Thursday, January 14, 2010

Some Workers Are More Equal Than Others

George Orwell, the brilliant English author, is best known for his dystopian novel 1984, describing a future in which a “Big Brother” government absolutely controls its citizens, including their very thoughts. A lesser known, but equally important Orwell work is his short novel, Animal Farm, a brilliant satire on communism. In Animal Farm, a group of farm animals throw off the oppressive bonds of Farmer Jones and claim the farm for themselves. The animals, led by the smartest and most organized animals, the pigs, establish their own society, based on the “Seven Commandments of Animalism”, the most important of which is the seventh commandment, “All animals are equal.” As the story progresses, [SPOILER ALERT!] the pigs wrest more and more control. Finally, the animals awake one morning and find that the seventh commandment has been amended to read, “All animals are equal, but some animals are more equal than others.”

Animal Farm was written as a satire, but today we can also see it as prophecy. This week, President Obama and leaders of the House and Senate met for a full-day meeting with heads of the labor unions. The labor unions have been vocal in their opposition to a component of the “health-care reform” bill that would tax so-called Cadillac health plans – those plans given to employees by employers that have premiums greater than $8,000 for a worker and $12,000 for a family (this includes both the workers and employers contributions to the plan.) The unions have a very good reason for their opposition – most union employees have such a plan.

It is now being reported that an agreement has been tentatively struck which would exempt those Cadillac health plans that were the result of a collective bargaining agreement. In other words, two workers, making exactly the same wage, receiving exactly the same benefits would be taxed differently solely because one of those workers belongs to a labor union while the other does not.

Apparently, according to the Democratic leadership in Washington, you do not matter as much if you do not belong to a union as you do if you belong to a union. All workers are equal, but some workers are more equal than others. This should be of no surprise to anyone. In Washington, your needs are not important. What is important are the votes you can deliver to those who are in power. The unions are a reliable constituent of the Democratic Party that deliver a lot of votes and a lot of money. Ergo, they are important and worth protecting. You are not.

This is yet another result of identity politics. We have all been divided into various categories – racial minority or majority, rich or middle class, gay or straight, management or labor, union or non-union, and the list goes on and on. Our government has ceased representing the country as a whole and now only represents those who can help them get re-elected. Do not think for a minute that the politicians in Washington have your best interests in mind, the only interest for which they are looking out is their own.

This “health-care reform” bill is only the latest and most egregious example of that. The persistent bribes in order to secure votes and continue the campaign contributions flowing attest to that. That is why the people of Louisiana and Nebraska receive enormous benefits that are not accorded to other states. Not because those states are in any particular dire need of those benefits - Nebraska has the eleventh best economy in the country - but because the bill is so bad that it was necessary to offer those bribes to ensure passage. That is why, if you are a blue collar worker, even though you probably get paid less and receive poorer benefits than your union co-horts, you get to pay the bill for their health care plans.

Chances are that you are already a second-class citizen of this country. Chances are that, while everyone is equal, you are less equal than some other groups. If not, doubtless you soon will be. Is this really good for our country? I think not.

At the end of Animal Farm, the pigs go into partnership with the previously despised and discredited humans. As the other animals looked through the windows of the farmhouse where the pigs and the humans were drinking and playing cards together, they realized that the pigs and the humans looked more and more alike until they found that they were no longer able to tell the difference.

Sunday, January 10, 2010

Reid, Racism, and a Double Standard

Is there any politician that puts their size 11 in their mouth more often than Harry Reid? I mean, this is the guy who, when touting the new Capitol Visitor’s Center said that at least Congress wouldn’t have to smell the tourists, anymore: "In the summer because of the heat and high humidity, you could literally smell the tourists coming into the Capitol. It may be descriptive but it's true." In December, Reid likened those who are opposed to the governmental take-over of our health care system to slave holders and those who would deny women the right to vote and to deny civil rights. Of course, health care “reform” protestors, to Reid, are “evil-mongers.”

Now, Dirty Harry is backpedaling over comments he made during the Presidential campaign saying that Barack Obama could potentially win since he is “light-skinned” and “no Negro dialect, unless he wanted to have one.” Yesterday, Reid gave the obligatory apology saying, “I deeply regret using such a poor choice of words. I sincerely apologize for offending any and all Americans, especially African-Americans for my improper comments. I was a proud and enthusiastic supporter of Barack Obama during the campaign and have worked as hard as I can to advance President Obama's legislative agenda."

It might be instructive to remember what Reid said when then Senate Majority Leader, Trent Lott faced a similar situation. At a 100th birthday party for long-time Senator and former segregationist Presidential candidate, Strom Thurmond, Lott said, "I want to say this about my state: When Strom Thurmond ran for president, we voted for him. We're proud of it. And if the rest of the country had followed our lead, we wouldn't have had all these problems over all these years, either," In spite of a very similar apology, Lott was forced by the party to step down from his leadership position. Commenting on Lott’s resignation, Reid said, "He had no alternative. If you tell ethnic jokes in the backroom, it's that much easier to say ethnic things publicly. I've always practiced how I play."

Of course, there is a huge difference in the Harry Reid and Trent Lott situations, namely that amid calls for resignation, the Republican party heeded those calls and forced Lott out of his position while the Democrats are rallying around Reid. Diane Feinstein said, "First of all, all of us are imperfect. Clearly, this was a mistake. Clearly, the leader misspoke and he's also apologized.... The president has accepted the apology and it would seem to me the matter should be closed."

Harry Reid is not the first Democrat to utter racially insensitive quotes. The human gaffe-machine, Joe Biden said of Obama, "[He is] the first mainstream African-American who is articulate and bright and clean and a nice-looking guy." Biden also previously raised eyebrows when he famously stated, “You cannot go to a 7/11 or a Dunkin' Donuts unless you have a slight Indian accent. I’m not joking." And, of course, let’s not forget former KKK Exalted Cyclops (really!) Robert Byrd, Senator from West Virginia who once stated in an interview, “There are white niggers. I've seen a lot of white niggers in my time.” As is happening in the Reid instance, these statements are defended by being misunderstood, unintentional, and vestiges of childhood speech.

Maybe they are, I don’t know. I do think it is interesting that Republicans don’t receive this benefit of the doubt. When Joe Wilson shouted, “You lie!” during an Obama Presidential address, Maureen Dowd read his mind to say that what he meant was really, “You lie, boy!” Liberal intellectual, Jeneane Garofalo called the tea-partiers, “Racist red-necks,” and added, “This is about hating a black man in the White House. This is racism straight up." I notice that we haven’t heard from Ms. Dowd or Ms. Garofalo on the Reid comments.

Is Harry Reid a racist? I don’t know. I suspect he is not a racist, merely just an incompetent boob. Barack Obama really is light skinned and I don’t know if that helped with the electorate. I would like to think not, but maybe it did. In any case, the comments were stupid and offensive to a large number of people – or at least offensive when uttered by a conservative.

Conservatives get tired of being branded racists for daring to be conservative. The same people who opposed Hillary-Care are now being branded racists for opposing Obama-care. It is a term that is too easily thrown around and is too unevenly applied. In my opinion, this should not cause Harry Reid his leadership position since he has been able to retain it in spite of all the other incredibly stupid things he’s uttered and done. But, what’s good for the goose is good for the gander.

If we are so quick to use the term “racism”, let’s just make sure the terms are equally applied.

Tuesday, January 5, 2010

Taxation Without Representation - 21st Century Style

As any schoolchild can tell you, well, at least the schoolchildren who were educated before patriots like Samuel Adams, Patrick Henry, and Nathan Hale were edited out of our textbooks in order to provide room for such historically significant luminaries as Michael Jackson and Oprah Winfrey (unfortunately, I am not making this up), the primary cause for the American Revolution was taxation without representation. Our forefathers found themselves staggering under onerous taxes, imposed by a British political system in which they had no input or influence. This gross unfairness was sufficient for the colonies to revolt against their own country and declare their independence.

Unfortunately, universal suffrage is only a relatively recent phenomenon in the United States. In spite of Abigail Adams’ entreaties to her husband, John, a delegate to the Continental Congress to “remember the ladies,” it wasn’t until 1920 that the 19th Amendment to the Constitution guaranteed women’s right to vote. In 1870, the 15th Amendment guaranteed that the right to vote could not be denied by race. Even so, many minorities were prevented the vote by state sanctioned “work-arounds”, such as poll taxes, literacy tests, etc. In 1965, Lyndon Johnson, in conjunction with the Republican legislature, overcame the protests of Southern Democrats to pass the Voting Rights Act of 1965. Since that time, although there have been a few, isolated cases of voter intimidation or suppression, most recently by the New Black Panther Party in Philadelphia in the 2008 Presidential election, there is near universal acceptance that, with a few exceptions (those under age 18, convicted felons, etc.), every American citizen has a right to vote for representation to their federal government.

Once the people have elected their Senator or Representative, as long as the elected representative meets Constitutional criteria, they are invariably seated in Congress, and rightly so. The people have the right to elect whom they choose and to not allow that person to represent his constituents seriously undermines the Constitution. Even when the Congressperson is in a minority, she has a right and responsibility to represent her constituents and allow their voice to be heard in debate. Refusal to allow any representative to participate in the lawmaking process runs counter to the principals on which this country is founded.

Unfortunately, under the Obama-Reid-Pelosi troika, that is exactly what has happened. Bills are being written in back rooms without allowing the input of minority voices and debate. Utilizing arcane rules, when the bills are presented to the full chamber, debate is severely limited and the opportunity for introducing amendments is prohibited. The bills are introduced at the last possible moment, not allowing members to read the bills before voting on them and, sometimes, as in the case of the cap-and-tax bill, the bill is still being written as it is being voted on. If not unconstitutional, this at the very least undermines the very spirit of the Constitution and the American ideal. This, in spite of Democratic promises that this would be the most transparent administration and legislative process, ever.

The most recent example of this abuse is the announcement that there will be no conference committee to reconcile the differences in the House and Senate health care reform bills. Normally, a bill passes the House and a similar bill passes the Senate, then a conference committee is formed to hammer out differences between the two bills. Members of the conference committee are appointed from both the majority and minority parties. Once the conference committee reaches agreement, the final bill is sent back to both the House and Senate, where it is voted on. If it passes both chambers of Congress, it is then sent to the President where, if he signs it, it will become law.

In the case of the current bills, however, Congress plans to depart from this tradition. Instead, the administration and the leaders of the House and Senate will meet behind closed doors to try to hammer out a plan. Republicans will not be allowed in the room. When a compromise is reached, Harry Reid will take the bill to the Senate Democratic caucus and Nancy Pelosi will do the same for the House Democratic caucus. Again, Republicans will not be allowed in the room. Each Democratic caucus will have the opportunity to give suggestions, accept bribes, or have their arm twisted, until there is a final agreement. After the compromise is reached, the final bill will be introduced to each house of Congress for a final vote, probably at the last minute and, almost certainly, before Republicans or the press has a chance to find out what is in the bill.

Let me reiterate the process – first, a bill is written behind closed doors without the input, or even debate, by the minority. It is voted upon before anyone has the opportunity to read it, and then a compromise will be reached behind closed doors without the input of any of the minority party. In other words, a bill to revise 1/6 of our economy, including a rash of new taxes, will be passed without representation of a substantial part of the country. As someone whose duly elected representative to the House of Representatives was not allowed any input or debate on this bill, I have a difficult time seeing how the taking of my taxes is legitimate since I was denied representation.

The first time this happened, there was a revolution. Hopefully, the American people will retain the spirit of the founding fathers and will revolt at the ballot box.

Monday, January 4, 2010

Responsible Discrimination

As a physician, if I was presented with a child having back or bone pain and shortness of breath, and both parents were of African descent, one of the first tests I would order would be a test for sickle cell disease. If both parents were of Mediterranean descent, I might not initially order a sickle cell test, but it would certainly be in order if my initial testing proved fruitless. If one of the parents were white, I would not order a sickle cell test at all.

Is this discriminatory? Absolutely. My patients expect me to discriminate between diseases that they are likely to have versus diseases that they are unlikely to have, based on my knowledge and experience. To do anything less would be abrogation of my responsibility as a physician. If I indiscriminately order tests that have little or no possibility of being positive, it wastes critical health care dollars, can delay the diagnosis, and clogs up the system for everyone else. Believe it or not, in some quarters, this is controversial. Just Google “race-based medicine” for a number of opinions on why this is so. But I believe that most of us would agree that this type of discrimination is entirely justified. It is evidence based and non-malignant. It ensures that medical care is tailored to benefit the patient and society at large.

On New Year’s Eve, one of my Facebook friends posted the following status:

"Protecting the rights of terrorists has been more important than protecting the lives of Americans. That must now change decisively. It is time to know more about would-be terrorists, to profile for terrorists and to actively discriminate based on suspicious terrorist information." -Newt Gingrich. Disgusting; I do not see how this is morally defensible...

I admire my friend’s passion for social justice, but I disagree with his conclusion. I believe that it is not only morally defensible to actively discriminate based on suspicious terrorist information, but that it is morally indefensible not to do so.

A government’s first responsibility is the protection of its citizens. To endanger its citizens for the purpose of ensuring that someone’s feelings are not hurt is an abrogation of the mandate of a government. The preamble of the United States Constitution explicitly states this purpose of establishing the government:

We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.

In the case of terrorism, the government has not only the right, but also the responsibility to be prejudicial against citizens of other countries, if necessary to protect its own citizens. This is not to say that we should intentionally harass non-citizens without cause, but that is not what Newt said. He specifically said that we must “actively discriminate based on suspicious terrorist information.” [italics mine.] No one who is not a citizen of the United States has a right to enter our country without permission. If we have the slightest reason to believe that someone may have terrorist connections or sympathies, it is essential that those suspicions be totally allayed before that person is allowed entrance into the United States.

These protective measures may necessarily include profiling. There is no question that over the last decade, the vast majority of terrorist incidents in the world, and against the United States, have been conduction by young Muslim men. That is not to say that women or members of other religions cannot conduct terrorist activity, but it is irresponsible for the government not to concentrate its attention on the group that is most likely to conduct a terrorist act. To do otherwise diverts resources and tells our enemies that we are not serious about combating terrorism.

This is not just an Obama administration issue. It started during the Bush administration, after 9/11, when we saw Norwegian grandmothers going through intrusive screening at the same rate as young, Middle Eastern men – maybe more in our attempt not to appear discriminatory – and we all had our fingernail clippers confiscated. Since the Richard Reid shoe-bombing incident, we all have to take off our shoes to go through security. Now, since the panty-bombing attempt, we can’t go to the restroom or have a blanket or a book on or laps during the last hour of a flight. The TSA under the Obama administration is merely continuing the dangerous policies of the Bush administration.

As Christopher Hitchens said, “Why are we so bad at detecting the guilty and so good at collectively punishing the innocent?” I think the reason is that we are unwilling to use our collective knowledge and experience to do those things that are necessary to effectively and efficiently use the information available to concentrate on those few people who are the risk. Instead, in our politically correct society, we are more concerned with sparing feelings than saving lives.

Why this is so controversial, I don’t know. In medicine, we know that to discriminate based on knowledge and evidence is essential in order to save lives. Why should we be so reluctant to do the same when it comes to air safety and national security?