A radical (explosive?) answer to Brexit and the future of Great Britain

The most vexing problem with Brexit is Northern Ireland and its open border with the Republic of Ireland to its south.

Northern Ireland was always an anomaly.  It has been a pain the neck since Cromwell imported a bunch of extreme Protestant settlers from Scotland into Ireland centuries ago.  If it were not for these  stubborn  Protestants, who are becoming a minority in their own baileywick, by the way, the island of Ireland would be united.  In the not-so-old days the Catholic Church ran the south, but does so no longer.  The religious Protestants have increasingly less to worry about.  Northerners have been moving  and trading  easily and increasingly over the border,  coming and going constantly while the whole island is part of the EU.  Meanwhile, Northern Ireland costs the English a small fortune, but contributes little to Britain economically.

The whole Brexit fiasco could be resolved by the prime Minister announcing that she is proposing a vote in Northern Ireland on a merger between  North and South. The vote would be predicated on the termination of English subsidies, and the promise by the government in London to facilitate the move of those who strongly object to unification to England, together with financial help for them to find homes and jobs.

Doing this, with the cooperation of Dublin, of course, ( I am assuming that unification would be popular with the vast majority of Irish people, even most Norterners) would remove the need for a backstop as England leaves the EU and recognises the fact that Northerners voted strongly to remain in the EU (yes!).

I acknowledge that the corollary of this idea raises the immediate question of the future of Scotland in the union.  Scotland also voted strongly to remain (yes!) So let them go if they vote to do so, with the understanding that there would be a hard border between Scotland and England.  Being a canny lot they would apply to rejoin the EU.  They might or might not vote for independence, but in any case  this is the side effect of the manoeuvering of the Leave faction, that is, the breakup of the “United” Kingdom.  “Leave” leaders have a lot to answer for.  It’s just that they take responsibilty for nothing.

Why is this anything to do with Epicureanism?  Because in Britain friends are unfriending friends, neighbours aren’t speaking to one another, the public discourse is extreme and almost violent and families are divided.  I personally favour a new referendum, but it isn’t clear that that would achieve a resolution.  If this goes on much longer the country will not only be an economic basket case but will remain bitterly divided.  Better to have a moderate resolution.  The above idea would aggrieve a small number of northern Ireland Protestants. That  is regrettable but preferable to continuing with a situation that benefits only Vladimir Putin.

 

 

 

 

 

War with Iran? Part 2

Continued from yesterday:

The Trump administration is, in fact, experiencing increasing difficulty finding allies ready to join a new Coalition of the Willing to confront Iran. The only two charter members so far, Israel and Saudi Arabia, are, however, enthusiastic indeed. Last month there was a rally in Warsaw to promote war, featuring Netanyahu as the  ringleader of the war party.   He was heard remarking that Israel and its Arab allies want war with Iran.  “This is an open meeting with representatives of leading Arab countries that are sitting down together with Israel in order to advance the common interest of war with Iran.” (He later insisted that the correct translation should have been “combating Iran,” but the damage had already been done.)  Many of America’s allies, staunchly opposing Trump’s decision to pull out of the Iran nuclear accord, would have nothing to do with it. In an effort to mollify the Europeans, in particular, the United States and Poland awkwardly renamed it: “The Ministerial to Promote a Future of Peace and Security in the Middle East.”  But the French, the Germans, and the European Union, among others, flatly declined to send ministerial-level representatives, since their policy is to salvage the Iran nuclear deal and to circumvent American sanctions (Trump and Pence are furious).  The many Arab nations not in thrall to Saudi Arabia similarly sent low-level delegations. Turkey and Russia boycotted altogether, convening a summit of their own in which Presidents Vladimir Putin and Recep Tayyip Erdogan met with Iran’s Rouhani.

In past year the Iranian has taken a nosedive, the currency has plunged, inflation is rampant, and there have been street demonstrations with shouts denouncing the Dictator.   Zarif, Iran’s  Western-oriented foreign minister, who supported the nuclear deal, resigned, although Rouhani rejected the resignation.   However, there are hard-liners who want Rouhani to go, want to abandon the accord and resume the nuclear program.  The Zarif resignation crisis threw into stark relief the deep tensions within Iranian politics and raised a key question: As the Trump administration accelerates its efforts to seek a confrontation, will they find an echo among Iranian hardliners who’d like nothing more than a face-off with the United States.  Maybe that’s exactly what Bolton and Pompeo want.  If so, prepare yourself: another stupid and unnecessary American war unlikely to work out the way anyone in Washington dreams it might.

An edited (for length) version of an article by Bob Dreyfuss, an investigative journalist, published in TomDispatch .  He is the founder of  The Dreyfuss Report and a contributing editor at the Nation.  He  has written for Rolling StoneMother Jones, the American Prospect, the New Republic, and many other magazines.      Original Copyright 2019 Bob Dreyfuss.

To visit the Bob Dreyfuss website:  TheDreyfussReport.com  https://thedreyfussreport.com

To visit TomDispatch:    tomdispatch@nationinstitute.org

War with Iran? Part 1 (divided into two for readability. It is long, but very important – it may not be reported in the mainline media)

(The following 3 paragraphs are by Tom Engelhardt, editor of Tom Dispatch, the inside, go-to publication for military affairs, edited for length. Go to tomdispatch@nationinstitute.org

It is possible that the next U.S. military disaster of the twenty-first century might be Iran. That country has, of course, had a significant spot on Washington’s war-making to-do list since the days of George W. Bush’s presidency. After all, the Washington catch-phrase of that moment when neocons like John Bolton helped take us so disastrously into Iraq was “Everyone wants to go to Baghdad. Real men want to go to Tehran.” The “real men” didn’t make it then. The question is: Will they now?

On  entering the Oval Office, Donald Trump turned to retired Marine Corps General James Mattis, revelling in his nickname, “Mad Dog”, as secretary of defense. As it happened, Mattis already had a reputation for being obsessed about Iran. As the head of U.S. Central Command in 2011, he reportedly responded to a query from President Obama about the top three threats across the Greater Middle East by saying, “Number one: Iran. Number two: Iran. Number three: Iran.” In the end, he was evidently removed from that command early because he hatched a scheme to take out an Iranian oil refinery or power plant  to pay Iran back for supporting Iraqi Shia militias then fighting American troops.

In the Trump era, the media began reporting that the same James Mattis was acting as a crucial restraint — yes, restraint — on the president!   Alongside him is National Security Advisor John Bolton (famous for a 2015 New York Times op-ed entitled “To Stop Iran’s Bomb, Bomb Iran”), and that other notorious Iranophobe, Secretary of State Mike Pompeo. (Bolton, a man who never saw a regime he didn’t want to change, has had similar urges when it comes to North Korea and may recently have been responsible for torpedoing the president’s summit with Kim Jong-un.) Now, of course, Mattis is gone, but the other two remain.

(The following is by Bob Drefuss, edited for length).

President Donald Trump, Israeli Prime Minister Benjamin Netanyahu, and Saudi Crown Prince Mohammed bin Salman, are all weakened at home and have few allies abroad.  Are they reckless enough to set off a war with Iran? Could military actions designed to be limited — say, a heightening of the Israeli bombing of Iranian forces inside Syria, or possible U.S. cross-border attacks from Iraq, or a clash between American and Iranian naval ships in the Persian Gulf — trigger a wider war?

Worryingly, the answers are: yes and yes. Even though Western Europe has lined up in opposition to any future conflict with Iran, even though Russia and China would rail against it, even though most Washington foreign policy experts would be horrified by the outbreak of such a war, it could happen.  Such a war could quickly spread across much of the Middle East, not just to Saudi Arabia and Israel, the region’s two major anti-Iranian powers, but Iraq, Syria, Lebanon, Yemen, and the various Persian Gulf states. It might indeed be, as Iranian President Hassan Rouhani suggested last year (unconsciously echoing Iran’s former enemy, Iraqi ruler Saddam Hussein) the “mother of all wars.” And though the Democratic National Committee passed a resolution last month calling for the United States to return to the nuclear agreement that President Obama signed, there are still a significant number of congressional Democrats who believe that Iran is a major threat to U.S. interests in the region,  a prime state sponsor of terrorism.

By openly calling for the toppling of the government in Tehran, by withdrawing from the Iran nuclear agreement and reimposing onerous sanctions to cripple that country’s economy, by encouraging Iranians to rise up in revolt, by overtly supporting various exile groups (and perhaps covertly even terrorists), and by joining with Israel and Saudi Arabia in an informal anti-Iranian alliance, the Administration is attempting to force the collapse of the Iranian regime, which just celebrated the 40th anniversary of the 1979 Islamic revolution.

There are three potential flashpoints where limited skirmishes, were they to break out, could quickly escalate into a major shooting war.

The first is in Syria and Lebanon. Iran is deeply involved in defending Syrian President Bashar al-Assad and is closely allied with Hezbollah, the Lebanese Shiite political party with a potent paramilitary arm. Weeks ago, Israeli Prime Minister Netanyahu openly boasted that his country’s air force had successfully taken out Iranian targets in Syria. In fact, little noticed here, dozens of such strikes have taken place for more than a year, with mounting Iranian casualties.

Until now, the Iranian leadership has avoided a direct response that would heighten the confrontation with Israel, just as it has avoided unleashing Hezbollah, a well-armed, battle-tested proxy force.  That could, however, change if the hardliners in Iran decided to retaliate. Should this simmering conflict explode, does anyone doubt that President Trump would soon join the fray on Israel’s side or that congressional Democrats would quickly succumb to the administration’s calls to back the Jewish state?

Next, consider Iraq as a possible flashpoint for conflict. In February, a blustery Trump told CBS’s Face the Nation that he intends to keep U.S. forces in Iraq “because I want to be looking a little bit at Iran because Iran is the real problem.” His comments did not exactly go over well with the Iraqi political class, since many of that country’s parties and militias are backed by Iran.

Trump’s declaration followed a Wall Street Journal report late last year that Bolton had asked the Pentagon — over the opposition of various generals and then-Secretary of Defense Mattis — to prepare options for “retaliatory strikes” against Iran. This roughly coincided with a couple of small rocket attacks against Baghdad’s fortified Green Zone and the airport in Basra, Iraq’s Persian Gulf port city, neither of which caused any casualties.  Pompeo blamed Iran for the attacks, which he called “life-threatening,” adding, “Iran did not stop these attacks, which were carried out by proxies it has supported with funding, training, and weapons.” No “retaliatory strikes” were launched, but plans do undoubtedly now exist for them and it’s not hard to imagine Bolton and Pompeo persuading Trump to go ahead and use them — with incalculable consequences.

Finally, there’s the Persian Gulf itself. Ever since the George W. Bush years, the U.S. Navy has worried about possible clashes with Iran’s naval forces in those waters and there have been a number of incidents. The Obama administration tried, but failed, to arrange a hotline to the  Iranians to try to defuse any such incident.  Under Trump, however, such caution is disregarded.   Trump himself reinforced the US naval presence in the Gulf and asked Mattis to prepare plans to blow up Iran’s “fast boats,” small gunboats there.  In response, President Hassan Rouhani announced that his country had developed submarines capable of launching cruise missiles against naval targets.  The Iranians also began a series of Persian Gulf war games and, in late February, test fired one of those sub-launched missiles.

Add in one more thing: in an eerie replay of a key argument George Bush and Dick Cheney used for going to war with Iraq in 2003. In mid-February the right-wing media outlet Washington Times ran an “exclusive” report , citing Trump administration sources, claiming that Iran is now aiding and abetting al-Qaeda with a “clandestine sanctuary to funnel fighters, money, and weapons across the Middle East.”  It added that the administration is seeking to use this information to establish “a potential legal justification for military strikes against Iran or its proxies.” Needless to say, few are the terrorism experts or Iran specialists who would agree that Iran has anything like an active relationship with al-Qaeda.

Part of an edited (for length) version of an article by Bob Dreyfuss, an investigative journalist, published in TomDispatch .  He is the founder of  The Dreyfuss Report and a contributing editor at the Nation.  He  has written for Rolling StoneMother Jones, the American Prospect, the New Republic, and many other magazines. He is the author of “Devils’ Game: How the United States Helped Unleash Fundamentalist Islam”  Original Copyright 2019 Bob Dreyfuss   TheDreyfussReport.com  https://thedreyfussreport.com

TOMORROW:  PART 2

Liberty and licence: a moral and ethical question.

The  posting below about Big Soda trying to persuade the government that consuming excessive sugar is fine as long as you take plenty of exercise raises the issue of Liberty.

The Obama Administration was taken to task for what some regarded as too many regulations protecting consumers, the environment etc.  The current Administration is scrapping swathes of these regulations.

I would like to hear from a Libertarian about the moral and ethical issues that arise from this dismantling policy.  For instance, is it ethical for the government to tell people it’s o.k to drink as much sugar – sweetened soda as they want as long as they get some exercise, when all the medical research tells us that exercise cannot,  by itself, prevent obesity and illness?   Is it o.k to allow companies to dump toxic waste near rivers that provide drinking water?  Is it the legitimate exercise of liberty to foul the air we breathe with coal and other fumes and particulates that create long term health problems?  It is, in the name of liberty, o.k to feed , say, chickens copious amounts of antibiotics ( to protect farm investment) that are then consumed by humans?  Is it acceptable to allow mining and oil drilling in “protected” areas of natural beauty?

One could go on for pages!  What I would like to know is at what point is it acceptable to Libertarians to restrain the impulse to monetarise and exploit everything in sight in the name of profit, shareholder value and capitalism?  And what and who would you protect from disease and death?  Did you oppose the campaign to rein back Philip Morris and their tobacco business?   ( apologies for being dramatic, but in my world a government exists to benefit the whole population , not just those with connections and money. Yes, think moderation).

Big soda altering government policies in their own commercial interest

Consumer groups in the US have accused Coca Cola of trying to alter the policy of the  Centers for Disease Control in relation to sugar consumption by donating $1 million to the CDC Foundation and pressing the CDC to downplay sugar consumption as a cause of obesity and bad health (diabetes, heart attacks, strokes and cancer) and  instead talk about the importance  of exercise, which, by itself, in isolation will not reverse obesity or diabetes.  There have been no investigations or regulatory activity by Congress into Big Sugar and Big Soda under Obama or under Trump, so far.  

Just another case that illustrates who runs the country.  This is a run-of-the-mill example of how the interests of the ordinary citizen are subordinated to raising cash for Party coffers . Thousands of lives were lost before previous governments actually did something to stop Big Tobacco knowingly supply products that caused lung cancer.  Eventually, warnings were printed on cigarette packs, and cigarette use dwindled.  High consumption of sugar costs the country huge amounts in terms of healthcare.   American healthcare costs per head of population are already high enough, for goodness sake.

Moderation is a key Epicurean principle.  If the government, quaking with fear before a hoard of highly-paid lobbyists, cannot even try to protect the health of unaware consumers, then at least it shouldn’t allow the industry to peddle the lie that you can drink as much sweet soda as you want as long as you get a bit of exercise.  Stand up to these lobbyists.  Drink soda in moderation!  ( Mr. Trump, are you listening?)

 

On hustling your life forward

“Everyone hustles his life along, and is troubled by a longing for the future and weariness of the present. But the man who … organizes every day as though it were his last, neither longs for nor fears the next day… Nothing can be taken from this life, and you can only add to it, as if giving to a man who is already full and satisfied food which he does not want but can hold.

“So you must not think a man has lived long because he has white hair and wrinkles: he has not lived long, just existed long. For suppose you should think that a man had had a long voyage who had been caught in a raging storm as he left harbor, and carried hither and thither and driven round and round in a circle by the rage of opposing winds? He did not have a long voyage, just a long tossing about”.  (Seneca).

My take: This is good…. “organizing each day as if it were your last”.  The problem comes when all that youthful energy and zest for life starts to be nibbled at by lower energy and the trickle of aches and pains that consume your precious days and force yet another visit to a doctor.  None of these visits may be life threatening, just tiring and, dare I say it, boring.   We live longer than most people in the days of Seneca, so can be better acquainted with the sentiment,  “Oh, no! Not another pill or visit to the physical therapy department.”   The thing is  never to be weary of the present, but plan exciting things for the future.  After that, be determined.

 

 

The bright side of Brexit

To The Times

A visibly noticeable benefit of Brexit is that we will be able to have whiter teeth. The problem lies with EU bureaucracy. The EU allows less than 0.1% of hydrogen peroxide in over-the-counter products, which means that their effectiveness is low. In America, up to 10% is considered safe, and Americans have whiter teeth. A further benefit of a post-Brexit move to allow effective home whitening kits would be to reduce the high income inequality caused by dentists charging high fees for whitening while lobbying Brussels to maintain the low concentration limit for home products.

John O’Keeffe, London. (The Week. 2 Mar 2019)

I don’t think he is joking, but in any case he has hit upon about the only good thing about Brexit.  Thank you, Mr. O’Keefe!

I can’t wait to be able to whiten the teeth that, over the decades have been wrecked by incompetent  British dentists and replaced by crowns!  (note to readers: British doctors are generally excellent; dentists are not held in such high regard, anyway, not by me.

Private education

“The U.S. Department of Education is sending emails to about 15,000 people across the country telling them: You’ve got money.

“These are former students — and some parents of students — who took out loans for colleges that shut down between Nov. 1, 2013, and Dec. 4, 2018.  About half attended campuses run by Corinthian Colleges. They will get their money back or have their debt forgiven — an amount estimated at $150 million, all told — under a provision called Automatic Closed School Discharge.

“As part of the Obama-era crackdown on for-profit colleges like ITT Tech and Corinthian Colleges, the Education Department wrote something called the “borrower defense rule.” It specified how students could get their loan money repaid if their schools were found to be shady. Borrowers had to submit an application and show how they were being defrauded. But if the school was shut down altogether, the loan discharge was supposed to be automatic.

“Under Education Secretary Betsy DeVos, the department took a series of steps to try to delay borrower defense from going into effect, as it was supposed to do in the summer of 2017. DeVos called it: “a muddled process that’s unfair to students and schools, and puts taxpayers on the hook for significant costs.”

“But the department lost in court repeatedly and also missed a key technical deadline for replacing the rule. In October, a federal judge ordered that the department begin forgiving loans under the rule. Now, the government seems to be complying with the closed-school portion of the rule, at least.

”Since 2013, 3,600 schools have closed at least one campus, according to the National Student Legal Defense Network, an advocacy group that has filed many lawsuits against the department. Education Corporation of America, another for-profit college chain, officially closed on Dec. 5, stranding another 20,000 students. So the department’s liability could ultimately mean many more millions of dollars beyond the initial $150 million being returned or canceled.

“Meanwhile, there are thousands of students entitled to automatic relief who in all likelihood don’t know it, while the U.S. Department of Education continues to try and weaken the borrower defense rule and to slow-walk the claims of students who say they are being defrauded. Thus does Betsy DeVos, who is devoted to privately funded education and wants local government out of the education “business” ( a business??!)  and who is supposed to be a referee between the ordinary citizen and grasping capitalism, treat the weak and poor, who simply want some qualifications to get a job.”  (based on an article on National Public Radio).

My comment: For-profit schools are supposed to be the Republican answer to publically- funded education. Clearly, this system is not working or workable,  and is doing no favours at all to the children (and their parents) who have entered the lottery of private education.  Kids should not have to raise loans to go to high school.  If schools are taking per-capita public money as well as charging students extra, this is unacceptable. Education for all  is the price the rest of us have to pay in taxes to have new generations grow up employable, knowledgeable and able to make their way in the world.  S it is the level of education – and general knowledge – is hardly stellar; we shouldn’t make it worse.

Migration into the United States

In February more than 76,000 migrants crossed the Southern border without authorization, an 11 year high.

76,000 illegal immigrants in one month!

This blog is liberal in outlook, and is even run by an immigrant!  However, such a big number is shocking.  Apparently, while the majority of  Latino migrants used to be men, now they are women and children, and, to the disgust of most people, the children are being separated from their mothers and no one seems to know how many separated kids there are, where they have been sent or how to match them up with a parent, so incompetent are the immigration authorities.  All we know is that they are scattered and some are being kept in jail cells or “cages”, as Democrats affirm.

The optics are dreadful; the government should be ashamed.  But not just the American Administration.  The Governments of the Central American countries of origin of the refugees should be even more ashamed, ashamed of their drug economies, the corruption endemic in the region, and the fact that so many citizens are desperate to leave.

Having said this, and sympathized with both the adults and innocent children involved, I still have very mixed feelings about this massive influx of undocumented people.  For any country the numbers are huge .  How do you cope with thousands of mothers with tiny children? Where do you put them?  How will they earn a living with small children to look after?

But there is something else.  I came to America in 1994 with a green card wbich I applied for and received before I left my home country. As soon as possible I applied for (dual) citizenship.  This turned out to be mind-bendingly bureaucratic and lengthy business. They lost my fingerprints three times. Not a process anyone would enjoy, and quite exasperating.  Nonetheless, I struggled through the process and became a US citizen, obeying the law.  I therefore feel rather annoyed that so many people should try to enter the country illegally, assume they will get in with minimal checking or surveillance.

The other aspect of all this immigration is the reaction of people who migrated and now have a settled life and jobs.  Ask them what they think of the undocumented surge and I bet they would want it curtailed.  Why? Because new migrants undercut the wages of more established migrants, which is why immigrants in the UK support Brexit – to reduce the wage competition from East Europeans just arriving.

Life is never simple. But I would maintain that obeying the law, however inconvenient, is the duty of everyone, and of Epicureans in particular.  This is because a peaceful and pleasant life is the object of living, and you cannot achieve ataraxia ignoring the law.

Privatising publicly owned land in Britain

There has been much debate over the profiteering and mismanagement at British privatised enterprises, such as Carillion, a “stark, rotting symbol of everything that has gone wrong with the privatisation of local public services”. What has had little attention is the sell-off of public lands in the UK that started with Margaret Thatcher about 39 years ago.

Since then, all types of public land, held by local and central government alike, has been targeted. And while disposals have generally been heaviest under Tory and Tory-led administrations, they did not abate under New Labour; indeed the NHS estate, in particular, was ravaged during the Blair years. All told, around 2 million hectares of public land have been sold to private interests during the past four decades. This amounts to an eye-watering 10% of the entire British land mass, and is about half of all the land that was owned by public bodies when Thatcher assumed power. The approximate value of that land has been estimated to be £400bn in today’s prices. This dwarfs the value of all of Britain’s other, better known, and often bitterly contested, company privatisations.

Much of the public land was sold to private-sector developers, who have long been the biggest buyers of government land. This was supposed to have helped alleviate Britain’s housing problems, but it has done nothing of the sort. Land has been sold to developers, with the expectation that there would be adequate new housing created. On the contrary developers’ bulging land banks are chock-full of land acquired from public bodies, but they have chosen not to develop it. Now local authorities are in the perverse position of needing enhanced powers to affordably acquire land for a new generation of council houses because, for four decades, they have been forced to sell the land needed for social housing. The cost of this is astounding.

Now half the public land has been sold, and it would be difficult, not to mention politically highly controversial, to get much of that land back, presumably at highly inflated prices.

If today the government could take one single action that would do more than any other to help arrest the intensification of Britain’s housing crisis, halting the sale of public land would be it. To be sure, with so much of Britain’s valuable public land having gone, much of the damage has already been done But if half of it is still left. This land should be protected, treasured, and used for public benefit, before it is too late.

(Based on a new book by Brett Christophers, professor in the Department of Social and Economic Geography, Uppsala university. His book, The New Enclosure: The Appropriation of Public Land in Neoliberal Britain)

My  comment:  This has been straight theft from future generations.  It was done to benefit the Exchequer as an alternative to putting up taxes (“dear, dear can’t increase taxes on our supporters!”) Now, in no time really, that series of windfalls has been spent.  Because you cannot create new land (statement of the obvious) the value of the scarce former public land steadily goes up to the benefit of the developers, and no one else.  Few new house are being built, but the balance sheets must look great, and donations to you- know who are probably healthy, too.  I don’t know whether this whole catastrophe can be classed as corrupt, but if you think it is, I won’t argue.

“Stress” interviews: hiring by humiliation

Job interviews are rarely a pleasant experience but the one Olivia Bland recently endured appears to have been particularly hideous. The 22-year-old graduate says she was left in tears at the bus stop after a two-hour grilling by Craig Dean, the boss of a tech company in Oldham where she had hoped to become a communications assistant. In a letter to the company turning down a job offer, which she posted on Twitter, Bland complained that Dean had called her an “underachiever”, torn apart her written application, asked personal questions and even criticised her music taste as he scrolled through her Spotify account. The interview, she wrote, felt like “being sat in a room” with her “abusive ex”.

One point of view:  Interviews are meant to be “robust and challenging”, to reveal the best candidates. Bland deserves credit for bravely speaking out, but her response will have reinforced the view of many that “the default position for privileged middle-class millennials is to paint themselves as victims who would rather turn to social media than wake up to a real world that’s often stressful and unfair”.

Another point of view:  Experts are divided about the effectiveness of the “stress interview” concept.  Some believe that deliberately unsettling candidates can reap useful insights into how individuals cope with pressure and approach problems. “But virtually all agree that using any level of derision and humiliation is unacceptable and outdated.”    (drawn from:  Peter Rubinsten, BBC News; James Moore, The Independent; Amanda Platell, Daily Mail; and The Week 13 Feb 2018).

My reaction:  At one time I had 120 employees.  Half of running a business is motivating the employees; the other half is keeping the customers.  Neither can be done by bullying, because the above account is just that- bullying.  An interviewee comes before you nervous to start with.  Upset them and you yourself have blown the interview.  Aside from that you want the new staff member to look forward to joining, and setting to with enthusiasm.  No, the Epicurean employer treats his/her staff with respect.  Making a success is a team effort.

Medicare for All?

The current, hugely expensive American health system absorbs 18% of U.S. GDP and leaves nearly 30 million people uninsured and another 40 million underinsured with large deductibles and copays.

A surprising study by the Koch brothers- funded Mercatus Center shows how, under Medicare for All, every single resident of the U.S. can be guaranteed good-quality health care at an overall cost that is nearly 10% less than our current system — savings that can translate into lower health-care costs for both households and businesses.  Average businesses that cover their workers will lower their costs by 8%. Middle-class households who now buy insurance on their own will see a savings of 14% of their income. That is, their net income will rise by 14% through Medicare for All.

On top of these cost savings, no American will ever again be uninsured or have to fight with an insurance company for coverage or worry about having to cover co-pays or deductibles while living on a tight budget;  or live in fear of a family member getting sick and facing bankruptcy as a result.

The study also considers in depth how to provide a Just Transition to people now employed in the private health insurance industry–providing them with retraining, relocation, job placement, as well as direct financial support as the country moves away from our existing private health insurance system.

The study reflects the reality of every other similar economy in the world: guaranteed healthcare for all with no barriers to care. This saves lives and costs less.   However, I also have to  report a figure $32 trillion of extra Federal government expenditure  over 10 years  under the Sanders bill as currently written.  This has caused the debate to get roiled in arguments about government expenditure rather than benefit to the economy and to general health and medical cost reduction.

The study was peer-reviewed by a group of eminent experts on the subject. One of the reviewers, Professor Jeffrey Sachs of Columbia University, concluded that, “This study is the most comprehensive, detailed, authoritative study ever undertaken of Medicare for All, and it points powerfully and unassailably in support of MFA.”.      (The Costs of a National Single-Payer Healthcare System” by Charles Blahous,  Mercatus Center,  George Mason University).

My comment: a government dedicated to shrivelling the role of government is never going to let Medicare for All become reality.   There is no benefit to the rich in extending tbis idea to the poor, just higher taxes. Already the knives are out .  In todays New York Times there is an article by the very moderate David Brooks entitled  “The Impossible Medicare for All”.  Watch while a positive idea about helping ordinary people, struggling with health costs, is savaged and disposed of.

Medicare in America

The top 1% of Medicare patients account for 20% of the total cost of Medicare. The top 5% account for 50% .  This is the greatest threat to the US government finances, scarcely discussed, after the profligate funding of futile foreign wars.  And now the huge Baby Boomer population is starting to have a threatening effect on the cost of Medicare, potentially blowing the budget, just as Republicans are planning to reduce taxes!

The high costs, to be fair, are caused by a moving population of people with serious conditions, who cost a lot for a few months , then revert to “normal”, that is, if they don’t die in hospital.  But there are some patients with chronic conditions of multiple co-occurring conditions who are treated for months.  The doctors dare not end the treatment for fear of legal challenges, and relatives won’t let the sick person go.  The taxpayer is stuck with the bill.

It will come as no surprise to learn that the very people who advocate spending less on the poor through Medicaid, are the biggest consumers of publically funded Medicare, ready to call a lawyer at a moment’s notice, and eager to fund research into ever longer lives for themselves – as long as they don’t have to pay for it out of their own pockets.

Surprisingly, under Republican rule,  seniors will have to pay a larger share in 2018 for Medicare the richer they are ( as defined by their 2016 Federal tax returns).  Higher premiums will be paid for both Medicare Part B and Part D for individuals with modified adjusted gross income which exceeds
$85,000.00, and married couples with joint incomes above $170,000.00.  (I have tried to understand the Medicare website setting out the new arrangements, but it is written by an illiterate and, to me, it is incomprehensible.  I will not try to list the new rules because you won’t probably understand them either).

The point is that there is a segment of the (well-off) population for whom no amount of public money is enough to keep them alive.  Rationing is anathema for them, but reducing even basic healtthcare for the poor is apparently fine by them. It is one thing to help someone recover from acute injury, but long-term cognitive impairment should be a matter for intelligent discussion between doctors and family.  Keeping alheimers patients alive at all costs is cruel to everyone ( I have personal experience).  End-of-life is end- of-life.  If relatives want to extend it, they should make a major contribution towards the cost, not expect the taxpayer to pay out with no end in sight.

And yet…and yet…. Americans are under the illusion that American medical care is the best in the world, even though US life expectancy is lower than  all the other OECD countries.

Tomorrow: Medicare for all?

A passage worthy of Epicurus and appropriate for our roiled-up times

“There are among us still those who would deny to others the right to hold a different understanding of the fundamental issues of our time.  Thus, if we look around us , we see dogma still in conflict with rival dogma; we see people of one culture or belief at odds with their human neighbours who are of a different culture or belief; and we see many who are prepared to act upon this difference to the extent of denying the humanity of those with whom they differ.  They are prepared to kill them, and other innocents, in the process, in order to strike at those whom the perceive to be their enemies, even if these so-called enemies are, like them, simple human beings, with families that love them, and with hopes and fears about their own individual futures.

( A long-dead person returning to visit us) “would recognise those self-same conflicts and sorrows which marred his own world and made it such a dangerous place….He would, I suspect, say that much has remained the same; that even if we have put some of the agents of division and intolerance to flight, there is still much evidence of their work among us.

………..” Let us remind ourselves of the possibility of combating, in whatever small way we can, those divisions that come between man and man , between woman and woman, so that we may recognise in each other that vulnerable humanity that informs our lives, and makes life so precious; so that each may find happiness in his or her life, and in the lives of others.  For what else is there for us to hope for? What else, I ask you, what else?”

( An excerpt from Alexander McCall Smith’s book “At the Villa of Reduced Circumstances”, pages 56 and 57.   McCall Smith is the author of the wonderful series  “The No.1 Ladies’ Detective Agency” .)

 

Physician- assisted suicide: the attitudes of doctors are changing, slowly.

Polls show that many Americans think doctors should be allowed to help terminally ill patients end their lives.

The AMA’s Council on Ethical and Judicial Affairs spent two years reviewing resolutions, not so much on whether to support the practice but on whether to take a neutral stance. On 2018 the council recommended that the Code of Medical Ethics “not be amended” and continue to refer to “physician-assisted suicide,” saying that language still “describes the practice with the greatest precision.”

Doctors showed strong support for the status quo, a  position that is increasingly at odds with public opinion.  Polls show that many Americans think  doctors should be allowed to help terminally ill patients end their lives.

Among doctors some argue that physician-assisted death should be a choice for patients who are already dying and want to end their suffering on their own terms. Those on the opposing side contend that such assistance violates one of the core principles of their profession — do no harm — and could become a slippery slope to euthanasia. There’s even disagreement about how to characterize the practice. Opponents say terms such as “aid in dying” are euphemisms that obscure the harsh reality, while proponents see “doctor-assisted suicide” as stigmatizing patients who choose it.

“This is not just a medical issue,” said cardiologist Thomas Sullivan, an AMA delegate from Mkassachusetts who agrees with the recommendation for no change. “This is a social issue. This is a moral issue. This is something that many, many people are faced with from time to time, when your own parents or your own children or your brother or sister or you are faced with a terminal illness.”
Neurologist Lynn Parry, a delegate from Colorado, said she will vote to reject the ethics council’s stance and ask it to spend more time “looking at what protections for physicians, and particularly for patients, would need to be in place” for the AMA to amend its guidance.
“How we look at the universe is really driven by our personal belief system and, in large part, by our philosophies and religious beliefs, and that’s as it should be,” she said.
Her state is among those that allow physician-assisted death. Oregon led the way with a 1994 ballot measure, followed by Washington in 2008 and then Vermont, California, Colorado, the District and Hawaii. A court case established the legality of assisted death in Montana. (California’s 2015 law was overturned by a judge last month, a decision that is being appealed.)

John Radcliffe, right, who was diagnosed with cancer in 2014, watches as Hawaii Gov. David Ige signs a bill in April to legalize medically assisted suicide.  (Sophia Yan/AP)
The practice drew intense national attention in fall 2014 after a terminally ill woman named Brittany Maynard moved from her home in California to Portland so she could utilize Oregon’s Death with Dignity Act. The 29-year-old had been diagnosed with a Stage 4 brain tumor — glioblastoma, the same aggressive cancer that Sen. John McCain (R-Ariz.) is battling — and was told it would kill her within six months. She instead set her own timeline, taking a fatal dose of barbiturates that November.
Half a year later, a Gallup poll found nearly 7 out of 10 Americans surveyed said doctors should be allowed to assist terminally ill patients in ending their lives — a notable increase from 2014.
David Grube, a retired family physician from Oregon and national medical director for Compassion & Choices, calls the current AMA policy “antiquated.”
“ ‘Do no harm’ leads to a lot of harm in medicine,” he said, with “people on breathing machines for months and all kinds of things.” He considers the “enemy” to be terminal suffering, especially the cases where doctors can’t ease patients’ pain. Since his state passed its law, Grube said, “more people haven’t died, but fewer people have suffered.”
But doctors are still debating it.
“I just do not believe that in the medical profession, which at its core is about protecting the quality and quantity of life, we should become the agent by which we hand them a prescription so they can choose the exact time and moment of their death,” said M. Zuhdi Jasser, an internist and primary-care physician who serves as an AMA delegate from Arizona.
Jasser, who presented the resolution to maintain the term physician-assisted suicide, said he plans to vote for the association to hold firm.
“The big question that I think physicians are going to be dealing with over the next five, 10, 15 years as more of these states legalize it is: Are our ethical guidelines and core principles going to be determined by cultural shifts and by popular vote or populism,” he said, “or are they going to be things that we adhere to and hold on to regardless of the shifting winds of populists’ concerns?”. (Washington Post, June 10 Lindsey Bever?