I wonder if that Confederate flag will become a symbol of freedom.

June 27th, 2015

Confederate_Rebel_Flag.svg

The hysteria is in high gear over the Confederate battle flag. The controversy began with the the shooting of nine people in the Emmanuel AME Church in Charleston, SC by a schizophrenic young man. South Carolina is, of course, the first state to secede from the union after Lincoln’s election in 1860. Since the Civil War, South Carolina has been ruled by the Democratic Party until the past few years when Republicans have elected the governor and legislature. In 1962, in an act of defiance, Governor Fritz Hollings (D) presided over the placing to the Confederate flag on the capital building. The flag was subsequently moved to a Confederate memorial on the capital grounds by a Republican governor.

Meanwhile, Fox News’s Special Report noted this fact during one of the show’s “All-Star Panel” segments with host Bret Baier alluding to it as well as how a Republican was in office when the flag was taken down from the dome and moved to the Capitol’s grounds as a compromise in 1998.

The shooter appears to me to be a paranoid schizophrenic who lived in appalling conditions with a weird father who seemed to care little about his welfare.

The hysteria about the Confederate flag seems to be a planned assault on southern states and on conservative politics. The fact that the South was ruled by Democrats until very recently is also an issue for these people who resent the recent appeal of the Republican Party. The cry of “Racism” seems a bit exaggerated when there is a trend recognized even by the leftist New York Times of black families moving back to the southern states.

The percentage of the nation’s black population living in the South has hit its highest point in half a century, according to census data released Thursday, as younger and more educated black residents move out of declining cities in the Northeast and Midwest in search of better opportunities.

The share of black population growth that has occurred in the South over the past decade — the highest since 1910, before the Great Migration of blacks to the North — has upended some long-held assumptions.

Both Michigan and Illinois, whose cities have rich black cultural traditions, showed an overall loss of blacks for the first time, said William Frey, the chief demographer at the Brookings Institution.

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Obamacare Lives !

June 25th, 2015

UPDATE: The decision is analyzed at Powerline today with quotes for the decision.

The Affordable Care Act contains more than a few examples of inartful drafting. (To cite just one, the Act creates three separate Section 1563s. See 124 Stat. 270, 911, 912.) Several features of the Act’s passage contributed to that unfortunate reality. Congress wrote key parts of the Act behind closed doors, rather than through “the traditional legislative process.” Cannan, A Legislative History of the Affordable Care Act: How Legislative Procedure Shapes Legislative History, 105 L. Lib. J. 131, 163 (2013). And Congress passed much of the Act using a complicated budgetary procedure known as “reconciliation,” which limited opportunities for debate and amendment, and bypassed the Senate’s normal 60-vote filibuster requirement. Id., at 159–167.

Therefore, Roberts rewrote it. Nice !

Today, the Supreme Court upheld the Obamacare state exchange subsidies.

The Supreme Court has justified the contempt held for the American people by Jonathan Gruber. He was widely quoted as saying that the “stupidity of the American people “ was a feature of the Obamacare debate. This does not bother the left one whit.

Like my counterparts, I have relied heavily on Gruber’s expertise over the years and have come to know him very well. He’s served as an explainer of basic economic concepts, he’s delivered data at my request, and he’s even published articles here at the New Republic. My feelings about Gruber, in other words, are not that of a distant observer. They are, for better or worse, the views of somebody who holds him and his work in high esteem.

The New Republic is fine with him and his concepts.

It’s possible that Gruber offered informal advice along the way, particularly when it came to positions he held strongly—like his well-known and sometimes controversial preference for a strong individual mandate. Paul Starr, the Princeton sociologist and highly regarded policy expert, once called the mandate Gruber’s “baby.” He didn’t mean it charitably.

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Planning a trip to Greece

June 20th, 2015

I have been a student of Greek history for many years. When I was a medical student and later a surgery resident, I kept a copy of J.B.Bury’s “History of Greece to the Death of Alexander on my bedside table as reading material for relaxation. I have read it several times.

Another source of pleasure has been the novels of Mary Renault, the pen name of Eileen Mary Challans. Sh wrote a series of historical novels which won awards and which provided a more intimate view of Greek society in the classical era. Some of her novels provide a more sympathetic view of homosexuality than I have found anywhere else but that is not the attraction. Her history sounded like something written by one who lived it.

Another favorite novelist is Helen MacInnes who wrote novels of adventure set in and after World War II. Two of them were about places in Greece and one of those, Mykonos, is a favorite spot.

Mykonos harbor

Her novel describes this harbor and, while a new cruise ship terminal has replaced some of her story, the harbor looks just as she described it.

Mykonos square

The story, titled “The Double Image” describes a tiny square in the town that sounds exactly like this one looks.

We are looking forward to this trip with some trepidation, however. Why ? Because Greece may be heading into serious trouble.

Since December, Greeks have been preparing for a weekend such as this, pulling more than 30 billion euros out of banks. Week after week, the Bank of Greece borrowed banknotes from the rest of the continent to replenish this hoarding of the one asset Greeks still trust — cold, hard cash. Its liabilities to the rest of the euro area for the excess physical cash it has to put into circulation quadrupled between December and April, the last month for which there’s available data.

In November of 2012, there was rioting in Athens and it was about proposed austerity.

On the same day that Greece’s parliament passed harsh new austerity measures as part of a multi-billion euro rescue package, workers cleared wreckage from burned-out buildings damaged during a round of intense riots the day before.

The unpopular bailout deal requires dramatic cuts in wages, pensions and jobs, according to Reuters, and Sunday’s protests saw the worst violence in Athens in years.

Since those riots, a new radical leftist government has been elected that has vowed to defy the EU and austerity.

Greece’s new leftist government opened talks on its bailout with European partners on Friday by flatly refusing to extend the program or to cooperate with the international inspectors overseeing it.

Prime Minister Alexis Tsipras’ government also sacked the heads of the state privatization agency after halting a series of state asset sales.

The politically unpopular policy of privatization to help cut debt is one of the conditions of Greece’s 240-billion-euro bailout that has imposed years of harsh austerity on Greece.

Now, the moment of truth approaches and what will happen ?

Everything comes together on Monday [Monday June 22 !]. Greek Prime Minister Alexis Tsipras, back from a visit with Vladimir Putin in St. Petersburg, will spend his weekend coming up with a proposal to take to a Monday showdown with euro-area leaders.
A deal there is key. The bailout agreement that’s kept Greece from defaulting expires June 30. That’s the day Greece owes about 1.5 billion euros to the International Monetary Fund.
In an interview published Saturday in Brussels-based l’Echo newspaper, Greek Finance Minister Yanis Varoufakis warned that the ruling Syriza party could be replaced by neo-Nazis if Greece ends up defaulting and leaving the euro.

This may be standard leftist scare tactics but what will happen ? We have planned the trip to anticipate potential trouble in Athens. I have been to Athens before and have been to the Acropolis and the Parthenon.

Annie in Athens

Annie much more photogenic than I am and this was taken when she was 14 and standing on the Acropolis.

The plan is to fly to Athens and then spend only two nights there. I have planned a side trip to another place described in one of Helen MacInnes’ novels, Decision at Delphi, which is set soon after World War II and describes Sicily as well as Athens and Delphi. Delphi is quite high in the mountains north of Athens and involves some climbing so we will spend most of that time in the Delphi Museum.

Important finds included sculptures from the Temple of Zeus, the Nike of Paeonius, the Hermes of Praxiteles and many bronzes. In total 14,000 objects were recorded. The finds were displayed in a museum on the site.

Today, the Museum contains treasures from those excavations.

olympia-museum-greece

The museum itself.

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And the interior with the exhibits. The trip can be made in a day and I have made arrangements.

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On the way to Delphi, I want to make a short side trip to see the Lion of Chaeronea. This statue was erected over the common grave of the Sacred Band of Thebes. This was a unit of sworn lovers, probably all homosexual but in the fashion of classical Greece in which women were closely held in harem-like seclusion and men tended to adopt a pattern of an older man with a younger boy which might be merely sexual or it might be a sort of apprenticeship in arms. The Sacred Band had never been defeated in battle until that day, August 2, 338 BC. On that day, the Sacred Band was annihilated by the army of Philip II of Macedon, the father of Alexander the Great. The Band was buried in common grave and the lion statue erected over their grave. It was found by British tourists around 1900 and excavated and restored. Beneath the site were found the skeletons of nearly 300 men.

Battle_of_Chaeronea,_338_BC_en.svg

The battle,according to accounts which survived, was won when the Macedonians’ right flank conducted a sudden retreat, drawing the Athenians out of line. The Sacred Band was destroyed holding the line. I want to see their grave.

After that day trip, we plan to fly to Thessaloniki, a city east and north of Athens to visit the tomb of Philip II, the father of Alexander and winner of the battle of Chaeronea.

philip-woman-warrior-greaves_as_found

The remains in the tomb have recently been confirmed as those of Philip II

The tomb, itself, is well preserved and restored. The town of Vergina is near Thessaloniki and too far from Athens to drive in a day.

From Thessaloniki, we will fly to Crete and spend a few days near the Palace of Knossos and its museum.

knossos

The museum and the palace ruins should keep us busy for five days, then we fly back to Athens for one night and catch our flight to London and home the next day.

Or so the plan goes.

The book is now on Amazon.

June 17th, 2015

cover.

I have a new book out on Kindle that is now published. It is called “War Stories: 50 Years in Medicine.”

I’ve been working on this for 20 years and kept having to revise it as I would put it down and then go back to it after ten years. I finally decided to rework it and publish it two years ago. My students were reading the draft on my laptop while I was editing so maybe it will be interesting.

It is a memoir of patients. They are all patients’ stories that I have tried to describe accurately and to describe what we did then. Sometimes I screwed up and I tell those stories, too. Sometimes we did the best we could and we now know better. Some of these cases are still hard to explain.

Two of them, in the chapter on Melanoma, are about young women who developed major melanoma metastases years after the primary was excised but when they had become pregnant. The melanoma went wild in pregnancy, in one case ten years later. In the other, three years after I had removed the primary, she developed extensive metastases while pregnant. She refused abortion and I thought it would cost her her life. In both cases the melanoma vanished after pregnancy ended. In one case, the woman, last I heard, was free of melanoma 25 years later. The other was free ten years later. The medical literature says pregnancy has no effect on melanoma. Neither ever became pregnant again.

Another case is an example of the only supernatural near-death experience I have ever heard.

The book starts when I began medical school in 1961 and describes experiences with patients, including my summer working with schizophrenic men in 1962. I have a series of stories about patients I saw as a student and sometimes intersperse stories from later that are about similar cases and events. One that is amusing, I guess, is about my very first pelvic exam, on a 40 year old prostitute who had just gotten out of prison and enjoyed it thoroughly. I had a dozen student nurses as witnesses. I do have some biography in it but try to keep it to minimum.

After the first eight chapters, I go on to residency and then finally to private practice. I continued to teach and there are a few of those stories. There is a chapter on ethics including my thoughts on euthanasia and “benign neglect.” Toward the end of my career, I started and ran a trauma center in our community hospital. I also did a fair amount of testifying in court in both trauma cases and some civil cases where I testified for plaintiffs and for defense. I consider it a compliment that Kaiser Permanente had me testify for their defense even though I had also testified against them.

Anyway, the book is on Kindle and I hope somebody is interested. It has some similarity to my medical history book, which I plan to do a Kindle version of once this one is launched. In this one, I spend some time explaining the diseases in a way that I used to explain to patients and I still do to students. Without some basic understanding, most of these stories would not make sense and I hope the explanations are not too dull. If so, all comments are welcome. If anyone likes it, feel free to post a review on Amazon. Two reviewers from the first book in 2004 told me to let them know if I did another one and I have contacted them.

If anyone wants to discuss the book here, feel free to add comments. I guess I should add a link to my medical history book, A Brief History of Disease, Science and Medicine.

Is the Republican Party Worthwhile ?

June 14th, 2015

hillary

Today, an interesting column was published suggesting that, if the Republicans don’t beat Hillary, they should just disband the party.

I think this makes some sense. We have an attractive group of candidates and some valid issues, including the economy and foreign policy. She is a terrible candidate.

Add this to the mounting scandals, polls showing a lack of trust for her, the historical difficulty of political parties winning three presidential elections in a row, and the deep bench of fresh-faced Republican options, and the GOP should be in prime position to win the next election.

But the next election will test whether demographic headwinds are too much for Republicans to overcome.

Maybe the country is just not serious about issues anymore.

She brought up Republican skepticism on climate change and opposition to abortion, saying “they shame and blame women rather than respect our right to make our own reproductive health decisions.”

She blasted Republicans for supporting policies that would increase deportation of immigrants and for “turn[ing] their backs on gay people who love each other.” She lashed out at Republican support for voter ID laws. “I’ll fight back against Republican efforts to disempower and disenfranchise young people, poor people, people with disabilities and people of color,” she said. And she argued that, “Fundamentally, [Republicans] reject what it takes to build an inclusive economy. It takes an inclusive society.”

Some of us read history and can recall that the Whig Party dissolved over the issue of slavery. The history of the Whig Party was of a party devoted to economic progress. It was also a party of opposition. Lincoln, when a Whig, opposed the Mexican War at some cost to himself.

The work of the Whigs was, as (James G.) Blaine admitted, negative and restraining rather than constructive. Still, “if their work cannot be traced in the National statute books as prominently as that of their opponents, they will be credited by the discriminating reader of our political annals as the English of to-day credit Charles James Fox and his Whig associates—for the many evils they prevented.” If that is true, then we have not had very much in the way of “impartial” histories of American politics since Blaine’s day.

Also true. Particularly Coolidge and Harding were slandered by the Progressives of the New Deal and its apologists.

Part of the success of Schlesinger’s casting of antebellum America as Jacksonian lay in Schlesinger’s identification of Andrew Jackson and Jackson’s Democratic party with Franklin Delano Roosevelt and the New Deal. To this day, one comes away from The Age of Jackson with the clear sense that Jackson and the Jacksonians embodied democracy and championed the interests of the “common man,” while the Whigs were the voice of selfish elite interests, and looked like nothing so much as forecasts of Herbert Hoover and Robert Taft.

The Republicans have had hardly better treatment by the news media of today than the Whigs by the Progressives.

[T]he question arose whether the Whig complaint against Jacksonian Democracy might have had more substance to it than it had seemed.

That question rose first in one of the genuinely pathbreaking works of American political history, Daniel Walker Howe’s The Political Culture of the American Whigs (1979).

The Whigs sound more like Republicans today than those of the 19th century.

Howe reintroduced the Whigs, not as Eastern elitists bent upon wickedly obstructing the righteous class-leveling justice of Jackson/Roosevelt, but as the “sober, industrious, thrifty people,” as the party of the American bourgeoisie, attracting the economic loyalty of small businesses and small commercial producers, and enlisting the political loyalty of those who aspired to transformation. Transformation was the key concept. It made the Whigs optimistic and serious all at once, since it embraced both the religious moralists and moral philosophers of the established denominations and colleges who preached personal and moral transformation as well as the upwardly mobile professionals who found in the dynamic world of international commerce the opportunity to escape from rural isolation and agrarian drudgery.

Sound familiar ? The Whigs were the party of railroads and canals that linked commerce across the country. Their fall from power, and from grace, occurred as the culture broke apart in the colossal struggle with slavery.

it was the Whigs who advocated an expansive federal government—but it was a government that would seek to promote a general liberal, middle-class national welfare, promoting norms of Protestant morality and underwriting the expansion of industrial capitalism by means of government-funded transportation projects (to connect people and markets), high protective tariffs for American manufacturing, and a national banking system to regulate and standardize the American economy.

The question today is whether the Republican Party can cope with the rapid debasement of the culture with gay marriage and bizarre aberrations like transexual exhibitionism.

The Democrats seem to be succeeding with their new emphasis on the strange and the bizarre.

Jackson’s Democrats came off as frightened, snarling, and small-mindedly anticapitalist in mentality. Jacksonianism glorified agriculture and defined wealth as landholding, and its interest in the “common man” was limited to building defenses around an agrarian stasis—simple subsistence farming, trade in kind, and no taxes, banks, or corporations—that would never be threatened by the demons of competition or the fluctuations of markets. Linked to this preoccupation with stasis and personal independence was the Jacksonians’ resistance to public declarations of morality.

Andrew Jackson fought a duel with a man who criticized his wife, Rachel, who had some controversy regarding her previous marriage.

During the presidential election campaign of 1828, supporters of John Quincy Adams, Jackson’s opponent, accused his wife of being a bigamist, among other things.

Here is Holt’s story of the Whigs, in as compressed a fashion as possible: Rather than being a branch out of the root of Federalism, the Whigs evolved like the Jacksonians from the original Jeffersonian Republicans who triumphed in the “Revolution of 1800.” They were originally an opposition faction to Andrew Jackson in the 1820s, but they detached themselves as a separate organization in 1834 under the leadership of Jackson’s nemesis, Henry Clay of Kentucky, and took the name Whig to underscore their opposition to Jackson’s high-handed near-dictatorship in the presidency. They cast themselves first as republican antimilitarists.

The modern Republican Party has adopted national security as a core issue but it was not always so. Democrats dominated military subjects from 1912 until Lyndon Johnson when the party revolted over the Vietnam War. Republicans fought the Civil War over slavery, the basic reason of the party, but the rest of the century was one of peace and only Theodore Roosevelt, a figure of the early Progressive Movement, was interested in war. His career really took wing with the Spanish-American War, which was not a “war of necessity” shall we say.

The 1837 economic panic also set in place the two principal mechanisms for Whig electoral success, which were (a) to concentrate public attention on the failings of Democratic politics and (b) to scoop up the largest percentage of new voters in every presidential cycle. It is a significant point in Holt’s description of antebellum parties that American voters, once recruited to a party, rarely switched allegiances over time. What was critical in each presidential cycle, then, was to energize the existing Whig voter base by throwing their policy distinctives into sharp contrast to the Democrats’ and by organizing new voters.

Can the Republicans, or a succeeding party, interest new voters ? The welfare state did not exist prior to the New Deal and this has warped American politics in new and unprecedented ways.

[W]henever it made the mistake of relying on charming personalities to head tickets or making generous accommodations with the Democrats on major issues [it lost ground]. But keeping such focus steady was an ideological problem for Whigs. They prided themselves on being a coalition of independent thinkers, unlike (in their imagination) the disciplined faithful of the Democrats, and they did not hesitate to turn on each other with divisive and disheartening abandon. Linked to that, the Whigs valorized the image of themselves as statesmen rather than (like their opposite numbers) party hacks who loved politics only for the power political office conferred.

The similarity is striking. There are differences, of course,. The issues of the 1850s were not the same as they are now but there is a theme to be kept in mind.

What finished the Whigs was their failures, not over national policy questions, but in the state and congressional elections in 1854 and 1855, where the new parties could get the most ready purchase on the electorate. No longer did Whig voters, galvanized by Democratic awfulness, take their votes to Whig candidates to express their disgust; they could go to the Know-Nothings, to the Free-Soilers, the Republicans, and so on.

Third parties are no solution to the problem of the Republicans. I think the Tea Party must capture the party mechanisms and oust the representatives of The Ruling Class. If that does not occur peacefully, it may occur with violence.

Stanley McChrystal

June 13th, 2015

Hugh Hewitt interviewed General Stanley McCrystal on his radio show yesterday and the interview is pretty interesting. McCrystal has a memoir out called “My Share of the Task, and a new book on leadership called, “Team of Teams.

The discussion is pretty interesting. First of all, McCrystal was fired by Obama after a reporter printed a story about McCrystal’s officers disrespecting Obama.

In a statement expressing praise for McChrystal yet certainty he had to go, Obama said he did not make the decision over any disagreement in policy or “out of any sense of personal insult.” Flanked by Vice President Joe Biden, Defense Secretary Robert Gates and Adm. Mike Mullen, chairman of the Joint Chiefs of Staff, in the Rose Garden, he said: “War is bigger than any one man or woman, whether a private, a general, or a president.”

Of course, it was Obama’s petulance and sense of outrage that anyone would think him less than competent.

In the magazine article, McChrystal called the period last fall when the president was deciding whether to approve more troops “painful” and said the president appeared ready to hand him an “unsellable” position. McChrystal also said he was “betrayed” by Ambassador Karl Eikenberry, the man the White House chose to be his diplomatic partner in Afghanistan.

He accused Eikenberry of raising doubts about Karzai only to give himself cover in case the U.S. effort failed. “Now, if we fail, they can say ‘I told you so,'” McChrystal told the magazine. And he was quoted mocking Vice President Joe Biden.

McCrystal has emerged looking better and better and is obviously a great leader and general. Some of the interview’s insights into his leadership are worth repeating. I plan to read both books.

When I first took command, we were doing about four raids a month, or one a week, and we would take time to develop intelligence, rehearse the force, execute, and then try to digest it. By about two and a half years later, we were up to 300 raids a month or ten a night. And so for the force, it meant that most of the force fought every night. And so we would do the majority of operations at night, and then most of the force would go to bed about dawn. I would go to bed about dawn, wake up mid-morning, and then we’d spend that afternoon maturing intelligence, collecting, cross-leveling, making decisions on priorities, and then start to execute for that night. And then of course, there was a percentage of operations, because of emerging opportunities, that came during the day.

That was when he took over Joint Special Operations Command in Iraq.

On ISIS he has this to say.

I think the Islamic State is a threat that has to be taken seriously. But I think more broadly and more disturbingly, they’re a symptom. This is an organization with an unacceptable ideology, abhorrent behavior. They’re really not resonating with the vast majority of people in the region, but they’re holding terrain, they’re making progress, they’re frightening people, and that shouldn’t happen. It really, to me, symbolizes the incredible weakness of the Mid-East right now, and the weakness of developing a coalition. In better days, an organization like this ought to have a very short life, and it ought to be crushed quickly.

His conclusions are not very reassuring.

it appears that al Qaeda in Iraq now organized as the Islamic State or al Nusra in other places has increased their battle rhythm exponentially even as we’ve withdrawn from the field. Have you seen that from afar? Do you think they’re getting faster than they even were then? And by the way, kudos on the opening head fake second chapter in Team of Teams.
SM: Well Hugh, that’s exactly the conclusion I derive. What happened with al Qaeda in Iraq is they became a 21st Century organization not by intent, they just happened to grow during that period, and so they leveraged these. ISIS, I think, is a 21st Century manifestation of information technology. Think about their agility on the battlefield, and we see what they do, but think about how many people they influence every day with their information operations. They reach about 100 million people a day through various things. They only have recruit a tiny percentage of those to have a real impact.

HH: Do you think al-Baghdadi is as malevolent and as capable a character as al-Zarqawi, whom you hunted down and killed?
SM: Zarqawi was very good, and I’m not convinced that al-Baghdadi is. It seems to me he is more of an iconic figure. But he doesn’t have to run this thing. He doesn’t have to micromanage it. What he does is create the idea, create the environment, and then they operate in a very decentralized, rapid way that makes him very resilient.

They are growing and adapting rapidly. That is not good news.

As for Iran, he says this :

Are they as capable as our task force people are? Do you think the Iranians have this kind of adaptability that you’re talking about?

SM: I think that they do. They’re not as capable as we are in some of the technical systems. They’re not probably as well-trained in some of the small teams. But they have this extraordinary advantage of proximity. And I don’t mean physical proximity, I mean cultural proximity. They put people inside Iraq. They put people inside Syria. They allow their force to get close enough to have a really good feel for it. Of course, the leader, Soleimani, he’s around the battlefield, and he’s become an iconic, heroic figure, because he’s there and engaged.

China is less of an immediate concern.

SM: Well, I think the Chinese first are, they start with this growing economic power, which gives them a launch point to do things, to build aircraft carriers, to build cyber capacity. They’ve been spending an awful lot of money on their military now. They are not very overtly poking us in the eye around the world, in my view. What they are doing is raising the bar to the point where for the United States or even a coalition to shape China’s behavior either through containment or through threat, they’re raising the bar high enough where it’s going to be very difficult to do that, anti-ship missiles and other capabilities. So suddenly, they’re not in a position of being pushed around. I don’t think that they are posturing themselves, yet, for a confrontation, and they may never. I certainly wouldn’t claim to say that that’s their angle, but they want to be the middle kingdom. I mean, they had 200 bad years, but if you look at the sweep of history, that’s a pretty short period.

I agree. I think China is less of a threat than Russia right now and may never be. I plan to read his books.

What’s with the Trade Bill ?

June 11th, 2015

For years we have had trade authority granted to presidents as “fast track” authority so the treaties don’t become bidding wars in Congress. The treaty has to be voted up or down as a single entity. This has been done under Democrat and Republican presidents with Republicans usually more in favor of free trade. Under Bill Clinton, we had The North American Free Trade Agreement or NAFTA which was controversial on issues like Mexican truck drivers qualifications.

Obama has delayed a trade treaty with Columbia for political reasons for years until the GOP dominated Congress ratified the treaty in 2012, eight years after it was negotiated under Bush.

Colombia’s Congress approved the agreement and a protocol of amendment in 2007. Colombia’s Constitutional Court completed its review in July 2008, and concluded that the Agreement conforms to Colombia’s Constitution. President Obama tasked the Office of the U.S. Trade Representative with seeking a path to address outstanding issues surrounding the Colombia FTA.[2] The United States Congress then took on the agreement and passed it on October 12, 2011. The agreement went into effect on May 15, 2012.

At present President Obama is asking for “fast Track Authority” and may finally get it but the opposition is different this time.

The House will vote Friday on a bill that would give fast-track trade authority to President Barack Obama, a measure likely headed for passage in a close vote after months of lobbying by the White House and business groups.

Representative Kevin McCarthy, the California Republican who is majority leader, set out in a memo to lawmakers a two-day vote schedule designed to solidify support of Democrats who will back the bill. The House begins Thursday with a measure to promote trade with poorer countries.

Not all Republicans are on board, many because much of the bill is secret.

Regarding the Trans-Pacific Partnership, for example, there are around 30 major “chapters” being negotiated, many of which would reshape the rules and legal environment for business in the 21st century. Only a few of these 30 chapters directly involve “market access,” such as tariff rates and quota restrictions. Many more deal with cross-border investment, investor-state relations and international business regulation. Fast-track authority granted now would enable the administration to negotiate fundamental changes in business law and regulation without democratic scrutiny of the deals until it’s too late.

Both left and right are concerned about the secrecy. There have been disclosures of alleged portions of the bill.

The latest trove of secret trade documents released by Wikileaks is offering opponents of the massive deals currently being crafted by the Obama administration more fodder to show that such agreements can impact United States laws and regulations.

The latest leak purports to include 17 documents from negotiations on the Trade In Services Agreement, a blandly named trade deal that would cover the United States, the European Union and more than 20 other countries. More than 80 percent of the United States economy is in service sectors.

According to the Wikileaks release, TISA, as the deal is known, would take a major step towards deregulating financial industries, and could affect everything from local maritime and air traffic rules to domestic regulations on almost anything if an internationally traded service is involved.

Supporters, like the Wall Street Journal, which is using ad hominem style on opponents, are not addressing the arguments. The comments to the Journal article show it is not working.

A big free-trade vote is headed for the House floor as soon as Friday, and opponents have launched a honeypot operation to ply the dumber or more partisan Republicans into defeating the bill. Protectionists on the right claim that President Obama can’t be trusted, and their last gasp is to claim the bill includes secret new immigration powers that are nowhere in the bill.

I was not the only commenter who asked how they know this since the bill is secret. Supporters say the concerns are unfounded.

Brendan Buck, a spokesman for House Ways and Means Committee Chairman Paul Ryan (R-Wis.), pointed to the fast-track bill as a way to ensure people get to see what is in the deals before they pass, noting that under fast track, the president would have to unveil each proposal and wait for two months before Congress could vote on it.

“If secrecy is a concern, TPA is the solution,” Buck said. “For the first time, it will ensure a trade agreement is public and posted online for 60 days before it can be sent to Congress.”

If so, why is the bill a secret ?

This is the president who famously said, “If you like your doctor, you can keep your doctor.”

The problems seems to be a fundamental one of trust. After the Obama amnesty, who thinks he will respect the Constitution on trade agreements ?

Another D-Day anniversary.

June 6th, 2015

I have posted a few photos from our trips to Normandy in years past. I haven’t been back since then but have been reading about it. Here is SLA Marshall’s description of the first wave at Normandy.

It was very nearly a disaster for the whole invasion although Utah and the British and Canadian beaches were far less dangerous for the troops. One reason was the geography.

Utah Beach was nearly flat and there was no bluff as there was at Omaha. The problem at Utah was that the country behind the beach was low and the Airborne drop was to secure the causeways that controlled access to the dry ground beyond the fields flooded by the Germans. Sante Mere-Eglise was the center of the Airborne mission.

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It is much more quiet today although the famous parachute still hangs from the church roof.

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Chicago 2015

May 31st, 2015

I went back to the neighborhood where I grew up today. Here are some photos from that visit.

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This is the church I attended as a child. To the left is the rectory, the priests’ house. Behind that was the school where I attended kindergarten for a couple of days. After being rapped on the knuckles for some reason, I decided not to return. The next day, instead of going to school (I heard the school bell and knew I would be late, I went next door to the florist shop and nursery owned by friends of my father’s who knew me. I helped “Hug” Krause in the nursery until I heard the school bell ring at noon. I then left and walked home. I did not go back to school and, fortunately for me, we moved in November to our new house.

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This was the house we lived in until my father bought a new house on Paxton Avenue about a mile away. It is on Clyde Avenue between 75th and 76th streets.

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This is another view showing the house next door. That one was owned by an older couple who retired to Michigan where they bought a peach farm.

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St Philip Neri was the new parish and the church is still beautiful although the neighborhood shows serious trouble. The interior is worthy of a cathedral.

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At Christmas time the altar had life sized figures in a cresh on the altar to the side.

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St Philip Neri school where I attended from 4th grade until graduation from 8th grade. The elementary school building, which housed kindergarten to 3rd grade, has been razed to build a supermarket. Also gone is Aquinas high school where my sister attended. The school is larger now although the number of students is much reduced. The school building is dated 1913 and was originally the church, as well.

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This is the house I lived in from November 1944 until I left for college in August 1956. The house looks in good shape although the neighborhood has deteriorated.

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The basement had a party room built by my father after the purchase of the house for $12,000 in 1944. It was built in 1912 and had gas fixtures in the living room and the bathroom on the second floor. They were never used but installed as a precaution, I guess. The photo of the party room was taken about 1946 or so. Everybody was home from the war.

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The house next door was owned by an elderly man, Mr Hausler, with whom I spent many hours watching him build a new fence and restore his bluebird house every spring. He had a lovely yard which he kept meticulously. He even had the first sprinkler system I had ever seen.

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Directly across the street was the house owned by a patent attorney named Nearman who enjoyed working on electronics and who volunteered to repair any TV in the neighborhood that needed work.

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Next to Nearman’s was the house owned by a dentist named Cox. His daughter played with my sister.

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Across the street next to Nearman’s was the McGuire house, now in sad shape. Jack and Bobby and Ginny were kids we played with. Tom, the oldest was a music major and later moved to San Francisco where he was a church organist. The youngest, Billy, was born after I had left for college and he became an artist. He painted a very nice picture of our house. The house is now abandoned. It was a very nice home when I lived across the street.

Next to the McGuire house is one that was owned by an attorney named Monaghan. My sister Pat used to babysit for them. He had a beautiful wife named Lois and they had several servants. Lois Monaghan was serene except on the servants’ day off when she looked like different person. They were lovely people.

Michelle Obama grew up in a home on the next block long after we had left.

The neighborhood shows the effects of years of crime and the lack of commercial business although most of the houses show care by the owners.

Why Doctors Quit.

May 29th, 2015

Today, Charles Krauthammer has an excellent column on the electronic medical record. He has not been in practice for many years but he is obviously talking to other physicians. It is a subject much discussed in medical circles these days.

It’s one thing to say we need to improve quality. But what does that really mean? Defining healthcare quality can be a challenging task, but there are frameworks out there that help us better understand the concept of healthcare quality. One of these was put forth by the Institute of Medicine in their landmark report, Crossing the Quality Chasm. The report describes six domains that encompass quality. According to them, high-quality care is:

1) Safe: Avoids injuries to patients from care intended to help them
2) Equitable: Doesn’t vary because of personal characteristics
3) Patient-centered: Is respectful of and responsive to individual patient preferences, needs and values
4) Timely: Reduces waits and potentially harmful delays
5) Efficient: Avoids waste of equipment, supplies, ideas and energy
6) Effective: Services are based on scientific knowledge to all who could benefit, and it accomplishes what it sets out to accomplish

In 1994, I moved to New Hampshire and obtained a Master’s Degree in “Evaluative Clinical Sciences” to learn how to measure, and hopefully improve, medical quality. I had been working around this for years, serving on the Medicare Peer Review Organization for California and serving in several positions in organized medicine.

I spent a few years trying to work with the system, with a medical school for example, and finally gave up. A friend of mine had set up a medical group for managed care called CAPPCare, which was to be a Preferred Provider Organization when California set up “managed care.” It is now a meaningless hospital adjunct. In 1995, he told me, “Mike you are two years too early. Nobody cares about quality.” Two years later, we had lunch again and he laughed and said “You are still too years too early.”

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