Weekly Letter to the President
Copyright © 2017
ofthisandthat.org. All rights
INAUGURATION, January 20, 2009
Drunk in its stale air
For two hundred years.
Fettered in mind and body,
The soul, the safe escape
To let me breathe the cries
Of my heart singing
Tears of mel-an-choly.
The tears flow free today
Washing the stains of blood
And sweat in brotherhood.
Raise the curtain then an'
Let the world look in
On this promised land --
We breathe free today.... almost.
--- Arshad M. Khan
We will be known forever by the tracks we leave.
--- Native American proverb
September 1, 2017 (posted September 3, 2017)
Mr. President: So frequently is the word 'freedom' employed in the political
vernacular, it has come to mean whatever the listener desires. For Mr. Trump, it is
one word in the volcanic plume countering a society's rhythm, designed to attract
attention. That he has garnered in spades, enough to win him the highest office in
To many freedom is an absence of worry. The desire and need for a social fabric knit
well to support the basic prerequisites: food, shelter, health and education. None of
them charity, because they are an investment in the fundamental source of a
society's well-being: human capital.
The selfishness of the haves has contributed to loss of competitiveness. The old GM
was paying $100-$200 per car in health insurance costs, and manufacturers were
also forced to provide remedial education for high school graduates to enter the world
of complex modern manufacturing. Neither was a similar burden on competitors from
Japan and Germany. Suffice to say though that this was not the only reason for
But selfishness is not all with regard to healthcare, the focus of this piece. The
biggest culprit by far is general complacency. Added to a Republican majority in
Congress and Donald Trump, there is little hope in the near future.
Reading about healthcare recently, I came across an article in a prestigious magazine
offering a solution. Affiliated to Stanford, the authors were a MD/MBA candidate and
a venture capitalist adjunct. It says it all. Why would a doctor want an MBA? It is not
an uncommon program, by the way. The answer is simple and obvious: the medical
profession is big business. Did the authors have a prescription? Indeed they did.
Force everyone to have insurance and force insurers to insist on primary care.
As a percent of GDP, the U.S. spends more on healthcare than any other
industrialized nation. Yet it lags far behind in measures like child and maternal
mortality, life expectancy an chronic illness.
A survey last November by the New York based Commonwealth Fund compared the U.S. with
10 other advanced countries. The Netherlands came out on top; the U.S. dead last. By
coincidence, the Dutch are the tallest people on earth. "U.S. adults are sicker and have the
highest rates of material hardship," observed Robin Osborn who led the survey. A dramatic
[https://www.propublica.org/article/why-giving-birth-is-safer-in-britain-than-in-the-u-s] serves as
the backdrop for a comparison of obstetrical procedures in the U.S. and the U.K., which has
three times less maternal deaths in childbirth.
Of note, despite dilapidated facilities in Cuba, universal healthcare has paid off. Life
expectancy is higher than the U.S. by about a year.
The slogan 'Medicare for all' is catchy, and, were it to happen, would transform
healthcare. All the same, Medicare has gaps throwing people back into the arms of
insurers, and into the morass of bills from hospitals, accounting by insurers as to what
is covered, and arguments back and forth; not to mention overcharges by hospitals,
which have their own litany of unbelievable tales.
In the British system -- under attack by the Conservatives for some time and being
gradually dismantled -- no one ever sees a bill. It allowed post Second World War
generations of poor and disadvantaged to bring up healthy, educated children who
contributed to the growth of the country.
If there is an answer to the problems in the U.S. system, it will have to come from
independent experts. Profit oriented hospital corporations buying up community
hospitals and headed by multi-million salaried CEOs is not the answer. Neither are
for-profit insurers. Who has the guts to pour 'liquid plumber' down this clogged-up
drain? That is the real question. The Canadian politician who fought for their
healthcare system is a national hero. Any takers here?