Saturday, February 16, 2008
Important Video
When the election is over and some poor son of a bitch or whatever is elected to clean up Our Leaders' messes, this will live on. It's about priorities.
Friday, February 15, 2008
Shown: Our Leaders' Love For Their Vets
The Department of Veterans Affairs (VA) will treat about 333,000 sick and injured veterans of the Iraq and Afghanistan wars in 2009, according to VA statistics released last week. That number is a 14 percent increase over this year's casualty total. Yet, despite the Bush administration's promises to prioritize the VA even as other domestic departments' funds are cut, its annual budget request for next year places more financial burdens than ever on many returning soldiers.Link.
At first glance, Bush's 2009 budget may seem like a boon to veterans: It would increase the VA budget by $3.4 billion.
"The President's ongoing commitment to those who have faithfully served this country in uniform is clearly demonstrated through this budget request for VA," said VA Secretary James B. Peake at a budget hearing last Thursday. "Resources requested for discretionary programs in 2009 are more than double the funding level in effect when the president took office seven years ago."
However, veterans' advocates argue the budget's growth has not kept pace with the skyrocketing size of the veteran community - or the increasing cost of servicing them.
"Bush only provides the news on the increased budget without providing full facts on the increased demands and costs," said Paul Sullivan, executive director of Veterans for Common Sense.
Although the "discretionary spending" Peake mentions has indeed doubled since Bush entered office, the VA budget as a whole has only increased by about a third - roughly in proportion to the growth of the veteran population, according to VA statistics.
Peake's comparison of today's VA budget to that of seven years ago also sidesteps the reality of changing market values. Congressman Bob Filner, chairman of the House Veterans Affairs' Committee, says that regardless of the administration's sweeping claims, the 2009 VA budget is not much improvement over last year's. According to Filner, the budget's much-touted 5.5 percent increase for veteran health care "barely covers the cost of medical inflation."
"The service and sacrifice of our veterans is real, and the budget for the VA must provide realistic funding levels to meet these needs," Filner said in a statement upon the budget's release. "I am concerned that this budget proposal contains only modest increases for veterans' health care while paying for this slight increase with cuts in other veterans' programs below the historic levels this Congress provided for in this fiscal year."
For example, the new budget would require veterans to pay more out-of-pocket expenses, such as pharmacy co-pays and annual enrollment fees. Also, under Bush's plan, the VA's medical research budget would drop below 2007 levels, with the expectation the department would outsource its research needs.
"The VA reduces its research budget [in 2009] and sets sights on coordinating with other agency research activities, agencies such as the Institute of Medicine," said Rick Jones, legislative director of the National Association for Uniformed Services. "With so much unknown on traumatic brain injury and post-traumatic stress disorder, it seems ill-advised to depend on outside-agency coordination when these issues are veteran-centric."
The administration's proposal cuts the VA medical and prosthetic research budget by 8 percent and veterans' rehabilitation research by 7 percent.
It also slashes construction funds for new medical facilities by about 44 percent, with grants for construction of extended care facilities losing 49 percent.
Moreover, after the 2009 VA budget increase, the Bush plan calls for billions of dollars in budget cuts over the next four years, according to Filner. For a system already playing a losing game of catch-up, the reductions could be devastating.
"The VA's backlog of claims and appeals has been exacerbated by funding shortfalls," said Jay Agg, national communications director for American Veterans (AMVETS). "Currently, 870,000 veterans are awaiting decisions from the VA, a process that may take many months or even years. That's about the same size as 15 Yankee Stadiums full of veterans."
The administration has shown no signs of altering its 2009 VA request; in fact, it is currently immersed in a lawsuit defending its right to deny health care to Iraq and Afghanistan veterans.
However, veterans' advocacy groups aren't giving up. During last Thursday's testimony, Jones and representatives from several other organizations, including AMVETS, presented "The Independent Budget" (IB): their own proposal for next year's VA spending. It would up the Bush budget by almost $3 billion, emphasizing mental health research and medical facility construction.
"The IB is by veterans, for veterans, and provides a full picture of veterans' needs and how our government can meet them," Agg said. "Our position is that the administration and Congress, having authorized funding for war, must now be prepared to provide sufficient, timely and predictable funding to meet the needs of our war fighters."
Despite the Bush administration's firm stance on the VA budget, some advocates see signs of hope. Last Thursday's hearing was not a battle, according to Sullivan; in fact, administration officials appeared interested in listening to what the "other side" had to say.
"While Secretary Peake and VA's top political appointees testified first, they broke their usual pattern of quickly departing the hearing room," Sullivan said. "Instead of bolting for the door, Peake asked Under Secretary Kussman and Under Secretary Cooper to remain, and they all remained and listened to the testimony of ten different [veteran] groups."
As casualties mount and the end of the Bush administration draws nearer, Congress will take up the VA request and, likely by this summer, propose its own version of the budget.
And watch this:
Continuing: More Love For Our Troops From Our Leaders Who Sent Them To Patently Unnecessary Wars
The four tours in Iraq served by the Second Brigade at Fort Drum here have created an unusual level of stress, especially after the standard Iraq tour was increased to 15 months from 12. Yet according to a new report on the shortcomings of mental health care at the base, a soldier’s wait to be seen for psychological help can take more than a month.Link.
The draft report, “Fort Drum: A Great Burden, Inadequate Assistance,” which was given to The New York Times last week, was done by Veterans for America, a nonprofit advocacy organization for wounded members of the armed forces. It also uncovered several other problems with the mental health services on the post, which is north of Syracuse.
Based on interviews with a dozen soldiers and the mental health providers on the base, the report describes problems with understaffing, a reliance on questionnaires to identify soldiers in need of treatment and a sometimes dismissive view at the company level of post-traumatic stress disorder.
“The system is very much overburdened,” said Jason W. Forrester, director of policy for Veterans for America, in a telephone interview last week. “These problems are going to continue as long as we have units, such as the Second Brigade Combat Team, that have seen high-intensity combat, extended deployments and inadequate time between deployments.”
Maj. Gen. Michael Oates, the commander of the 10th Mountain Division, which includes the Second Brigade, acknowledged the shortcomings of the mental health care on the base, and said the problems were being addressed. “We recognize that there is stress on the force and our families from this conflict,” General Oates said. “But until recently we have not fully appreciated the extent of some of the mental stresses and injuries or how best to identify them”
In particular, he said, the providers of psychological services on the base have been expanding their effort to interview “those who are most at risk,” though “the screening process is not where we want it to be.”
Indeed, the report said that the wait for an appointment has eased since three Army psychiatrists were reassigned last month from Walter Reed Army Medical Center, joining three psychiatrists already on the base, to address the needs of 3,500 Second Brigade soldiers recently back from Iraq. But, the report noted, the reassignment was “only a temporary fix” since the psychiatrists from Walter Reed would probably return to Washington in a few weeks.
Fort Drum lacks its own hospital, so any soldier needing inpatient treatment has to be sent to Samaritan Medical Center in Watertown, which recently increased the number of beds in its psychiatric unit to 32 from 24.
But the report said that when the psychological facilities at the base have closed for the day, some soldiers have bypassed Samaritan and driven more than an hour to Syracuse for treatment. The Veterans for America report said the soldiers fear that doctors at Samaritan will side with some base leaders, who had, “in some cases, cast doubt on the legitimacy of combat-related mental health wounds.”
“The Department of Defense itself has recognized that with every tour you increase the likelihood of post-traumatic stress disorder,” said Adrienne Willis, spokeswoman for Veterans for America. “Here we have a brigade that has served four tours.”
Nor is the heavy service the only problem at Fort Drum. In the last two weeks, it has been at the center of a controversy over whether the Army instructed the Department of Veterans Affairs last March to stop helping soldiers there with their disability claims. At first, the Army surgeon general, Eric B. Schoomaker, denied that the Army had told Veterans Affairs to do so.
But after National Public Radio reported on a memorandum from the March meeting in Buffalo in which a colonel was quoted as directing Veterans Affairs to discontinue counseling, the surgeon general apologized for his denial and said it was based on a “miscommunication.”
In the report issued by Veterans for America, one soldier, Eli Wright, 26, who was a medic in Iraq in 2003 and 2004 and remains on active duty while awaiting a medical discharge, said his symptoms of post-traumatic stress disorder began after his tour ended and have worsened since then.
“My nerves are basically shot,” Mr. Wright said in a recent interview at the Different Drummer Cafe downtown. “I have flashbacks if I hear loud noises, especially if weapons are being fired. Sometimes just putting on my uniform can bring me right back to my experience in Iraq.”
He said that when he was in Iraq, he treated more civilians than American soldiers, and that two in particular stood out in his mind: an old woman and a child who were shot through a door as soldiers were “going door to door, tearing apart entire neighborhoods” searching for insurgents.
Mr. Wright said he waited weeks at Fort Drum to see a mental health professional, who diagnosed post-traumatic stress disorder. He was prescribed medication and pointed toward group therapy, where, he said, “half the time the group is staring at the floor.” At times, he was taking two pills at once. “I couldn’t stay awake,” he said.
But his chief complaint with the Army is the long wait for treatment. “The average wait time is five to six weeks,” he said. “When a soldier is having a mental breakdown, he has to wait over a month to see a counselor about his problems.”
Mr. Forrester of Veterans for America said that while the top brass at Fort Drum, especially General Oates, have spoken passionately about the need for soldiers to seek psychological treatment, others have not.
“There’s a trickle-down problem with the message, and that is that there’s still a pervasive stigma around mental health treatment in the military, along with a lack of confidentiality,” he said. “For those who still doubt the legitimacy of these wounds, they often are quite abusive of fellow soldiers or people in their units.”
While Fort Drum has two dozen psychologists, social workers and substance-abuse counselors, the low number of psychiatrists is worrisome because psychiatric medication is common, Ms. Willis said. “They’re heavily medicated, and it’s not something a social worker can deal with,” she said. “You really need a psychiatrist to manage that.”
America On The March!
What's the matter with Kansas?
It's fucked up, same as it always has been.
A woman can't referee a boys' basketball game 'cause no woman can be in an authoritative position over males.
It's fucked up, same as it always has been.
A woman can't referee a boys' basketball game 'cause no woman can be in an authoritative position over males.
Kansas activities officials are investigating a religious school's refusal to let a female referee call a boys' high school basketball game.Link. And after you read this and click on the link, you may search the website and look for the swimsuit pix.
The Kansas State High School Activities Association said referees reported that Michelle Campbell was preparing to officiate at St. Mary's Academy near Topeka on Feb. 2 when a school official insisted that Campbell could not call the game.
The reason given, according to the referees: Campbell, as a woman, could not be put in a position of authority over boys because of the academy's beliefs.
Campbell then walked off the court along with Darin Putthoff, the referee who was to work the game with her.
"I said, 'If Michelle has to leave, then I'm leaving with her,"' Putthoff said Wednesday. "I was disappointed that it happened to Michelle. I've never heard of anything like that."
Fred Shockey, who was getting ready to leave the gym after officiating two junior high games, said he was told there had been an emergency and was asked to stay and officiate two more games.
"When I found out what the emergency was, I said there was no way I was going to work those games," said Shockey, who spent 12 years in the Army and became a ref about three years ago. "I have been led by some of the finest women this nation has to offer, and there was no way I was going to go along with that."
Shockey noted that referees normally don't work Saturday games, but he agreed to officiate because his daughter's basketball game slated for that day was canceled.
The Activities Association said it is considering whether to take action against the private religious school. St. Mary's Academy, about 25 miles northwest of Topeka, is owned and operated by the Society of St. Pius X, which follows older Roman Catholic laws. The society's world leader, the late Archbishop Marcel Lefebvre, was excommunicated by Pope John Paul II in the late 1980s.
Gary Musselman, the association's executive director, said the organization will not make a decision until it confirms whether St. Mary's Academy has a policy of not allowing female referees to work boys basketball games.
If that is indeed the school's written policy, Musselman said, the association could decide to remove St. Mary's Academy from the list of approved schools and take away its ability to compete against the association's more than 300 member schools.
St. Mary's Academy officials declined comment when contacted by The Associated Press on Wednesday.
St. Mary's Academy is among 30 schools on the list that are not full association members but compete against schools that are. Musselman said St. Mary's Academy plays one or two games per season against member schools but has no more scheduled this school year.
He said if removed from the approved list for next school year, St. Mary's Academy still would be able to compete against approved schools that are not members of the association.
Musselman said the association hopes to resolve the matter sometime this week. He said he sent a letter to the school's principal, Vicente A. Griego, the day of the incident but has not heard back from him.
Putthoff and other supporters of Campbell said they believe state activities officials will handle the situation properly.
Campbell did not return phone calls seeking comment Wednesday.
However, she told The Kansas City Star that she was "dumbfounded" by the incident but that she is not angry at the school. She said she does not want the situation to go any further than it already has.
"This issue was going to come up eventually," said Campbell, 49, a retired Albuquerque, N.M., police officer who now lives in Ozawkie, Kan. "I just happened to be the person who was there this time.
"It's kind of a sticky situation. It needs to be looked at carefully, slowly, with all the facts."
Putthoff said he has called games at St. Mary's Academy off and on for 10 or 12 years, but doubts he will officiate at the school again.
"Out of defense to Michelle, I'm probably going to decline to go back there," he said. "We have to support our fellow officials."
Campbell, one of about five female referees in the Topeka Officials Association, has been officiating games for about two years.
"We don't support any institutions that would discriminate against any of our officials," said Steve Bradley, president of the Topeka group. "We support Michelle 100 percent.
"Michelle works hard. She cares about what she does. She is not a person who's on a crusade. She's a good person. She's a good official. You will not find a person who's more serious about doing a good job than Michelle."
Musselman said this was his first time dealing with a situation in which a school turned away a referee because of gender.
"We view officials not as male or female, Hispanic or African-American or Asian-American. We view officials as officials," Musselman said. "Discrimination against our officials is something we can't be party to."
Still, he said, the association wants to be fair to everyone involved and gather all the information before taking action.
FISA For Dummies
Greenwald spells it all out, nice and simply.
FISA was not enacted in 1842. If we are "forced" to live under that law for a few weeks or even longer, we are not "going dark." We are not "more vulnerable" to the Terrorists Who Want to Kill Us. Even under FISA, the Government is fully able to eavesdrop on all of the Terrorists and suspected Terrorists their hearts desire.
FISA was enacted in 1978 and updated multiple times since then to accommodate all the modern technologies Terrorists use, including cell phones and computers. It was even amended in October, 2001, when a Congress that was even more compliant than it is now gave the President every change he wanted to that law.
No need to take my word for it. Here is what the Leader himself said about FISA -- the law he is now attempting (with a drooling, eager assist from our press corps) to depict as some dangerous relic from the obsolete era of telegraphs -- once it was amended in October, 2001 by the Congress, during the ceremony where he signed those amendments into law:
FISA and the Protect America Act both equally allow eavesdropping on the Terrorists Who Want to Kill Us. The material difference is that FISA requires warrants for eavesdropping on Americans (after the fact, if necessary) while the Protect America Act allows the President to eavesdrop on any Americans without having any oversight at all. The difference does not relate to the ability to eavesdrop on the Terrorists but on the nature and level of oversight from that eavsdropping. Moreover, the FISA Court is and always has been a rubber-stamping tribunal that does not ever block any surveillance on any suspected Terrorists.
Thus, we're not all going to die under FISA. We're not "going dark." FISA is a modern law that was re-written at George Bush's direction and which he himself said allowed for full surveillance on all of the evil Terrorists and all of their complex, super-modern means of communications. None of this has anything to do with the Government's ability to listen in When Osama Calls. It is only about whether the nation's largest telecoms will have pending lawsuits, brought by their customers for breaking the law, dismissed by Congress. Is that really so hard to understand and explain?
UPDATE: One of the tortures I endured yesterday was watching the House hearing involving Roger Clemens and the trainer who claims to have injected him with steroids. The press could not have been any more riveted and was fully knowledgable of every relevant detail. Almost every House Committee member came to the hearing thoroughly prepared, grilled the witnesses with the expertise of an experienced litigator, and thundered about the grave seriousness -- and consequences -- of lying to Congress.
The drama was high, the gravity palpable, and the interest level intense. Ponder how much better our country would be if even a fraction of all of that were conjured up for acts of chronic lawbreaking and serial lying by our highest government officials, rather than our baseball stars.
On a not unreleated note, David Broder wrote his latest paean to "bipartisanship" today and made clear what he -- and most others -- mean by that (h/t Denning):
FISA was not enacted in 1842. If we are "forced" to live under that law for a few weeks or even longer, we are not "going dark." We are not "more vulnerable" to the Terrorists Who Want to Kill Us. Even under FISA, the Government is fully able to eavesdrop on all of the Terrorists and suspected Terrorists their hearts desire.
FISA was enacted in 1978 and updated multiple times since then to accommodate all the modern technologies Terrorists use, including cell phones and computers. It was even amended in October, 2001, when a Congress that was even more compliant than it is now gave the President every change he wanted to that law.
No need to take my word for it. Here is what the Leader himself said about FISA -- the law he is now attempting (with a drooling, eager assist from our press corps) to depict as some dangerous relic from the obsolete era of telegraphs -- once it was amended in October, 2001 by the Congress, during the ceremony where he signed those amendments into law:
The changes, effective today, will help counter a threat like no other our Nation has ever faced. . . .In his radio address the following week, this is the lavish praise the Commander-in-Chief heaped on the newly amended FISA law:
We're dealing with terrorists who operate by highly sophisticated methods and technologies, some of which were not even available when our existing laws were written. The bill before me takes account of the new realities and dangers posed by modern terrorists. It will help law enforcement to identify, to dismantle, to disrupt, and to punish terrorists before they strike. . . .
Surveillance of communications is another essential tool to pursue and stop terrorists. The existing law was written in the era of rotary telephones. This new law I sign today will allow surveillance of all communications used by terrorists, including e-mails, the Internet, and cell phones. As of today, we'll be able to better meet the technological challenges posed by this proliferation of communications technology. . .
The bill I signed yesterday gives intelligence and law enforcement officials additional tools they need to hunt and capture and punish terrorists. Our enemies operate by highly sophisticated methods and technologies, using the latest means of communication and the new weapon of bioterrorism.Every President until George Bush was able to defend the nation by engaging in surveillance under FISA. That even includes the Great and Powerful Warrior Ronald Reagan, who vanquished the incomparably nefarious Soviet Union while adhering to FISA. It was only George Bush who claimed that we would All Die unless FISA was modernized, and it was modernized -- repeatedly, to his satisfaction and at his direction.
When earlier laws were written, some of these methods did not even exist. The new law recognizes the realities and dangers posed by the modern terrorist. It will help us to prosecute terrorist organizations -- and also to detect them before they strike. . . .
Surveillance of communications is another essential method of law enforcement. But for a long time, we have been working under laws written in the era of rotary telephones. Under the new law, officials may conduct court-ordered surveillance of all modern forms of communication used by terrorists.
FISA and the Protect America Act both equally allow eavesdropping on the Terrorists Who Want to Kill Us. The material difference is that FISA requires warrants for eavesdropping on Americans (after the fact, if necessary) while the Protect America Act allows the President to eavesdrop on any Americans without having any oversight at all. The difference does not relate to the ability to eavesdrop on the Terrorists but on the nature and level of oversight from that eavsdropping. Moreover, the FISA Court is and always has been a rubber-stamping tribunal that does not ever block any surveillance on any suspected Terrorists.
Thus, we're not all going to die under FISA. We're not "going dark." FISA is a modern law that was re-written at George Bush's direction and which he himself said allowed for full surveillance on all of the evil Terrorists and all of their complex, super-modern means of communications. None of this has anything to do with the Government's ability to listen in When Osama Calls. It is only about whether the nation's largest telecoms will have pending lawsuits, brought by their customers for breaking the law, dismissed by Congress. Is that really so hard to understand and explain?
UPDATE: One of the tortures I endured yesterday was watching the House hearing involving Roger Clemens and the trainer who claims to have injected him with steroids. The press could not have been any more riveted and was fully knowledgable of every relevant detail. Almost every House Committee member came to the hearing thoroughly prepared, grilled the witnesses with the expertise of an experienced litigator, and thundered about the grave seriousness -- and consequences -- of lying to Congress.
The drama was high, the gravity palpable, and the interest level intense. Ponder how much better our country would be if even a fraction of all of that were conjured up for acts of chronic lawbreaking and serial lying by our highest government officials, rather than our baseball stars.
On a not unreleated note, David Broder wrote his latest paean to "bipartisanship" today and made clear what he -- and most others -- mean by that (h/t Denning):
The voters' message is getting through, not only in settling the fights for the Republican and Democratic nominations but in changing the mind-set of Washington.In Broderian Beltway World, when Democrats join the Republicans to give the Leader "exactly" what "he has sought," that is "bipartisanship." When they refuse to carry out the Leader's instructions, that's "partisan bickering."
The clearest evidence of the change is what happened last week on the economic stimulus bill. A week ahead of their self-imposed deadline, the House and Senate, by overwhelming votes, sent to President Bush almost exactly the kind of relief measure he had sought for the staggering economy.
Progress!
-- as in, Our Leaders succeed in dragging America even further down, in this case turning the clock way back on civil rights:
Thursday, February 14, 2008
God Bless Our Wonderful Legal System!
But let me tell you about our suit with the owner of a chicken-processing plant. We are suing for his workers, under the so-called WARN Act, which requires a notice before a plant closing. In this case, the owner did not give the required sixty days' notice before he closed the plant. "But the Department of Agriculture shut me down," the owner argues. "How could I foresee that?" He argues that year, he may have done bad things, and let rats run wild, and let rats shit on the chicken meat. And yes, it is even true that the inspectors of the Department of Agriculture gave him write-ups.Link.
But here is the issue: Was it reasonable for the owner to foresee that the Department of Agriculture would enforce its own regulations?
He had an argument: "I'm in the business, and they never enfore the law." Never. That was his claim. The Department of Agriculture is more or less a joke. Under Bush I, then Clinton, and then Bush II, it' gotten worse. "Everyone knows!" Nows comes the ruling of the district judge, who is a liberal, a Clinton appointee: Yes, he says, it was unforeseeable. It was as if he took judicial notice that as a matter of common knowledge, the government does not enforce the laws.
Case dismissed!
I'm still in shock that the employer got away with such an argument. But he had a point. We cut back on inspectors. We don't impose fines. So he had no way of knowing that the Department of Agriculture would shut him down.
In other words, the application of the Rule of Law is the equivalent of an act of God. Completely arbitrary. Like a hurricane.
Yes, we appealed. I helped edit the brief. It was not my case, but my colleague's. All I did was strike out the word "rodent" and put in the word "rat." And the word "rat" came up a lot because the plant was filthy: fill of rats and rat droppings all over the meat. The scary part was that the plant had gone on like this for years. The more we deregulate, and the more the inspectors are told not to threaten but to work in a "cooperative spirit," the more the rodents, and the rats, are free to go on dropping on our chicken wings and nuggets.
So what happened on appeal? Well, of course we argued that a judge cannot assume that it is "unforeseeable" for the laws ever to be enforced. In the United States, has the Rule of Law really come to this? Even though we got the District Court judgment reversed, we did not really win the point.
Instead, we have to go to trial. We have to have a trial to determine whether the owner of the chicken-processing plan has to believe the government when it says to him they're going to enforce the law.
Wednesday, February 13, 2008
The Truth About Canadian Healthcare?
In the universal health care debate, Canada is once again getting dragged into the fracas, shoved around by both sides as either an exemplar or a warning — and, along the way, getting coated with the obfuscating dust of so many willful misconceptions that the actual facts about How Canada Does It are completely obscured in the melee. As a health-care-card-carrying Canadian resident and an uninsured American citizen who regularly sees doctors on both sides of the border, I'm in a unique position to address the pros and cons of both systems first-hand.Part II
2008 is shaping up to be the election year that we finally get to have the Great American Healthcare Debate again. Harry and Louise are back with a vengeance. Conservatives are rumbling around the talk show circuit bellowing about the socialist threat to the (literal) American body politic. And, as usual, Canada is once again getting dragged into the fracas, shoved around by both sides as either an exemplar or a warning -- and, along the way, getting coated with the obfuscating dust of so many willful misconceptions that the actual facts about How Canada Does It are completely lost in the melee.
I'm both a health-care-card-carrying Canadian resident and an uninsured American citizen who regularly sees doctors on both sides of the border. As such, I'm in a unique position to address the pros and cons of both systems first-hand. If we're going to have this conversation, it would be great if we could start out (for once) with actual facts, instead of ideological posturing, wishful thinking, hearsay, and random guessing about how things get done up here.
To that end, here's the first of a two-part series aimed at busting the common myths Americans routinely tell each other about Canadian health care. When the right-wing hysterics drag out these hoary old bogeymen, this time, we need to be armed and ready to blast them into straw. Because, mostly, straw is all they're made of.
1. Canada's health care system is "socialized medicine."
False. In socialized medical systems, the doctors work directly for the state. In Canada (and many other countries with universal care), doctors run their own private practices, just like they do in the US. The only difference is that every doctor deals with one insurer, instead of 150. And that insurer is the provincial government, which is accountable to the legislature and the voters if the quality of coverage is allowed to slide.
The proper term for this is "single-payer insurance." In talking to Americans about it, the better phrase is "Medicare for all."
2. Doctors are hurt financially by single-payer health care.
True and False. Doctors in Canada do make less than their US counterparts. But they also have lower overhead, and usually much better working conditions. A few reasons for this:
First, as noted, they don't have to charge higher fees to cover the salary of a full-time staffer to deal with over a hundred different insurers, all of whom are bent on denying care whenever possible. In fact, most Canadian doctors get by quite nicely with just one assistant, who cheerfully handles the phones, mail, scheduling, patient reception, stocking, filing, and billing all by herself in the course of a standard workday.
Second, they don't have to spend several hours every day on the phone cajoling insurance company bean counters into doing the right thing by their patients. My doctor in California worked a 70-hour week: 35 hours seeing patients, and another 35 hours on the phone arguing with insurance companies. My Canadian doctor, on the other hand, works a 35-hour week, period. She files her invoices online, and the vast majority are simply paid -- quietly, quickly, and without hassle. There is no runaround. There are no fights. Appointments aren't interrupted by vexing phone calls. Care is seldom denied (because everybody knows the rules). She gets her checks on time, sees her patients on schedule, takes Thursdays off, and gets home in time for dinner.
One unsurprising side effect of all this is that the doctors I see here are, to a person, more focused, more relaxed, more generous with their time, more up-to-date in their specialties, and overall much less distracted from the real work of doctoring. You don't realize how much stress the American doctor-insurer fights put on the day-to-day quality of care until you see doctors who don't operate under that stress, because they never have to fight those battles at all. Amazingly: they seem to enjoy their jobs.
Third: The average American medical student graduates $140,000 in hock. The average Canadian doctor's debt is roughly half that.
Finally, Canadian doctors pay lower malpractice insurance fees. When paying for health care constitutes a one of a family's major expenses, expectations tend to run very high. A doctor's mistake not only damages the body; it may very well throw a middle-class family permanently into the ranks of the working poor, and render the victim uninsurable for life. With so much at stake, it's no wonder people are quick to rush to court for redress.
Canadians are far less likely to sue in the first place, since they're not having to absorb devastating financial losses in addition to any physical losses when something goes awry. The cost of the damaging treatment will be covered. So will the cost of fixing it. And, no matter what happens, the victim will remain insured for life. When lawsuits do occur, the awards don't have to include coverage for future medical costs, which reduces the insurance company's liability.
3. Wait times in Canada are horrendous.
True and False again -- it depends on which province you live in, and what's wrong with you. Canada's health care system runs on federal guidelines that ensure uniform standards of care, but each territory and province administers its own program. Some provinces don't plan their facilities well enough; in those, you can have waits. Some do better. As a general rule, the farther north you live, the harder it is to get to care, simply because the doctors and hospitals are concentrated in the south. But that's just as true in any rural county in the U.S.
You can hear the bitching about it no matter where you live, though. The percentage of Canadians who'd consider giving up their beloved system consistently languishes in the single digits. A few years ago, a TV show asked Canadians to name the Greatest Canadian in history; and in a broad national consensus, they gave the honor to Tommy Douglas, the Saskatchewan premier who is considered the father of the country's health care system. (And no, it had nothing to do with the fact that he was also Kiefer Sutherland's grandfather.). In spite of that, though, grousing about health care is still unofficially Canada's third national sport after curling and hockey.
And for the country's newspapers, it's a prime watchdogging opportunity. Any little thing goes sideways at the local hospital, and it's on the front pages the next day. Those kinds of stories sell papers, because everyone is invested in that system and has a personal stake in how well it functions. The American system might benefit from this kind of constant scrutiny, because it's certainly one of the things that keeps the quality high. But it also makes people think it's far worse than it is.
Critics should be reminded that the American system is not exactly instant-on, either. When I lived in California, I had excellent insurance, and got my care through one of the best university-based systems in the nation. Yet I routinely had to wait anywhere from six to twelve weeks to get in to see a specialist. Non-emergency surgical waits could be anywhere from four weeks to four months. After two years in the BC system, I'm finding the experience to be pretty much comparable, and often better. The notable exception is MRIs, which were easy in California, but can take many months to get here. (It's the number one thing people go over the border for.) Other than that, urban Canadians get care about as fast as urban Americans do.
4. You have to wait forever to get a family doctor.
False for the vast majority of Canadians, but True for a few. Again, it all depends on where you live. I live in suburban Vancouver, and there are any number of first-rate GPs in my neighborhood who are taking new patients. If you don't have a working relationship with one, but need to see a doctor now, there are 24-hour urgent care clinics in most neighborhoods that will usually get you in and out on the minor stuff in under an hour.
It is, absolutely, harder to get to a doctor if you live out in a small town, or up in the territories. But that's just as true in the U.S. -- and in America, the government won't cover the airfare for rural folk to come down to the city for needed treatment, which all the provincial plans do.
5. You don't get to choose your own doctor.
Scurrilously False. Somebody, somewhere, is getting paid a lot of money to make this kind of stuff up. The cons love to scare the kids with stories about the government picking your doctor for you, and you don't get a choice. Be afraid! Be very afraid!
For the record: Canadians pick their own doctors, just like Americans do. And not only that: since it all pays the same, poor Canadians have exactly the same access to the country's top specialists that rich ones do.
6. Canada's care plan only covers the basics. You're still on your own for any extras, including prescription drugs. And you still have to pay for it.
True -- but not as big an issue as you might think. The province does charge a small monthly premium (ours is $108/month for a family of four) for the basic coverage. However, most people never even have to write that check: almost all employers pick up the tab for their employees' premiums as part of the standard benefits package; and the province covers it for people on public assistance or disability.
"The basics" covered by this plan include 100% of all doctor's fees, ambulance fares, tests, and everything that happens in a hospital -- in other words, the really big-ticket items that routinely drive American families into bankruptcy. In BC, it doesn't include "extras" like medical equipment, prescriptions, physical therapy or chiropractic care, dental, vision, and so on; and if you want a private or semi-private room with TV and phone, that costs extra (about what you'd pay for a room in a middling hotel). That other stuff does add up; but it's far easier to afford if you're not having to cover the big expenses, too. Furthermore: you can deduct any out-of-pocket health expenses you do have to pay off your income taxes. And, as every American knows by now, drugs aren't nearly as expensive here, either.
Filling the gap between the basics and the extras is the job of the country's remaining private health insurers. Since they're off the hook for the ruinously expensive big-ticket items that can put their own profits at risk, the insurance companies make a tidy business out of offering inexpensive policies that cover all those smaller, more predictable expenses. Top-quality add-on policies typically run in the ballpark of $75 per person in a family per month -- about $300 for a family of four -- if you're stuck buying an individual plan. Group plans are cheap enough that even small employers can afford to offer them as a routine benefit. An average working Canadian with employer-paid basic care and supplemental insurance gets free coverage equal to the best policies now only offered at a few of America's largest corporations. And that employer is probably only paying a couple hundred dollars a month to provide that benefit.
7. Canadian drugs are not the same.
More preposterious bogosity. They are exactly the same drugs, made by the same pharmaceutical companies, often in the same factories. The Canadian drug distribution system, however, has much tighter oversight; and pharmacies and pharmacists are more closely regulated. If there is a difference in Canadian drugs at all, they're actually likely to be safer.
Also: pharmacists here dispense what the doctors tell them to dispense, the first time, without moralizing. I know. It's amazing.
8. Publicly-funded programs will inevitably lead to rationed health care, particularly for the elderly.
False. And bogglingly so. The papers would have a field day if there was the barest hint that this might be true.
One of the things that constantly amazes me here is how well-cared-for the elderly and disabled you see on the streets here are. No, these people are not being thrown out on the curb. In fact, they live longer, healthier, and more productive lives because they're getting a constant level of care that ensures small things get treated before they become big problems.
The health care system also makes it easier on their caregiving adult children, who have more time to look in on Mom and take her on outings because they aren't working 60-hour weeks trying to hold onto a job that gives them insurance.
9. People won't be responsible for their own health if they're not being forced to pay for the consequences.
False. The philosophical basis of America's privatized health care system might best be characterized as medical Calvinism. It's fascinating to watch well-educated secularists who recoil at the Protestant obsession with personal virtue, prosperity as a cardinal sign of election by God, and total responsibility for one's own salvation turn into fire-eyed, moralizing True Believers when it comes to the subject of Taking Responsibility For One's Own Health.
They'll insist that health, like salvation, is entirely in our own hands. If you just have the character and self-discipline to stick to an abstemious regime of careful diet, clean living, and frequent sweat offerings to the Great Treadmill God, you'll never get sick. (Like all good theologies, there's even an unspoken promise of immortality: f you do it really really right, they imply, you might even live forever.) The virtuous Elect can be discerned by their svelte figures and low cholesterol numbers. From here, it's a short leap to the conviction that those who suffer from chronic conditions are victims of their own weaknesses, and simply getting what they deserve. Part of their punishment is being forced to pay for the expensive, heavily marketed pharmaceuticals needed to alleviate these avoidable illnesses. They can't complain. It was their own damned fault; and it's not our responsibility to pay for their sins. In fact, it's recently been suggested that they be shunned, lest they lead the virtuous into sin [1].
Of course, this is bad theology whether you're applying it to the state of one's soul or one's arteries. The fact is that bad genes, bad luck, and the ravages of age eventually take their toll on all of us -- even the most careful of us. The economics of the Canadian system reflect this very different philosophy: it's built on the belief that maintaining health is not an individual responsibility, but a collective one. Since none of us controls fate, the least we can do is be there for each other as our numbers come up.
This difference is expressed in a few different ways. First: Canadians tend to think of tending to one's health as one of your duties as a citizen. You do what's right because you don't want to take up space in the system, or put that burden on your fellow taxpayers. Second, "taking care of yourself" has a slightly expanded definition here, which includes a greater emphasis on public health. Canadians are serious about not coming to work if you're contagious, and seeing a doctor ASAP if you need to. Staying healthy includes not only diet and exercise; but also taking care to keep your germs to yourself, avoiding stress, and getting things treated while they're still small and cheap to fix.
Third, there's a somewhat larger awareness that stress leads to big-ticket illnesses -- and a somewhat lower cultural tolerance for employers who put people in high-stress situations. Nobody wants to pick up the tab for their greed. And finally, there's a generally greater acceptance on the part of both the elderly and their families that end-of-life heroics may be drawing resources away from people who might put them to better use. You can have them if you want them; but reasonable and compassionate people should be able to take the larger view.
The bottom line: When it comes to getting people to make healthy choices, appealing to their sense of the common good seems to work at least as well as Calvinist moralizing.
10. This all sounds great -- but the taxes to cover it are just unaffordable. And besides, isn't the system in bad financial shape?
False. On one hand, our annual Canadian tax bite runs about 10% higher than our U.S. taxes did. On the other, we're not paying out the equivalent of two new car payments every month to keep the family insured here. When you balance out the difference, we're actually money ahead. When you factor in the greatly increased social stability that follows when everybody's getting their necessary health care, the impact on our quality of life becomes even more signficant.
And True -- but only because this is a universal truth that we need to make our peace with. Yes, the provincial plans are always struggling. So is every single publicly-funded health care system in the world, including the VA and Medicare. There's always tension between what the users of the system want, and what the taxpayers are willing to pay. The balance of power ebbs and flows between them; but no matter where it lies at any given moment, at least one of the pair is always going to be at least somewhat unhappy.
But, as many of us know all too well, there's also constant tension between what patients want and what private insurers are willing to pay. At least when it's in government hands, we can demand some accountability. And my experience in Canada has convinced me that this accountability is what makes all the difference between the two systems.
It is true that Canada's system is not the same as the U.S. system. It's designed to deliver a somewhat different product, to a population that has somewhat different expectations. But the end result is that the vast majority of Canadians get the vast majority of what they need the vast majority of the time. It'll be a good day when when Americans can hold their heads high and proudly make that same declaration.Link.
Government-run health care is inherently less efficient -- because governments themselves are inherently less efficient.Link.
If anything could finally put the lie to this old conservative canard, the disaster that is our health care system is Exhibit A.
America spends about 15% of its GDP on health care. Most other industrialized countries (all of whom have some form of universal care, either single-payer or entirely government-run) spend about 11-12%. Canada spends about 8-9% -- and most of the problems within their system come out of the fact that it's chronically underfunded compared to those other nations. If they spent what the UK or Germany do, those problems would mostly vanish.
Any system that has people spending more and getting less is, by definition, not efficient. And these efficiency leaks are, almost entirely, due to private greed. There is no logical way that a private system can pay eight-figure CEO compensation packages, turn a handsome a profit for shareholders, and still be "efficient." In fact, in order to deliver those profits and salaries, the American system has built up a vast, Kafkaesque administrative machinery of approval, denial, and fraud management, which inflates the US system's administrative costs to well over double that seen in other countries -- or even in our own public systems, including Medicare and the VA system.
Not incidentally: one of the benefits of single-payer health care is that it largely eliminates the entire issue of "fraud." You can only "cheat" a system that already views its primary business as rationing and withholding care. In Canada, where the system is set up to deliver health care instead of profits, and medical access is considered a right, this whole oversight machinery is far cheaper and more compact. In general, the system trusts doctors and patients to make the right choices the first time. As a result, people generally don't have to lie, cheat, and grovel to get the system to deliver the care they need. They just go and get it -- and walk out without a moment's dread about the bills.
Shareholder profit, inflated CEO salaries, and top-heavy administration -- all of which serve to work against the delivery of care, not facilitate it -- are anti-efficiencies that siphon off 20-25% of America's total health care spending. These are huge sums; yet it's mostly money down a gold-plated rathole. In the end, it doesn't provide a single bed, pay a single nurse or doctor, or treat a single patient.
We'll have rationed care
Don't look now: but America does ration care. And it does it in the most capricious, draconian, and often dishonest way possible.
Mostly, the US system rations care by simply eliminating large numbers of people from the system due to an inability to pay. Last year, one-quarter of all Americans didn't go to a doctor when they needed one because they couldn't afford it. Nearly that many skipped getting a test, treatment, prescription, or follow-up appointment recommended by a doctor. In Canada, those same numbers are in the 4-5% range; in the UK, 2-3%. Also: nearly 20% of all Americans had a hard time paying a medical bill last year; and these stresses now trigger over half of all personal bankruptcies in the country.
Furthermore, nominally having health insurance is no guarantee against financial ruin, as Sicko amply illustrated. Being cut off or denied by your insurance company is rationing, too. And there are vast numbers of fairly well-off Americans -- many of them middle-aged, and too young for Medicare -- who have pre-existing conditions that render them uninsurable at any price. They're one heart attack, one diabetic event, or one bad turn away from financial disaster. Please don't insult these people by telling them that the American system doesn't ration care.
Another persistent (and ridiculously mendacious) rationing myth about the Canadian system is that old people are cut off from treatment and left to die. I've never heard about a single case of this in Canada; but it happens routinely to Americans on Medicare and many private policies, which have strict limits on how long you can stay in the hospital with an acute illness. When the benefits run out, ready or not, they send you home. If you die, you die. The Canadian plan has no such limits: you stay for as long as you need to. But in the US, these limits fit the very definition of "rationed care."
Effectively shutting one-quarter of the population out of the medical system entirely, and putting many of the rest on short rations, certainly does make things so much nicer for those happy few who are still in it. In fact, Americans have these missing millions to thank for their system's impressively short wait times. Only 4% of American have to wait more than six months for non-elective surgeries, while 14-15% of Canadian and Britons do. (Don't blame this on government care, though: in Germany and the Netherlands, the number is closer to 2%.) When conservatives start bellowing about Canada's terrifying wait times (which, by the way, are carefully triaged: it's rare for people to die waiting, though it happens), we need to remind them that there are 75 million Americans who have been wait-listed forever. If my friend's Aunt Millie gets her emergency hip surgery today because I'm willing to hobble along for an extra couple months before getting my knee surgery -- well, for any morally serious person, that choice should be a complete no-brainer.
You can't have medical innovation without the incentives provided by the free market.
As in the US, Canada's government funds major medical research that has led to a continuous stream of new medical breakthroughs [1]. (And as this link shows, the rate of innovation didn't slow down in the least when Canada moved to single-payer in the 1960s.) All of the country's medical schools are located within public research universities. The university that houses my local medical school, the University of British Columbia, ranked ninth in North America last year -- in league with UC, Stanford, and other powerhouses -- in total public and private research grants received by its labs. Among other things, it leads the way in genetics (David Suzuki is emeritus faculty), and stem-cell research (having attracted a handsome roster of American scientists whose research was thwarted by the political situation at home).
Because the Canadian health care system is driven by delivering care instead of profits, the focus of research is sometimes different -- and often wider-ranging. While there's plenty of pursuit of patents and innovations, there's also considerable research put into questioning whether new treatments are really more effective than older ones; and in pursuing possible treatments that may not be patentable by anyone. The system is focused first on what works; and after that, on what might make someone some money.
Single-payer health care will make America less competitive.
I can't believe people still have the gall to argue this point, but apparently, they do. There are several reasons this is flat-out wrong:
Jobs, Jobs, Jobs -- It's no secret that public health care is making Canada a more attractive business environment for large manufacturers, who typically have very high insurance overhead. Toyota and GM have both moved plants to Canada in recent years, in large part to avoid the spiraling costs of insuring American workers. (Toyota also cited Canada's better-educated workers, but that's another issue for another day.) As long as $900 of every car GM makes is going to supply health care to the people who make it, the US's current system of employer-based health care is going to continue to drive skilled jobs out of the country.
A Smarter, More Entreprenurial Workforce -- Being relieved of insurance worries also makes individual citizens more competitive. How would your life choices change if you didn't have to worry about health care? Would you go back to school and get your PhD in lepidoptery? Start a blog -- or a small business? Work part-time and travel? Tell your boss where he can stick it? Spend a few years at home with your kids?
Countries with universal coverage free up their citizens to take advantage of personal development opportunities that, in the long run, stimulate the economy and create a more skilled, traveled, educated, and fulfilled workforce. Americans, on the other hand, routinely stay chained to jobs they hate -- and are forced to pass up on chances to expand their horizons and their fortunes -- because they can't afford to jeopardize their health care coverage. Our health care mess has reached a point where it jeopardizes not only our lives, but also our liberty and our ability to pursue happiness -- as well as the long-term strength of the economy as a whole.
Increased Financial and Social Capital -- When families are bankrupted by medical bills, or are thrown into poverty when a working member is disabled because they can't afford proper care, or simply break down and fall apart under the stress of debt and illness, it's not long before the country's entire social fabric begins to show the wear and tear -- along with the sense of optimism and the common good required for a democracy to function.
Part of what makes a country competitive is its own commitment to the common good. I've often been impressed by the very tangible sense of civic pride and shared effort my Canadian neighbors have in the fact that they're taking the best possible care of their own, regardless of status, age, or ethnicity. Every encounter with the medical system reminds them that they're all in this together. A medical system that routinely drives families into bankruptcy or divorce court is actively destroying, rather than adding to, the essential social capital that makes the whole society function.
No Deferred Maintenance -- Decades of foregone medical care are starting to catch up with Americans. We're seeing serious declines on many fronts: infant mortality, lifespan, cancer rates, heart disease rates, and increased diabetes. On most of the major markers of public health, America is nowhere near the top tier anymore. In some areas, there are a few small former Communist countries doing better than we are.
Business relies on healthy workers who aren't distracted by their own illness or that of a family member. America's uninsured, increasingly unhealthy workforce is in no position to compete on equal terms with the strong, healthy workers of other countries who are getting the care they deserve.
We have more important matters to tend to -- like national security and the war.
Getting everyone insured is, unequivocally, a clear matter of national security.
Our every-man-for-himself attitude toward health care is a security threat on a par with unsecured ports. In Canada, people go see the doctor if they're sick for more than a day or two. It was this easy access to early treatment, along with the much tighter public health matrix that enables doctors to share information quickly, that allowed the country's health care system to detect the 2003 SARS epidemics in Toronto and Vancouver while they were still very localized, act within hours to stop them before the disease spread any further, and track down and treat exposed people before they got too sick to be helped. In both cases, the system worked flawlessly. The epidemic was stopped within days and quashed entirely in under a month, potentially saving of millions of lives.
In the U.S., that same epidemic might easily have gone unnoticed for critical days and weeks. If the first people to get sick were among those 75 million without adequate insurance, they probably would have toughed it out a few extra days before finally dragging their half-dead carcasses into an ER somewhere. Not only would they be much farther along in the course of the disease -- and thus at greater risk of death themselves -- every one of them could have infected dozens or even hundreds of other people in the meantime, accelerating the spread of the epidemic.
Worse: America's underfunded public health system might have taken several days to piece together the whole picture of an epidemic; and perhaps another week or two might have passed before the E. Coli conservatives in charge (having thrown out the science-based management plans thoughtfully developed by the bureaucracy) cooked up some kind of half-assed ideology-driven decision about how to proceed. (It would, of course, involve spectacular amounts of lying to the public.) By that point, tens of millions could have been infected, leading to a death toll that would make 9/11 and Katrina look like minor statistical blips.
Think about superbugs and the ongoing waves of immunological imports from the world's swamps and jungles. Think about terrorists with bioweapons. And then think again about the undeniable fact that every single underinsured American is a gaping hole in the safety net that protects us all from a catastrophic epidemic. This really is one of those cases in which none of us are safe as long as even one of us is left at risk. And from a purely economic standpoint: would you want to invest in a country where there was a significant risk that an epidemic or a bio-attack, managed by incompetent officials, might force you to shut down your business at a moment's notice?
As for the war: Bush's Folly will generate upwards of half a million veterans, many of whom will require some kind of sustaining care for the rest of their lives. VA funding ebbs and flows with the national political will, and veterans often fall behind other priorities. But if they can enter the same health care system every other American depends on, then we can only forget their interests by forgetting our own as well.
I feel a lot better knowing my taxes are taking care of my fellow Canadians rather than buying bombs to drop on Iraqi towns, supporting a fully-equipped CIA gulag, or funding Baghdad pizza deliveries via Halliburton. It's hard to become a worldwide empire when you're putting half your tax revenue into hospitals and doctors, as Canada does. But, on the other hand, it's hard to insure your citizens when half your tax revenue is going to feed your war machine.
In a very real sense, America has chosen to secure its oil supply at the cost of its own citizens' health. The more we spend on the former, the less we have for the latter. And our own relative health -- both physical and economic -- is starting to show the consequences of that choice. Ultimately, all these things are connected: by making ourselves energy independent, we might not only make ourselves more secure, we'll also finally be able to invest in the kind of health care that will make us truly competitive in the world community.
The Bottom Line
In America, a lucky employee with gold-plated employer-based coverage may well get access to A-level care (though that level of coverage becoming rarer by the month, even among the professional classes). On the other hand, about 50 million under-insured Americans are barely scraping by with C or D-level care; and the nearly 50 million with no insurance at all get next to no care whatsoever. Worst of all: 18,000 Americans die every year due to lack of access to healthcare. That's one every 30 minutes, around the clock, every day of the year -- the equivalent death toll of six 9/11s every single year that passes.
In Canada, everybody gets at least B-level care, pretty consistently across the board -- and, on occasion, quite a bit better than that. You might not like those odds if you're one of the shrinking handful of Americans who's used to A-level care; but if that's not you, you'd be getting a much better deal in Canada.
The private sector has had 20 years to prove that it could deliver low-cost, quality care using those vaunted business-style efficiencies; and it has failed us utterly and completely. This fact should be the ultimate nail in the coffin of the old conservative canard that "the free market always does it better." If that was true, privatizing health care would have been the shining example that proved it once and for all. Instead, all we got was a colossally expensive national disaster that's denying full coverage to a third of the country --- and putting our health, competitiveness, financial and social capital, and national security at risk in the process. It's also devastating the aspirations of our entire middle class, which is being hollowed out by our current health policies.
A famous Hebrew prophet once advised his followers to take the log out of their own eyes before trying to remove the splinter from someone else's. As much as it hurts American pride to admit it, Canada and the rest of the industrialized world has us roundly beat on this one. Those who are so quick to criticize the Canadian system might be better off holding their fire until they've shown us they can do better. America, and the world, is waiting.
Our Security (And The World's!) Rests On Our Allies
Oops!
Two employees of Pakistan's atomic energy agency have been abducted in the country's restive north-western region abutting the Afghan border, police say.Link.
The technicians went missing on the same day as Pakistan's ambassador to Afghanistan, Tariq Azizuddin, was reportedly abducted in the same region.
Mr Azizuddin had been going overland from the city of Peshawar to Kabul.
Pakistan's north-west has witnessed fierce fighting between Islamist militants and government troops.
The pro-Taleban guerrillas declared a unilateral ceasefire last week after months of clashes with troops garrisoned there.
The workers from Pakistan's Atomic Energy Commission were on a mission to map mineral deposits in the mountains when they were kidnapped, police say.
"The technicians were going for some geological survey in the area when they were kidnapped at gunpoint along with their driver," Romail Akram, a senior police official, told Reuters news agency.
Their vehicle was intercepted by masked gunmen in the Dera Ismail Khan district, a stronghold of local militants.
"We don't know if the abductors were militants or members of some criminal gang," a local police chief, Akbar Nasir, told the AFP news agency.
He said efforts to locate the missing men had yet to yield any results.
Karzai concerned
Efforts are also continuing to locate the missing Pakistani envoy, Tariq Azizuddin.
Mr Azizuddin went missing on Monday as he was travelling overland from the Pakistani city of Peshawar to the Afghan capital, Kabul.
Afghan President Hamid Karzai said he was certain the envoy had been abducted, adding: "I hope he is safe and I hope he will be released soon."
The Khyber region has long been a base for bandits and smugglers but has seen little of the unrest linked to an uprising by Islamist militants in adjoining areas.
Pro-Taleban militants recently kidnapped more than 200 Pakistani troops in the South Waziristan region.
The soldiers were reportedly released in a prisoner exchange with Pakistani authorities.
'Protected road'
Pakistan's government has refused to confirm Mr Azizuddin has been kidnapped, saying only that he was missing.
The Pakistani embassy in Kabul said contact was lost with Mr Azizuddin at around 1045 local time (0645 GMT) on Monday.
There were reports on Pakistani television of his car going through a checkpoint without stopping.
An official of the Khyber agency tribal administration told the BBC that the ambassador went through the Khyber agency without taking a security escort that was waiting for him at the start of the tribal territory.
Correspondents say that such escorts are routinely sent with dignitaries and officials when they travel through tribal areas.
But some travellers dispense with them because they think it makes their movements more noticeable.
Mr Azizuddin is said to have previously travelled to Kabul by road, often without the tribal security escort.
The route through the agency is believed to be the shortest and quickest way between Peshawar and Kabul.
Being the main trade route, the Khyber agency road is busy in daylight hours, supplying reinforcements and to the US and Nato forces in Afghanistan.
It is also one of the most protected of all the tribal roads, with a contingent of tribal police posted every 100m. The paramilitary Frontier Corps have a fort along the road.
Tuesday, February 12, 2008
Steve Gerber
One of the very best comic book writers -- a great writer -- Steve Gerber, died the other day. Details at http://www.stevegerber.com/sgblog/.It's synchronicitic (which might've tickled Gerber): I had been thinking of death and dying the last day or so (not in a suicidal way), more particularly meditating on a good way to go.
Gerber, I would think, expensively sickly, did not go particularly well: as I said, expensively sickly with a pretty much untreatable illness, working far less than he should; around sixty or so and still eking out a living.
I hope he was surrounded by love at the end; will try and find out.
But there's so much sadness nonetheless in his dying....
Our Leaders' Love For Their Troops
Seriously, why does crap like this happen??
A Fort Carson soldier who says he was in treatment at Cedar Springs Hospital for bipolar disorder and alcohol abuse was released early and ordered to deploy to the Middle East with the 3rd Brigade Combat Team.Link.
The 28-year-old specialist spent 31 days in Kuwait and was returned to Fort Carson on Dec. 31 after health care professionals in Kuwait concurred that his symptoms met criteria for bipolar disorder and "some paranoia and possible homicidal tendencies," according to e-mails obtained by a Denver newspaper.
The soldier, who asked not to be identified because of the stigma surrounding mental illness and because he will seek employment when he leaves the Army, said he checked himself into Cedar Springs on Nov. 9 or Nov. 10 after he attempted suicide while under the influence of alcohol. He said his treatment was supposed to end Dec. 10, but his commanding officers showed up at the hospital Nov. 29 and ordered him to leave.
"I was pulled out to deploy," said the soldier, who has three years in the Army and has served a tour in Iraq.
Soldiers from Fort Carson and across the country have complained they were sent to combat zones despite medical conditions that should have prevented their deployment.
Late last year, Fort Carson said it sent 79 soldiers who were considered medical "no-gos" overseas. Officials said the soldiers were placed in light-duty jobs and are receiving treatment there. So far, at least six soldiers have been returned.
An e-mail sent Jan. 3 by Capt. Scot Tebo, the brigade surgeon, says the 3rd Brigade Combat Team had "been having issues reaching deployable strength" and that some "borderline" soldiers were sent overseas.
Paul Sullivan, executive director of Veterans for Common Sense, was outraged.
"If he's an inpatient in a hospital, they should have never taken him out. The chain of command needs to be held accountable for this. Washington needs to get involved at the Pentagon to make sure this doesn't happen again.
"First, we had the planeload of wounded, injured and ill being forced back to the war zone. And now we have soldiers forcibly removed from mental hospitals. The level of outrage is off the Richter scale."
The soldier said that on Nov. 29, he was called to the office at Cedar Springs. His squad leader, his platoon leader, his Army Substance Abuse Program counselor and two counselors from Cedar Springs "came and ambushed me."
He said an Army alcohol counselor told him alcoholism and anxiety could not stop him from being deployed.
"They said, 'You know what? Tough it out. All of us like to drink.'"
In the December e-mail, Tebo tells brigade leaders: "Evidently, while at Cedar Springs, he was started on psychiatric medications that should have made him non-deployable, but somehow no one was notified. He may have been pending a diagnosis of bipolar disorder, but that information was not passed on at discharge. He deployed with his unit and has not been doing well here."
In Kuwait, the soldier isolated himself. He said he had "racing thoughts" and couldn't keep still.
"I was ... burning my fingertips with cigarettes, just anything to keep my mind off of things," the soldier said. "I had homicidal thoughts. I don't know at the time if I intended on doing anything. But at the time, it was there, I had homicidal and suicidal thoughts."
Since his return, he has been in treatment. He said his medical record contains a permanent profile for bipolar disorder, an illness that makes him unfit for military service. He is undergoing the process to be medically discharged from the Army.
News You Knew: Our Leaders Lied To Us About Iraq Planning
A reminder:
The Army is accustomed to protecting classified information. But when it comes to the planning for the Iraq war, even an unclassified assessment can acquire the status of a state secret.
That is what happened to a detailed study of the planning for postwar Iraq prepared for the Army by the RAND Corporation, a federally financed center that conducts research for the military.
After 18 months of research, RAND submitted a report in the summer of 2005 called “Rebuilding Iraq.” RAND researchers provided an unclassified version of the report along with a secret one, hoping that its publication would contribute to the public debate on how to prepare for future conflicts.
But the study’s wide-ranging critique of the White House, the Defense Department and other government agencies was a concern for Army generals, and the Army has sought to keep the report under lock and key.
A review of the lengthy report — a draft of which was obtained by The New York Times — shows that it identified problems with nearly every organization that had a role in planning the war. That assessment parallels the verdicts of numerous former officials and independent analysts.
The study chided President Bush — and by implication Secretary of State Condoleezza Rice, who served as national security adviser when the war was planned — as having failed to resolve differences among rival agencies. “Throughout the planning process, tensions between the Defense Department and the State Department were never mediated by the president or his staff,” it said.
The Defense Department led by Donald H. Rumsfeld was given the lead in overseeing the postwar period in Iraq despite its “lack of capacity for civilian reconstruction planning and execution.”
The State Department led by Colin L. Powell produced a voluminous study on the future of Iraq that identified important issues but was of “uneven quality” and “did not constitute an actionable plan.”
Gen. Tommy R. Franks, whose Central Command oversaw the military operation in Iraq, had a “fundamental misunderstanding” of what the military needed to do to secure postwar Iraq, the study said.
The regulations that govern the Army’s relations with the Arroyo Center, the division of RAND that does research for the Army, stipulate that Army officials are to review reports in a timely fashion to ensure that classified information is not released. But the rules also note that the officials are not to “censor” analysis or prevent the dissemination of material critical of the Army.
The report on rebuilding Iraq was part of a seven-volume series by RAND on the lessons learned from the war. Asked why the report has not been published, Timothy Muchmore, a civilian Army official, said it had ventured too far from issues that directly involve the Army.
“After carefully reviewing the findings and recommendations of the thorough RAND assessment, the Army determined that the analysts had in some cases taken a broader perspective on the early planning and operational phases of Operation Iraqi Freedom than desired or chartered by the Army,” Mr. Muchmore said in a statement. “Some of the RAND findings and recommendations were determined to be outside the purview of the Army and therefore of limited value in informing Army policies, programs and priorities.”
Warren Robak, a RAND spokesman, declined to talk about the contents of the study but said the organization favored publication as a matter of general policy.
“RAND always endeavors to publish as much of our research as possible, in either unclassified form or in classified form for those with the proper security clearances,” Mr. Robak said in a statement. "The multivolume series on lessons learned from Operation Iraqi Freedom is no exception. We also, however, have a longstanding practice of not discussing work that has not yet been published."
When RAND researchers began their work, nobody expected it to become a bone of contention with the Army. The idea was to review the lessons learned from the war, as RAND had done with previous conflicts.
The research was formally sponsored by Lt. Gen. James Lovelace, who was then the chief operations officer for the Army and now oversees Army forces in the Middle East, and Lt. Gen. David Melcher, who had responsibility for the Army’s development and works now on budget issues.
A team of RAND researchers led by Nora Bensahel interviewed more than 50 civilian and military officials. As it became clear that decisions made by civilian officials had contributed to the Army’s difficulties in Iraq, researchers delved into those policies as well.
The report was submitted at a time when the Bush administration was trying to rebut building criticism of the war in Iraq by stressing the progress Mr. Bush said was being made. The approach culminated in his announcement in November 2005 of his “National Strategy for Victory in Iraq.”
One serious problem the study described was the Bush administration’s assumption that the reconstruction requirements would be minimal. There was also little incentive to challenge that assumption, the report said.
“Building public support for any pre-emptive or preventative war is inherently challenging, since by definition, action is being taken before the threat has fully manifested itself,” it said. “Any serious discussion of the costs and challenges of reconstruction might undermine efforts to build that support.”
Another problem described was a general lack of coordination. “There was never an attempt to develop a single national plan that integrated humanitarian assistance, reconstruction, governance, infrastructure development and postwar security,” the study said.
One result was that “the U.S. government did not provide strategic policy guidance for postwar Iraq until shortly before major combat operations commenced.” The study said that problem was compounded by General Franks, saying he took a narrow view of the military’s responsibilities after Saddam Hussein was ousted and assumed that American civilian agencies would do much to rebuild the country.
General Franks’s command, the study asserted, also assumed that Iraq’s police and civil bureaucracy would stay on the job and had no fallback option in case that expectation proved wrong. When Baghdad fell, the study said, American forces there “were largely mechanized or armored forces, well suited to waging major battles but not to restoring civil order. That task would have been better carried out, ideally, by military police or, acceptably, by light infantry trained in urban combat.”
A “shortfall” in American troops was exacerbated when General Franks and Mr. Rumsfeld decided to stop the deployment of the Army’s First Cavalry Division when other American forces entered Baghdad, the study said, a move that reflected their assessment that the war had been won. Problems persisted during the occupation. In the months that followed, the report said, there were “significant tensions, most commonly between the civilian and military arms of the occupation.”
The poor planning had “the inadvertent effort of strengthening the insurgency,” as Iraqis experienced a lack of security and essential services and focused on “negative effects of the U.S. security presence.” The American military’s inability to seal Iraq’s borders, a task the 2005 report warned was still not a priority, enabled foreign support for the insurgents to flow into Iraq.
In its recommendations, the study advocated an “inverted planning process” in which military planners would begin by deciding what resources were needed to maintain security after an adversary was defeated on the battlefield instead of treating the postwar phase as virtually an afterthought. More broadly, it suggested that there was a need to change the military’s mind-set, which has long treated preparations to fight a major war as the top priority. The Army has recently moved to address this by drafting a new operations manual which casts the mission of stabilizing war-torn nations as equal in importance to winning a conventional war.
As the RAND study went through drafts, a chapter was written to emphasize the implications for the Army. An unclassified version was produced with numerous references to newspaper articles and books, an approach that was intended to facilitate publication.
Senior Army officials were not happy with the results, and questioned whether all of the information in the study was truly unclassified and its use of newspaper reports. RAND researchers sent a rebuttal. That failed to persuade the Army to allow publication of the unclassified report, and the classified version was not widely disseminated throughout the Pentagon.
Neither General Lovelace nor General Melcher agreed to be interviewed for this article, but General Lovelace provided a statement through a spokesman at his headquarters in Kuwait.
“The RAND study simply did not deliver a product that could have assisted the Army in paving a clear way ahead; it lacked the perspective needed for future planning by the U.S. Army,” he said.
A Pentagon official who is familiar with the episode offered a different interpretation: Army officials were concerned that the report would strain relations with a powerful defense secretary and become caught up in the political debate over the war. “The Army leaders who were involved did not want to take the chance of increasing the friction with Secretary Rumsfeld,” said the official, who asked not to be identified because he did not want to alienate senior military officials.
The Army has asked that the entire RAND series be resubmitted and has said it will decide on its status thereafter.
Is McCain A Done Deal??
The results on Super Tuesday removed all doubt about who would win the Republican presidential nomination -- John McCain's lead was insurmountable. Senators who hate him began endorsing him, Mitt Romney was forced from the race, and the Arizona senator was suddenly free to shift his emphasis to a general-election strategy. It was a done deal.Link.
Realistically, it probably still is, but it's worth considering just how embarrassing yesterday's GOP results were for the presumptive nominee. It was as if Republican voters in three states -- one in the South, one in the West, and one in the Plains -- collectively got together to smack McCain in the face.
Louisiana-- Huckabee 43%, McCain 42%, Romney 6%, Paul 5%
Kansas -- Huckabee 60%, McCain 24%, Paul 11%, Romney 3%
Washington (with 87% of the precincts reporting) -- McCain 26%, Huckabee 24%, Paul 21%, Romney 17%
Sure, McCain wasn't exactly campaigning aggressively in these states -- neither was Huckabee or Paul -- but the obvious frontrunner for the nomination probably expected to have at least a little more support from the party faithful. In Kansas, McCain had Sam Brownback touting his campaign, but that didn't prevent a 36-point drubbing.
For that matter, Washington was supposed to be an easy one for McCain; Huckabee had few built-in advantages here. And yet, McCain apparently won a squeaker. (In what is, in effect, a two-person race, the frontrunner barely won a quarter of the vote. Ouch.)
In response to the poor showing, a campaign spokesperson said last night, "John McCain is the presumptive nominee in this race and our path forward is unchanged by today's results."
That's probably right, but is still has to sting.
It's a reminder of just how much work McCain still has to do. Over the past several days, the Republican establishment has, for the most part, reluctantly come to accept the realities of the political landscape. It was time, they decided, to close ranks.
But rank-and-file conservative Republicans apparently didn't get the memo. This isn't to say McCain will falter before claiming the nomination, but if yesterday proved anything, it's that he's going to have to work for it.
Jonathan Martin added:Mike Huckabee blew him away in the Kansas caucuses and edged him out in the Louisiana primary. In Washington, which held caucuses, McCain bested Huckabee by two percent. And in a symbolic straw poll vote at CPAC, McCain was narrowly topped by Romney.As for Huckabee, he scored another two wins, without even trying very hard (he lacks the resources to mount serious campaigns in any state).
None of these results will have significant practical bearing on McCain's seizing the nomination. But the Kansas and, to a much lesser degree, CPAC results underscore the maverick's challenges with conservative activists. And Huckabee's success in Louisiana demonstrate his continued appeal among evangelicals in the South and offer a reminder of why McCain didn't enjoy a clean sweep on Super Tuesday.... [E]ven taking such symbolic hits after a week of questions about McCain's ability to heal old wounds on the right flank is not the way they wanted to start the path to November.
It's also a reminder of a point I've tried to emphasize all week -- McCain is now going to have to move to the right, when he wants to move to the center.
Asked last night why he's still in the race, Huckabee said, "I have nothing else to do." I guess that means he'll be sticking around for a while longer.
Possibly All You Need To Know About The Mortgage Crisis And How It Came To Be
Or not. You read, you decide. Link.
Music For Obama
This is entertainment, not meant as any sort of endorsement of anything other than free entertainment on the web and is for enjoyment only (or not).
It Isn't Just Subprime Borrowers. How About That?
It took two reporters to finally figure this one out: When you live on home equity and your equity suddenly vanishes and therefore cannot be accessed, badness occurs -- and in a consumer-based economy, that cannot be a good thing, can it now?
The credit crisis is no longer just a subprime mortgage problem.Link.
As home prices fall and banks tighten lending standards, people with good, or prime, credit histories are falling behind on their payments for home loans, auto loans and credit cards at a quickening pace, according to industry data and economists.
The rise in prime delinquencies, while less severe than the one in the subprime market, nonetheless poses a threat to the battered housing market and weakening economy, which some specialists say is in a recession or headed for one.
Until recently, people with good credit, who tend to pay their bills on time and manage their finances well, were viewed as a bulwark against the economic strains posed by rising defaults among borrowers with blemished, or subprime, credit.
“This collapse in housing value is sucking in all borrowers,” said Mark Zandi, chief economist at Moody’s Economy.com.
Like subprime mortgages, many prime loans made in recent years allowed borrowers to pay less initially and face higher adjustable payments a few years later. As long as home prices were rising, these borrowers could refinance their loans or sell their properties to pay off their mortgages. But now, with prices falling and lenders clamping down, homeowners with solid credit are starting to come under the same financial stress as those with subprime credit.
“Subprime was a symptom of the problem,” said James F. Keegan, a bond portfolio manager at American Century Investments, a mutual fund company. “The problem was we had a debt or credit bubble.”
The bursting of that bubble has led to steep losses across the financial industry. American International Group said on Monday that auditors found it may have understated losses on complex financial instruments linked to mortgages and corporate loans.
The running turmoil is also stirring fears that some hedge funds may run into trouble. At the end of September, nearly 4 percent of prime mortgages were past due or in foreclosure, according to the Mortgage Bankers Association.
That was the highest rate since the group started tracking prime and subprime mortgages separately in 1998. The delinquency and foreclosure rate for all mortgages, 7.3 percent, is higher than at any time since the group started tracking that data in 1979, largely as a result of the surge in subprime lending during the last few years.
An example of the spreading credit crisis is seen in Don Doyle, a computer engineer at Lockheed Martin who makes a six-figure income and had a stellar credit score in 2004, when he refinanced his home in Northern California to take cash out to pay for his daughter’s college tuition.
Mr. Doyle, 52, is now worried that he will have to file for bankruptcy, because he cannot afford to make the higher variable payments on his mortgage, and he cannot sell his home for more than his $740,000 mortgage.
“The whole plan was to get out” before his rate reset, he said. “Now I am caught. I can’t sell my house. I’m having a hard time refinancing. I’ve avoided bankruptcy for months trying to pull this out of my savings.”
The default rate for prime mortgages is still far lower than for subprime loans, about 24 percent of which are delinquent or in foreclosure. Some economists note that slightly more than a third of American homeowners have paid off their mortgages completely. This group is generally more affluent and contributes more to consumer spending and the economy relative to its size.
Unlike subprime borrowers, who tend to have lower incomes and fewer assets, prime borrowers have greater means to restructure their debt if they lose jobs or encounter other financial challenges. The recent reductions in short term interest rates by the Federal Reserve should also help by reducing the reset rate for adjustable loans.
Still, economists say the rate cuts and the $168 billion fiscal stimulus package are unlikely to make a significant dent in the large debts weighing on many Americans, because banks have tightened lending standards and expected rebates from the government will not cover most house payments.
The problems are most acute in areas that experienced a big boom in housing — California, the Southwest, Florida and other coastal markets — and in the Midwest, which is suffering from job losses in the manufacturing sector.
And it is not just first-mortgage default rates that are rising. About 5.7 percent of home equity lines of credit were delinquent or in default at the end of last year, up from 4.5 percent a year earlier, according to Moody’s Economy.com and Equifax, the credit bureau.
About 7.1 percent of auto loans were in trouble, up from 6.1 percent. Personal bankruptcy filings, which fell significantly after a 2005 federal law made it harder to wipe out debts in bankruptcy, are starting to inch up.
On Monday, Fitch Ratings, the debt rating firm, reported that credit card companies wrote off 5.4 percent of their prime card balances in January, up from 4.3 percent a year ago. The so-called charge-off rate is still lower than before the 2005 law went into effect.
Banks are responding to the rise in delinquencies by capping home equity lines of credit in areas with falling real estate prices. A few credit card companies have also moved to reduce the credit limits of customers they deem more risky.
Bank of America, Citigroup, Countrywide Financial, JPMorgan Chase, Washington Mutual and Wells Fargo are expected to announce on Tuesday at the Treasury Department that they will offer both prime and subprime borrowers who are more than three months behind a chance to halt foreclosure proceedings for 30 days and work out new loan terms.
In a conference call with analysts in December, Kenneth Lewis, the chief executive of Bank of America, said more borrowers appear to be giving up on their homes as prices fall, noting a “change in social attitudes toward default.”
“You don’t mind making a $2,000 payment when the house is going up” in value, said Steve Walsh, a mortgage broker in Scottsdale, Arizona, who has seen several clients walk away from their homes because they couldn’t refinance or sell. “When it’s going down, it becomes a weight around your neck, it becomes an anchor.”
Home prices in the North Las Vegas neighborhood of Brenda Harris, a technology analyst at a casino company, have fallen 20 percent to 30 percent. The builder who sold her a new three-bedroom home on Pink Flamingos Place for about $392,000 in 2006 is now listing similar properties for $314,000. A larger house a block down from Ms. Harris was recently listed online for $310,000.
But Ms. Harris does not want to leave her home. She estimates that she has spent close to $40,000 on her property, about half for a down payment and much of the rest on a deck and landscaping.
“I’m not behind in my payments, but I’m trying to prevent getting behind,” Ms. Harris said. “I don’t want to ruin my credit.”
In addition to the declining value of her home, Ms. Harris, 53, will soon be hit with a sharply higher house payment. She has an option adjustable-rate mortgage, a loan that allows borrowers to pay less than the interest and principal due every month. The unpaid interest gets added to the principal balance. She is making the minimum monthly payments due on her loan, about $2,400.
But she knows she will not be able to pay the $3,400 needed to cover her interest and principal, which she will be required to pay once her loan balance reaches 115 percent of her starting balance. And under the terms of her loan, which was made by Countrywide Financial, she would have to pay a prepayment penalty of about $40,000 if she chose to refinance or sell her home before May 2009.
She said that she now wishes she had taken a traditional fixed-rate loan when she bought the home. At the time, she asked for a loan that could be refinanced after one year without penalty. She said her broker had told her a week before the closing that the penalty would extend until May 2009 and that she reluctantly agreed because she had already started moving.
A nonprofit community group, Acorn Housing, is trying to broker a modification of Ms. Harris’s loan. In a statement Friday, Countrywide said the company had been in touch with Ms. Harris and would work with her.
Credit counselors say many borrowers like Ms. Harris were cajoled or pushed into risky mortgages that they never had the ability to repay.
Others disregarded warnings about complex loans because they wanted to be a part of the housing boom, which like the technology stock bubble lured people in with seemingly instant and risk-free profits, said Mory Brenner, vice president of Financial Firebird Corporation, a company based in Pittsfield, Mass., that publishes consumer debt information and refers borrowers to credit counselors.
“I’d say, Let me tell you something, this is crazy,” Mr. Brenner said. “You cannot afford this house, even if nothing happens and rates stay as low as they are today. And the response would be: I don’t care.”
Lenders extended credit to people without verifying their incomes and allowing them to make little or no down payments.
But borrowers like Mr. Doyle, the engineer in Northern California, say they are victims of their circumstances — housing prices collapsed and lending standards tightened just as they needed to sell or refinance.
In refinancing their home in 2004, Mr. Doyle and his wife were doing what millions of other homeowners did in the last decade — tapping into the rising value of their homes for home improvements, paying off credit card debt, college tuition and for other spending.
The Doyles took advantage of the housing boom by refinancing their home nearly every year since they bought it in 1995 for $275,000. Until their most recent loan they never had a problem making their payments. They invested much of the money in shares of companies that subsequently went bankrupt.
Still, Mr. Doyle does not regret refinancing in 2004. “My goal was clear: I wanted to help my daughter go through college,” he said. “It wasn’t like it was for us.”
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