The State of Healthcare Firsthand, From the Doctor

I went to a hospital today to have a procedure done.  When the nurse apologized for the quantity of paperwork, I casually mentioned that things might become more complicated with Obamacare.
I was not ready for the answer.  Actually, being in a very socially liberal city and healthcare system, I thought I was going to hear support for the program.  I instead was told how government has corrupted the system, made it worse for both Doctors and patients and other horror stories.  I replied that the government has not helped healthcare in a long time to which the nurse responded that the decline of morals in our culture was the beginning of the problem.  How correct this nurse was.

Next, I met with the Doctor to go over what the procedure was going to entail.  I again mentioned whether the healthcare system was affecting his job.  Again I received a surprise answer.

The doctor told me of his passion for his practice all of his life.  He then told me that what is being done to us by Washington has him considering getting out.  He was honorable enough to not practice if he couldn’t do his best.  It was a John Galt conversation.  There are others like this doctor.  I’ve found that if you are contemplating your retirement in your mind, you are already in the process of retiring.

To a person, the hospital staff admitted that Washington and the damage they have done and are doing to our healthcare system makes it worse for patients and providers.  This is not a partisan statement for the record.

Let me point out that this was a highly successful practice with state of the art equipment and professional personnel making these perspicacious comments to me.

It was  clear that they wanted to help people and do their job, but our own government is in the way.  It seems obvious that they have overstepped their role in making sure that medicine is safe and lawful.

If I hadn’t heard it from the horse’s mouth, I wouldn’t have known.  I did go in looking for a cure, but I left with a dose of information.  It is easy to conclude that we need to fix or excise Washington from the healthcare system and put it back in the hands of the doctors.

Here is another story by a Doctor in a completely different area of the country from me that I read by chance on the same day as my procedure.

After 18 years in private practice, many good, some not, I am making a very big change.  I am leaving my practice.

No, this isn’t my ironic way of saying that I am going to change the way I see my practice; I am really quitting my job.  The stresses and pressures of our current health care system become heavier, and heavier, making it increasingly difficult to practice medicine in a way that I feel my patients deserve.  The rebellious innovator (who adopted EMR 16 years ago) in me looked for “outside the box” solutions to my problem, and found one that I think is worth the risk.  I will be starting a solo practice that does not file insurance, instead taking a monthly “subscription” fee, which gives patients access to me.

I must confess that there are still a lot of details I need to work out, and plan on sharing the process of working these details with colleagues, consultants, and most importantly, my future patients.

Here are my main frustrations with the health care system that drove me to this big change:

  1. I don’t feel like I can offer the level of care I want for my patients.  I am far too busy during the day to slow down and give people the time they deserve.  I have over 3000 patients in my practice, and most of them only come to me when there are problems, which bothers me because I’d rather work with them to prevent the problems in the first place.
  2. There’s a disconnect between my business and my mission.  I want to be a good doctor, but I also want to pay for my kids’ college tuition (and maybe get the windshield on the car fixed).  But the only way to make enough money is to see more patients in my office, making it hard to spend time with people in the office, or to handle problems on the phone.  I have done my best to walk the line between good care and good business, but I’ve grown weary under the burden of having to make this choice patient after patient.  Why is it that I would make more money if I was a bad doctor?  Why am I penalized for caring?
  3. The increased burden of non-patient issues added to the already difficult situation.  I have to comply with E/M coding for all of my notes.  I have to comply with “Meaningful Use” criteria for my EMR.  I have to practice defensive medicine to avoid lawsuits.  I have more and more paperwork, more drug formulary problems, more patients frustrated with consultants, and less time to do it all.  My previous post about burnout was a prelude to this one; it was time to do something about my burn out: to drop out.

Here are some things that are not reasons for my big change:

  1. I am not angry with my partners.  I have been frustrated that they didn’t see things as I did, but I realize that they are not restless for change like I am.  They do believe in me (and are doing their best to help me on this new venture), but they don’t want to ride shotgun while I drive to a location yet undisclosed.
  2. I am not upset about the ACA (Obamacare).  In truth, the changes primary care has seen have been more positive than negative.  The ACA also favors the type of practice I am planning on building, allowing businesses to contract directly with direct care practices along with a high-deductible insurance to meet the requirement to provide insurance.  Now, if I did think the government could fix healthcare I would probably not be making the changes I am.  But it’s the overall dysfunctional nature of Washington that quenches my hope for significant change, not the ACA.

What will my practice look like?  Here are the cornerstones on which I hope to build a new kind of practice.

  1. I want the cost to be reasonable.  Direct Care practices generally charge between $50 and $100 per patient per month for full access.  I don’t want to limit my care to the wealthy.  I want my practice to be part of a solution that will be able to expand around the country (as it has been doing).
  2. I want to keep my patient volume manageable.  I will limit the number of patients I have (1000 being the maximum, at the present time).  I want to go home each day feeling that I’ve done what I can to help all of my patients to be healthy.
  3. I want to keep people away from health care.  As strange as this may sound, the goal of most people is to spend less time dealing with their health, not more. I don’t want to make people wait in my office, I don’t want them to go to the ER when they don’t need to.  I also don’t want them going to specialists who don’t know why they were sent, getting duplicate tests they don’t need, being put on medications that don’t help, or getting sick from illnesses they were afraid to address.  I will use phones, online forms, text messages, house calls, or whatever other means I can use to keep people as people, not health care consumers.
  4. People need access to me.  I want them to be able to call me, text me, or send an email when they have questions, not afraid that I will withhold an answer and force them to come in to see me.  If someone is thinking about going to the ER, they should be able to see what I think.  Preventing a single ER visit will save thousands of dollars, and many unnecessary tests.
  5. Patients should own their medical records.  It is ridiculous (and horrible) how we treat patient records as the property of doctors and hospitals.  It’s like a bank saying they own your money, and will give you access to it for a fee.  I should be asking my patients for access to their records, not the reverse!  This means that patients will be maintaining these records, and I am working on a way to give incentive to do so.  Why should I always have to ask for people information to update my records, when I could just look at theirs?
  6. I want this to be a project built as a cooperative between me and my patients.  Do they have better ideas on how to do things?  They should tell me what works and what does not.  Perhaps I can meet my diabetics at a grocery store and have a dietician talk about buying food.  Perhaps I can bring a child psychologist in to talk about parenting.  I don’t know, and I don’t want to answer those questions until I hear from my patients.

This is the first of a whole bunch of posts on this subject.  My hope is that the dialog started by my big change (and those of other doctors) will have bigger effects on the whole health care scene.  Even if it doesn’t, however, I plan on having a practice where I can take better care of my patients while not getting burned out in the process.

Is this scary?  Heck yeah, it’s terrifying in many ways.  But the relief to be changing from being a nail, constantly pounded by an unreasonable system, to a hammer is enormous.

France’s Rich Jumping Ship To Switzerland. The Effect of Raising Taxes

THE CAUSE – VIA USA TODAY

Recently elected President Francois Hollande’s Socialist government introduced France’s 2013 budget with steep tax increases on the rich that include a 75% tax rate on those earning more than $1.28 million for two years and a new 45% rate for revenues of more than $193,000. Higher taxes on businesses are proposed as well.

THE RESULT

“In the north, we are hearing that more and more people are preparing to leave the country,” said Sebastien Huyghe, a conservative UMP lawmaker. “This autumn, a number of people may make their arrangements.

“The 75% tax will not fill the country’s coffers; instead, it sends a strong signal that will both scare away those who have the means to create jobs, and prevent others from coming and investing in France,” he said.

Economists and analysts say the super-tax is more symbolic than effective, saying it would affect only 2,000 to 3,000 French households while adding little to state revenue.

“From a strictly budgetary and economic point of view, the impact will be marginal, but the Socialists expect a political effect, and they are right,” said Thierry Pech, editor-in-chief of Alternative Économiques monthly magazine. “There is a deep resentment (by the public) against the ultra-rich, one that could feed populism.”

Many French say these super-rich must contribute more, and those seeking tax exile betray the very country that gave them the savoir-faire that led to their international success, a sort of French version of the “You didn’t build that” claim that President Obama leveled against successful businesspeople in America.

“Has (Arnault) thought about all the help he has received from French investors and from the French state itself to make it where he is now?” asks French taxpayer Olivier Weber in Paris.

Last year, 16 business tycoons and other holders of French fortunes wrote an open letter in the French weekly magazine Le Nouvel Observateur with the title “Tax us!”, saying that after benefiting from the “French model,” they were willing to pay more in times of crisis. But that was before a super-tax.

Many of them have changed their minds, such as Jean-Paul Agon, the chief executive of L’Oréal, the biggest cosmetics company in the world.

“If there is such a new tax rule, it’s going to be very, very difficult to attract talent to work in France, almost impossible at a certain level,” he told The Financial Times.

Even Stéphane Richard, CEO of telecom company Orange , who is close to the Socialist party, is worried about the “accumulation” of taxes and the impact on the French economy.

“I’m worried that we start by taxing the rich, and that’s it,” he told French daily Le Monde. “It’s one thing to call on economic patriotism, it’s another to organize a looting (of the rich) that will turn on the tax exile machine.”

Some French shrug their shoulders with typical Gallic distaste

“It’s normal to pay your taxes — it’s important — it means you belong to a community,” said Christine Templier, 38.

IS THE USA GOING DOWN THIS PATH?

Share the wealth has been the mantra of the current government.   Current policies emulate France, Greece and the PIIGS.  Based on our tax system, we certainly seem to be headed in the direction of not having enough taxpayers to pay for the entitlements.

It is said that the 1% need to pay more.  In fact, if you confiscated 100% of their wealth, it wouldn’t make a dent in the deficit.  It causes division and class warfare.  It clearly defies the history of success where “a rising tide raises all boats”. 

SO WHAT IS THE ANSWER?

Besides the obvious of spending less, which congress does not have the ability on either side to do, grow the base of taxpayers and more revenue will come in.  JFK and Reagan (and other Presidents) proved this so we have history to support this.  In fact, the largest year of tax revenue ever by the government was 2007.   There are far more complex economic theories, but increase a tax base who are not afraid to spend more, and tax revenue will rise.

CONCLUSION

I don’t think Zuckerberg, Gates and Buffet will leave America if they raise taxes, but many are leaving California (at 2000 per week).  If you look at history, we can do more by having an economy that is growing for everyone.  By not singling out a specific group, we get the rising tide and an economy shift with more jobs and more tax revenue.

As for the rich French, many are now in Switzerland. 

Maybe there will be a lesson in here for them and they can get their tax base back.

The Escape Key and The Guy Who Invented Ctl-Alt-Del….and Why

I worked in the PC Group, wisely sold to Lenovo years ago.  On the 20th anniversary, they looked for interesting tidbits from those who invented the PC.

David Bradley worked down the hall from me.  He’s the guy who invented Ctl-Alt-Del.  I asked him why and he told me DOS 1.0 keep crashing, so he wrote a quick and dirty program to restart the computer quickly without having to turn it off.

Later, David was kind enough to give me a copy of his personal copy of DOS 1.0 and Visicalc, a program for which I was a giant at using.  I still have it in my original IBM-PC I picked up off the trash pile while working there.

His best line though was when they had a reunion of the PC development team and Dave said to a reporter in front of everyone that he wrote the program, but Bill Gates made it famous.

THE ESC KEY

Bob Bemer invented this key.  I never worked with Bob, but per the NY Post, it goes like this:

The key was born in 1960, when an I.B.M. programmer named Bob Bemer was trying to solve a Tower of Babel problem: computers from different manufacturers communicated in a variety of codes. Bemer invented the ESC key as way for programmers to switch from one kind of code to another. Later on, when computer codes were standardized (an effort in which Bemer played a leading role), ESC became a kind of “interrupt” button on the PC — a way to poke the computer and say, “Cut it out.”

Why “escape”? Bemer could have used another word — say, “interrupt” — but he opted for “ESC,” a tiny monument to his own angst. Bemer was a worrier. In the 1970s, he began warning about the Y2K bug, explaining to Richard Nixon’s advisers the computer disaster that could occur in the year 2000. Today, with our relatively stable computers, few of us need the panic button. But Bob Frankston, a pioneering programmer, says he still uses the ESC key. “There’s something nice about having a get-me-the-hell-out-of-here key.”

I, KEYBOARD

Joseph Kay is a senior scientist at Yahoo! Research.

Why do outmoded keys, like ESC, persist? Our devices have legacies built into them. For more than a hundred years, when you wanted to write something, you sat down in front of a typewriter. But computers look different now — they’re like smartphones. It will be interesting to see whether in 10 or 15 years the whole idea of a keyboard will seem strange. We might be saying, “Remember when we used to type things?”

How would we control computers in this future-without-typing? Think of the Wii and Kinect, or even specialized input devices for games like Guitar Hero or Dance Dance Revolution. All might be bellwethers for the rest of computing. We might see a rise in all sorts of input, like voice recognition and audio control — think about Siri.

World Record Parachute Jump By Felix Baumgartner, A Round Up Of Coverage and Issues

Here is the video of the jump above.

Here is the video from his chest camera:

Here is a view of all angles of the jump:
http://gizmodo.com/watch-felix-baumgartners-space-jump-from-every-angle-i-1445173582?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+gizmodo%2Ffull+%28Gizmodo%29&utm_content=Bloglines

On October the 9th, Felix Baumgartner will jump from the edge of space at 120,000 feet, breaking the speed of sound as well as all the records for a human parachuting.

Normally, this would have been only mildly interesting, but I went to school with Fred Kittenger, son of current record holder Joe Kittenger.  Fred was one of the nicest, most motivated young men that I went to school with.  Unfortunately, his father didn’t seem to be a part of it.

Nevertheless, I was still fascinated with the feat and I liked Fred, plus it was a tremendous show of testicular fortitude which I admired.  Many died trying to break his records and given the technology then vs. now, it was quite a feat.
KITTENGER PLUNGE

As recorded byDiscovery

Kittinger made his highest jump, and set the still unbroken high altitude jump record, on the third and last jump of Project Excelsior. On Aug. 16, 1960, Kittinger lifted off from an old abandoned airstrip north of Tularosa, New Mexico in an open gondola; his pressure suit was his only defense from the harsh environment of near space. At the tests starting altitude of 102,800 feet, Kittinger had 99.2 percent of the atmosphere beneath him.

Then he jumped, and the Beaupre multistage parachute system worked perfectly. After a 13 second free fall, a 6-foot parachute opened and stabilized his fall — this is the one that prevented the spin dummies that had fallen before experienced. After another four minutes and 36 seconds he was down to about 17,500 feet where the main 28-foot parachute opened. He floated the rest of the way to Earth.

BAUMGARTNER’S TECHNOLOGY

Francis F. Beaupre came up with the system built around a series of parachutes that would deploy in sequence to stabilize the pilot. Here’s how the sequence was designed:

Right after bailing out, the pilot would pull a cord to release an 18-inch pilot parachute after a few seconds of delay. Once it was fully inflated, the pilot chute would pull out a 6-foot diameter stabilization parachute. Next would come the main parachute release. It would inflate partway until the pilot passed through 14,000 feet as measured by an aneroid barometer on his person. Passing this altitude would trigger full release of the 28-foot diameter main parachute. It would inflate fully, and he’d make a soft landing on Earth.

Beaupre’s stabilization parachute system worked at altitudes where jet aircraft were normally flying, but it needed to work higher. Aircraft like the X-15 were brushing the fringes of space, and they would need a safe way to bailout of the rocket plane just like pilots did from jet aircraft. So the Aeromedical Research Laboratory at Holloman Air Force Base began a series of high altitude parachute tests where pilots jumped from balloons. This was Project Excelsior.

Project Excelsior wasn’t a long term project. There were just three tests, but they were manned, most famously by then Captain Joseph W. Kittinger Jr.

Here are the 5 biggest risks to making it safely or biting the big one.

Felix talks about the risks, the jump, the record and more.

Red Bull Status Update, Countdown and Information

I wish him luck and hope he makes it.  It certainly is a ballsy feat.

For fun, here is a link to 8 of the craziest skydives in history

It even set the record for most live web streams.

Felix hits Mach 1.24, faster than the auto land speed record

Engineering issues that had to be overcome

Doug Casey on American Socialism

I was hoping this was not true, but it is his Doug’s point of view.

(Interviewed by Louis James, Editor, International Speculator)

[Skype rings. It’s Doug, as expected.]

L: Hi, Doug. I got the Alan Colmes article you sent. I can see why it got your goat – guess you’ve got a good rant in mind?

Doug: I don’t approve of rants. It’s true that I have strong opinions, and I’m not afraid to express them – but a considered and defensible opinion, even if it’s delivered with conviction, is essentially different from an emotional outburst.

L: Okay, sorry. No rants. But if the other side starts name-calling, we can be forgiven for a little emotion on our side – how does one answer a snarky dismissal of anyone who doesn’t agree with so-called progressives, labeling them “regressives”?

Doug: I’m certainly not above delivering an appropriate and well-deserved insult. An insult is really all that the lame attempts of progressives to shame people into voting for Obama deserve. From a long-term perspective, it certainly doesn’t much matter who wins the coming election; Romney would be just as great a disaster for what’s left of America as Obama, just in slightly different ways, with different rhetoric.

It’s interesting how certain breeds of statist are now re-labeling themselves as “progressives.” I guess they like the sound of the root word – progress – even though they only want progress towards collectivism. They used to call themselves “liberals,” a word which in America used to stand for free minds and free markets. But they appropriated it and degraded it – classical liberals had to rechristen themselves “libertarians.” World-improvers, political hacks, and busybodies in general are excellent at disguising bad ideas with good words, ruining them in the process.

It’s said that “Sticks and stones may break my bones, but words can never hurt me.” But that’s actually untrue; propaganda is a very effective weapon. As Orwell pointed out, if you control the language, you control people’s thinking; and if you control people’s thinking, you control their actions. So I despise the way these types manipulate words.

As for the case at hand, one of the things that annoys me most about Colmes’ vapid article is his dishonest and misleading, albeit conventional, defense of the New Deal – America’s first great lurch towards socialism. He defends all the harm it’s done as a wonderful thing. He repeats the fiction that the New Deal rescued the economy from the last depression. It actually made the Depression deeper, and made it last longer.

L: Do tell.

Doug: Well, to start with, Colmes, a self-appointed whitewasher of American socialism, begins by resting his case on the claim that it is American socialism that has made America exceptional. It’s quite a bold assertion, since socialism as well as fascism are antithetical to everything that was good about America. He really is a cheeky bastard.

L: He calls his socialism “liberalism.”

Doug: Yes, but that too is an Orwellian perversion. As always, we should start with a definition. Around the world, you ask people what a liberal is, and they say something that at least relates to the word’s original meaning: liberals favor liberty. And that’s not just the civil liberties defended by the ACLU, but also economic liberty – meaning freedom to engage in free trade with others. The free market.

But back in the 1930s, socialists like Norman Thomas started to realize that they were never going to persuade the majority of Americans to accept socialism outright, so they changed the name and embarked on a deliberate campaign to implement their agenda, one piece at a time, calling it liberalism. And who could be against that?

L: I’ve read that most of Thomas’ 1932 platform has now become law in the US.

Doug: I believe that’s true. Take a look at this Word document [it will download automatically]. Actually, the same is true of Marx’s Communist Manifesto. But back to today, Colmes’ claim is absolutely ridiculous. Social Security, Medicare, and progressive income taxes have not made America exceptional, but just the opposite; they’ve made it like all the other socialist and fascist countries that cover the face of the globe like a skin disease. They are burdens that have slowed the economy and distorted people’s incentives and ideas.

These programs have, perversely, hurt the poor – the very people they’re supposed to help – the most. They’ve acted to corrupt them and cement them to the bottom of society. They’ve destroyed huge amounts of capital, which would otherwise have raised the general standard of living, redirecting it from production toward consumption. These coercive ideas all originated and were first implemented in Europe before so-called liberals foisted them on Americans, in the name of freedom. It’s quite Orwellian, the way they’ve twisted concepts to mean the opposite of what they once did.

L: Some people would argue that things like Social Security liberate them – free them from fear of poverty in old age.

Doug: That claim shouldn’t be worth answering – but it must be answered, because Boobus americanus believes it. It’s a classic “big lie.” Say it often enough, and people think it’s true. In fact, Social Security acts to impoverish the country, by destroying the incentive to save.

L: How so?

Doug: By taking almost 15% of a person’s wages right off the top, Social Security makes it much harder for a poor person to save money. Worse yet, it makes people think they don’t need to save for themselves; it gives them a false sense of security. Even worse is that the money never really belongs to the presumed recipient; it’s simply another unsecured obligation of a bankrupt government.

Social Security payments should at least be set aside as discrete accounts in each person’s name, and become assets for them. If that money were placed in an individually owned pension plan, with just average management, the results would be many times what people now hope to get. And the plan wouldn’t be a burden to future taxpayers. Social Security is, in fact, just a gigantic Ponzi scheme, where the next generation of young people is forced to support the last generation of old people.

Worst of all, the program causes people to be irresponsible. This is a disaster, because a free society can only exist when everyone takes personal responsibility seriously. It’s a swindle, and it corrupts everyone. No wonder parents can no longer rely on their own children to support them in old age. Maybe the Chinese will lend the US government the money it needs to pay its Social Security obligations…

But the numerous practical failures of a program like Social Security are not the main problem.

The primary problem with a scheme like Social Security is that it’s not voluntary; it’s coercive, which makes it unethical. You can’t force people to do what you think is right and then claim to be liberating them. Alleged freedom from fear of poverty in old age in exchange for theft of wages in the present – and the correct word for taking people’s money without their consent is “theft” – is not liberal in any defensible meaning of the world. It’s brute, “might-makes-right” power clothed in noble-sounding words.

L: Colmes says that Social Security keeps 40% of seniors above the poverty line today, and “helps families with disabilities and those who have lost loved ones.” That’s a bad thing?

Doug: No one seriously thinks they’ll be able to have a decent quality of life on Social Security retirement income alone. Why do you think so many senior citizens are working at Walmart or the like? Colmes is committing the same error Bastiat pointed out 200 years ago; choosing to value immediate, direct, and visible benefits, but ignoring the delayed and indirect costs, which only become obvious later.

The long-term costs of Social Security, Medicare/Medicaid, food stamps, and so forth include bankrupting the country, among other economic consequences. But even more disturbing and damaging is the degradation of once self-reliant people to subservience and dependence, which is what happens when government assumes responsibilities that adult individuals should bear themselves.

For example, Social Security disability benefits are being used as an alternate income source by the unemployed. As of August, 2012, there were about 10.8 million people collecting disability income – that’s a larger number than the entire population of most US states, and up from 8.1 million in 2007, when the Greater Depression began. It can be a great scam, claiming PTSD, unprovable back pain, or a mood disorder. There’s a whole class of ambulance-chasing lawyers that takes these cases on contingency.

L: What about the individuals who try and can’t bear the responsibilities of adulthood?

Doug: The programs exist and have not prevented that from happening; there are plenty of homeless people today. I would argue that most of them are in that position because they’ve developed bad habits. There would be a lot fewer of them if they didn’t get taught from childhood that assuring their own lives and well-being is really the state’s responsibility, not their own. The system is failing these people, but again, that’s beside the point; two wrongs don’t make a right. The whole idea of a government “safety net” is wrong, in principle and practice.

Ideas have consequences in the physical world, and lies, twisted words, and self-contradictory, impossible claims can be extremely damaging. You can’t liberate people by putting them in financial chains.

L: I understand the principles, but many people don’t – or just don’t care. People like Colmes see the parks built by the Civilian Conservation Corps and the infrastructure built by the Works Progress Administration as unmitigated goods, the work given to all the millions employed by the government as life-saving, and the idea of helping those in need to be a moral imperative they don’t question.

Doug: The average person has been handed this party line throughout his life, from teachers in government schools to talking heads on TV. He’s been discouraged from thinking critically or independently. We have two widely shared myths – that Roosevelt’s New Deal cured the Depression and Johnson’s Great Society cured poverty – although both beliefs are counterfactual. It’s pretty much as Will Rogers liked to say: “It isn’t what we don’t know that gives us trouble; it’s what we know that just ain’t so.”

Now a new myth is being hatched, that Obama and Bernanke’s quantitative easing saved the economy. But that will never catch on; it will be totally debunked over the next few years as they destroy both the dollar and the economy.

Colmes seems completely unaware that government programs have costs. The money used to pay the Civilian Conservation Corps and Works Progress Administration workers had to come from somewhere – where? It’s either forcibly taken from current taxpayers, who then can neither enjoy it nor invest it as they prefer – or it comes from taking on debt, which means future taxpayers, who are thereby turned into indentured servants. That money was redirected from whatever uses those who earned it had for it, and put to uses government employees deemed best.

The political process, of course, has a perverse tendency to result in “pork” spending on the most useless, wasteful, and idiotic programs imaginable. It goes for things that are politically productive for the people who control the state, not necessarily economically productive for either society or the taxpayers. But again, this is all secondary to the ethics of the matter; that is vastly more important.

Parks are nice, but should the money to build them have been taken from entrepreneurs struggling to build businesses in the 1930s? Or single mothers in, say, Harlem, struggling to feed their families? It’s the little people who can’t afford the lawyers and accountants needed to cut tax bills who suffer the most.

Coercing people to do what politicians decide is simply unethical.

L: What about the argument that it’s not coercion if the people voted for the politicians who passed the laws that created these programs?

Doug: Essentially another big lie. In the first place, people vote for politicians – who rarely keep promises – not for laws at the federal level. None of these laws were enacted by the people. Second, unless you could get unanimous consent of every person affected, it would still be coercive to people who have committed no crime and want no part of it, and thus unethical.

If 51% of the people vote to enslave 49% of the people, that doesn’t make that slavery right. If 99% vote to enslave 1% – something many of the ignorant, torch-wielding masses seem to be clamoring for these days – it’s still wrong. Ethics is not a matter of popularity contests.

Anything that society wants or needs can, should, and will be provided by entrepreneurs working for a profit.

L: Can you elaborate on that? It’s all fine to criticize stupid ideas, but unless you offer a constructive alternative, what’s the point?

Doug: Indeed. We’re talking about products and services that people regard as necessary or beneficial for society as a whole, but which they say private enterprise wouldn’t provide adequately. Roads, schools, and post offices are frequently cited examples.

Government post offices were a bad idea to begin with – even back in the 1800s when most people thought they were vitally important, a man named Lysander Spooner set up a private company to deliver mail – and do so for less than the government charged. This superior service upset the apple cart, and was outlawed and shut down. Today, everyone knows that UPS and FedEx do a better job than the post office; no sensible person trusts the government when it absolutely, positively has to get there. Between that and email, the post office should have been shut down, rather than propped up, long ago. It now costs taxpayers on t he order of $12 billion a year.

Similarly, there’s a history of private roads going back to previous centuries. The fist transcontinental highway, the old Route 66, was paved with private money. There are private roads in the US and around the world today. It’s simply not true that you need a government to build things that people actually need. You need government roads about as much as you need government cars.

We’ve covered schools and education. The schools are absolutely the last thing the state should do…

L: What about things like the military, police, and courts?

Doug: Well, I would argue that even those should be handled by the private sector, but I understand that many people can’t get away from the idea that these services are core government functions that should not be privatized. That’s because they fear they would not be fair and impartial – though it’s a cruel joke to think that government courts today are fair and impartial. At any rate, I could live with it if government were limited to these core functions; but police and courts are only a tiny fraction of what government does today.

There’s great danger in having the government do anything, quite frankly. But it could be better if more people like Ron Paul or my friend Marc Victor were in office. Check out Victor; he has the potential to be the next Ron Paul – on steroids.

L: Understood: if no one can make a buck providing some good or service, how vital can it be? Anything people actually want will be provided by entrepreneurs, making a profit. And like you, I too like to start by asking what is right, before I ask how much it costs. But most people just don’t seem to think this way. That’s why I keep coming back to the practical arguments. It seems that, regardless of one’s politics, it should matter that the state’s coffers are empty.

Colmes argues that by 2022 Obama’s Affordable Care Act “will provide coverage to 33 million Americans who would otherwise be uninsured.” He doesn’t mention that mandated government spending and interest payments have already taken over the entire federal budget. Even now, with a $1.5 trillion deficit, most of the $700 billion for the military, the $227 billion for interest on the national debt and the $646 billion for regular government services is borrowed every year. The whole thing is an impossible pipe dream that absolutely ensures the bankruptcy of not just the US government, but American society itself.

Doug: It seems insane – people wouldn’t believe us if we’d written this into a story some years ago.

But you can see the scary truth in the news every day; people in Europe’s totally broke and failing economies protest violently in the streets for their governments to spend more money those governments don’t have and won’t be able to borrow. Colmes exhibits this same breathtaking unwillingness to face the facts. He talks about one in seven people being on food stamps, as though it were a good thing. He talks about how politicians voted to extend unemployment benefits with money they don’t have as though that’s an unquestionably good thing to do.

L: So is Colmes an evil manipulator or a misguided dupe?

Doug: I don’t see how any intellectually honest person can write a long article praising a whole alphabet soup of government agencies without ever once admitting their failure, asking how much they cost, or examining the ethical basis for their existence. So I suspect he’s both a knave and a fool.

Colmes’ article encapsulates wrong-headedness and willful ignorance in exactly the same way that Paul Krugman and Thomas Friedman invariably do. They’re all very destructive people. Since they don’t appear to be stupid – in the sense of having low IQs – I’m forced to assume they’re ill-intentioned.

L: So… What’s in it for him to circulate such obviously biased and misleading opinions?

Doug: Perhaps he’s simply a sociopath who gets pleasure from destruction. Or perhaps he’s just motivated by fame and money and has found a profitable gig. Despite being an apologist for socialism, the man hosts a talk show and writes books which make him money; he doesn’t do it pro bono. He has identified a market and is making money, pursuing his own self-interest, deliberately or unwittingly to the detriment of society.

L: Just like a politician.

Doug: He sees the government as the solution to every problem. But since government is pure coercion by its very nature, you can count on it to do the wrong thing – and often even the exact opposite of the right thing.

L: It’s perverse.

Doug: [Laughs] Took the words out of my mouth.

L: Investment implications?

Doug: Nothing specifically related to Colmes. He’s just another sign of the degradation of America, yet another data point supporting my view that the US is probably past the point of no return. The place that was once America is going through the wringer, and so is the rest of the world. And the way to deal with that is what we’ve been saying for some time now: rig for stormy weather.

L: Liquidate, consolidate, speculate, create – and internationalize.

How Warren Buffet Ends The Deficit in 5 Minutes

Warren Buffett, in a recent interview with CNBC, offers one of the best quotes about the debt ceiling …

“I could end the deficit in 5 minutes,” he told CNBC.  “You just pass a law that says that any time there is a deficit of more than 3% of GDP, all sitting members of Congress are ineligible for re-election.”

The 26th amendment (granting the right to vote for 18 year-olds) took only 3 months and 8 days to be ratified!  Why?

Simple!  The people demanded it.

That was in 1971 – before computers, e-mail, cell phones, etc.

Of the 27 amendments to the Constitution, seven (7) took one (1) year or less to become the law of the land – all because of public pressure.  Warren Buffet is asking each addressee to forward this email to a minimum of twenty people on their address list; in turn ask each of those to do likewise.  In three days, most people in The United States of America

will have this message.

 1. No Tenure/No Pension

A Congressman/woman collects a salary while in office and receives no pay when they’re out of office.

2. Congress (past, present & future) participates in Social Security.

All funds in the Congressional retirement fund move to the Social Security system immediately. All future funds flow into the Social Security system, and Congress participates with the American people. It may not be used for any other purpose.

3. Congress can purchase their own retirement plan, just as all other Americans do.

4. Congress will no longer vote themselves a pay raise.

Congressional pay will rise by the lower of CPI or 3%.

5. Congress loses their current health care system and participates in the same health care system as the American people.

6. Congress must equally abide by all laws they impose on the American people.

7. All contracts with past and present Congressmen/women are void effective 12/1/12.

The American people did not make this contract with Congressmen/women.

Congress made all these contracts for themselves.

Serving in Congress is an honor, not a career.

The Founding Fathers envisioned citizen legislators, so ours should serve their term(s), then go home and back to work.

If each person contacts a minimum of twenty people then it will only take three days

for most people (in the U.S.) to receive the message.

Don’t you think it’s time?