Health Care

Freedom, the Village, and the Internet

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I’ve reviewed two books by German writer Hans Fallada: Little Man, What Now?, and Wolf Among Wolves  (the links go to the reviews), both of which were excellent. I recently finished his novel Every Man Dies Alone, which is centered on a couple who become anti-Nazi activists after their son Ottochen is killed in the war…it was inspired by, and is loosely based on, the true story of  a real-life couple who distributed anti-Nazi postcards and were executed for it.

I thought this book was also excellent…the present post, though, is not a book review, but rather a development of some thoughts inspired by a particular passage in the story.

Trudel, who was Ottochen’s fiancee, is a sweet and intelligent girl who is strongly anti-Nazi..and unlike Ottochen’s parents, she became an activist prior to being struck by personal tragedy: she is a member of a resistance cell at the factory where she works.  But she finds that she cannot stand the unending psychological strain of underground work–made even worse by the rigid and doctrinaire man (apparently a Communist) who is leader of the cell–and she drops out. Another member of the cell, who has long been in love with her, also finds that he is not built for such work, and drops out also.

After they marry and Trudel becomes pregnant, they decide to leave the politically hysterical environment of Berlin for a small town where–they believe–life will be freer and calmer.

Like many city dwellers, they’d had the mistaken belief that spying was only really bad in Berlin and that decency still prevailed in small towns. And like many city dwellers, they had made the painful discovery that recrimination, eavesdropping, and informing were ten times worse in small towns than in the big city. In a small town, everyone was fully exposed, you couldn’t ever disappear in the crowd. Personal circumstances were quickly ascertained, conversations with neighbors were practically unavoidable, and the way  such conversations could be twisted was something they had already experienced in their own lives, to their chagrin.

Reading the above passage, I was struck by the thought that if we are now living in an “electronic village”…even a “global village,” as Marshall McLuhan put it several decades ago…then perhaps that also means we are facing some of the unpleasant characteristics that–as Fallada notes–can be a part of village life. And these characteristics aren’t something that appears only in eras of insane totalitarianism such as existed in Germany during the Nazi era. Peter Drucker, in Managing in the Next Society, wrote about the tension between liberty and community:

Rural society has been romanticized for millenia, especially in the West, where rural communities have usually been portrayed as idylic. However, the community in rural society is actually both compulsory and coercive…And that explains why, for millenia, the dream of rural people was to escape into the city.  Stadluft macht frei  (city air frees) says an old German proverb dating back to the eleventy or twelfth century.

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The Drug War

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My sentiments on the whole drug question have been influenced by some experience with the medical aspect of the problem. Drugs are slipping out of any control due to developments in synthetic variations of older substances that stimulate brain chemistry, sometimes in unknown ways. The traditional drugs, if we can use that term, are also slipping out of control with Mexican drug wars replacing the Columbian cartels even more violent than their predecessors.

What about marijuana ? It is widely used by the younger generation and, while I do think there are some harmful consequences, especially in potential schizophrenics, the fact is that the laws are widely ignored and do little good and much harm. First, what about the link to psychosis ?

Epidemiological studies suggest that Cannabis use during adolescence confers an increased risk for developing psychotic symptoms later in life. However, despite their interest, the epidemiological data are not conclusive, due to their heterogeneity; thus modeling the adolescent phase in animals is useful for investigating the impact of Cannabis use on deviations of adolescent brain development that might confer a vulnerability to later psychotic disorders. Although scant, preclinical data seem to support the presence of impaired social behaviors, cognitive and sensorimotor gating deficits as well as psychotic-like signs in adult rodents after adolescent cannabinoid exposure, clearly suggesting that this exposure may trigger a complex behavioral phenotype closely resembling a schizophrenia-like disorder. Similar treatments performed at adulthood were not able to produce such phenotype, thus pointing to a vulnerability of the adolescent brain towards cannabinoid exposure.

This suggests that adult use may be less harmful.

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Alternatives to Obamacare

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As Obamacare looks more and more as though it will collapse, there are some alternatives beginning to appear. Several years ago, I suggested using the French system as a model. At the time, the French system was funded by payroll deduction, a source affected by high unemployment, and used a national negotiated fee schedule which was optional for doctors and patients. The charges had to be disclosed prior to treatment and the patient had the option of paying more for his/her choice of physician. Privately owned hospitals competed with government hospitals and patient satisfaction was the highest in Europe.

Recently the French system has run into trouble.

French taxpayers fund a state health insurer, “Assurance Maladie,” proportionally to their income, and patients get treatment even if they can’t pay for it. France spends 11% of national output on health services, compared with 17% in the U.S., and routinely outranks the U.S. in infant mortality and some other health measures.

The problem is that Assurance Maladie has been in the red since 1989. This year the annual shortfall is expected to reach €9.4 billion ($13.5 billion), and €15 billion in 2010, or roughly 10% of its budget.

This may be due to several factors. The French economy is in terrible shape with high unemployment. More of the funding for the health plan is coming from general revenues. This was not how it was supposed to work. It was payroll funded, much as the German system is, with a wider source than individual employers. This allows mobility for employees and allows employers to distribute risk among a larger pool. Germany allows other funding sources such as towns and states. I think it is still a good model for us but, with the passage of Obamacare, it will take a generation before another large reform would be viable. Obamacare must stand or fall first and I think it will fall but, as in most government programs, it takes years before the sponsors will admit defeat.

Another proposal has been made by a serious study group.

1. The government should offer every individual the same, uniform, fixed-dollar subsidy, whether used for employer-provided or individual insurance. For everyone with private health insurance, the subsidy would be realized in the form of lower taxes by way of a tax credit. The credit would be refundable, so that it would be available to individuals with no tax liability.

2. Where would the federal government get the money to fund this proposal?

We could begin with the $300 billion in tax subsidies the government already “spends” to subsidize private insurance. Add to that the money federal, state and local governments are spending on indigent care. For the remainder, the federal government could make certain tax benefits conditional on proof of insurance. For example, the $1,000 child tax credit could be made conditional on proof of insurance for a child.10 For middle-income families, a portion of the standard deduction could be made conditional on proof of insurance for adults. For lower-income families, part of the Earned Income Tax Credit could be conditioned on obtaining health coverage.

3. If the individual chose to be uninsured, the unclaimed tax relief would be sent to a safety net agency providing health care to the indigent in the community where the person lives, so that it would be available there in case he generates medical bills he cannot pay from his own resources. The result would be a system under which the uninsured as a group effectively pay for their own care, without any individual or employer mandate. By the very act of turning down the tax credit for health insurance in choosing not to insure, uninsured individuals would pay extra taxes equal to the average amount of the free care given annually to the uninsured. The subsidies for the insurance purchased by the insured would then effectively be funded by the reduction in expected free care the insured would have consumed if uninsured. [See Figures II and III.]

The paper goes on to explain the proposal The trouble is that this is another major reform and I see no chance for it in the foreseeable future.

What then is the most likely development ?

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When Nixon Meets RICO, Obama’s Real IRS Problem

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Over the week end of May 18-19 2013 the Obama Administration official Dan Pfeiffer went out and spun the IRS scandal saying “The law is irrelevant”. On the contrary, the law is very much relevant to the IRS scandal, including prohibitions against specific acts by IRS personnel and more general laws of which the ones to watch concern private civil actions for damages under the federal Racketeering, Influence and Corrupt Organizations (RICO) Act (18 USC 1961, et seq.) and Civil Rights Act (42 USC 1983, et seq.). There is every possibility that the victims of the IRS’s suppression of Obama political opponent free speech rights will sue the IRS and individual IRS employees under the civil rights and civil RICO laws for a $150-to-$650 million legal payday.

Remember, _THE IRS CONFESSED_. There is no argument that it admitted some of its actions concerning Tea Party organization tax-exempt applications were unlawful, i.e.., illegal. It is obvious that the IRS and its staff engaged in an organized multi-work unit, multi-state, plus Washington DC Headquarters, wide conspiracy to suppress the Tea Party. The IRS unlawfully applied special rules to Tea Party applicants that it did not to others and that conspiracy prevented them from exercising their free speech rights for the 2010 and 2012 election cycles.

It also is very clear that the IRS — via the questions it was asking the Tea Party and other religious non-profits — was busy creating a quite extensive Nixonian/Ailinskyite ENEMIES LIST for future use in intimidation and the depriving Obama Administration political opponents of their Constitutional Rights.

Those are classic CONSPIRACY AGAINST RIGHTS (18 USC 241) and DEPRIVATION RIGHTS UNDER COLOR OF LAW (18 USC 242) violations.

See these criminal federal civil rights statutes, whose violation gives rise to civil liability for damages too:

“Conspiracy Against Rights (18 USC 241)
If two or more persons conspire to injure, oppress, threaten, or intimidate any person in any State, Territory, Commonwealth, Possession, or District in the free exercise or enjoyment of any right or privilege secured to him by the Constitution or laws of the United States, or because of his having so exercised the same; or

If two or more persons go in disguise on the highway, or on the premises of another, with intent to prevent or hinder his free exercise or enjoyment of any right or privilege so secured—

They shall be fined under this title or imprisoned not more than ten years, or both; and if death results from the acts committed in violation of this section or if such acts include kidnapping or an attempt to kidnap, aggravated sexual abuse or an attempt to commit aggravated sexual abuse, or an attempt to kill, they shall be fined under this title or imprisoned for any term of years or for life, or both, or may be sentenced to death.”

and

“Deprivation Rights Under Color of Law (18 USC 242)
Whoever, under color of any law, statute, ordinance, regulation, or custom, willfully subjects any person in any State, Territory, Commonwealth, Possession, or District to the deprivation of any rights, privileges, or immunities secured or protected by the Constitution or laws of the United States, or to different punishments, pains, or penalties, on account of such person being an alien, or by reason of his color, or race, than are prescribed for the punishment of citizens, shall be fined under this title or imprisoned not more than one year, or both; and if bodily injury results from the acts committed in violation of this section or if such acts include the use, attempted use, or threatened use of a dangerous weapon, explosives, or fire, shall be fined under this title or imprisoned not more than ten years, or both;

and if death results from the acts committed in violation of this section or if such acts include kidnapping or an attempt to kidnap, aggravated sexual abuse, or an attempt to commit aggravated sexual abuse, or an attempt to kill, shall be fined under this title, or imprisoned for any term of years or for life, or both, or may be sentenced to death.”

That is the criminal side of things.

The problem AG Holder is going to suffer obstructing discovery in civil rights and civil RICO lawsuits against the IRS is that criminal prosecutions and civil suits for damages proceed in tandem. The civil suits aren’t stayed by criminal prosecutions on the same subject, let alone by criminal “investigations” short of prosecutions.

The IRS “Special Group’s” delay of tax exempt status prevented Tea Party NGO’s from fund raising and participating in two political cycles (2010 and 2012) by educating “low information voters” as to the political issues of the day, like the National Rifle Association does. The NGO’s whose applications for tax-exempt status were slow-rolled can claim “trade and business” damages under Civil RICO provisions of Federal law. And the Supreme Court of the USA decided decades ago that criminal acts by the Federal government “under the color of law” do not qualify for sovereign immunity under the Federal supremacy clause of the constitution.

To quote a lawyer I know

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Conspiracy Theories

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Last week was a week for the conspiracy theories. First, we had Benghazi and the hearings which interviewed career State Department officers, most of whom probably vote for Democrats. The fact that they were ordered not to talk to Congressmen and denied any attempt at help when under attack, even from as close as Tripoli, invites speculation about motive. Peggy Noonan, a little unusually, hits this one out of the park.

Since it is behind a pay wall, I’ll quote a few bits.

What happened in Benghazi last Sept. 11 and 12 was terrible in every way. The genesis of the scandal? It looks to me like this:

The Obama White House sees every event as a political event. Really, every event, even an attack on a consulate and the killing of an ambassador.

Because of that, it could not tolerate the idea that the armed assault on the Benghazi consulate was a premeditated act of Islamist terrorism. That would carry a whole world of unhappy political implications, and demand certain actions. And the American presidential election was only eight weeks away. They wanted this problem to go away, or at least to bleed the meaning from it.

That sounds about right to me.

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