From the Mail Bin

"I've been reading your blogs and i find them quite intriguing. I agree with u regarding the many myth and fable like stories in the Bible. The part that i find more difficult is that if the Torah was not given as a Divine Revelation then how did we get such a complex and vast Talmudic system. I mean the laws in the Talmud seem so far fetched and abstract that its difficult to believe that God didnt have some part of it. I dont thing there is any other man made system of laws that is as vast and complex as the Talmud. what r your thoughts?"


Whether God had a part in it or not is not the question, since most would agree that the Talmud was composed l'shem shamayim and with God in mind. The question is whether Talmudic law requires supernatural intervention to explain itself. I don't believe it does. I don't know if you've studied the Talmud but it's essentially an effort to justify and further clarify the rules of the Mishna from the text of the Torah with proof texts, allusions and the like.

Many times these proof texts work very well and are indeed impressive and clever, but that should be expected since the Mishna itself was composed with the Torah in mind. Other times though the efforts of the Amoraim (the Talmudic scholars) seem pretty strained and they have to go through several iterations of hair-splitting or "this-case-is-an-exception-because..." in order to come to some conclusion when an apparent contradiction arises. And there are also plenty of times when the Talmudic discussion ends in "Taiku" - where they can figure out no resolution.

Add in the fact that the Talmud itself occasionally cites natural "facts" that are now known to be false to make arguments or simply as side discussion, complements the conclusion that it is a great but still an eminently human work.

If you're looking for another vast and complex system of laws, I'd refer you to the United States' tax code. For comparison, the Talmud is written formally on less than 6000 pages, while the tax code is now more than 16,000, 70,000.

Medicare for All = Healthcare for None

Doctors Are Opting Out of Medicare

By JULIE CONNELLY

EARLY this year, Barbara Plumb, a freelance editor and writer in New York who is on Medicare, received a disturbing letter. Her gynecologist informed her that she was opting out of Medicare. When Ms. Plumb asked her primary-care doctor to recommend another gynecologist who took Medicare, the doctor responded that she didn’t know any — and that if Ms. Plumb found one she liked, could she call and tell her the name?
...
Many people, just as they become eligible for Medicare, discover that the insurance rug has been pulled out from under them. Some doctors — often internists but also gastroenterologists, gynecologists, psychiatrists and other specialists — are no longer accepting Medicare, either because they have opted out of the insurance system or they are not accepting new patients with Medicare coverage. The doctors’ reasons: reimbursement rates are too low and paperwork too much of a hassle.
...
Of the 93 internists affiliated with New York-Presbyterian Hospital, for example, only 37 accept Medicare, according to the hospital’s Web site.

Two trends are converging: there is a shortage of internists nationally — the American College of Physicians, the organization for internists, estimates that by 2025 there will be 35,000 to 45,000 fewer than the population needs — and internists are increasingly unwilling to accept new Medicare patients.

In a June 2008 report, the Medicare Payment Advisory Commission, an independent federal panel that advises Congress on Medicare, said that 29 percent of the Medicare beneficiaries it surveyed who were looking for a primary care doctor had a problem finding one to treat them, up from 24 percent the year before. And a 2008 survey by the Texas Medical Association found that while 58 percent of the state’s doctors took new Medicare patients, only 38 percent of primary care doctors did.


29 percent of Medicare recipients can't find a physician who is willing to take them as patients. That's huge. How high would that number go if most of the country became Medicare or Medicare-like recipients? How high will this number go if the federal government's scheduled 21% cut in Medicare payments to physicans comes real (on January 1st, 2010)?

Yeah, give everyone free coverage, but don't be surprised when you can't find anyone willing to accept it.

Just Brilliant: "A Doctor's Plan for Legal Industry Reform"

By RICHARD B. RAFAL

Since we are moving toward socialism with ObamaCare, the time has come to do the same with other professions—especially lawyers. Physician committees can decide whether lawyers are necessary in any given situation.

At a town-hall meeting in Portsmouth, N.H., last month, our uninformed lawyer in chief suggested that we physicians would rather chop off a foot than manage diabetes since we would make more money doing surgery. Then President Obama compounded his attack by claiming a doctor's reimbursement is between "$30,000" and "$50,000" for such amputations! (Actually, such surgery costs only about $1,500.)

Physicians have never been so insulted. Because of these affronts, I will gladly volunteer for the important duty of controlling and regulating lawyers. Since most of what lawyers do is repetitive boilerplate or pushing paper, physicians would have no problem dictating what is appropriate for attorneys. We physicians know much more about legal practice than lawyers do about medicine.
Following are highlights of a proposed bill authorizing the dismantling of the current framework of law practice and instituting socialized legal care:

• Contingency fees will be discouraged, and eventually outlawed, over a five-year period. This will put legal rewards back into the pockets of the deserving—the public and the aggrieved parties. Slick lawyers taking their "cut" smacks of a bookie operation. Attorneys will be permitted to keep up to 3% in contingency cases, the remainder going into a pool for poor people.

• Legal "DRGs." Each potential legal situation will be assigned a relative value, and charges limited to this amount. Program participation and acceptance of this amount is mandatory, regardless of the number of hours spent on the matter. Government schedules of flat fees for each service, analogous to medicine's Diagnosis Related Groups (DRGs), will be issued. For example, any divorce will have a set fee of, say, $1,000, regardless of its simplicity or complexity. This will eliminate shady hourly billing. Niggling fees such as $2 per page photocopied or faxed would disappear. Who else nickels-and-dimes you while at the same time charging hundreds of dollars per hour? I'm surprised lawyers don't tack shipping and handling onto their bills.

• Legal "death panels." Over 75? You will not be entitled to legal care for any matter. Why waste money on those who are only going to die soon? We can decrease utilization, save money and unclog the courts simultaneously. Grandma, you're on your own.

• Ration legal care. One may need to wait months to consult an attorney. Despite a perceived legal need, physician review panels or government bureaucrats may deem advice unnecessary. Possibly one may not get representation before court dates or deadlines. But that' s tough: What do you want for "free"?

• Physician controlled legal review. This is potentially the most exciting reform, with doctors leading committees for determining the necessity of all legal procedures and the fairness of attorney fees. What a wonderful way for doctors to get even with the sharks attempting to eviscerate the practice of medicine.

• Discourage/eliminate specialization. Legal specialists with extra training and experience charge more money, contributing to increased costs of legal care, making it unaffordable for many. This reform will guarantee a selection of mediocre, unmotivated attorneys but should help slow rising legal costs. Big shot under indictment? Classified National Archives documents down your pants? Sitting president defending against impeachment? Have FBI agents found $90,000 in your freezer? Too bad. Under reform you too may have to go to the government legal shop for advice.

• Electronic legal records. We should enter the digital age and computerize and centralize legal records nationwide. All files must be in a standard, preferably inconvenient, format and must be available to government agencies. A single database of judgments, court records, client files, etc. will decrease legal expenses. Anyone with Internet access will be able to search the database, eliminating unjustifiable fees charged by law firms for supposedly proprietary information, while fostering transparency. It will enable consumers to dump their clunker attorneys and transfer records easily.

• Ban legal advertisements. Catchy phone numbers such as 1-800-LAWYERS would be seized by the government and repurposed for reporting unscrupulous attorneys.

• New government oversight. Government overhead to manage the legal system will include a cabinet secretary, commissioners, ombudsmen, auditors, assistants, czars and departments.

• Collect data about the supply of and demand for attorneys.Create a commission to study the diversity and geographic distribution of attorneys, with power to stipulate and enforce corrective actions to right imbalances. The more bureaucracy the better. One can never have too many eyes watching these sleazy sneaks.

• Lawyer Reduction Act (H.R. -3200). A self-explanatory bill that not only decreases the number of law students, but also arbitrarily removes 3,200 attorneys from practice each year. Textbook addition by subtraction.

Enthusiastically embracing the above legal changes can serve as a "teachable moment" and will go a long way toward giving the lawyers who run Congress a taste of their own medicine.

Dr. Rafal is a radiologist in New York City.

Moral Objectivity, Revisited

Excellent post found here that mirrors much of my thinking on ethical objectivity, but written much more clearly and comprehensively than anything I've ever written on the subject.

Common human prosperity and wellbeing are the goals of ethics and true, objective ethical rules are those that lead to their apex. We can analyze which ethical rules we use are closer or further away from the "true objective rules" by comparing their effects on societies on Earth, historical comparisons, logical critiques for internal consistency and the like, and reasoned discourse.

The only assumptions here are that human prosperity and wellbeing ought to be universally valued and that we have common understanding of these terms to build a consensus of action. These are not really much of leaps, especially as compared to the deontological set of rules assumed wholesale to be objectively correct by various moral Absolutists. And this way of thinking escapes the sinkhole of moral relativism where moral rules are proposed and defended by nothing more than emotion and whim.

Yet Another Reason Why Nuclear Power is Good

Medical Isotope Shortage

Joan Stephenson, PhD
JAMA. 2009;302(7):732.

A worldwide "critical shortage" of medical isotopes is expected due to the shutdown until late 2009 of a nuclear reactor in Ontario, Canada, according to Canadian authorities. The reactor, which stopped operations because of a heavy water leak, produces as much as 40% of the global supply of molybdenum 99 (99Mo), which decays to form technetium 99m (99mTc). 99mTc is currently used in approximately 80% of nuclear medicine scans.

According to Natural Resources Canada, the world's current supply of 99Mo is produced by 5 aging reactors in Belgium, Canada, France, the Netherlands, and South Africa. The shortage was expected to be exacerbated by the temporary closing of the Netherlands reactor for a month-long maintenance inspection from July 18 to August 18. Because the isotopes have a relatively short half life, they cannot be stockpiled.

Canadian authorities said they were working with medical isotope distributors and others to maximize the use of existing isotope supplies and with other international producers to increase isotope production and to coordinate shutdowns and other operations.


That's right, we use nuclear power to make medically-important isotopes. Well, not "we," as in local US plants but we rely on foreign plants to irradiate our 'topes for us. I'm not sure why we don't have our own plants churning out isotopes ourselves, but that could be related to the fact that we haven't built a new nuclear plant in America in 30+ years. There's a brain drain of nuclear expertise from this country and we'd probably have to import some European-made design if we ever started being smart with nuclear and joined the proper energy source of the 21st century.

That's right, I think nuclear power is great. Think about it: nuclear power produces virtually no greenhouse gases and can make us virtually energy independent. Two big birds down with one stone. Oh, and if you want to create jobs - how about building new plants and building a smart nuclear engineer workforce in America? Nuclear energy has a proven safety record in America - and this is with using clunking designs from 50 years ago. How much better would we be with if we built new, more efficient and safer designs that we find in places like France? This is one area where France got it right: most of the electrical energy of France is supplied by French nuclear power plants.

Worried about nuclear waste? Read up about Yucca Mountain - a location long-studied in geology as an ideal place to store radioactive waste and practically ready for operation if the politicians would only let it. Worried about transportation of radioactive waste? The US has a track record of shipping waste thousands of times and there has never been an incident or accidental release of waste. Worried about terrorists? Seriously? You can't hold back our nation's progress based on the fear of a might-happen. All nuclear facilities in America are very well guarded.

That all said, I don't think nuclear fission will be the only power source of the future. I think solar energy is an excellent source as well. Solar energy bathes America with tons of free energy on a daily basis and if we could harness even a bit of that (particularly from our little populated, but very illuminated Southwest deserts) the Sun could easily supply more energy for us than this country uses many times over. Hydroelectric power has its niche uses but it's poor for general energy supply. Wind energy seems like a goofy idea to me and likely to always be marginal since it's such an eyesore. Other ideas like geothermal are unlikely to become much since their technical maturity would come at around the same time as nuclear fusion power and fusion could be the real powerhouse for the end of the 21st century.

Nuclear power is power of the future - whether it's made right here on Earth or has to travel 93 million miles from Sol.

The Essential Orthoprax

Every now and again Jewish skeptics of various stripes respond with some surprise when I tell them that I am observant of Jewish rituals, traditions and the like. Sure, they can understand wearing a yarmulkah for social reasons, playing along while in public and eating Thursday night chulent, but observance in private for its own sake seems like a bewildering concept. So I'd like to go over here my reasons for observance in no particular order.

First off there's the basic essential of Jewish identity. Of course many Jews are not observant and especially not of all the minutiae of Halacha and yet still consider their self-identification as Jews to be very strong, but I find that if I'm not cognizant of the likes of Shabbos and our annual pageant of holidays then I'm missing a big part of the Jewish experience. I'm set apart from core Jewry if I don't know where the local synagogue is or what time candles are supposed to be lit. I'd feel out of sync and adrift if I'm not fasting on Tisha B'av or attending a seder for Pesach or even keeping kosher in inconvenient places. There's nothing immoral about eating meat during the nine days, but you're breaking with a shared Jewish experience if you do so. To be Jewish is to DO Jewish and identity absent these core activities may be fragile.

And this leads into the related reason of demographics. I care about the Jewish people and our fate as a group - but demographically we are suffering deeply from the likes of assimilation and intermarriage. And who are most likely to marry out or otherwise be lost from Jewry? These are the people who are least observant. Reform Jews have an astounding intermarriage rate and low retention over generations. If Reform Judaism was the only brand of Judaism available today I would have grave doubts about the survival of Jews as an identifiable group for even just a few generations down the line. Observance is correlated with significant knowledge of Jewish texts and general heritage and is correlated with intramarriage and strong Jewish identities over generations. Commitment to an observant life is a vote of confidence in the livelihood of the Jewish people.

Another important reason is that doing frank religious acts is a way of bringing the sacred into everyday life. Modern man is overly concerned about what he can get out of an activity. Shaking a bush and a lemon seems like a silly (and costly) thing to do without any benefit to anyone - and materially that's true. But what it does, through our history of investing in the act a sense of the divine, it brings the divine into what is otherwise a very secular existence. Now, as is well known by most who read my blog (I think), my conceptions of God are rather different from the popular views and even from what much of tradition suggests, but nevertheless, raising our minds to the transcendent of existence by using Jewish rituals as vehicles is something I consider a worthwhile effort.

This is also related to another criticism I've heard from a friend of mind who stated that he didn't particularly believe in God because once it was understood that God wasn't a doorway for on high reward or punishment and that intercessionary prayer is ineffective then he didn't really care about the metaphysics of the matter as it doesn't really effect him either way. The philosophical abstractions I tend to conceive of don't interest him, even while he may recognize them as plausible. This is a fair criticism if you are seeking religiosity as a means to an end in the way modern man approaches virtually everything - What's in it for me? But if the goal is simply truth-seeking then it is simply that life choices follow convictions. The point is not to choose convictions for the mere sake of making your life easier. So it is from my conviction of basic philosophical positions that observant life follows.

Now, here's a bunch of potluck ideas that are not full justifications on their own but do string through my mind: There's the sense of continuity and history with thousands year old practices. Pride in being a Jew and in being a Jew and a man in the street and at home. A sense of irony that Jews should give up their cultural and religious vocation at a unique time in history when Jews can choose whether to be Jewish or not. A sense of duty to past generations that have suffered and sacrificed on behalf of being Jewish and doing Jewish. Ethical improvement that can be accomplished through correctly applying various traditional experiences and measures. And of course for various acts there is the simple fact that I enjoy performing them.

So is it still so surprising why I remain Orthoprax?

In Usufruct to the Living

The question Whether one generation of men has a right to bind another, seems never to have been started either on this or our side of the water...and that no such obligation can be so transmitted I think very capable of proof.--I set out on this ground, which I suppose to be self evident, "that the earth belongs in usufruct to the living": that the dead have neither powers nor rights over it. - Thomas Jefferson, 1789 [From here]

This is an interesting quote which means that one generation cannot obligate a later generation in any way. This is relevant in terms of great public debts where, by right, the time to pay it off ought to be within the same generation's lifetime which benefited from the loan. The Earth belongs to each generation fully in each's turn and a past generation cannot rightly rule over those presently living.

As Jefferson goes on (my bolding):

To keep our ideas clear when applying them to a multitude, let us suppose a whole generation of men to be born on the same day, to attain mature age on the same day, and to die on the same day, leaving a succeeding generation in the moment of attaining their mature age all together. Let the ripe age be supposed of 21. years, and their period of life 34. years more, that being the average term given by the bills of mortality to persons who have already attained 21. years of age. Each successive generation would, in this way, come on, and go off the stage at a fixed moment, as individuals do now. Then I say the earth belongs to each of these generations, during it's course, fully, and in their own right. The 2d. generation receives it clear of the debts and incumberances of the 1st. the 3d of the 2d. and so on. For if the 1st. could charge it with a debt, then the earth would belong to the dead and not the living generation. Then no generation can contract debts greater than may be paid during the course of it's own existence.

Jefferson went even further and calculated with the given life expectancy of his time and actuarial numbers that at 21 years of age, half of the people of that generation would be dead in 18 or 19 years and therefore, "19 years is the term beyond which neither the representatives of a nation, nor even the whole nation itself assembled, can validly extend a debt." As a half-life, extending a repayment of a debt any longer than that would impinge on a following generation which never agreed to accept the debt in the first place.

In an egregious example: "Suppose Louis XV. and his contemporary generation had said to the money-lenders of Genoa, give us money that we may eat, drink, and be merry in our day; and on condition you will demand no interest till the end of 19. years you shall then for ever after receive an annual interest of 125/8 per cent. The money is lent on these conditions, is divided among the living, eaten, drank, and squandered. Would the present generation be obliged to apply the produce of the earth and of their labour to replace their dissipations? Not at all."

I suppose that the recieved opinion, that the public debts of one generation devolve on the next, has been suggested by our seeing habitually in private life that he who succeeds to lands is required to pay the debts of his ancestor or testator: without considering that this requisition is municipal only, not moral; flowing from the will of the society...but that between society and society, or generation and generation, there is no municipal obligation, no umpire but the law of nature. We seem not to have percieved that, by the law of nature, one generation is to another as one independant nation to another.

Consider this idea as our nation's federal government's uncontrolled spending of recent years has left us with a huge $11 trillion deficit with annual interest payments that amount to nearly 10% of our whole federal budget. Is it our generation alone who will be paying this debt?

Are we doing right by our children?

Insensible Losses

I weigh about 190 pounds. That's equal to about 85 kilograms.

To figure out the appropriate hourly fluid replenishment for a (basically) healthy 85 kg patient just lounging around in the hospital we follow the 4-2-1 rule, which is that for the first 10 kg we supply 4 cc per kg per hour, the next 10 is 2 cc per kg per hour and then 1 cc per kg per hour for the rest of the weight. So 40 + 20 + 65 = 125 cc per hour.

This means that a basically healthy 85 kg guy (like me) loses around 125 mL of fluid from urine and insensible losses (think sweating, respiration, etc) per hour.

Over a 25 hour period that amounts to a nice figure of 3,125 mL or 3.125 Liters. Think about it - that's a huge water debt. A big bottle of soda is only 2 Liters of fluid.

People don't drink enough before a fast and it's dehydration far more than hunger that makes them feel like crap.

So drink well and have a meaningful fast.

Healthcare, Oh Boy

So I was asked recently to publish my views on the ongoing healthcare debate facing this country. I’m not sure why my views are so sought out given that I have some obvious vested interests in the issue, but regardless it is a topic of interest to me and I haven’t blogged in awhile so this is a good topic to rebreak the ice on.

To be clear, the issue at hand is the concept of a broad-covering government sponsored ‘insurance’ plan essentially modeled after similar programs like Medicaid for the poor and Medicare for the elderly to include anyone else who doesn’t fit into either of those titles. And apparently there are a whole bunch of Americans who are set in just that fix – 47 million is the number which gets thrown around, but just who are these 47 million Americans?

From the US Census Bureau:

Did you know that nearly 18 million of them are people from households that make more than $50,000 a year, i.e. people who could afford insurance but opt otherwise? And 8 million or so are between the ages of 18 and 24?
Did you know that around 10 million of these uninsured are not citizens of the United States, i.e. those who would not be covered by any of the public options being bandied around Congress anyway (and even should they be covered)?
Did you know that about 25% of these uninsured are estimated to already be eligible for existing public programs?

Now these figures likely overlap a bit, but you can pretty easily see that 47 million problems have been cut in at least half, if not more. Do ~20+ million truly uninsurable American citizens require an entire reformation of the system or are there some obvious and simple tweaks we could make that would absorb them into what already exists? Could we do that without costing (likely far more than) a trillion dollars over ten years? Hmm...

It has also been suggested by ‘objective’ assessments of medical care provided by different countries that the United States offers healthcare at about as good quality as Iran, or something to that effect. By counting things like average life expectancy and infant mortality and comparing them to some European nations, it appears that the US comes far inferior. But what these same comparisons fail to realize is that it’s isn’t just healthcare that determines those figures. Americans tend to also be generally more unhealthy in their simple daily diets and activities than those other countries – this alone could leave the statistics showing a reduced life expectancy in America. And unlike in Europe, Americans are far less likely to abort imperfect fetuses and far more willing to try and save premature babies – thereby leading to higher reports of infant mortality.

Additionally, US News and World Reports writes “[I]t's shaky ground to compare U.S. infant mortality with reports from other countries. The United States counts all births as live if they show any sign of life, regardless of prematurity or size. This includes what many other countries report as stillbirths. In Austria and Germany, fetal weight must be at least 500 grams (1 pound) to count as a live birth; in other parts of Europe, such as Switzerland, the fetus must be at least 30 centimeters (12 inches) long. In Belgium and France, births at less than 26 weeks of pregnancy are registered as lifeless. And some countries don't reliably register babies who die within the first 24 hours of birth. Thus, the United States is sure to report higher infant mortality rates.”

Now, putting that all aside for now, I’d like to discuss a couple of philosophical problems I have with the idea of these semi-socializing welfare programs in general. The key thing to always keep in mind with welfare programs is that they sound nice and kind, but there ain’t no such thing as a free lunch. See, it’s a great political ploy that works again and again and again whenever it’s tried since not only do politicians get to play the moral high ground by offering the people free healthcare, for example, (as they oppose the opposition which clearly prefers that people die without treatment) – they also get to offer them free stuff! And what electorate can resist the idea of free stuff with the moral superiority package? But it ain’t free – somebody has to foot the bill.

Historically, those who were mandated to pay for the peoples’ insurance were the general taxpayers as they funded Medicaid, Medicare, SCHIP and so on – all unrestrained entitlements that are bankrupting this country. But also corporations and small businesses had to supply their workers with expensive health benefits which was a cost passed simply onto the consumers (ie the American people) and made American products completely uncompetitive on the international markets (which is also part of the reason why the United States is no longer an industrialized nation). And who has recently been suggested to pay for this newest gift to the American people? The middle class, of course. But how smart do you think it is to continue taxing the most productive segments of society – in a recession no less! - to sink money into the least productive? At a certain point, those smart people are going to realize that their hard work and ability is no longer working for them, but against them as they sooner and sooner hit marginal returns on their EARNED rewards. Better for them to work 30 hours a week and keep $150,000 than to work 60 hours a week and take home $200,000, eh? From where then are any of these programs going to be funded? Thus you should be not shocked at all to find that European per capita GDPs tend to be 25% less than America’s.

And despite what people clamor on and on about, healthcare is NOT a right. You cannot have a right to a service that someone else provides. Rights are natural things that surround the idea of personal freedom which others ought not interfere with. You have the right to life, liberty and the pursuit if happiness, but you don’t have the right to impose your will on a medical professional to treat you since that would enslave him and take away his rights. Free people trade value for value and you have the right to pursue professional care of your health through peaceful interactions. Doctors are not serfs and will not put up for long being government property.

Now, with even all of that said, the key thing to recognize is that financially the US healthcare system sucks. The U.S. healthcare system costs double what other countries cost with largely comparable end results. Even though nations with socialized medicine have a degree of rationing – so do we, TODAY. Sure, it’s not the government largely doing the rationing (though it obviously is in part as any Medicare recipient is well aware) but is it better when private insurance companies do not cover everything or have restrictively high premiums? In America we don’t ration by first come first serve, we ration by ability to pay. Better? And even though we don’t have a well organized socialized system, we still mandate that anyone coming in to an ER will be seen and treated – which is essentially the way the government eventually picks up the tab for the uninsured. The uninsured have no provisions for regular visits and simple meds to keep them in health so they show up to the Emergency Room when disaster eventually strikes, costing the system way more than regular upkeep would. So we effectively already have socialized medicine in America, we’re just paying for it ass-backwards.

The solution? I favor the gradual removal of all of these government-sponsored entitlement programs and a return to individual payment for medical care. Way better than any fraud-infested bloated bureaucracy or even any profit-driven corporation, the best person to take care of your own expenses is you. If you’re paying, little doubt you’d pay attention to the reasons for every proposed test, little doubt you’d seek the generic drug when you’re told it works as well as the more expensive new one, little doubt you’d not want to overload the system with minor complaints, little doubt you’d take a measure of responsibility for your own care and know your own history so that your doctor at the new hospital doesn’t need to redo a whole slew of the same tests you got at the hospital in your old town. This reality plus a healthy charity mentality in medicine is the way to go. Healthcare should be recognized as a charity of high regard – millionaires should endow hospitals and individuals can help others in their community. Doctors too should be willing to take a certain number of pro bono cases, since after all, they can afford it now that they are actually receiving the money they billed from their regular patients.

But since this is never going to happen, is a broad covering government insurance option the worst idea? Perhaps not. If creating it removes our other non-afforded entitlement programs then it may be well worth it. But will it end up being the same kind of bloated bureaucracy, with waste and fraud being hallmarks of government involvement - most probably. My prediction: it will happen eventually - it will cost a ton of money, be moderately effective and significantly rationed which will lead to the existence of a two-tiered medical coverage system. People who have private coverage will want to stay private while everyone else will be grouped in the new program. It won’t change medical care all that much but will possibly lead to simpler medical billing for many Americans. Economically we'll get by but with people far less willing to share their earnings charitably (like it is in Europe, charity is a rare gift) and our grandchildren will be the ones still paying the interest on our out of control spending today.

Better?

Memorial Day

On report about the land of America:

"Jews, there, are treated just like human beings, instead of dogs. They can work at any business they please; they can sell brand new goods if they want to; they can keep drug-stores; they can practice medicine among Christians; they can even shake hands with Christians if they choose; they can associate with them, just the same as one human being does with another human being; they don't have to stay shut up in one corner of the towns; they can live in any part of a town they like best; it is said they even have the privilege of buying land and houses, and owning them themselves, though I doubt that, myself; they never have had to run races naked through the public streets, against jackasses, to please the people in carnival time; there they never have been driven by the soldiers into a church every Sunday for hundreds of years to hear themselves and their religion especially and particularly cursed; at this very day, in that curious country, a Jew is allowed to vote, hold office, yea, get up on a rostrum in the public street and express his opinion of the government if the government don't suit him! Ah, it is wonderful."

-Twain, Mark. "The Innocents Abroad," 1869.


It bothers me to no end how too often do people nowadays completely take for granted the amazing country we live in. It's so cliche already, but the real freedoms we have here as well as the opportunities which permit us to reach as high as we are able are gifts unprecedented in all of human history. Sure, America is not perfect and there's plenty to criticize in its history and recent events, but the ideals it stands for, as embodied in the Constitution and the Bill of Rights, are among the best and highest ever set in text.

So it's quite proper now to take a moment and acknowledge the great sacrifices (some with the ultimate sacrifice) given by American servicemen to protect us and our way of life. May we soon see the day when no further American soldier need give so much.