her parents were happy, and I believe the priest was happy to see the early arrival.

At another point, the priest turned his attention away from the bride and groom and received the two children of Lorena’s sister, Ruth. The priest then baptized them. That was a first for me. Obviously the priest was open for business and prepared to take on any religious duties required of him at that time.

Perhaps the biggest surprise was the music during the service. There was a trio of sopranos who performed from time to time during the service along with the band. They sang a couple of songs I did not know, although they produced a pleasant pastoral sound which seemed to be inspired by the madrigal music of the Renaissance.

Then came the only point in the service performed in English when the trio sang “Moon River.” Where did that come from? Ir reminded me of the time that Tutter Tyndal of our church allowed a performance of “Take Me Out To The Ball Game” at the wedding of Tim Hudson, who is now a star pitcher with the Atlanta Braves. This wedding was really getting to be interesting!

Later on the band performed an African piece which I believe was the theme song of the TV show “The Ladies Number One Detective Agency.” By that time I thought nothing would surprise me.

When the service came to an end, the guests began to leave the sanctuary while the wedding party was remained at the altar. This made some sense and because the aisles were so clogged that the bride and groom could not get through. However, even guests continued to leave until no one was left in the sanctuary .except the wedding party and a few stragglers such as Monty and me.

Then Lorena, Oscar and their families strolled out with little fan fare. When Lorena and Oscar reached the doorway a celebration erupted into a frenzy the band playing in the parking lot. There was hugging, kissing, laughing and joy like I have seldom seen. The men grabbed the groom and threw him into the air. It was noisy, raucous and just plain fun.

But Spanish weddings are not limited to the church ceremony. The entire crowd migrated to Ayllon to the restaurant owned by Teodoro. there was a new band with many hor d’oeuvres served and drinks flowing. The Spanish seem to drink a lot but do not take strong drinks. In that way they can continue to party for hours without peeling over. And they love to dance. The Spanish are graceful dancers, and they are tireless.

Lunch was served in a seated dinner at four o’clock. During the meal, many of Oscar’s contemporaries would shout at Oscar. I could not translate what was being said but it was apparent that his friends were doing their best to embarrass Oscar, probably by referring to past misadventures. Oscar was up to the task and would responded with his own retorts.

I was able to understand one of the guests who shouted out,”Kiss the Bride!” There was no response. Then he repeated, “Kiss the bride!” Still no response. The rest of the crowd started to join in by chanting in unison, “Kiss the bride! Kiss the Bride!” Finally the couple relented, stood up and joined in a warm embrace - and everyone cheered. The Spanish know how to have a good time.

After the lunch the dancing resumed. Monty and I were exhausted and decided to retire to our room for a rest. The party was still in high gear when we returned in two hours, and it did not appear that anyone, old or young, had left.

Dinner was served at eight thirty. Mercifully it was a light meal featuring the Spanish version of sandwiches, but the party was showing no evidence of slowing up. About ten thirty Monty and I gave up and went in for the night. We understand that Teodoro closed the party at midnight.

We had planned to leave the next morning to drive over to the Pyrenees for a few days. We were ready to leave by nine thirty. We wanted to say goodbye to Teodoro and thank him for his hospitality, but were concerned that we would not be able to see him. Surely he would sleep in to midday after that ordeal. Nevertheless we stopped by the restaurant, and, somewhat to our surprise, Teodoro was busy at work cleaning up the mess created the night before. It turned out that he had gone to sleep at two in the morning and awakened at five to start work. We also saw Ruth who was supervising half dozen workmen in the ballroom cleaning up and setting up for another event that would start the next day Next came Henar The whole family was there except Lorena.. No, I was mistaken. Around the corner came Lorena in her work clothes.

I was stunned at the sight. Obviously the Nietos work as hard as they play. They are quite a family.

I would never have felt that any wedding was worth traveling across the Atlantic Ocean to see, but I was wrong.

Monday, August 30, 2010

Teachers and Test Scores

It is not fair to blame Paul Hubbert, Executive Secretary of the Alabama Education Association, for all that is wrong with our school system. We suffered for many generations with poor schools long before he came along. Nevertheless, he manages to be identified with substantial road blocks to progress in education.

It is noteworthy, then, when he makes a sound point. I am referring to his opposition to using test scores to evaluate teacher performance. It is understandable why the boards may want to find an objective measuring stick to determine promotions and retention of teachers. With strong tenure rules, the incompetent teachers seem to be embedded in the system. Bureaucrats need an objective test that is both fair and effective in weeding out the incompetents. Unfortunately test scores may be objective, but they are not a fair measuring tool.

I do not think that these tests were designed to evaluate teachers or schools. They are supposed to assess the progress, accomplishments and capacity for learning of the individual student. The tests provide valuable information which should enable the school to determine the needs and opportunities available to that student.

Using test scores to make hiring, firing and retention decisions is based on an assumption that teachers have the capacity to materially affect those scores. That is simply not the case. For instance, Mountain Brook students regularly score at the top and those from poorer communities bring up the rear. Is it realistic to suggest that the teachers in a black belt county can under any circumstances teach their students up to the Mountain Brook level? I have no hesitation to suggest that the students of the worst teacher in the Mountain Book System would easily out perform those of the best teacher in one of our poor counties. On the other hand I suspect that the star teacher from the poorer school would be much the better teacher.

Therefore, where is the fairness in comparing teachers on a test score basis when they are not working on a level playing field?

A common retort would be that the teacher should be measured by the “improvement” in test scores instead. The assumption there is that all teachers in all systems have been performing poorly in the past and even an average teacher should be able to raise the scores. Do I need to answer that argument?

Then there is the teacher who does in fact raise the scores but has turned the class room into a year long cram course for the test. This can be done by finding in old tests and looking at the tendencies that would indicate what will be asked. (Law graduates do this all the time when preparing for the bar exam.) If the score has been raised, it means nothing other than that the school has learned how to short cut the system. It does not indicate any inherent improvement in the quality of the education.

The truth is that successes of great teachers are not measured by improving statistics but by their impact of the teacher on individuals one by one. Most people who are successful in life can point to one or two of such teachers and are grateful for the profound impact those teachers made. That is what teaching is all about.

I wish I could say that this phobia over test score evaluations is harmless, but it is not. In the first place, it represents a gigantic misuse of scarce resources. But it is much more. It stifles creative teaching. I had much rather my child be exposed him to the magic of Mark Twain or Louisa May Alcott, rather than pouring over old tests.or listening to a lecture on how to eliminate the obviously wrong answer on a multiple choice test in order to improve the odds of finding the correct one.

Worst of all, the test score is so simplistic that the school boards (who are a big part of the problem but not the subject of this blog) act on misinformation and come up with poor choices in the direction of their school systems. Their job of making personnel evaluations is extremely difficult and can always be flawed, but there is no panacea. Drawing draconian conclusions based on a multiple choice tests is both meretricious and misguided.

Mark up an attaboy for Paul Hubbert.

Monday, August 23, 2010

Mosques and Demogogues

The dispute over a mosque across the street from Ground Zero is an excellent example of how democracy can get steered into the Theater of the Absurd. (I am not sure what Theater of the Absurd is all about, but it sounds like an apt metaphor.)

The Imam in charge of the proposed mosque stated that he was seeking to serve as a bridge of understanding between Islam and the United States.

If that was his goal, he got off to a bad start. New Yorkers are super sensitive about the Twin Towers, and their pain has not subsided. Thus a highly predictable uproar erupted over the proposed facility. As best I can tell the local officials jumped in quickly seeking some solution that would be satisfactory to the Imam and would abate the criticism. I have not heard anyone claim that there was any genuine objection to some compromise effort. In fact it would be reasonable to assume that the support of the local authorities would in fact aide the effort of the Muslims to build bridges.

Under any circumstances, every politician who feels the need for publicity seems to be conscience stricken to step in and be of assistance.

One such politician was Congressmen Rick Lazio, who is engaged in a heated contest for governor of the state. He seem to be certain that the problem was caused by the ineffectiveness of the state attorney general, who happens to be his opponent. He suggested that the Imam may be using money from nefarious sources which needs to be investigated before the mosque is approved..

That is fine indeed, but, apparently, he did not think up this idea until the polls told him that the proposal was extremely unpopular with the electorate. Moreover, he has an Italian name. That makes him Italian, not American. He must have some connection with the Mafia - at least as much as does the Imam with the Al Qaeda. Why isn’t he taking his witch hunt to Manhattan to find out the source of funding of at least half of the finer Italian restaurants in the city?

Then the matter was ratcheted up again by our President, who has a disconcerting habit of opening his mouth before his brain is fully activated, entered the fray. He wrapped himself in the comforting arms of the Bill of Rights. He said that the Muslims have a constitutional right to build a mosque in accordance with local laws.

It is reassuring to know that the First Amendment has not been abrogated recently, but he injected a non-issue into the conversation.. No one claims to be denying the freedom of religion to the Muslims. Even he seems to recognize by implication that the issue of where the mosque might be located is a matter of local law. What the President did was mischaracterize the facts so that he could utter an inapplicable principle relating to a situation that does not exist.

The President’s position was not good politics, either, since about a fourth of the population believes that he is Muslim, himself.

Now the runaway train is totally out of control. Newt Gingrich equates the location of the mosque next ot Ground Zero with placing Nazi headquarters next to a holocaust memorial. The Democrats loved that. Now the Arab world has been encouraged by our President to believe that a substantial segment of our country is attempting to override the constitution in support of efforts to persecute the Muslims who live here.. People in all continents of every persuasion are now weighing in - all because our politicians stuck their nose into a matter that probably would have been handled best by the persons in the City of New York who have been entrusted with the responsibility of dealing with the situation.

Ain’t democracy great!

Friday, March 26, 2010

Travel to Galapagos I : Quito, Equador

Monty and I have just returned from a trip to Equador and Galapagos Islands. We first went to Quito for a short visit, flew on to the Islands and boarded a small ship that cruised around the Archipelago, and then returned to the port city of Guayaquil. I plan to report on my reactions to this very exciting trip in ths series of four postings.

I did not know what to expect from Quito. I knew it was the capital but little else. As it turned out, Quito is a very interesting city with one of the best preserved old towns in the world and a rich history.

The city itself is a metaphor for a paradox. It has many beautiful buildings constructed in the European style and yet it is bordered by the slums we come to expect in less developed countries. It is a major international city plopped in the middle of the Andes Mountains over 9,000 feet above sea level. The contrast of a modern city surrounded by the rugged mountain is landscape is overwhelming. It is located on the slopes of an active volcano and within about a mile of the equator.

How could this immense, sophisticated city emerge in the remotest of possible locales rather than on the Pacific coast? I can only speculate that Quito was located where it is for military reasons. The Spanish must have found a need to establish a presence in the mountains in order to sustain the conquest of the indigenous people who for their own reasons lived in the heart of the Andes.

Under any circumstances it is not surprising that Quito a was the first city to be designated by UNESCO as a world heritage site.

The people of Equador also piqued my curiosity. Our guide said that eighty per cent of the inhabitants are of Indian stock. Unlike Mexico and many Central American countries, neither the invasion of the Spaniards nor the transporting of Africans to the Western Hemisphere seem to have made much of a dent into the Equadorian genetic pool. As a result, these people give us a peek into what the Incan people must have been like. They are very short in stature but very muscular, and appear to be somewhat mild mannered. Even their food is less spicy than that found in some of the neighboring countries. I saw very little begging or evidence of idleness. Our jingoistic caricatures of hotheaded Latins loafing around aimlessly is not substantiated by these people.

Equador on the surface seems to be a relatively stable economy with an emphasis on a robust fishing industry, a wide variety of agricultural products and some oil. I got the feeling from the people I talked to that there is a nervousness about whether this stability can continue. A major threat is cocaine. The government of Columbia, which is next door, is engaged in a war with its drug lords. So far Equador has been spared from being a significant player in drug trafficking, but the Columbian drug lords are slipping across the border to set up operations that could be a serious problem down the road. Second, Equador’s current president is flirting with Chavez of Venezuela. There is a concern that the Equador’s bustling trading relationship with the United States could be disrupted if the Venezuela populist movement slips into the Equadorian political landscape.

I have run into many people who express a desire to visit the Galapagos Islands, but there is very little mention of the mainland portion of the trip. If you of that persuasion, let me assure you that you are in for a surprise.

Thursday, March 18, 2010

The Stabler Health Cost Reduction Plan

I have identified four primary sources of the rise in costs - the impact of medical research (2/26/10), restrictive entry into medical schools causing anti competitive pricing (3/2/10), an over insured population (3/5/10), and tort law suits (3/9/10). These four issues must be addressed in order to contain health costs. Here are the components of the Stabler Health Cost Reduction Plan:

1. Medical schools must reorganize their teaching methods, particularly in the clinical programs, and use their impressive resources more efficiently in order to double or triple the number of doctors produced each year. If medical educators really put their mind to the project, I suspect that the additional tuition income would come close to covering the marginal costs of educating additional students. The economic savings coming from increased enrollments would significantly reduce costs, increase the availability of medical services and thus produce a far superior health care system.

2. I propose to limit tax deductible plans to those that pay no more than 80% of the ordinary medical costs with a 20% deductible paid by the insured. I believe that in most cases the cumulative savings from lower premiums would exceed the cost of paying the larger deductible. With low cost plans being the norm, universal coverage would be much easier to accomplish.. Moreover, the patient who has a 20% stake in the cost of medical services will pay much closer attention to how the money is spent. The Stabler Plan would allow greater, but not 100%, coverage for catastrophic expenses and would provide some sort of welfare payments for the indigent.

3. It is doubtful that the pace of medical research will ever happen, nor should it. The only way I can see that its effect on medical costs can be reduced would be to invest more public moneys into research to replace the work of pharmaceutical and medical equipment companies. Public investments do not need to be recovered out of the proceeds of sales. Nevertheless, the savings, if any, from that source would require much more investigation and study that I am capable of producing.

4. I see little prospect of material cost reduction coming out of tort reform as long as health care is dispensed in a noncompetitive environment. Therefore, the Stabler Plan requires that the supply of doctors and other health professions be dramatically increased before tort reform is included in the program. (See my discussion in the posting issued on 3/5/10). It would be unconscionable to give the doctors full immunity from the consequences of their tortious actions. Two features of tort reform have merit, however. Punitive damages deserve to be curbed, or even abolished. I believe that it is the province of the criminal laws to mete out punishment. The proper role of civil law suits is to compensate victims for their loss. Second, tort laws could be amended to give the medical professionals a good faith defense. Most medical procedures have a risk attached to them. The defendant who can prove that he or she acted in good faith and with diligence should be given a break.

Tuesday, March 9, 2010

Is Tort Reform Really the Answer to Rising Health Costs?

Is Tort Reform Really the Answer to Rising Health Costs?

Tort Reform is one of the cornerstones of every Republican health care proposal. Normally the tort reform package proposal takes the form of some sort of cap on recoveries. Tort reform is not simply a cost savings device. There are considerations other than cost that weigh heavily in the tort reform debate. My limited concern at this point is whether tort reform can induce meaningful cost savings.

The proponents frequently make the argument that there are too many frivolous malpractice claims. It is true that there are many frivolous claims because, at least in Alabama, the defendant prevails in a very high percentage of the claims filed. Nevertheless, I submit that it is not the frivolous claims that raise the costs most significantly. It is the meritorious claims that cost the big bucks.

Costs of tort reform can be easily identified because virtually every practitioner carries insurance and the premiums define the dominant cost. The complexity comes from the fact that the premiums vary widely based on the specialty. The highest premiums are paid be obstetricians which have been reported to be in the range of $150,000. The reason for this are because babies suffer the most serious damage and have the longest life expectancy extending the time that they may suffer the consequences of an adverse event. Both factors run up the cost of claims dramatically. These premiums are not typical. I suspect that the premiums for pathologists would be toward the bottom of the scale and would be negligible, but other specialties are spread all over the landscape. The point is that there is more need for reform for some aspects of the practice than others.

I cannot figure out whether tort reform would have any effect on the cost of medical services. As I have discussed in another posting, the doctors enjoy monopoly power which means that they can raise their prices above the competitive level. Insurance would be classified as a fixed cost. As I recall from distant studies of price theory the true monopolist will raise prices until the price matches the marginal cost. Marginal cost represent the additional costs for serving one more patient. The cost of insurance does not materially increase when a patient is added.

Put another way. Competitive prices have a close relationship to costs. In a competitive environment additional costs translate into higher prices. On the other hand the monopolist charges what the traffic will bear regardless of total costs. Therefore, it would seem to me that the cost of insurance does not govern the prices set by the medical profession for their services.

I suspect you can detect, that I really do not fully know what the economic impact of tort reform on the cost of health care would be. I would like to find studies done by respectable academicians (who are not employed to find a predetermined answer). Under any circumstances I do not believe that tort reform is likely to produce substantial cost savings..

This is the last posting for the week. I will publish the next one on Tuesday, March 16, 2010 . At that time I will discuss my ideas as to the most effective means of containing health costs.

Friday, March 5, 2010

Medical Costs- Are We Overinsured?

Monty and I went to the health department the other day looking for shots immunizing against various diseases we might contract on an upcoming trip. The lady at the desk advised me that my insurance and Medicare probably will not cover the costs. There was a prominently displayed sign on the wall of the nurse practitioner showing the exact cost of each and every shot that was available. We were asked whether we wanted to take a typhoid booster shot. She said that there was some typhoid threat in the jungles of the country we plan to visit, but that if we stay in the city the chance of contracting typhoid are very small. I saw that the shot would cost about $100.00. I considered whether immunizing against an extremely low risk of contracting typhoid fever was worth $100.. And decided not to take it. Would I have taken the shot had it been covered by insurance? Probably. After all there was some risk, and it would cost me nothing.

This story underlines the fact that our own over consumption of medical service is skewed because most of us are over insured. Doctors quickly cite the malpractice threat as a cause of over treatment, which has some merit. Who is complaining that our decisions to acquire medical service are unrestrained by any economic considerations. We are on a treadmill. We utilize more tests, more discretionary treatment because the insurance company will pay for it. The insurance company turns around and increases the premium to cover the costs, and we complain. Put on your glasses. You will see the enemy and the enemy is us.

Nowhere is the overuse of medical services more prevalent than when end of life decisions are faced.. Whenever our loved one dies of a long illnesses we tend to want to be sure that we have done everything we can to save her. That approach is certainly proper and laudable. However, when the decision is made on house money, too many of us keep searching for a miracle and prolong life that would have terminated earlier had not medical science devised means to sustain people who are terminal. The Democratic solution to the end of life dilemma is to have a bureaucrat make the decision taking the family and the doctor out of the equation.

Obama promises that the health plan will not increase the deficit. He is relying in part on a belief that the younger population will pay more in premiums that they will receive in benefits. That is to say, the insurance companies will overcharge the younger population to underwrite the older people who are sicker on the average. I do not know he has made his calculations.

I do know to a point of moral certainty that the additional thirty million persons receive coverage will increase their use of medical services. We already have a severe shortage of medical personnel. Has anyone addressed how we will cope with ever greater demands on a severely stretched health system?

My next blog which will most likely be posted next Tuesday to discuss tort reform. Then, in a following posting, I will discuss the elements of what I would consider to be an effective reform of the system.

Tuesday, March 2, 2010

How Medical Education Has Impacted Health Costs

I have discussed in a previous blog (2/23/10) how economic regulation will not solve the problems of rising health costs.. In the last blog (2/26/10) I discussed how medical research and development leads to rising costs. In this posting, I will lift up the role of medical education.

The Carnegie Foundation published a report prepared by Abraham Flexner in 1910 on the state of American medical education . The report addressed many much needed issues involving the quality and amount of education needed for the training of doctors. Particularly helpful was its emphasis on clinical training.

Other aspects proved to be unfortunate, however. Flexner stated that half of the medical schools should be closed.. Whatever the merits of the suggestion may have been at the time, the American Medical Association embraced that part of the report and engaged in a determined campaign to restrict entry into medicine so as to raise the income of the doctors.

The campaign has been quite successful. As our population has expanded and with the ever growing varieties of specialties that have emerged, medical schools have continued to educate only a small portion of the doctors needed to serve our population.

The University of Alabama is a typical example.. They receive about 2000 applications a year and produce only about 175 doctors. With at least 8 hospitals, over a thousand faculty members, and a budget of perhaps a hundred million dollars, the medical school’s failure to produce more doctors cannot be considered to be a matter of necessity but of choice..

UAB is not the culprit, though. They are applying generally accepted standards which have evolved out of the Flexner Report. High quality education has served as a cover up for the less admirable goal of excessively restricting practice of medicine to a select few.

The adverse effects of restricted entry into the profession cannot be overstated. Nobel Laureate Milton Friedman pointed out in the early forties the restricted entry into medicine has been an efficient means of raising the prices above the competitive level.

Today the scarcity of doctors is growing. Small towns in Alabama must go to India to find a doctor to serve them. Internal medicine doctors can simply open their office and obtain a full stable of patients in a short time. One doctor recently commented to my daughter that if an internal medicine practitioner can see you, you probably do not want him. Doctors with waiting rooms stacked full of patients too often refer even the minor emergencies to emergency rooms because of their inability to adequately serve all of their patients.. Moreover, virtually all doctors in all specialties have little incentive to be competitive in their pricing because of the paucity of competition in their fields. The medical profession has become a gigantic cartel.

Ironically Blue Cross, which Congress wants to demonize, and Medicare are the only two entities of which I am aware that have the economic power to put any brakes on the reckless expansion of charges for medical services.

Medical education needs to be extensively overhauled whereby they will supply sufficient doctors to make the profession competitive. If this is not done from within, then outside forces should be applied to them in much the same manner as the automobile companies were forced to make high gas mileage products.

Friday, February 26, 2010

Why do health costs go up? -- Research

I have previously pointed out that economic regulation will ineffective in holding down health costs. Before addressing how to contain costs, discourse should begin by exploring why costs are so high. I do not pretend to have all the answers. Nevertheless there are several obvious sources of high health costs that I will explore in this and other blogs. We will start with the impact of medical research.

Much is made of the shortfalls in our investment in science and technology. That cannot be said about medical research. I doubt the world has ever seen an explosion of medical advances like those which have occurred in my lifetime. I hear it said that the quality of care in this country is not superior to other countries. That may be true, but I find it hard to believe. Every day I see myself and others who have escaped the grim reaper because of leading edge medicine.

When I was young, my father suffered from a thyroid condition that the doctors could not diagnose for two years. He almost died because of the delay. Today standard blood tests routinely identify thyroid abnormalities. My mother died of breast cancer that would be picked up in a regularly scheduled mammogram today. My brother in law died of heart attack that would have been corrected by open heart surgery today. Two aunts were institutionalized for conditions that would now be controlled by drugs. On the other hand, my prostate operation came in time to spare me of the ravages of cancer because of the PSA test which is regularly administered on a yearly basis to middle aged males. My gall bladder operation that required a three and a half hour stay in the hospital and about a twelve hour recuperation was once a dreaded massive operation that could send the patient to bed for months with a scar that stretched across the torso..

These stories are not unique. Our life expectancies are expanded because of massive investments, public and private, into medical research over the previous decades. Nevertheless, inventions carry their costs. When a new medicine is developed, its inventor receives a legal monopoly for a specified period of time. The FDA must allow the pharmaceutical company to recover its research costs of developing that drug. These companies must also recoup the costs attributable to exploratory research that did not result in producing a marketable drug. Otherwise the enterprise cannot sustain itself.

Moreover when a drug, device or procedure is invented, the costs must often be recovered out sales in a relatively small market. An MRI machine for instance can only be sold to a handful of hospitals and other diagnostic centers. You cannot sell MRI machines like automobiles that fill up two car garages.

Some demagogues argue that those costs can be avoided by letting the government control all medical research thereby eliminating “excess profits.” Don’t believe it. The costs described above exist regardless of who may bear them. If the government does not receive enough return for its investment to cover the successful and unsuccessful research as well as the cost of raising the necessary capital, then it must absorb the costs and charge us to make up the loss costs either by taxing us or borrowing the money from somebody, probably the Chinese. We are getting a full dose nowadays of the dangers of that tactic.

The costs of research are vividly revealed when our favorite medicine becomes generic and the research costs are no longer a factor. Our insurance companies have educated us to the fact that generic drugs are the same medicine at drastically reduced prices, simply because the influence of research costs on the price of medicine has ended.

Under any circumstances, I doubt that our appetite for medical innovation is waning. I do not believe that we, the consumers, will tolerate a reduction in medical research, particularly with respect to the ailment that affects us or our families. Moreover, I would not be surprised if the recoverable costs actually increase as the drugs and devices brought onto the market become more specialized treating fewer patients a thereby creating ever smaller markets for the products.

In my next blog, I will discuss American medical education and how it contributes to higher costs.

Tuesday, February 23, 2010

Obama's Price Controls- Is he disingenuous or brain dead?

Obama is in a hole. He needs to get out of it as soon as possible. He needs a bill with the title “Health Care Reform” on top of it. He needs to put this mess to bed as fast as possible and go on to other matters. I was encouraged last week that he had seen the light. This week I am not so sure.

He is now pulling out his new panacea. He is pushing for a general federal jurisdiction over price controls on health care insurance, effectively controlling all prices for hospital and medical services as well as pharmaceuticals. If he seriously pushes for this jurisdiction, he will drag the country back through the dismal swamp of partisanship. I cannot believe that a reprise of this sort will enure to the benefit of his party. It is bad politics, but it is worse economics.

It has been pretty well established since the New Deal experience that government regulation could can be quite effective in matters other than prices. such safety and environmental regulations. Business interests predicted the sky would fall in when OSCHA and automobile mileage standards were enacted, but by and large these laws have worked.

On the other hand studies have shown that efforts to control pricing have not effectively reduced costs. Price control has been tried in industries classified as so called natural monopolies such as transportation, communication, natural gas and electrification It is pretty well established that these control have resulted in no significant savings to the consumer.

Instead regulated industries have often become inefficient and unncompetitive as a result of regulation. For instance, when the airline industry was deregulated, prices were reduced drastically because of competitive forces in the industry. Regulation was actually holding prices up rather than down.

Nixon’s attempt to resurrect price controls during the spiraling stagflation was ineffective. Market forces are simply too strong to be controlled by a bureaucracy.

So, when Obama suggests that health costs can be controlled by the government for any length of time, he is either disingenuous or brain dead.

Sen. Judd Gregg of New Hampshire claimed on the PBS Newshour last night that this attempt to regulate health care insurance is a predicate for going to a single payer system, which is a euphemism for extending Medicare to all persons. Democratic Senator Sherrod Brown did not deny the allegation.

If Gregg’s assertions are correct, we are really facing a debacle. It is generally agreed that the federal budget problems are caused primarily by the rigid entitlements found in Social Security, Medicare, and Medicaid.. Our president voices concern about that deficit and at the same time seems to be working toward quadrupling Medicare, which is our biggest fiscal problem. He reminds me of a lawyer person I once knew whose nkickname was Gator. That is, he smiled at you and ate you up.

Monday, February 22, 2010

Gambling In Alabama

Recent newspaper reports show that Milton McGregor has donated in excess of a million and half dollars to the campaign to legalize bingo gambling. This current effort is a part of the ongoing fight to bring the gambling industry to the state.

I am opposed to the whole idea. My objection is not based simply the issue of morality of gambling. Like most of us, I find a small wager to be entertaining and do not feel that I have committed some mortal sin in doing so.

I do not feel the same way about the gambling industry. It is a fact that the leading employers in a community have a direct effect on the quality of life. Our governor has successfully brought industries into Alabama that employ many of our citizens who were previously unemployed or under employed. These companies are good citizens and serve to bring about a better community life. Does the gambling industry offer the same? I do not think so.

Several weeks ago it was reported that a prominent politician who had been friendly to gambling interests visited a casino in Mississippi and encountered unbelievable good luck hitting jackpot after jackpot until he won over a million dollars. Welcome to the real world of gambling.

What does the gambling industry offer to the state? It can provide a handful of low paying jobs and a little entertainment for their patrons. From time to time some patrons lose their pay check, or their car, or their house, and receive nothing in exchange. The casinos flood the highways with billboards containing false advertising puffing all the winnings, when we know that losing is ultimately inevitable. Consider the millions that Toyota is expending because of the public outcry over perhaps a hundred incidents worldwide. Yet the gambling industry wipes out its customers regularly and not a peep is heard.

And now they gambling interests are using what appears to be phenomenal profits to push for more and more of the same. What kind of leaders will we have when they, too, “enjoy phenomenal good luck” in the slots or at the crap table? Next time it will be casino gambling. What next? Nevada has pushed the envelope now to cover legalized prostitution. Before we aspire to be the next gambling Mecca, I suggest that we consider whether we want Las Vegas and Atlantic City to be our future.

Tuesday, February 16, 2010

Books of the Bible- Answers to the test

1. Which of the following books does not begin with the words “In the beginning”?

C. Matthew

Genesis opens with “In the beginning God created the heavens and the earth”. John begins with “In the beginning was the word...”

2. Which of the following books is found in the New Testament?

C. Philemon.

Philemon is a short letter from Paul to a friend recommending to him the services of Onesimus. Though short in length, this letter is considered an authentic example of the fellowship of the early Christian believers.

Ezra is the story about the priestly rule of Israel when Israelites returned from captivity. Nahum is a minor prophet.

3. Which of the following books takes place totally outside the land now known as Israel?

D. All the above.

Daniel took place in Babylonia under the rule of Nebuchadnezzar and Daniel lived during the time after the Persians conquered Babylonia. Numbers chronicles the wandering of the Israelites in the wilderness after leaving Egypt but before they reached the promised land.

4. Which two books did Martin Luther say should have been excluded from the bible?

B. James and Revelations.

5. Which of the following letters was not written by Paul?

A. Jude

6. Which of the following books (Genesis, Matthew, and Romans) does not mention Moses by name?

A. Genesis

The events in Genesis took place before Moses was born. Matthew stated that Jesus directed the leper he had healed to present the offering that Moses commanded (8:4) he also reported that Moses appeared to Jesus at the time of the transfiguration (17:3) and Jesus later discusses his stricter attitude toward divorce as compared with Moses (19:7-9). Paul argues that the law did not exist up until the time of Moses and thus “Death reigned “ but for grace. (5:14).

7. Which of the following books (Genesis, Matthew, and Romans) does not mention Abraham by name?

D. None of the above.

The narrative of Abraham’s life appears in Genesis. Matthew leads off the genealogy in the first chapter with Abraham (1:2) Jesus chastised the Pharisees for claiming that they had Abraham as their father (3:9) In chapter 8 Jesus states that many will recline at the table of Abraham in heaven (8:11). He reminded those who said that God is the God of Abraham that the Father is the God of the living (22:32). In Romans Paul

7. Which of the following books does not contain words spoken by Jesus?

A. Mark
B. John
C. Acts
D. None of the above.

8. Which of the following books were written to a person known as “Theophilus”?

A. Luke and Acts.

9. What is the last book in the Old Testament?

B. Malachi

10. In which book did the Jews finally arrive in the promised land?

B. Joshua.

Monday, February 15, 2010

Books of the Bible

The following is a test of your knowledge of the Books of the Bible. The answers will appear in tomorrow’s blog:

1. Which of the following books does not begin with the words “In the beginning”?

A. Genesis.
B. John.
C. Matthew
D. None of the above.

2. Which of the following books is found in the New Testament?

A. Ezra.
B. Nahum.
C. Philemon.
D. None of the above.

3. Which of the following books takes place totally outside the land now known as Israel?

A. Daniel
B. Esther
C. Numbers
D. All the above.

4. Which two books did Martin Luther say should have been excluded from the bible?

A. Ezra and Nehemiah.
B. James and Revelations.
C. Song of Solomon and Ecclesiastes.
D. None of the above.

5. Which of the following letters was not written by Paul?

A. Jude
B. Philippians.
C. Titus.
D. All of the above.

6. Which of the following books does not mention Moses by name?

A. Genesis
B. Matthew
C. Romans.
D. None of the above.

7. Which of the following books does not mention Abraham by name?

A. Genesis
B. Matthew
C. Romans.
D. None of the above.

7. Which of the following books does not contain words spoken by Jesus?

A. Mark
B. John
C. Acts
D. None of the above.

8. Which of the following books were written to a person known as “Theophilus”?

A. Luke and Acts.
B. Corinthians I and Corinthians II.
C. Chronicles I and Chronicles II.
D. None of the above.

9. What is the last book in the Old Testament?

A. Haggai.
B. Malachi
C. Revelation.
D. None of the above.

10. In which book did the Jews finally arrive in the promised land?

A. Deuteronomy.
B. Joshua.
C. Kings I
D. None of the above.

Thursday, February 11, 2010

Travel - The legacy of the Khmer Empire

Angkor Wat Archeological Park is located near Siam Reap, Cambodia. The park contains a series of the millennium-old temple ruins of the Khmer Empire dating back to 1000 A.D. If it were located in this hemisphere or near Europe, it would be as famous and as popular with travelers as the pyramids and Machu Picchu. It has been designated by UNESCO as a World Class Heritage Site.

Angkor Wat, is a massive 'temple-mountain' dedicated to the Hindu god, Vishnu. It is surrounded by a moat and an exterior wall measuring 1300 meters x 1500 meters. The entire temple is covered with murals and art images .but the most memorable are the bas reliefs on the exterior walls depicting stories and characters from Hindu mythology and the historical wars of the rule at that time. These pictures are an unparalleled display of the life and times of the Khmer Empire.

There is much more to see at Angkor Wat with countless numbers of other temples. The entire area was abandoned for many centuries. As a result many of the structures were invaded by enormous trees that cannot be fully extricated from the ruins. Thus, it is a fascinating study of the power of unabated jungle growth

It is not necessary to live in a hut in Cambodia either. Like most Southeast Asia destinations Siam Reap has a world class hotel called the Angkor Wat very close to the ruins. The rates are quite reasonable, too.

Wednesday, February 10, 2010

Travel: An Overlooked Gem in Alabama

Travel: A Gem in Alabama

I have previously suggested trips to distant lands in Asia and Africa in this series. You may recoil at the time, effort, and expense needed to reach those places. You have no such excuse with respect to today’s posting. It surprises me that so few of my acquaintances have ever been to what I regard as the second best travel destination in Alabama, Tuskegee University.

Booker T. Washington was an amazing man. He was employed in the late Nineteenth Century to run an impoverished school for Negroes in an unlikely locale in Southeast Alabama. When he completed his work, Tuskegee Institute was one of the finest educational institutions for African American in the United States and remains so today. He had a remarkable ability to raise funds from rich Yankees and Southern white politicians. He also became the primary spokesman for African Americans during the first two decades of the Twentieth Century.

Tuskegee University campus remains a reflection of the man, Booker T. Washington. He believed that true liberation to the black man would come from education, particularly education that qualified his graduates to have the skills necessary to be gainfully employed. His students constructed the early buildings on the campus out of materials that they had manufactured themselves. These buildings remain today. They are simply designed but an eloquent statement of the history of the school

Monty and I visited Tuskegee primarily to see the “Singing Windows,” portraying various Negro Spirituals. It is probably the best known window in the state. The window was nice enough, but I was stunned by the chapel itself. The old chapel had burned down and the new one was designed by the famous architect and Auburn graduate, Paul Rudulph. It is the most impressive contemporary building I have seen in Alabama, and there are few that can match it anywhere.

Other sites well worth the trip are the Booker T. Washington-George Washington Carver museum. We saw the movie on Booker T. Washington, and it is well worth the twenty minutes or so. Washington’s home is now on display on the campus. The airport where the Tuskegee Airmen were trained during World War is a few miles out of town. One of those flyers, Chappie Hayes, a Tuskegee graduate, became the first African American General in the Air Force. I had the privilege of hearing him speak at the Birmingham Rotary Club in the early seventies, where he received a rarely bestowed standing ovation.

Spend a day at Tuskegee and you will not regret it.

Tuesday, February 9, 2010

Breaking News - President Obama’s News Conference

I have just heard Obama’s news conference concerning his meeting with Congressional leaders from both parties. It was, in my judgment, a watershed event

Obama seems to be doing all the things he should done a year ago. He stated that the country cannot endure another year of wrangling over health care. He called on the leaders to find those parts on which they can reach agreement.. In addition he indicated a willingness to horse trade on the issues which are the sacred cows of both parties.

He must have been persuasive because the Republican leaders hinted that they are willing to participate in the process.

He also took a middle position on the energy policy. He said that both sides must recognize that there is a need for expanding our use of carbon fuels to satisfy the needs for the short run and for research and development of “clean” sources of energy, particularly for the long run. I believe that his position will resonate well in Congress and in the country.

I view that this new position towards compromise and accommodation may reverse the downward trent of hyper-partisanship and that the country will benefit from it.

What has happened to bring about a change of heart? We certainly can thank the people of Massachusetts who sent a welcome wake up call to Washington. Another possibility has not been mentioned anywhere to my knowledge. Obviously President Obama read, studied and understood the message contained in last week!

Monday, February 8, 2010

Travel - A Charming Saharan Land

If you are squeamish about visiting Arab countries, then consider Morocco. The U.S. enjoys its oldest non-broken friendship treaty with this country. It has a peaceful history and is very hospitable to foreigners.(Morocco is not to be confused with the neighboring Algeria, which has a much more speckled history.) It is also a delightful country worthy of a trip.

Geographically, Morocco is divided by the Atlas Mountains which run parallel to the Mediterranean coast. Most of the economic and governmental centers are north of the mountains. The Saharan desert is located to the south.

We flew into Marrakech, which lies on the northern edge of the Atlas Mountains. Marrakech is a popular spot for Europeans but does not get its due from USA. It has great hotels, top restaurants and other accoutements of a modern tourist town and also has authentic old town where story tellers and snake charmers can be found.

We stayed in a small residential hotel that ranks with the best we have seen. Our luxurious room was accompanied by a private rooftop patio. Having breakfast on the roof was an unforgettable experience.

From Marrakesh we hired a driver for the rest of the trip. Using a driver is probably the best means of travel and not prohibitively expensive, although driving a rented car is a perfectly acceptable alternative. We crossed the Atlas Mountains into Ouarzazate, where the best known Kasbahs have been preserved. Kasbahs are adobe buildings associated with Saharan Morocco.

From Ouarzazate we drove to Erfoud on the eastern corner of the desert. The drive was very interesting. We were able to observe life in the desert where camels remain the staple transportation of people and property.

Erfoud has one main attraction, that is a chance to see the desert sun at dawn. I sometimes wondered why we were going so far to see a sunrise, but Erfoud was one of our favorite stops.

The concierge at our hotel informed us that we would be picked up at four o’clock the next morning and taken to a special place to see the sunrise. The next morning we were met by one of the fiercest and most dangerous looking human beings imaginable. Monty was afraid that this man was an imposter who would kidnap us once we left the hotel. No one was awake in the hotel to confirm that he was indeed our guide for the morning. I kept my thoughts to myself, because I was not sure Monty was wrong.

Our fears were not allayed when our driver stopped the car in the loneliest place on the planet, so it seemed. It was a perfect scene for a mugging. He directed us to get out of the car, which we did with apprehensively. Then he pointed up to the sky. What we saw was as beautiful as any sight I can remember. There was the milky way in its full splendor and virtually every star in the heaven. He then broke into a big smile extremely proud of what he was showing us.

He next took us to an area where dunes dotted the landscape. We then embarked on a camel ride in the dark running through the dunes in the darkness. At the conclusion of the ride we were deposited on one of the dunes to wait for the sunrise. The whole event was so thrilling that the sunrise itself was almost an afterthought.

I have ridden on several camels and have not particularly enjoyed it, but the Erfoud ride was something special.

From Erfoud we drove to Fés, supposedly the sight of the beginning of Moroccan history. Its Medina is supposed to be the nearest the modern visitor can get to a medieval town. It is the sight of the palace of the modern day king and one of the great mosques.

I have noted three principal reasons why people who like to travel tend skip Morocco. First, most of us are apprehensive about going to countries where we do not like their politics. I have long since learned that most people are not the same as their politicians, and that concern is often overrated. Moreover, Morocco is much more closely tied to the West than many of its Middle Eastern neighbors. I believe that there is more danger attached to traveling in New York or the District of Columbia than in Morocco.

The second obstacle is that people fear that their accommodations will be inferior in what they believe to be underdeveloped countries. My experience is that the facilities in many places such as Morocco are superior to what we find in this country.

Last, but not least. Many people, often choose to take a cruise and drop off for a day trip Unfortunately, the real Morocco is not found on the Mediterranean beach. You must explore, and the rewards will be great.

Thursday, February 4, 2010

The Failing Health Care Reform Bill IV - The Belligerent Left

The far left seemed to insist on strict conformity with their own agenda and regularly threatened to bolt if anything less was adopted. They ignored the fundamental fact that they can only pass what the sixtieth senator will support.

For instance Senator Baucus warned them early in the fall that the public option was dead. Yet the far left threatened to revolt, if it did not stay in. Keeping that issue alive prevented the Senate leadership from reaching the magic number of 60 before the Massachusetts election..

Obama also reneged on his promise that he would seek a bipartisan solution largely because the far left forced him into a more strident posture.. Both sides accuse the other of abandoning bipartisanship. I come down squarely on the side of the Republicans on this issue. Not because they were enthusiastic participants in a bipartisan strategy, but because the Democrats gave them no other viable alternative.

The Democrats have been in charge and must take the initiative. It appears to me that the Democratic idea of bipartisanship is to adopt their own plan and ask the Republican to rubber stamp it..

I do not believe that the Democrats ever really wanted to reach an accommodation with the Republican leadership. Instead they were simply trying to pick off a handful of backbenchers so that they would have a comfortable margin to pass the Democratic plan. That is not a bipartisan strategy in my book. Those tactics made the job of the Minority Whip to keep the Republicans in line very easy.

If the bill does not pass it will be the left who killed it.

Wednesday, February 3, 2010

The Failing Health Care Reform Bill III - Transparency

Obama vowed to bring transparency to government. Ironically, he is now identified with a massive, secretive and sometimes confusing campaign to pass health care reform.

We hear about backroom deals with blue dog senators that do not pass the smell test. In most instances the bill was drafted behind closed doors without significant dialogue in public hearings explaining how it works. It was initially presented to Congress and the Senate without any explanation as to how the costs would be covered. The public was simply supposed to trust them.

When details on financing came out, the vast bulk of the costs were to be underwritten by savings which the plan was supposed to generate. The proponents skipped over the details about how these costs would be wrenched out of the system. Obviously they were placing a lot of the burden on new regulations that they were also proposing.

I for one am cynical about cost reduction. History has proved that regulations coming out of the New Deal era were totally ineffective in reducing costs in the long run. Moreover, our government has proved that it has a rapacious appetite for spending saved moneys rather than paying off debt. I have watched the Department of Defense save costs decade after decade, but somehow the actual totals go up. We have already seen the Obama Administration’s propensity to spend. Last year the administration was downplaying the long term cost of TARP loans, because the banks would pay it back. Now that some of the banks are repaying the loans, Obama seems to be looking for ways to put the money into other give away programs.

Moreover, there are a myriad of taxes, including medicare premium increases, being proposed. Virtually every one of these taxes have been met by a maelstrom of criticism.

The sheer size of the bill also prevented thoughtful and thorough discussion of the ramifications of the plan. Most of the public, including me, does not understand all that the it entails.

Democrats charge the tea party types with distortion when they claim that the Federal government is planning to kill grandmother in order to save costs. The claim is easy to make, however, when no one can give an adequate explanation as to why that will not be the case. The cost savings are largely dependent on removing “unnecessary” expenses incurred in the final months of life. Admittedly a large portion of the costs are related to the final illness. Moreover, the present tends to enable incurring excessive expense for heroic but futile efforts to extend life. Who is going to make the decision as to which costs are unnecessary? Some bureaucrat?

The sprouting Tea Party movement has probably benefitted most from the non-transparency. They smell a conspiracy and have found that many others do, too. It is only human nature to believe that anyone who is hiding something does not want us to know the truth. I do not believe that the Democrats ever took them seriously enough until after they showed their muscle in Massachusetts. And then it was too late.

Tuesday, February 2, 2010

The Failing Health Care Reform Bill II- Overreaching Legislation.

The Democrats should have learned from Clinton’s experience that it is extremely difficult to adopt an comprehensive plan covering various subjects, all at the same time. One constituency may be concerned about by an isolated portion of the plan, but their best strategy is to oppose the entire package. Another segment may have entirely different concerns but they join in opposition in order to prevent their own interests from being adversely affected. Thus two groups with different interests combine to constitute a more formidable opposition.

That phenomenon is apparent in the case of health reform. Obama expressed shock that the insurance companies invested so much in their lobbying activities. Why not? Proposals such as the public option and single payer government insurance threatened their existence. I already mentioned the unions who suddenly became disaffected with the new taxes being assessed on the health plans they have proudly negotiated over the years.. The Medicare generation, which was betrayed by the NAARP, does not believe that their benefits will be secure. Even those who are approaching 65 have been hearing that they will not receive all the benefits now included in Medicare. Even the issue of the deficits is tied to self interest. Three quarters of the population are happy with the insurance they now have. Most likely they see the plan as a trillion dollar boondoggle for the benefit of some one other than themselves.

Clinton made the same mistake as Obama in attempting to take too big a bite at the apple, but he quickly retreated. If the Clintons had successfully sponsored a less ambitious plan, Obama could have built on what had been done and the Democrats might have had a significant trophy in their cabinet.

Sometimes overlooked is the fact that the most significant health care reform actually enacted was proposed by George W. Bush, who procured prescription drug benefits for the elderly. It certainly was not comprehensive, but it survived the scrutiny of a contentious congress.

Instead all the Democrats have done is generate a lot of hot air and, so far, have nothing to show for their work.

Monday, February 1, 2010

The Failing Health Care Reform Bill I - Who is to blame?

Obama and his party have a debacle on their hands.. They have fiddled with health care reform for an entire year, while more important issues remained unresolved. The Democrats have managed their razor thin majority in the Senate with the sophistication and finesse of a mafia hit man. Now that they have been caught making all the wrong choices, it is time to look for scapegoats.

The media has tended to look for parallels with the first years of the Reagan and Clinton. Both presidents escaped largely unharmed from their early failures. I believe that the Jimmy Carter years may be more apt. Carter had a strong mandate with a convincing victory over Gerald Ford and control of both houses. It appeared that the way was clear for the Democratic juggernaut to restore the New Deal. In fact they squabbled so much that very little was accomplished. The economy went south, and Carter ended up with a one term presidency.

The stunning defeat in Massachusetts now leaves the Democrats in limbo with a few choices that are all distasteful to them.

Abandoning the health care effort will make them look like the gang that cannot shoot straight.

Starting over again, as the Republicans smugly suggest, would take at least another six months. Neither the Congress, which is facing an uncomfortable election, nor the country will tolerate more of the endless bickering and stalemate.

The only viable choice would be for the House of Representative to adopt what the Senate already passed without changes. In that case, they would avoid the necessity of coming back to the Senate where the Republicans are armed with their forty first vote. The problem is that the Senate bill includes terms that the left wing Democrats deem to be abominable, such as restrictions on funding abortions and taxing the so-called Cadillac plans which are largely established through union collective bargaining agreements.

How did they get into the mess? I have three major suggestions, which will be discussed separately over the next three days. I hope you will join me.

Monday, January 25, 2010

Travel - A place you probably have not seen, but you should - Spice Island, Africa

Yes, there is a Zanzibar. I am sure that many of you may have thought that Zanzibar is the fictitious invention of some fantasy writer such as Rudyard Kipling. Others may know it exists but could not tell you the continent where it is located.

Zanzibar in real life is just as exotic as we may conjure up in our imagination. It is one of the Spice Islands off the coast of Tanzania, which is, of course, located in East Africa. Many of us may dream of taking an African Safari, which is one of the great experiences on this planet. If you choose to visit some of the popular places such as Mount Kilimanjaro or the Serengeti, consider reserving about three nights and two days at this unique place.

Zanzibar was a slave trading mecca in the past. Hapless Africans would be captured on the continent and their new masters would carry them off to Zanzibar where the slaves would be auctioned off to be transported to destinations all over the world. Today the Slave Market includes the old auction block and holding quarters, which make a sobering statement on the cruelty of slavery.

But do not think of Zanzibar as a downer. Far from it. Zanzibar has been ruled by many peoples over the centuries including, Arabs, Asians and Europeans. As a result, the inhabitants are the product of a confluence of many cultures. The Old Stone Town appeared to me to be extremely authentic. The streets are so narrow that I felt that I could touch the walls on each side at the same time.

One night we took a meal on the open air roof of one of the local hotels. Although our own hotel was only about a quarter of a mile or less away from the restaurant, the concierge insisted that a bell boy accompany us to and from the restaurant for fear that we would be hopelessly lost in the labyrinth of alley ways that passed for streets. Needless to say that walk itself deserved four stars.

The meal was just as exciting. The starry sky was clearly visible as the guests sat on the floor surrounded by pillows to make us comfortable. The eerie music, the food which was delicious but largely mysterious, made that night one of the highlights of all of our travels.

Zanzibar produces many spices, including clove, vanilla, cinnamon, turmeric, nutmeg. and black pepper. Spice farms dot the landscape and make for a wonderful day of meandering through the countryside.

Finally, when you return home and someone at a cocktail party asks you where you have been, you can say “Zanzibar.” Most likely they will be speechless.

Wednesday, January 20, 2010

My Take on the Tuesday Elections

Democrats and some of their friends in the media tried to spin the Scott Brown victory over Martha Coakley as a local race with minimal effect on the November elections. That tactic may have been persuasive in Virginia and even sounded reasonable when consistently Democratic New Jersey elected a Republican governor. In Massachusetts, however, Brown campaigned on platform dominated by national issues boasting that he would be the forty first senator who could derail the Obama juggernaut. Now that the Democrats have shown that they cannot hold power in the East, what is going to happen when seats are contested in the Midwest, South and beyond? It may not be pretty.

The fact is that the Democrats now have no safe seats in the November elections. Their efforts to raise money will be impaired, and they will have many more places to spend it. The health care bill has become an albatross and will only pass by use of brute force and awkwardness.

The White House is bound to be in disarray too. Obama chose to invest virtually all of his political capital on a health care plan which now enjoys support of less than a majority of Americans who view the economy as their number one priority. Health care is Nero’s fiddle while the economy is the fire burning in Rome. Moreover, Obama has not seemed to be any more effective in dealing with the mess in the Middle East than Bush.

There was another election. William Bell has finally become Birmingham’s mayor, a position that he thought would come to him many years ago. There are many needs for the city of Birmingham. At the top of my list would be the curbing of wholesale corruption, bringing sanity and some measure of competence to the education system, and attracting new businesses. Is Bell the man for the job? The answer is patently obvious.

Bell’s victory is no surprise. The election result last night was politics as usual in Birmingham. The most stunning event in my mind was a political ad Bell ran close to election day. Many years ago Art Hanes Sr., a hard nosed segregationist, was running for president of the old City Commission against Tom King, Sr., who was more moderate. (Both men had sons who ended up as distinguished judges in the Jefferson County Circuit Court. I always wondered what they discussed during coffee breaks.) The Hanes campaign hired a black man to approach King and shake his hand and a photographer to snap King’s picture. The picture was reproduced in Hanes ads to show that King was an “integrationist.” The ploy worked and Hanes was elected. That tactic has been widely regarded as one of the low points in the politics of the segregation era.

Now after many decades, the same tactic was used again in reverse. Bell ran an ad showing him and his wife accompanied by pictures of Patrick Cooper and Julia Boaz Cooper, Patrick’s ex-wife. Nothing was said in the ad, but the message was clear, Julia is white and Patrick is black. Bell was conveying the message that Patrick Cooper was not black enough to be mayor. Who said that racism is dead?

Oh well, Birmingham once called itself the “Pittsburgh of the South.” Today it would be more appropriate to be described as the “Newark of the South.”

Monday, January 18, 2010

Travel - A place you probably have not seen, but you should - The Land of the Rising Sun..

When Monty and I decided to go to Japan we were met with skepticism and downright opposition from our friends. “Why do you want to go to Japan?” You would think we were going to Siberia; but then, I would not mind going there either.

Japanese travelers usually appear to be aloof, iconoclastic and humorless, but, in their own country, they are the friendliest to tourists that we have seen. You are surprised aren’t you?

Before leaving we purchased a two week train pass. It was a necessity, because trains are the only feasible means of travel. After selecting our itinerary, we made a list of every train and departure time that we anticipated using for the entire trip. Shortly after reaching Tokyo we made all of our reservations with the precise dates and times for each trip. Only in Japan is such precision so easy.

I can recall at least five sites which were breathtakingly exciting and unique to Japan. They are:

1. Ryokans, the traditional hostel. It is hard to believe that sleeping in a spare room on palettes and eating meals while sitting on the floor can be one the most luxurious experiences imaginable, but it is true.

2. The Kabuki and Noh theaters. This traditional drama has a pace and eeriness unmatched in our experience.

3. The Kyoto National Museum. There are only a handful of museums in its class in the world, but it stands number one as a reflection of the nation it serves. I was particularly taken to see the early Buddhist art which was much finer than what was being produced in the West at the time.

4. Kyoto again - the vaunted tea ceremony. It is a thing of beauty and good taste and is unforgettable.

5. And of course there the trains. The Japanese idea of a late train is one that arrives two minutes after the scheduled time. All passengers line up in the premarked spots where their car will stop and it takes less than five minutes to load and unload the cars. The ride is exquisite. The most famous trains are the Shinkansen. We took one from Hiroshima to Tokyo. There were five stops and covered 850 miles in five hours.

There is not much downside to a trip to Japan. My only warning is to travel light. There are no red caps in the train stations although most of them are equipped with escolators making the walk easy

I am sorry I wrote this blog. As I think of it, I wish I were in Japan again.

Monday, January 11, 2010

Alabama’s Secret Weapon

Much has been said about Alabama’s national championship, but the pundits are strangely silent about Bama’s secret weapon without whom this team would never have reached its dream. That weapon is Lady Luck.

Consider the Tennessee game. The image of Terence Cody running off the field without his helmet before the play was even over will define him as a hero for the ages, much like Van Tiffin and his kick. But really, Alabama won the Tennessee game because a kicker was twice unable to elevate field goal attempts to their normal trajectory. That is real luck. Otherwise, Cody would have been weeping on the bench and Kevin Scarbinsky would not be boasting that this team was the best ever.

Mack Brown claims that he had the superior team and that he lost simply because Marcell Demarius pinched Colt McCoy’s nerve. Mack should be a better sport than that, but it is true that Texas was unlucky and Alabama was lucky when that injury occurred. The game would have been different with a healthy McCoy, but we will never know how different it would be.

The biggest stroke of luck for Alabama is what did not happen, namely it never suffered a crippling injury throughout the year.. The only significant loss was Dante Hightower, but Alabama was lucky because he was one of many talented linebackers who ably filled the void created by his absence.

I can remember when Auburn lost all of its centers and had to move a guard to the center positiion to deliver the ball to the quarterback. Nothing like that happened to this team. Terry Grant, a fourth string running back, was injured this year, Wasn’t Alabama lucky that they did not lose Mark Ingram for the year instead?

But the scariest prospect was at quarterback. The top three quarterbacks in the nation, Sam Bradford, Tim Tebow and Colt McCoy, all suffered signifcant injuries. Isn’t Alabama lucky that the same fate did not happen to Greg McElroy? He may not be in the class of those three, but do you really believe that Alabama would have won the national championship with Starr Jackson at the helm? I don’t.

Texas cannot complain. They lost the shot at the national championship last year because of a play that took place with one second left of the clock in the Texas Tech game. This year they would not have been able to show up on January 6, if the clock had ticked one second longer on the next to last play in the Nebraska game. They were lucky this year and last year they were not.

It is not my point to belittle Alabama’s accomplishment. I believe the most championships are accompanied by a generous dose of good luck. If Alabama, is to win another championship, they need the players, the coaches, the discipline, training and dedication to do the job. But if they really expect to succeed they must pay attention to the mysterious and powerful thirteenth woman of the gridiron - Lady Luck.