The Sad Truth About Health Care

There's an old rule that roughly applies in so many situations - the "80-20 rule". It means that 20% of a population accounts for 80% of a certain result. For example, as a church treasurer I know that 20% of contributing families account for 80% of the total contributions in many churches. Or, as I look out my window this morning, I consider that 20% of the times it snows account for 80% of the total annual snowfall in Rochester. Well, the same concept likely applies to health care - 20% of us probably account for at least 80% of total health care costs.

My ten years of work on an ambulance have given me a new outlook on health care. Prior to this work, I thought that people got sick randomly and that health care costs were distributed rather widely across the entire population. Now I know that this is not true; health care costs are concentrated in a few sub-groups of our population. If we are to get these costs under control, the areas of concentration are the primary places to look for savings. Yet these areas don't seem to be discussed at all in the "great health care debate" now taking place in Washington. This lack of candor represents a failure of our governmental process.

So, where are the costs concentrated? As you might guess, we spend a lot for health care of aged people with serious chronic health problems - heart disease, respiratory disease, circulation problems, and cancer. More than 25% of total health care costs are incurred for people who are in their last year of life, and much of this is spent in the last month of life. I've met many of these people - people whose quality of life is questionable at best due to pain, invasive medical treatment, and altered mental status due to the drugs they have been administered. I have serious doubts about the value of costly medical interventions for many of these patients, and some countries have established protocols that limit such interventions. Republicans have characterized these protocols as "death panels", and perhaps they are correct. However, in my view such panels are necessary and humane. Significant cost savings would be a by-product of letting these people die with dignity.

A second area of health care cost concentration relates to people with chronic diseases; diabetes and coronary/respiratory issues are likely the major ones, although other conditions like lupus and Crohn's Disease are also common. These are diseases that require constant attention and patient compliance with treatment regimens. In my experience, patient non-compliance is often an issue that results in frequent hospitalizations and increasingly costly interventions. At some point, non-compliance should result in the categorization of the patient as not interested in being stabilized, and costly interventions should be curtailed. It seems strange, but I've often felt that non-compliance is aimed at getting attention...but should society pay a high price to deal with conditions that patients knowingly create?

Health care costs are also concentrated for older persons with very severe mental illnesses. A large number of citizens are now permanently hospitalized for severe dementia or Alsheimers - conditions where many of them do not know where they are or who their relatives or caretakers are. When these people are afflicted with life-threatening medical conditions, is it right to employ costly procedures to continue a life they often cannot comprehend? I think not. Their families should have the authority to let them pass on with dignity and without pain, and at some point should be held accountable for costs that a "panel" feels go beyond reasonability given the overall condition of the patient.

Lastly, chronic drug use causes a host of severe health problems. These persons often cycle in and out of hospitals regularly, each time incurring very large bills that they cannot pay. One might wonder if there should be a limit on the cost any person can put onto society due to voluntary behavior. This is a very difficult issue, but also one that is much larger than most people would ever guess.

The issues discussed above are relatively new. During the past 50 years, medical science has developed the ability to keep many people alive who in previous times would have expired from natural causes. I'd be the first to agree that in many cases these life-saving procedures have added years of productive life to many, and particularly to those with cancer or heart disease. I am thankful that we live in an age when terrible diseases can be cured or arrested. However, it may be that technology has now forced us to come to grips with the reality of resource allocations to health care.

When the total cost of prolonging certain lives becomes great, one must consider the benefits of employing these resources elsewhere. For a fraction of the avoidable costs I've identified above, for example, every child could receive a college education or technical training, or the infrastructure of Haiti could be rebuilt. What other great needs might be met? Or, for you, does maximizing physical life for every person outweigh all other considerations? Something to think about...

Tiger...

It's not funny how so many people love to jump to negative conclusions, including those who discount Tiger Wood's contrition and subsequent vow to change his ways. Some say the apology was not sincere because he read from a script; some say it was all driven by the need to repair his commercial value; some say he left out too many details. They are all wrong, and I condemn them for disparaging someone who is trying to do the right thing. Sometimes you just can't win...

They forget that Tiger Woods had many other options, since he's rich almost beyond measure. He could have said that, for him, marriage was a mistake. He could have walked away from the limelight and tended to whatever else he fancied. He could have come back to golf right away and endured some derision until it faded; every topic wears out, you know. Instead, he said all the right things and committed himself to becoming a better man. He stated the true but simple reason for his philandering and what he had to internalize in order to stop it. I give him a lot of credit for saying exactly what needed to be said and no more. Now it's just a question of the doing.

Few of us can identify with a young man who achieved world-class fame and fortune before he was 30. How can we not understand that he had many role models - other athletes and celebrities - who cross the line every day and get away with it because that is their persona? And, of course, there were uncountable women who would do anything to get his attention. How easy it would be to fall! I believe that very few men would have been capable of withstanding that level of sexual pressure at his age, and I would not have been one of them.

I am giving Tiger my full support in his effort to come back in every way. Based on his history of incredible accomplishment, perhaps he will again set the example for making a beautiful sculpture from the trash of life. Go get'em, Tiger.

Earning Your Life's Prospects

Black leaders visited President Obama today and harped on the 16.5% unemployment rate for black Americans, which is much higher than the 9% rate for whites and 12.5% rate for Hispanics. The NPR news report mentioned their focus on the chronically unemployed base in the black community. I'm also aware that a high percentage of young black men are unemployed. It's a shame, but it's also their problem in far too many cases. We've got to have a little more personal accountability here.

The high schools in Rochester are open for business every day, and there are no state troopers keeping black youth out. If the students are from low income families they qualify for free breakfast and lunch at the school. Free transportation is provided to and from school. In other words, there are no institutional impediments to getting a good education in the city of Rochester. Yet only about 50% of Rochester's high school students graduate. It's not a discrimination problem; it's a social problem.

Nothing would make me happier than to see every black youth graduate from high school, then college, and then enter the work force prepared to compete on the basis of equal preparation. If the unemployment rate of high school or college-educated blacks stayed much higher than that of other races, then I'd complain about this apparent discrimination and try to do something about it. But I have little sympathy for those who don't take advantage of the opportunity to become educated and able to contribute to the U.S. economy.

I've heard all the rationalizations about kids growing up in poor, disfunctional families. I know it's tough to grow up in those conditions. At the same time, it's a matter of community pride and intent - if there isn't any, then nothing will change. Just giving money to poor, disfunctional families does not change attitudes. There has got to be an intent to succeed for success to occur.

I've been working with a group of Burmese refugees for several months. They've recently come the U.S. with only the clothes on their backs, and many come from tribal societies. Most have no English when they arrive. I'm amazed at how they have strived to adjust to American society, learn English, and get jobs. Their upward mobility from the absolute bottom is a sight to behold! The difference between them and many who surround them in poor neighborhoods is that they have decided to get with the program. There's no secret about what it takes to achieve some upward mobility in this country.

So, black leaders, go home to your communities and ask the hard questions. Tell the truth. You get what you give, and if you give no effort you can expect nothing. Chronic unemployment is not just about lack of opportunity; it is mostly about lack of preparation.

In this month of Martin Luther King day, I mourn his passing partly because he held up great expectations for the people he led. His successors seem to focus mostly on handouts. It's a darn shame!

Tim Tebow and Abortion

I'm really glad that Tim Tebow's mother did not have the abortion that doctors recommended she have. She made a great decison for herself, her family, Tim and many thousands of Florida Gator fans. She was right, they were wrong. But, she could have been wrong and she could have died as a result. You win some, you lose some. It's wrong to generalize from the results of an individual case, but that's what Focus on the Family did with their Super Bowl commercial.

I'm "pro-choice", primarily because I support the individual freedom that people are supposed to have in America. Even before being pro-choice, I'm "pro-contraception" - I don't want any babies conceived by accident or against the will of the mother. That's why we have only three children; we wanted to stop at three, and we made sure we did. But I digress...

"Freedom" means just that. If it's your body, you should be able to do what you want with it - what could be more personal than that. Not allowing a life to begin, or being able to end your own life, is the most personal expression of freedom that I can think of. I may disapprove of the decisions that some people might make in these areas, but I would never consider taking away their right to make those decisions. That's why I am perplexed by the "get government out of my life" crowd who are also vehemently anti-abortion. Huh?

Secondarily, I'm "pro-choice" because I believe families should make decisions about their future by considering all the likely outcomes of their decision to have, or not have, a baby. Many families, for example, cannot stand the strain of caring for a special needs child on top of the other major challenges they may be facing; many divorces result. Other families might have a structure that would accomodate, or even thrive with, the challenge of raising a special needs child. In short, every family is different; a "one size fits all" prescription on abortion makes no sense in the real world.

Some folks think this issue hinges on the crucial question of "when does life begin"? I don't feel that way at all, even though I'd say I have a very high respect for life. I just believe that life is full of hard choices and tragedies; any of us could be dead tomorrow, for example, from some unforseen cause either man-made or natural. There is no certainty in life, the uncertainty increases as one moves down the economic ladder, and God does not step in to save those who happen to be unlucky - including those who are not born due to someone else's choice.

Good for you, Tim Tebow. Your mother won the pregnancy lottery and you won the Heisman. It's a great story of pluck and luck. Now, let's hear the story of the child born with some terrible defect who died after enduring several years of agony, during which time its family went bankrupt and fell apart. After all, one conclusion based on anecdotal evidence deserves another, don't you think?

An Easy Winter, Except South of Here

I've been following the news stories about the "great storm" that's hit the eastern seaboard and areas west of it during the past two days. People who never have had to contend with 20-30 inches of snow have no idea of the impact such a storm makes. Transportation is basically halted; power goes out in many areas; and, emergency services are taxed to the limit.

How would you like to experience heart attack symptoms when ambulances cannot make it through the streets, or be a weak 90 year old person who loses power and cannot keep her home warm? Those who can cope think a storm like this is fun, but there are others for whom it results in tragedy. During the three years when I managed our local ambulance corps I saw the unusual problems that a storm can bring; how about an otherwise smart person who runs a generator in a closed garage and almost kills himself, for example?

I remember taking the Xerox corporate jet into White Plains airport, just as a big storm like this hit Connecticut. Somehow I made it to the hotel where I spent the next three days as the city dug out from over 20 inches of snow. Another time, I was at a church retreat in the southern tier of New York when over 20 inches of snow hit; we enjoyed an extra day there and upon arrival at home found our 19 year old son exhausted from shoveling our long driveway. Big snows are truly paralyzing!

It seems strange to be sitting here in upstate New York watching a few snowflakes fall onto the 2-3 inches that have been on the ground for a few days, while people far south of me are trying to cope with a blizzard. We are used to the big snows and we are equipped to deal with them; we've had 62 inches already and hardly noticed it. But, how many people in D.C. own a snowblower? Good luck, you guys! I can at least imagine your pain.

More on Haiti

This past Sunday evening a group from my church met at our home. Late in the meeting the subject of Haiti came up. Four of us had been to Haiti, two of us twice, but none had gone together. The common opinion of us all was that Haitian culture was intractably corrupt and the Haitian mode of education and governance would not change regardless of what the "rescuing" countries did.

One of the men mentioned a conversation he'd had with a young man who'd spent 18 months in Haiti with the Peace Corps. This fellow was totally disillusioned after his stint there, and he believed that the country had little hope to become even a second world country. Americans who work in Haiti are involved, generally, in tiny projects that improve the lives of people in the countryside by providing clean water, for example. There seems to be no government interest in or capability to perform major projects that would restructure the country.

I keep hearing diplomats and other high ranking people drone on about giving the Haitians control over the rebuilding projects, but they are mistaken. There are far fewer qualified Haitians than there are projects to manage, and I'd guess that many of those Haitians are well-schooled in the art of corruption. My view is that outsiders should, with Haitian consultation, manage all the projects and employ as many Haitians as possible in responsible positions at good pay. Good training should be given to as many Haitians as possible. However, if a Haitian employee gets involved in corruption on a project, they should be fired.

If and when competent Haitian managers emerge, they should be given more responsibility. It would be wonderful to see a Haitian professional class emerge. But, until that happens, I feel the governmental and non-governmental relief and rebuilding organizations should stay in firm control of where their money goes and how things are done. Otherwise, they are likely to be pouring their resources down the drain.

Frustration

We'd like to believe that people are rewarded for being good and punished for being bad. It's a foundational element of our American culture, even if in reality it has often not been true. Consequently, the idea that those responsible for many of America's current problems have not got their just desserts is grating on the rank and file. I share main street's angst.

I'm outraged that so many of those who enabled and operated the sub-prime mortgage industry are living well on their profits while the rest of us suffer, either without jobs or getting no interest on our savings.

I'm incredulous that George W. Bush and his cronies got off scot-free after starting a very expensive war for no good reason.

I don't understand why my tax dollars bailed out GM and its retirees, both of which lived large for many years on extravagant wages and benefits as the company's products deteriorated and its market dried up.

It irks me that some of America's largest institutions, including the fossil fuel consortium and the teacher/public employee unions, are successfully lobbying to head off progress toward 21st century paradymes in their sectors of the economy.

And, maybe most of all, I'm sick of the U.S. congress - both parties - for standing around bickering when so many national issues need attention. The situation makes me wonder if our form of government makes sense anymore.

What to do? Beats me! That's why it's so frustrating. Perhaps widespread public anger will result in some positive change. That's our only good hope.

Haiti Update

I told you so. Haiti is a total mess, not only from the earthquake but because there are no Haitians in charge. Over the past 20 years, most people with any competency and integrity have left the country, leaving those without it to manage the place. Oh, and "manage" means manage the corruption. There is no national or local government with any standing as far as the people are concerned. As a beleagured Haitian said it on NPR yesterday, "We need aid, but don't give it to the government because we'll never see it." It's true.

So, where does that leave things? Well, there are lots (10-15 thousand) of international relief workers and American soldiers doing rescue and immediate relief activities right now. The dead will be buried before long, the injured will get some sort of treatment, and food/water distribution will be figured out. When that's over, about 3 million Haitians will be left standing around the rubble wondering what to do next. That's when the next big problem becomes apparent.

If you recall, General Colin Powell said before the Iraq War, "You break it, you own it." Well, it could also be said that, "You relieve it, you own it." At this point, the U.S. government and private agencies have committed to about $250 million in relief spending in Haiti. If 3.5 million Haitians were affected, that works out to about $71 per Haitian, many of whom lost whatever home they had. In other words, even if this aid number doubles, it's a spit in the ocean.

There is already talk of making Haiti a U.N. Protectorate - in other words, the U.N. would take over the governing role for Haiti until a competent Haitian authority could be put together. This means years, not months. The U.S., of course, would be the primary muscle and money behind the Protectorate, since no other countries really care about Haiti despite words to the contrary. We are in this for the long haul, it appears, and it's a bad thing.

Why is it bad? Did you know that there were 45,000 Americans in Haiti when earthquake struck? That's one American for every 200 Haitians, and most Amercans were doing humanitarian work. Despite this level of involvement, which has been going on for many years, Haiti remained a poor, unsuccessful, backward country. Part of the problem is its unique "Creole" language, a blend of French and native tongues; it's hard to modernize when you can't talk to anyone. Another part is the level of pride Haitians exhibit; they may be poor, but they don't like listening to foreigners. These issues will haunt us, because we have excessive expectations and the Haitians now have a claim on us - we must keep them alive indefinitely.

We are stuck. In order for Haiti to manage itself, it must change. If we try to force change, we will be accused of killing their culture. It's a recipe for unending stagnation and unending support of that population. If Obama was smart, he'd announce right now that we'll give our best efforts for three years and we're out of there, governmentally speaking. If the NGO's want to stay and help out, fine; they've been there forever, anyway.

The U.S. could do amazing things in three years, infrastructure-wise. Reliable power, good and accessible drinking water, some sort of sewage collection and treatment, for example. We could build cement plants to convert the rubble into new concrete blocks, and we could try to organize some sort of workable government process at all levels. In the end, though, the country belongs to the Haitians, and we should give it back to them. We didn't cause the earthquake, and we have no obligation to attempt a huge "nation-building" project there. President Obama, the time to say "goodbye" is now.

Hopeless Haiti

The big earthquake that hit Port au Prince has caused casualties in the hundreds of thousands, but Haiti has hardly any hospitals and some of those likely have collapsed. Even with the best relief efforts of other countries, only a small fraction of injured Haitians will be able to access professional health care during the next few weeks. It's going to be really ugly over there.

Having been in Haiti on two occasions in the early 1990's, I can easily envision the chaos that has ensued following the earthquake. Almost all buildings were constructed of substandard concrete block with little or no reinforcement, so they fell down when the first big shake occurred. The sharp, heavy blocks were perfect for killing or maiming people. And even in the best of times, injured people relied on friends to get them to the hospital because the few ambulances served only the very rich. Today, most of the injured have no place to go and no way to get there, anyway. The unmitigated agony must be surreal.

Haiti's warm climate and the inputs of cheap food and clothing from outside has allowed its millions of poor citizens to live at a very low standard. Developed counties send used clothing to Haiti, so even the poorest have something to wear. Shelter from heat and rain can provided by a corrugated metal panel supported by whatever will hold it up, with concrete blocks being the upscale solution. Typical food for the poor is basic, such as rice and beans with a tasty flavoring; meat is available for those who have money, as are tropical fruits such as plantains. Water is often provided by communal supplies that people access with bottles and buckets. In normal times, therefore, millions of Haitians live on the edge but survive because they have what they need to stay alive. However, nobody wants to get sick or injured because medical care is spotty at best.

The Haitian economy is primitive. When I was there, it was a cash or barter economy for most people. However, a few oligarchs controlled the few industries that can operate in Haiti - rum production and small factories, mostly, and the oligarchs lived well. In addition, many people received payments from funds transferred in by family members living in the U.S. or elsewhere outside the country. Small businesses such as corner stores and bars were common, all protected by iron bars on windows and doors to ward off theft. People got around by walking or paying to ride on brightly painted trucks of all sizes that had large platforms with wooden seats built into their beds. The population was very resourceful, however, and most people found ways to earn the small amounts of money they needed to survive. Charities often provided a buffer for the destitute.

One would be amazed at the lack of infrastructure in Haiti. Few areas had running water or sewers, and electricity was often not available due to the rationing of power from generating stations. Food was usually cooked on charcoal stoves, the charcoal coming from what few trees were left in a country once 97% forested. Most roads were hard-packed gravel, and major highways were two lanes wide. Rainstorms in the rainy season often created wash-outs, and I remember seeing a major stream running down the main street of the town where I worked; one walked across the street by stepping from large stone to large stone amidst the running water. This was normal.

From the above description, you may better understand the impact of the earthquake. In a subsistence economy there are no resources for dealing with emergencies. Damaged water supplies and roads prevent people from accessing the basics needed for life, so even those who were not harmed by the earthquake will be desperate. With millions needing assistance, the relief efforts must be massive to deal with immediate needs. Who knows how long it will take to get the country back to "normal"? It will be a long time.

I found the Haitian people to be friendly, very nice looking, and generally happy despite their deprivation. Many, including the poor, were quite intelligent and creative. Their problems were mostly related to living in a country that had little to offer in terms of output; where there is no production and no valuable natural resources, there is no money. Yet the availability of basics made it possible for Haitians to grow the population, thereby limiting the resources available to each individual. Under these conditions, I saw little that would give the average person any hope for getting ahead. Now, the earthquake has crushed whatever hope there was. The "failed state" of Haiti has descended into a state of hell.

What can be done? In my view, only a benevolent dictator regime can pull Haiti out of its mess over a long period. With no internal resources, foreign aid is the only hope - but endemic corruption will result in the looting of this aid unless extremely tough standards are applied. Because the society has ingrained corruption and few who are trained managers, outsiders would need to provide most of the leadership during the recovery period. However, I doubt Haitians would accept such an approach unless it was maintained by a level of force that would make liberals cringe. Even concepts such as enforced birth control would have to be considered in this dire situation. Who would impose such a regime? Probably nobody. So, don't pay much attention to those who predict Haiti will recover. The best outcome will likely be a return to a client state supported by international aid and living on the edge - until the next crisis again brings chaos.

Working Together

It's a new year, normally a time when one is optimistic about the future. I can be optimistic about my own life, since I'm relatively secure, pretty healthy, have a good support system of wife and friends around me, and have interesting work and play opportunities. However, my psyche is always affected by what is going on outside my little cocoon, that that stuff does not engender much optimism for 2010. The problem is that we humans seem to have a lot of difficulty working together, and that is the source of most of our problems.

In one of his most profound statements, Jesus said "Do unto others as you would have them do unto you". Reciprocity...it's such a simple concept, but hard to implement. Selfishness stands in the way, prompting us to see life as a zero sum game where we each must fight to keep what we have. We fail to see that, working together, we can create far more for everyone.

I'm astonished that obvious communal efforts are so often neglected, since the evidence that it works is all around us. In fact, our entire "modern world" is a result of groups of people working together to achieve common goals. Why is it, then, that we resist dealing in concert to solve so many issues that threaten our country and the world? As a pragmatist, I'm perplexed. Can we start to turn this around in 2010? It seems unlikely.

I heard yesterday that in many parts of the undeveloped world pregnant women suffer from an iodine shortage that robs their offspring of 10-15 IQ points due to iodine-deficient brain development. Providing iodized salt to these people would seem so easy to do, yet it is not being done. What a tragedy! Would I be writing this blog if my IQ was 15 points less? Why are countries that suffer from this problem not making it easy for other countries to provide this simple solution? Beats me! We just don't seem to be able to work together.

Nowhere is this problem of conflict more obvious than in American politics. Working together requires a common set of facts, to begin with, but our politicians seem allergic to facts but addicted to partisanship and special (read "selfish") interests. Both parties are smoking dope instead of identifying the core problems that American must deal with, gathering pertinent facts, and working together to find solutions in the common interest.

If it was up to me, I'd fire every sitting member of congress and replace them all with people who've shown little interest in politics and lots of ability to accomplish difficult tasks. In six months we could have a new congress that would remake America in ten years and leave few people unhappy with the outcome. That's because solving difficult problems makes everyone optimistic for the future. We really do have people who could lead us up this road.

So, I am very concerned about our ability to work together. For the moment, though, my attention is focused on "Abel". Abel is a 23 year old refugee from Burma who's been in the U.S. for eight months. Starting with no English, he now reads easily (pronounced and understood the word "idiomatic"), and speaks English pretty well. Perhaps this fluency results from his prior knowledge of two Chin dialects, Burmese, and some Chinese and Malay. He's taken his GED already, and likely will pass it. If he does, he will enter a good college in Rochester - for free.

Abel has been through hell in his young life (just believe me), but he wants to become a civil engineer. I'm making it my project to get him there, and enjoying the hell out of it. It helps that he's a hard working (two jobs) guy with a great smile. I love helping those who are willing to help themselves! Perhaps that's why I admire my own three sons, all of whom stand on their own two feet while helping others. Abel is a surrogate, perhaps, since the boys are all grown up.

Selfishness may kill America. Seniors complain about any reduction in their benefits, even if they are comfortable. Wealthy folks complain about higher taxes, even though taxes are relatively low. Kids complain about increases in state college tuitions, even though those tuitions are an incredible bargain. Union members complain about efforts to bring their job requirements and overall compensation in line with their abilities and their industry counterparts. Inner city parents and students have no clue and violence rules their streets; their future is bleak, but they seem indifferent to whatever they might do to change this. All of us seem to acknowledge that progress requires sacrifice, concerted efforts, and hard work - but few seem interested in becoming part of the solution.

Many say this century will belong to the countries of the far east, and they are probably right. I hope those countries do well, but I also wish that America would do well. Sadly, I'm not optimistic. We've lost our ability to work together, so we will decline together. In the meantime, though, I can help Abel achieve the kind of life he always deserved. I can be optimistic about that, at least. Call me if you know about any other, more promising, options for how I should spend my spare time. And, Happy New Year!

Sick of the Unions!

Unions have done a lot for the worker class, I'd be the first to admit. They won reasonable working hours, better working conditions, and better pay and benefits for their members. They also got processes that protected workers from capricious firing by managers. Despite the corruption that has plagued unions throughout their history, it's hard to argue that unions haven't been a major factor in the democratization of our country. Unfortunately, they now seem bent on bankrupting our country by standing in front of changes that are unavoidable - changes that primarily have to do with efficiency and accountability.

Hardly a day passes when I don't read another major story that, often unintenionally, describes a union that seems bent on driving its employer base into failure or subjecting its customers to substandard services. These stories are not in republican screeds or shouted out on Fox News; they are on the front pages of local newspapers and on media outlets like NPR. Union leaders have no shame, which apparently is a condition they've mutated into as a result of too many years in a closed shop. In my view, a monopoly of labor is just as pernicious as a monopoly of employers, and in many areas of our economy labor has just such a monopoly.

Today the New York State Troopers Union strongly objected to the state's decision not to have a new troopers class in 2010 to replace troopers who have retired. They complained about the larger geographies that troopers must cover with fewer people, and they criticized the governor for having about 200 troopers assigned to security details. What they failed to mention was that the total number of troopers was at a record level just last year, and that the state is facing a giant deficit for 2010. Could we expect these people to be part of the solution until the budget woes are controlled? No way.

The New York City school system has a "rubber room" where 700 teachers under suspension for a variety of accused misdeeds await their fate while receiving full pay. The cost is $65 million per year. Some of these teachers have been reporting to the "rubber room" for more than seven years while their cases proceed through the labrinthine process that the union somehow negotiated. Change this unwieldly process? No way. The process for dismissing an ineffective teacher also contains so many steps, documentation requirements, and appeals to higher and higher authorities that few principals have the time or interest to use it. It's obvious that teachers unions have little interest in the quality of education that their members deliver, even though bad teachers are often pariahs even in the teacher ranks of their own schools. This is what happens when unions gain so much political power that only candidates who support even their outrageous demands will get their funding support.

Today I listened to a co-worker describe a post office screw-up of a deposit for business reply mail. This was the third consecutive time that this type of transaction had been improperly processed by this local post office. If a private company had screwed up in this manner, it would have been easy to find a manager, explain the situation, and get the problem fixed. When it comes to the post office, you just shrug your shoulders and sigh, wishing that they'd go bankrupt and be sold off to FedEx or UPS after their union contracts were scrapped.

In Rochester, New York, the school system is run by a local school board of hacks who each get a few thousand dollars for their part time efforts. The drop out rate is ridiculous, and Rochester's teenage pregnancy rate leads the nation, so the mayor is making noise about getting permission to take over the system. In addition to citing the poor academic performance, he's concerned about the waste in the central administration of the system. Where is the teacher's union on this? Screaming! They see a disaster coming when an excellent mayor might get into their knickers after replacing a bunch of hacks who are easily bought off. Why should we be surprised?

Last year it cost the federal government over $60 billion to save GM and Chrysler, both of which were crippled by unions who fought the company's effort to become competitive. Well, we haven't seen anything yet. The public employee unions will be the death of the blue states before its over. Maybe unions were once good citizens, but now they are simply out to protect obsolete jobs and poor performers. I'm sick of them, and I'm going to vote for anyone who has the guts to take them on.

Napolitano Should Be Fired

Anybody who's been a manager knows that things go wrong. Policies and procedures can be deficient, or people charged with implementing them can make mistakes. Obviously, in the wake of learning all the information about the latest attempted airline bombing, something went terribly wrong and the process must be fixed. I don't blame Janet Napolitano, head of Homeland Security, for the problem, since she is not personally responsible for every failure within her organization, but I do believe she should be fired for her failure to respond appropriately to the bad news. In short, the system did not work, contrary to her representations on TV this weekend. We cannot accept leaders whose first reaction to bad news is to "purfume the pig".

Napolitano, even in the absence of complete information, should have simply reported that the system did not work and consequently, the lives of hundreds of Americans were jeopardized. She should have announced her plans for a complete and prompt review of the security breach, and her intent to correct the problems that caused the failure. That's what effective leaders do, and she did not do it. The correct response was left to the president, some three days after the incident occurred.

Napolitano's response shows that she does not have the right stuff. Obama should ask her to leave, and he should appoint a replacement who sets a no-compromise, no-excuse tone when it comes to airline security and security in general.

I recognize there will never be a foolproof system in place to safeguard the American people from every terrorist attack. There are too many vulnerabilities, and the resources to deal with them are not unlimited. We are left with "doing the best job that we can", and accepting that a future tragedy will probably occur. That said, there is no way that an identified potential terrorist should have been allowed to board a plane bound for the U.S. or keep his tourist visa. The system was broken, for sure, but Napolitano just didn't have the guts to tell it like it was. It's time for you to go, Janet.

A Christmas Coincidence

Yesterday morning I needed to stop at the local credit union before driving to downtown Rochester to do some church bookkeeping work.

As I waited at a red light near the credit union, I looked to my left and saw a man slowly walking down the snowy roadside toward me, using a cane. He wore an overcoat, carried a briefcase, and hobbled uncertainly because one of his legs was covered with a large brace. I wondered where he was going at such a slow pace, but then the light changed and I went on my way.

After finishing my banking, I departed by another way and soon approached another nearby intersection. There, waiting for the light to change, was the same man. I pulled over, stopped my car, and shouted, "Do you need a ride?" He replied, "Where are you going?" I said, "Anywhere you want to go! Hop in!" He smiled, hobbled over to the passenger door, and strugged into the passenger seat with his stiff leg. I noticed that he appeared to be of Hispanic origin and that he was well dressed.

"I was going up to Monroe Avenue", he said as I started out again. "Where, exactly, are you headed?", I asked. He said he needed to catch a bus to downtown where he worked. I knew Monroe Avenue was almost one mile away. Quite a walk for a man with a cane on a windy, snowy morning! We chatted some more; he said his office was in the Times Union Building, which was directly on my route to the church. He was happy when I said I'd be delivering him to his office door.

We conversed during the twenty minute drive. He told me he was an attorney in general practice, mostly working with low income people who had legal problems. He said he often took payment in barter services, or took clients who could not pay him. He didn't have a car, which didn't matter since he couldn't drive because of his stiff leg. He laughed when he said he had recently re-injured a chronically bad knee when he made a poor decision to dance at a party. I marveled at his pleasant demeanor, his obvious high intellect, and his courage in attempting the challenging walk to the bus stop. He gave me his card as we approached Times Union Building, and he said, "Please let me know if I can ever do anything for you." I waved goodbye.

Why did I stop for him? Well, as I've walked the Appalachian Trail for many years, I've had to ask many favors of strangers. I've thumbed a lot of rides in and out of small towns, I've had a lady wash my hiking clothes, for free, after she explained there was no laundromat in her town, and I've also been able to help a few strangers that had needs no one else was going to address. I've become accustomed to dealing with obvious needs, whether or not I knew the person in need. I always seem to benefit from these experiences in some unexpected way.

As I look back on yesterday morning, it seems like quite a coincidence that I had a chance to observe this man and evaluate his plight some minutes before I was presented with the choice to either stop for him or go on my way. Was this just a regular coincidence, or was it a Christmas coincidence? I'm still pondering why his destination was exactly where I was planning to go, even though I intended to transport him wherever he needed to go. What do you think?

"The ONE", Examined

I'd be the first to agree that a lot of air has gone out of Obama's balloon. Doing the job is a lot harder than running for it, actually, and idealism must be subordinate to pragmatism when things have got to be done. The Left is raging; their savior has turned out to be mortal after all.

But I like Obama's family image (please, Barack, don't be a Tiger!), his clear statements of American values, and his stamina and ability to deal with lots of big issues at the same time. Sometimes, though, I wish he'd just come on a bit stronger when the bad guys, domestic and foreign, act up. But he's a diplomat, and maybe that's best in the long run.

What really bugs me, though, is all the trash talk from the Right regarding Obama. They've set him up as "the ONE", a Matrix-like persona whose goals are the destruction of America as we know it. You would not believe all the bad things Obama has planned for us!!! Somehow, though, there isn't any evidence that he's pushing any of this stuff. It's the classic case of setting up a false target, then shooting it full of holes - but the fools on the Right love it. It's just what they want to hear, and who cares if it's true or not. Closet racism at its finest!

This would be a joke to me, just another reason to poke fun at the nutcakes who proliferate the red states and infect the blue ones...except that some of my friends actually push this crap. They're neither stupid nor heartless, but they've got it in for Barack. Therefore, I've concluded that everyday exposure to Glen Beck, Rush Limbaugh, and Sean Hannity does, in fact, constitute brainwashing. There really is a right wing conspiracy, and it's right in front of our eyes.