Ain't we got fun!

As the song goes, the rich get richer and the poor get poorer. Indeed, by some estimates this is the case in the US. Of course, there are a few questions:

• Is it true?
• Is it important?
• Is it actionable by government?

Here are two takes on the problem:

• http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1033902 The author argues that, as a civilized society, we need to increase the equality of income. He proposes a "wealth tax" that would be levied against overall wealth. This would mitigate against accumulation of wealth and would redistribute it to the lowest 20% of the population.
• http://mises.org/story/1229 The author argues that wealth inequity does not mean deprivation. Furthermore, the bottom 20% of the population lives as well as the wealthy did 50-100 years ago, and in some aspects, even better.

Two things do not pass the smell test.

• If we assume that people are and should be responsible for their own actions, we come to the conclusion that the chickens should come home to roost. If you work hard, sacrifice and save, you should acccumulate the fruits of your labor. Furthermore, you should be able to pass the fruits of your labor on to whomever you wish. Likewise, if you choose to be less productive than needed for your own survival, you should rely upon the goodness of your friends, neighbors and community for charity.
• If we assume that people are not responsible for their own actions, we come to the conclusion that everything is just a matter of random chance. A person works hard because of the random nature of his environment and a random gene collection within his cells. A person doesn't work for the same reason. A person is a criminal for the same reason. Under this philosophy, goodness is just a statistical commonality, not an absolute. If more people believe that it is not right to murder, it just reflects a majority opinion of the gene-environmental pool, biased by their makeup. Any judgement is based on opinion, not on fact. For example, if a person works hard, that is who that person is. If another person doesn't work hard, that is who that person is. Neither should be rewarded or punished for who they are. If we assume that outcomes are genetically and environmentally desired to be equal (a large logical leap), then government has the duty to equalize outcomes. The problem is that we do not have evidence that outcome equality is a desired result. Indeed, in my discussion with patients with different lifestyles, I have heard voiced different goals. The desire of government to simplify people to an equality of income is dehumanizing to those who do not fall into the majority position.

DocBrain has concluded that income redistribution on a federal level is an evil. If people are responsible for what they do, let the good people gain from freely donating time, goods and money to the poor and the poor learn to admire the good who help and to emulate them as they themselves rise from poverty. If people are what they are, products of genetics and environment, it is dehumanizing to assume that you can get into their heads and know what they want and need. The best thing government can do is to get out of their way or to enable everyone to do what is in their nature. This means anarchy, no laws, absolute freedom. Anything short of either of these positions is nuanced dishonesty.

Of course, many people will take the position that we have limited control of ourselves, so we should have some limited level of responsibility. Here, the devil is in the details. How much control should a person have? Do you measure this statistically, or is it an individual thing, with each person being his own standard?

If we use a universal standard for goodness, no one is perfect. If we use the individual standard for goodness, everyone is perfect. DocBrain believes that human evolution has to include goodness. It is our duty to future generations to move towards greater universal goodness by clearly defining goodness, raising the bar, and allowing people to strive for it, using reward and punishment. A good government is one that allows individuals to be good, not one that usurps its definition of goodness from the people. Such a government produces people whose goodness has been excised. A rich person doesn't give charity because the government gives it in form of tax redistribution. A poor person doesn't appreciate the sacrifices of his fellow citizens as gifts flow from the government, not his neighbors.

We get a schizophrenic world when we try to equalize that which cannot be assumed to be an equal desire. The only equality that all people seem to agree upon is equality under the law. Perhaps that is where it should stay.

JFK has left the building

President Kennedy asked us to think of what we can do for our country, not what our country can do for us. Following his death, all politicians have been thinking about is what their country can do for and to us. The current president and Congress are no different in mission, just more aggressive in tactics. From huge expenditures on questionable programs to supporting failing companies, the current Congress and the last one have been spending like crazy. Neither President has stood up for us. Obama is actually in sync with Congress, using his popularity and oratory skills to give them cover as they spend.

What all Democrats agree upon is that the rich (however they choose to define it) should bear much of the burden for our country, paying for whatever the government chooses to finance, rent or buy. Where the Democrats disagree is on the burden that we the nonrich should have. Many see little burden for us. This is most unfortunate, as it creates loss of esteem and pride among the less fortunate among us. Just because those of us who are not rich cannot fund the governmental largesse doesn't mean we cannot contribute to the financial health of our country.

Here are some things that we, the non-rich, can do to create self worth in these trying times:

• Take excellent care of ourselves. Healthy eating, weight control, regular exercise, taking medications as prescribed, no smoking, and good mental health can reduce overall health care costs.
• Pay it forward. Help others. Donate time. Pick up litter.
• No street drugs. If we don't use them, we will save money on law enforcement, health care costs, personal budgets, and improve our relationships with Mexico and other countries. It is amazing what impact we can have on foreign policy just by saying no to drugs.
• Conserve energy. Turn off the lights. Stay married with children.
• Improve our skills and knowledge. Think of things in the long term. It takes on average 10 years of training and practice to become excellent in any chosen field. If you don't like what you are doing, don't leave it until you know what you like. Perhaps, you may be a person who doesn't really like anything, so you might as well stay where you are.
• Think about what you as an individual are doing and see if it fits as part of the big picture of making America better. If you cannot see how you are doing that, then perhaps what you are doing is not making America better, and it is time to change direction.
• If you think you are doing enough, remember that the rich thought they were paying enough taxes. Take what you are doing to the next level.
• If you don't think that you can do this, then guess what? You are part of the problem. Get help or move to another country and be their problem.

DocBrain is not rich. But DocBrain is contributing to our country. Are you?

Crazy is the new Cool

Wherever you look, there are crazy people getting their 15 minutes (or longer) of fame. Unfortunately, we are beginning to see crazy people as being role models. This may turn out to be a very bad thing for society. Whether Brittany Spears or a story about Charles Manson or some emotionally disturbed person on a reality show, this is what passes for news and cool in today's world. DocBrain hopes this will be a passing phase. Crazy should be the new passe.

Duh!

1. The government causes bad debt by providing inducements and penalties to lenders to get them to lend to those who have a low probability of being able to pay back their loans.
2. The financial institutions get into trouble because of the debts from the bad loans become overwhelming.
3. The markets collapse because of trouble with the money supply.
4. The government agrees to buy back the bad debts.
5. The market recovers.

DocBrain has only one question: why was anything else needed? The hundreds of billions spent for other purposes seem to have been wasted (or, if you prefer, pork or spoils to the victors).

The US citizen has been played. PT Barnum and the modern Democrats would have gotten along quite well.

Health Care Ideas

If you read the prior post, you understand what I mean by Old School. Unfortunately, if we don't go old school on health care, we will be forced to ration.

Over the last 50 years, we have gone from a country of people dying from acute processes to a country of people dying of chronic ones. Acute illness and injury are relatively inexpensive.

In 1960, 4.4% of the household budget went to health care. In 2005, it was 13.3%.

For over 20 years, we have had government, managed care and malpractice attorneys trying to exert control over hospitals, providers, and pharmaceutical companies. If things are doing so poorly, how can we say that these interlopers into your health are part of the solution? Perhaps, in some ways, they are part of the problem. Think of this. If a managed care organization can profit in the short term by creating barriers to you getting prevention for a chronic disease, and if you get the chronic disease and then lose your job and go onto Medicare, they have saved their money but not your health.

If they are not the answer, what is? I believe it is Old School. We need to empower each of us to become more responsible for our own health. I do not mean to imply that everything is preventable. Only a telemarketer could say that! Some conditions are bad luck or bad genes. Cancer and traumatic spinal cord injuries, for example, are largely the luck of the dice. We need to free up some health resources to research this type of stuff.

Here are some ways that savings could come about:

• We need to try to turn chronic diseases into acute ones. Free refills for medications for prevention of ravages of chronic disease. For example, antihypertensives, diabetic medications, asthma medications, antidepressants.
• Refills come in undated bottles (except for expiration date). If you manage to return to the pharmacy within 5 days either way of the last scheduled dose, the refill is free. The further away from the refill date, the higher the copay. This would encourage compliance and adherence to therapy and reduction of long term disability.
• BMI tax, with exceptions for children and those particularly mesomorphic (muscular).
• Unhealthy food tax. If it is grossly unhealthy, tax it.
• Higher cigarette taxes. Free medications and treatments for stopping smoking.
• National policy and role modeling for healthy living. Use the same marketing techniques that work in politics and TV commercials to market healthy living.
• Reward those who maintain or improve their health.
• Pay for the harm that mistakes cause according to a fixed schedule. Root causes should be found for errors and fixed, with penalties for failure to address a problem before it happens again. Wanton misconduct should be addressed by a medical board or by a criminal court, depending on the nature of the event.

You get the idea. Just these simple ideas could save us 30% or more of our health care expenditures. However, simple is the enemy of the government, so it is unlikely we will see any of this in the future. Politicians would die before asking a potential voter to look in the mirror and be more self responsible. What we will see will most likely be: more regulations. Electronic health records that will be more time consuming and will take away face time with patients and will add another layer of bureaucracy and useless auditing. Blame of everyone except those who live unhealthy lives. Centralized health care is like centralized medical ethics. It looks good on paper, but produces judgemental thinking that can be detrimental to your health and your children's future.

The best gun used for home defense is the one you don't have to use. The best health care is the one you don't have to use because you have taken the best care of yourself that you can.

Old School

Individual responsibility. Hard work. Can do. Personal sacrifice in the present for a better future for ourselves and our children. Doing the right thing even when others aren't looking. Family. Charity. Personal best. Accepting blame. Spreading credit. Living up to one's word. Politeness, formality and manners. Learning as a personal goal and virtue. And, yes, even religion and values.

These were once the hallmarks of being an American. While some did not have all the opportunites of others, these were still the ideals. One would never ask unless in dire need. One would offer before being asked. Those who were destitute were ashamed of their lot and strived to improve. Those at the top gave back through philanthropy.

Where did all that go? Can America be great again without embracing these values and traits? Can we be great in a land of political correctness, of being nonjudgmental, of expecting the government to bail us out of any predicament our mouth can get us into? Can we be great when the rich buy unneeded luxuries without guilt and the poor grab their entitlements without shame, each looking at the government as justification for their behavior? Are we happier for being less and having a government that is more? It has been said that a weak government produces strong people and vice versa. Is it twilight for America? Could it be that what Islamic extremists could not do, we have done to ourselves?

Big government is an ethical challenge to a nation of individuals. It has poisoned the minds of the poor and has hardened the hearts of the rich. This will be the obituary of Americans: we died by our own hand, having become disillusioned with our own core principles and values. We demanded more and more of our government and less and less of ourselves until we disappeared into meaninglessness and the government became America. There is no New School. School is out. Turn on the TV... image is everything.

Economics for Demmies

I keep hearing about the failed economics under Bush, so I thought I would see for myself.

For 6 years (2001-2007), Republicans controlled the Congress and the White House. During that time:

• The gross domestic product was up each quarter except one (3rd of 2001)
• The unemployment rate was the lowest in modern history (between 4-6%)
• The stock market (DJIA) was relatively stable, with a 20% drop in 2003 and 20% increase between 2005 and 2007 (from baseline of approx 10800 at Bush's first innauguration)
• Adjusted Gross Income is calculated in different ways. However you look at it, average income increased beginning in 2002 and continuing through 2006-7.

For 2 years (2007-2009), Democrats controlled the Congress and Bush was in the White House. During that time:

• The GDP was positive 4/7 quarters, with 2 of them being the first two after the Democrats took over and before there was a chance for their policies to have a significant impact.
• The unemployment rate, which had been steadily falling for 4 years, slowly rose for one year and then rose rapidly beginning 1/08.
• The stock market (DJIA), which had been relatively stable, took a speculative 12% rise between 1/07 and 10/07 before beginning its gradual, then rapid 204% descent (current as of this blog date).
• Adjusted Gross Income has begun to fall since 2007.

DocBrain has concluded that the failed domestic policies of the Republicans was actually a fiction, especially when compared to the new Democrat policies. My analysis suggests that, while things went south under George W. Bush after 1/2007, it was due to the effect of Congress under Democrat rule during the last two years of the Bush presidency. As we see now, Congress pretty much calls the tune when it comes to domestic funding. Even the most ardent supporters of Obama cannot say that Obama believes in every provision of the stimulus package. He has said it himself. As we must hold Congress responsible for much of the pork in the current bill, we must also hold them responsible for bad economic decisions under Bush as well. Republicans can be held responsible for agreeing to parts of the absurd political agenda of the Democrats, such as failure to oversee bad loans for unaffordable housing.

Patient centered health care

Pharmacists are rewarded financially for filling generic prescriptions, regardless of what the patient and physician have decided. Managed care organizations also reap financial benefits when patients use generic medications and when they withhold or slow approval of needed testing and treatment. Is this a good thing?

The most economically favorable thing a physician can do is to poorly treat a patient. The patient will have many problems, will need many office and hospital visits and many tests. A physician who is economically driven can make thousands of dollars off a patient with minimal illness by focusing on profits first. Any thinking person would find this totally repugnant, that a physician would place his own interest above that of the patient.

Why should it be any different for managed care, pharmacists, medicare, or, come to think of it, malpractice attorneys?

I want what you've got

A wise man once defined evil as taking something that belongs to someone else. This definition sounds pretty air-tight. You could take someone's property, liberty, life, or even their ability to pursue their own goals.

What gives a government the right to take something that belongs to someone else? In particular, what gives a government the right to take from some citizens and give to others?

Can you ethically take something that a person already owns? For example, can you make taxation retroactive? As I understand it, this is not yet allowed in the US.

However, you can enact new laws and regulations to change a tax code to take more (or less) and in different ways in the future. What makes it legal is the citizens buying-in on the legitimacy of the government. As long as a government is seen as legitimate, good people feel an obligation to follow the law. But when a government begins to represent one set of previously defined good citizens against another for the purpose of taking from one to give to the other, the legitimacy of the government becomes questionable.

The classic example of taking from one is the Hollocaust, where the freedom and lives of some German citizens were taken. Good people had the choice of accepting the legitimacy of the government or standing up for the persecuted. It made no difference if it was a matter of self interest. It was a matter of moral principle, of the wrongful taking.

Taxes also can be wrongfully taken. As US citizens, we must be cautious that our desire for the money of the rich doesn't lead us to persecuting the group.

While many justify the persecution of the rich, the taking of their money, by the use of various pseudo-moral arguments, the bottom line is that it is a taking, an unwanted and morally questionable act. Once their money is in the possession of those who will profit from the taking, will there be gratitude for the sacrifice of the wealthy, or further envy and greed? If you favor a graduated income tax, look into your heart. The love of money is the root of all evil, even if it is someone else's.