Wednesday, October 28, 2009

The Tree of Liberty

"The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants."

Thomas Jefferson said those words a long time ago. But does anyone know what he was talking about? Do the tea baggers know what he was talking about when they proudly prance around in their Tree of Liberty t-shirts at their tea bag parties? Probably not.

Jefferson was referencing Shays' Rebellion in Massachusetts. Maybe the full Tree of Liberty Quote would be helpful for context.

"Yet where does this anarchy exist? Where did it ever exist, except in the single instance of Massachusetts? And can history produce an instance of a rebellion so honourably conducted? I say nothing of it's motives. They were founded in ignorance, not wickedness. God forbid we should ever be twenty years without such a rebellion. The people cannot be all, and always, well informed. The part which is wrong will be discontented, in proportion to the importance of the facts they misconceive. If they remain quiet under such misconceptions, it is lethargy, the forerunner of death to the public liberty. And what country can preserve its liberties, if it's rulers are not warned from time to time, that this people preserve the spirit of resistance? Let them take arms. The remedy is to set them right as to the facts, pardon and pacify them. What signify a few lives lost in a century or two? The tree of liberty must be refreshed from time to time, with the blood of patriots and tyrants. It is its natural manure."

Jefferson's words still ring true today. The tea bag parties might not have been "honourably conducted," but they were founded in ignorance rather than wickedness. For the most part. For the record, Jefferson said it was OK to kill a couple of ignorant tea baggers every twenty years or so for the sake of liberty. Luckily, we have moved beyond the need for such violence against ignorant tea baggers these days. Also:

"A government big enough to give you everything you want, is strong enough to take everything you have."

These words in 20th century vernacular are not the words of 18th century Jefferson no matter what you might read on the editorial pages of the Charleston Post and Courier. Gerald Ford said these anti-American words while president.

Tuesday, October 27, 2009

Open Up Your Arms

This is a campaign by Iraq and Afghanistan Veterans of America and the band O.A.R.

This O.A.R.'s latest video:

Thursday, October 22, 2009

Medical Malpractice

People are making some absurd claims regarding the need for medical practice liability reform.

I have read claims that make the outrageous allegation that medical malpractice costs $500 billion per year. The amount of tangible money spent on medical malpractice insurance is quantifiable and less than 1% of total health care expenditures. Claims are paid out of those premiums so add nothing to the total costs.

So where does the remaining nearly $500 billion come from? Proponents of malpractice reform stoop so low as to allege that physicians in this country are committing a fraud so large as to be preposterous. They allege that physicians defraud this country of nearly $500 billion a year through defensive medical practices that are entirely frivolous in order to prevent malpractice claims.

The idea is ludicrous and defamatory to our great medical professionals, most of whom never come close to committing malpractice. First of all, defensive medicine cannot prevent malpractice. Ever. Tests or either part of the standard of care, in which case they are not defensive, or they are not part of the standard of care, in which case they do not prevent malpractice. Second, there are a myriad of reasons a physician would order a test so it is impossible to label tests as solely to prevent malpractice claims and thus outrageously claim malpractice costs $500 billion.

Even if you assume that defensive practices exist, the CBO estimates that eliminating malpractice would save Medicare approximately $54 billion over 10 years. That is $5.4 billion a year in a system that spends about $1.5 trillion. $15 billion is 1% of $1.5 trillion and $5 billion is just one-third of that 1%. That is not real cost savings.

But here is the kicker. Medical expenses account for the largest element of medical malpractice damages. Single payer universal Medicare eliminates the need for medical expenses as a part of malpractice damages. It would also carry over to almost all other personal injury lawsuits. Universal Medicare would be the single most effective way to "reform" personal injury lawsuits.

Concierge Medicine

Or whatever you prefer to call it. There isn't really a good name for it because, really, it is what every general medical practice should be about.

Basically, you pay a retainer to a general practicioner . . . maybe $1500 per year. In return, the physician limits the number of patients in their practice, say to 300. That guarantees the physician revenue of $450,000 to cover their annual "fixed" expenses, assuming a maximum of 300 patients is actually achieved. Other than getting your foot in the office door, that annual fee includes a complete annual physical examination. But hopefully you won't need additional visits.

If you do get sick, you pay for office visits and tests and such as normal. The key thing is to focus on that annual physical and prevent illnesses before they occur. By reducing the patient load, physicians are better able to focus on prevention rather than cure. By guaranteeing a certain level of revenue, you can hopefully encourage people to become general practice physicians focused on preventive medicine.

If you were to add in the benefits of an active health club membership with a professional trainer, a health lifestyle for this country becomes an obtainable goal. It would be a good start.

I would like to see a health care reform bill that expands Medicare coverage to every legal resident of this country. It should include provisions for the above, concierge medical fees and health club membership with monthly monitoring by a professional trainer. This would rein in costs by helping people to be healthy and prevent illness. Anything less, in my opinion, would be a failure. And it would be a lot cheaper than many would imagine.

Monday, October 19, 2009


An adjective.
Favorable to or in accord with concepts of maximum individual freedom possibly, especially as guaranteed by law and secured by government.