Thursday, October 29, 2015

Branded Healthcare

In my fifth decade parts of my body remind me that I’m no longer in my second or third decade. Somewhere along the way I became that groaner – the one who expels a long breath/sigh after getting up. After a particularly long period of sitting at the desk I’ll rise and it’s like those old commercials for “Snap, Crackle and Pop.” I’m not complaining – I’m blessed with generally good health and most don’t think I’m anywhere near my actual age, which is always good for the ego if nothing else. Along the way, however, there are various things that have needed attention and as a result I take a couple of pills that those who are far brighter than I in such matters indicate that I need. Whether its my cynicism, bad luck or just the way the system works, it seems that the pills I’m on are always the ones that don’t have generic counterparts. My prescriptions therefore are quite pricey. I’m not alone.

In September 2015 Martin Shkreli made significant news by raising the price of a drug he acquired some 5,000%. He’s a hedge fund investor who has a history of acquiring a drug products and increasing its price. In this particular case his company Turing Pharmaceuticals purchased a company whose drug had been selling for $13.50 a pill to AIDS and cancer patients and upped the price to $750. Consumer activists, health care professionals and a range of progressives as well as politicians from all stripes derided capitalizing on people’s health in such a crass way. Shkreli suggested he’d lower the price, but never clarified to what or how much. His attempts to meet with Bernie Sanders by making the maximum contribution failed when Sanders donated those funds to charity.

It’s capitalism. That’s how it works. Supply and demand determine cost. It’s not always pretty. It’s not always right. And it’s not always fair. But it’s what we claim to be proud of about America.

Turn-around being fair play, Shkreli was himself outraged a few weeks later when Imprimis Pharmaceuticals announced that they would be providing an alternative (non-branded/generic) version of the same pill he was selling at $750 for $1 each.  Capitalism strikes back and wins.

This incident reignites the chasm I have between my philosophical libertarian beliefs and the practical application of them. Situations like these are crazy making not because of the positioning, but because healthcare should not be based on ability to pay. It just seems wrong to me. Shouldn’t America have a system where when you’re sick you go to a facility and are treated? If you need an operation you get it? If it’s vanity driven(and not medically necessary) then pay retail and there’s a price list to choose from. Sure there will be some diseases that affect a minority of the population that can’t be covered because this isn’t Utopia…but that happens in a more defecto way under the current system already. Let’s create a system where all of the decisions and discussions are around symptoms, remedies and recuperation and not coverage, eligibility and reimbursement.

Such a system was in place in America once. It was before government regulations and insurance became the driving for of healthcare…reinforcing my philosophical belief system. We can’t go back to that time. We can build from it. We won’t because of the entrenched interests of insurance and politics. To sell it, it has to be branded…the ultimate irony in capitalist healthcare. Guess we should all pray for good health. 

Thursday, October 22, 2015

Hacking a Hack

I joined America On-line in 1995. My account “name” was a series of numbers – you couldn’t personalize yet. I had a whole series of local phone numbers that the modem would try to connect to. After busy signals, the worst thing was the dreaded blue progress bar. The best thing was “You’ve Got Mail” calling out to you when you were connected. When spamming began a few years later I would naively reply back to each email with a polite “no thank you” or “remove.” Today my various accounts attract some 1,000 spams a week. AOL was responsible for moving the United States forward onto the information superhighway - at one point in the late 1990's half of all American's on the Internet came via AOL. The company was part of the largest merger in American history that nearly toppled and destroyed its acquirer/partner Time Warner. A variety of sales have occurred since then, the latest being Verizon buying the company in May 2015 for $4.4 billion. Today 2.1 million Americans continue to access the World Wide Web via AOL’s dial-up service even though using one’s phone actually connects to sites faster. Several of those users were embarrassed this week (10/20/15) with not only having an AOL account, but the disclosure that their accounts had been hacked.

CBS reports: “The personal emails of two of the highest-ranking national security officials have been hacked. CIA Director John Brennan and Homeland Security Secretary Jay Johnson.” Late night comedians, radio show hosts, pundits and bloggers have run amuck with the rich irony that the leaders of two such important government security institutions have themselves been victimized. It’s like the landscape architect who has brown grass and rocks in their garden or the financier who’s in bankruptcy. The irony is amusing.

IBM has reported that in 2015 there have been more than 600 data breaches and the average cost of a breach is $3.8 million. So there is a direct cost of $2.2 billion to the economy in a partial year. The study further identified that in 2014 25.33% of the attacks were on finance and insurance. Retail “took a hammering” with a 30% increase in attacks.

Willie Sutton, the original ‘slick Willie’ and famous bank robber was asked by reporter Mitch Ohnstad why he robbed banks. According to Ohnstad, he replied, "Because that's where the money is." He later claimed the story was made up by the reporter, but the simplicity and humor of the answer is as true for today’s hackers. It’s where the money is.

In the hack of the emails of the CIA and Homeland Security chiefs the perpetrator, claiming to be a high school student, tweeted: "We are not doing this for personal satisfaction, we are doing this because innocent people in Palestine are being killed daily.” Then, taunting officials the hacker asked: “Anyone know who we should target next?!” On CNN the allegedhacker said he was “probably high” when he did it. Newsflash: A high teenager breaches American Online’s email system.

In the 1990’s I learned the hard way what spam mail was. My defense of that naivete is that I wasn’t alone and the entire world learned at the same time. Two decades later you’d think that the leading security experts for the United States would have a more secure way of handing personal emails than AOL. I don’t know which is the bigger bunch of hacks – the guys who breached their privacy or the schmucks running the CIA and Homeland Security with their accounts on outdated technology.

Thursday, October 15, 2015

Standard Training

I am the son of educators. My parents spent their lives imparting wisdom to others - truly one of the most noble professions I know. The transfer of knowledge from one generation to the next is an incredible chain that ties the species together back to the beginning of time. Directly or indirectly my entire family is in the field – whether in the classroom or in my case working at a non-profit that enlightens in its own way. Before my current position I worked as a consultant where I would mentor and guide clients to be self-sufficient. That’s the benefit of training – giving others the ability to do for themselves. The U.S. has aspired to a similar goal but has had a long string of disappointments in this area especially in its foreign policy.

The current deployments of American military personnel cover a wide spectrum of projects throughout the globe. It involves everything from energy and environmental projects to health, human interest and community relations. Wikipedia  details further: “The military of the United States is deployed in more than 150 countries around the world, with over 156,000 of its active-duty personnel serving outside the United States and its territories and an additional 70,000 deployed in various contingency operations as well as through military attache offices and temporary training assignments in foreign countries.” There are currently 1,148,530 active duty personnel – so 6% of them are helping others to help themselves. A noble goal that is a failed policy.

President Obama recently ended his administrations training of Syrian rebels. The idea was that American forces would take the Syrian rebels and show them how to fight, use strategy and weapons, organize and defeat the oppressors. Half a billion dollars was spent. In September 2015 the Pentagon admitted that only “four or five” rebels were trained. Others who were being taught in Turkey surrendered to the opposition. I’m not quite sure how one spends $100,000,000.00 in six months to train one person. I rather doubt that those five guys are going to have much of an impact in the region.

Rather than giving up on its approach the Guardian report continues: “A senior US official said there would no longer be any recruiting of Syrian rebels for training in Jordan, Qatar, Saudi Arabia or the United Arab Emirates. Instead, a single training centre would be set up in Turkey, where a small group of ‘enablers’ – mostly leaders of opposition groups – would be vetted and taught operational methods, such as how to call in airstrikes.”

I am not a military expert. Far from it. I abhor violence and am largely a pacifist. It's from watching and enjoying war films and tv shows that I know a communications system (walkie-talkie, cell phone, etc.) is all that’s needed to alert somebody to an airstrike. Perhaps there’s more to it that justifies an entire program of training and funded by the American taxpayer...but there's no evidence of that.

President Obama in 2014 proposed a regulatory regime that would punish schools “for failing to place graduates in well-paying jobs.” That ill-advised idea that makes the educational institution responsible for its students performance can’t work and has been tied up in the legislative process because the President still supports the idea. Since he proposed the concept perhaps the same standard can apply to the military and their training efforts? Where's our refund?

Thursday, October 8, 2015

Sorry ... Not Sorry

I’m sorry. 7 letters that form 2 words with 1 apostrophe. It's an expression that  is a powerful communications tool and is laced with passion. I say it often – as much because I’ve flubbed something up and need to remedy things as to also defuse emotional situations. Acknowledging an upset through contrition is an incredible way to open up dialogue about other matters – whether they be with interpersonal relations or international relations. Is one apology enough? When is enough contrition justification to stop apologizing? If it’s not clear in our personal lives so it’s no surprise in world affairs that the art of the apology is as much about diplomacy as remorse.

Pope Francis has apologized for a wide range of issues including to the victims of sexual abuse by priests, for the oppression of Latin America during the colonial era, for persecution of Pentecostals. He also apologized for 'grave sins' against native people of America. While it took 350 years, eventually the Vatican did apologize for the persecution of the Italian astronomer Galileo.

Popes Benedict and John Paul II also apologized to the victims of sexual abuse.  Pope John Paul II also apologized to Muslims killed by crusaders and to Jews for the Vatican’s inaction on the Holocaust.

The Second World War has a lot of regret being expressed. The British government tried to make good for prosecuting a World War II hero and Nazi code breaker, Alan Turing, for the crime of being gay in its apology.

For generations Japan would apology for its role in the war. Japan’s remembrance of the 70th Anniversary of the end of World War II has its Prime Minister “express[ing] "profound grief" for the millions killed in World War II and remorse for his country's participation, but [he] said that future Japanese generations shouldn't need to keep apologizing.” In their case 70 years is enough time to say they're sorry.

In the war against gays, from 1993 to 2011 13,650 Americans were discharged from serving in the U.S. military under President Clinton’s “Don’t Ask, Don’t Tell” policy. Most (exact figures not known) were given less than honorable discharges. In addition to the base inequality of the policy it's important to remember that for more than half of the time the law was in place highly skilled and qualified patriots were being fired from protecting the US during the “War on Terror.” By not receiving “honorable” discharges the benefits afforded to other veterans aren't available – just because they’re LGBT.

There is a movement on to change the dismissal records from “less than honorable” to “honorable” in order to remedy the continued inequity. Hilary Clinton, wife of the President who created and signed the legislation and candidate for President has listed the upgrade in paperwork as part of her 10 promises to LGBT Americans if she’s elected.

Mrs. Clinton is now putting LGBT rights as the “pillar” of her 2016 campaign. This is on the heels of the disclosure of an email discussing the decision to change passport applications from “mother/father” to “parent 1” and “parent 2.”  Slate reports on the email from the former Secretary of State: “Then-Secretary of State Hillary Clinton was furious. In a recently released email, Clinton proclaimed that she would not defend the decision, “which I disagree w and knew nothing about, in front of this Congress.” She then wrote that she “could live w letting people in nontraditional families choose another descriptor so long as we retained the presumption of mother and father.” Failure to act immediately, she fretted, would lead to “a huge Fox-generated media storm led by Palin et al.” (The department quickly reversed the decision, apparently appeasing the secretary.)” 

Mrs. Clinton's commitment to the LGBT community isn't quite solid after all having not supported Marriage Equality and instead championed with her husband the Defense of Marriage Act along with DADT. Yes, she gave one good speech on human rights as Secretary of State, but her actions (per the email above) shows it's all talk.

Being sorry is difficult for some. Mrs. Clinton has had a particular challenge in expressing remorse – especially related to the email situation, but there are twenty years of other examples. As she re-introduces herself as a LGBT supporter, perhaps she could simply apologize for her and her husband’s role in their shameful part of American history first? 

Thursday, October 1, 2015


I spent part of the weekend at the National Zoo in Washington DC. I didn’t visit Congress – it was the actual animals in their faux habitat. Lions lounging, lizards slithering and elephants dancing – it’s an extraordinary thing to see these creatures. Unlike the First Lady earlier in the week, we weren’t able to see the Panda live, we got to see it on closed circuit television. (It could have been a replay for all I know, but that’s vestiges of my life in LA!) I’m well aware of the arguments for and against zoos – that’s not what got my attention. What struck me was that it was free. And packed – with locals, tourists and many people on a pleasant Saturday afternoon. Had we opted to, we could have visited a huge number of other Smithsonian sites at no cost. Free is relative, so what are the costs?

The Smithsonian currently has 19 museums in all in the Washington DC area. The institution has additional 144 affiliates around the U.S. where their collections are on long-term quasi-permanent loan status. It’s about to open its first overseas branch in the United Kingdom within London's Queen Elizabeth Olympic Park.

Wikipedia reports: “The birth of the Smithsonian Institution can be traced to the acceptance of James Smithson's legacy, willed to the United States in 1826. … The Smithsonian has expanded to twenty separate museums with roughly 137 million objects in their collections, including works of art, natural specimens, and cultural artifacts. The Smithsonian museums are visited by over 25 million people every year.”

The original gift of $500,000 was bequeathed to the U.S. mint to fund a national museum and Congress voted to accept the gift and oversee it using the proceeds and earnings. In today’s dollars that would have been a gift of $1.49 billion dollars. With a B. Plenty of funds to acquire objects and oversee its collection over a long period of time if the resources are managed efficiently and effectively.

Today nearly 80% of the Smithsonian budget comes from Federal funding. The Fiscal Year 2015 budget request was $851 million. That works out to $34.04 per visitor.

Disneyland  for 1 day for an adult is $99 and $93 for a kid. Universal Studios in Orlando is $147 for adults, $142 for kids. Six Flags New England is a relative bargain at $61.99 for adults and $51.99 for those under 54” in height. Certainly the experience of an amusement park is much different than that of a national museum … but both are activities that seek to engage people.

Entitlement programs like Social Security and Medicare consume the lion’s share of the Federal budget and in a $3.9 trillion (with a T) budget the Smithsonian line item represents 0.00002% of the fiscal 2015 budget. That’s 2-thousandths of a percent – not even a full percent or half a percent but a thousandth of a percent of the budget. It’s ridiculous to talk about such a small thing, right? I mean we’re talking about 1 penny out of every 3,900 dollars. If there were 3,900 sitting on a table would you miss one? Probably not – and the payback for providing unlimited access for nothing yields many benefits.

Why make it free? Charging $15 or $20 would halve the federal contribution to the budget. 25 million visitors kicking in an average of $17 generates $425 million dollars. Keeping it free, though, means that the users – TAXPAYERS – are feeling that for their thousands and thousands of tax payments that they’re getting something for free. In the case of a Government shutdown (or using my term: slowdown) it’s a visible and horrible tragedy to close national parks and zoos. It’s the worst kind of pandering. It’s PANDAring.