My ALS Adventure – What is ALS?

What is this malady of mine, Amyotrophic Lateral Sclerosis (ALS)?  I’ve researched it not to find a cure — none is known at this time — but so I don’t waste time on what cannot be a cure.

ALS is a progressive neurological disease in which motor neuron cells deteriorate and die.  Motor neurons send signals from the brain (upper motor neurons) via the spinal cord (lower motor neurons) to muscles throughout the body.

Motor neurons control all voluntary muscle movement including walking, talking, chewing and breathing.   As the signals they send grow weaker, the muscles they control waste away until at last the brain can no longer initiate and control voluntary movements.

Different groups of muscles are controlled by motor neurons in different parts of the brain (see illustration below).  About 70% of patients first develop symptoms in their arms or legs.  About 25% first notice speech or swallowing problems (bulbar onset) — I’m one of those — and about 5% start with symptoms in their trunk.

No matter where the first symptoms appear, the great majority of ALS patients end up losing function in all muscles.  We lose the ability to speak, eat, move, and even breathe.  Most of us die from respiratory failure, usually within 2 to 4 years, although about 10% of us survive for 10 or more years.

The literature says all ALS patients develop symptoms throughout their body but the chief neurologist I met at Lehigh, PA who has worked in the field the longest told me that’s not correct.  Some patients with bulbar onset ALS do not develop symptoms in other muscle groups.

Up to 10% of ALS patients inherit it from a parent via mutations in any one of over a dozen genes.  The remaining 90%, of which I am one, are believed to have a genetic predisposition to the disease that is activated by an environmental factor.

Genes are contained in chromosomes located mainly in the cell nucleus.  Every chromosome contains hundreds to thousands of genes and every human cell contains 23 pairs of chromosomes.  We have about 20,000 to 23,000 genes all told, around 400 random ones of which are, on average, defective in any one of us.

The entire structure and function of our body is governed by the proteins it synthesizes and that operation is controlled by genes.  Proteins are both building blocks for muscles, connective tissues, and other structures and they also, in the form of enzymes, carry out nearly all chemical processes within the body.  Our body produces thousands of different enzymes.

Our genetic system is highly complex.  Its operations incorporate error-correction mechanisms but it can go wrong with an enormous variety of results.  It amazes me it works at all!

How might errors (mutations) occur?  They can occur spontaneously.  When a cell divides, for example, it makes a copy of its DNA, the molecule that carries the genetic instructions controlling its operation.  Sometimes the copy is not quite perfect.  Environmental factors such as radiation, chemicals, bacteria and viruses can also cause DNA to break down and when it does, the cell may not repair it perfectly.

How does the body defend against environmental risks carried in the blood?  The walls of the blood vessels in the human brain are high-density cells that limit what substances can pass from the bloodstream to the brain more than the cell walls of capillaries do elsewhere in the body.

Severe inflammation such as I had in reaction to the Brown-tail Moths can temporarily weaken the bond between those cells making them a less effective barrier.

We know far more about how our genetic system works than we did even ten years ago but not yet enough.  Western medicine has no cure for ALS because its cause or causes are at this point still a mystery.  The only existing medication that slows its progression extends life by only a couple of months.  I take it.

Motor neurons are different from other cells because the genes that govern their operation are different.  Restoring their operation is not a matter of developing a drug to kill an external attacker such as a bacterium.  We’re not dealing with something that moves from one group of motor neurons to all others.  An environmental factor is triggering a change in our motor neurons’ genetic programming.

Curing ALS will require correcting the motor neurons’ genetic programming.  This December 10, 2017 report describes a potential approach based on CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats), a naturally occurring bacterial defense system.

CRISPRs are repeating sequences of genetic code interrupted by “spacer” sequences – remnants of genetic code from past invaders.  The system of which they are part serves as a genetic memory that helps the cell detect and destroy invaders when they return.

CRISPRs can be programmed to target specific stretches of genetic code and edit DNA at precise locations, thus permanently modifying genes in living cells.  The first method to engineer CRISPR to edit the genome in mouse and human cells was published in January 2013.

In its current form, CRISPR isn’t technically gene therapy. Rather than replacing a diseased gene with a good one, it goes into the nucleus and directly cuts out faulty genes.

Meanwhile, since there is not yet a gene therapy for ALS, I am taking a treatment that has cured a significant number of MS patients and more recently, a number of ALS patients, too.  It is based on the idea that the body can, if treated in the right way, heal itself.

The treatment was developed by a doctor of Tibetan medicine who, earlier in his career, was sent by the Dalai Lama to reestablish Tibetan medicine in Mongolia and who is now based in San Diego, CA.  I am receiving this treatment from the first Westerner to qualify as a doctor of Tibetan medicine, a truly amazing achievement.  Her mentor is the Tibetan doctor who developed the treatment.

I will add comments to this post as I learn more about ALS.  I knew little about biology eighteen months ago and would be very grateful for comments by anyone who can correct or add to what I’ve learned so far.

My ALS Adventure – June 2016 to April 2017

I didn’t choose this as I did the experiences I learned so much from in business and trekking in the Himalayas but it is just as much of an adventure, a powerful opportunity for learning.

I hope my trip reports from this adventure will help others with ALS, those who care about them, and perhaps medical professionals.  The progression of symptoms is detailed enough to be useful to researchers.  How I have remained happy may be helpful to fellow patients.

These reports also benefit me in the same way as writing monthly status reports did in business.  They help me reflect.  It’s impossible from day to day to get an accurate sense of important changes that only become visible when you gain altitude.

This post tells how my symptoms progressed toward a diagnosis.  Next I’ll post about the nature of ALS.  Subsequent posts will be based on emails to family, friends and my doctor.

I’d prefer to write after I regain health as I did about depression.  There would then be no risk you’d be distracted by sympathy, but Western medicine has no cure for ALS.

I am receiving care from a wonderful Tibetan doctor who has cured other ALS patients but we can’t know if the treatment will work for me, which points to the overwhelming lesson from this journey — if I don’t write now, I may not have the chance to do so later.

So please, whatever is the most important thing you can do with your life, do it now.

Enough preamble.  Here’s what happened up until my ALS diagnosis nine months ago.

My symptoms began in mid-June 2016 when I was working under oak trees in Maine.  Their leaves were being eaten by Brown-tail Moth caterpillars to which many people are allergic.  An itchy rash developed on all my exposed skin and my tongue felt enlarged.

The rash was gone after two or three days but my speech was slightly slurred.  I could curl my tongue so it seemed I had not had a stroke.

My slurred speech was a bit worse after about three weeks, too long for an allergic reaction to be the explanation, so I went to my primary care doctor who ordered blood samples and a brain MRI.

The MRI showed no structural damage to my brain.   We got the blood test results by phone and were told they indicated tick-borne disease.  We didn’t think to ask which one and the doctor’s office could not locate the results later but I was put on a three week course of antibiotics.

At the end of the three weeks, July 26, about six weeks after the first symptoms, my speech was worse and my tongue felt weaker.

I was then examined by a neurologist.  She detected double vision when I look toward the upper left.  I wasn’t too surprised because I also get double vision if my head gets very cold in winter.  The neurologist ordered an ultrasound for blood flow on both sides of my neck

The ultrasound results were normal.  On August 16 the neurologist ordered more blood work.  Everything was fine except for my usual high cholesterol.  The results for tick-borne disease were negative.  She ordered an MRI for blood flow in my brain.

My brain blood flow was normal.  On August 30 the neurologist prescribed pyrostigm because my symptoms could result from ocular myesthenia.

The pyrostigm had no effect by September 7.  I had been doing very heavy physical work and driving 11+ hours back and forth between Maine and Pennsylvania so I wondered if the medication had not had the right conditions to be effective.

The neurologist said I must have had a stroke that left no trace in the structure of my brain.  She ordered a barium swallowing test which I took on September 16.  No problems were detected.

We moved to Gettysburg, PA and on November 3 I visited a new primary care doctor who prescribed speech therapy.

After three weeks of speech therapy that taught me to articulate more deliberately but left my tongue weaker and my speech worse as I tired, the therapist told me to stop the exercises and recommended consulting another neurologist.  The exercises would have been beneficial if I’d had a stroke so she believed it must be something else.

It was now early December, almost six months since the first symptoms.  My speech was continuing to deteriorate, swallowing was growing more difficult and my nostrils kept getting blocked.  We scheduled a consultation with a neurologist at Johns Hopkins Hospital but it would not be until March 1st.

I went to Nepal for Tibetan Buddhist teachings for six weeks right after New Year’s day.

By the time I returned in mid-February, eating had become a struggle.  It was hard for my tongue to maneuver food between my teeth, food was getting stuck in my cheeks, and it was hard to avoid biting my cheeks when I chewed.  There was no problem with jaw movement and I could swallow food without difficulty but I could take only small sips of liquid and I would sometimes gag which led to coughing fits.

On March 1, 2017 the Johns Hopkins neurologist said my symptoms indicated either Bulbar Myesthenia, Bulbar Myopathy or Lou Gehrig’s Disease (ALS).  She ordered an EMG with Nerve Conduction Study.

The EMG was performed by a different Johns Hopkins doctor, one who specializes in ALS, on March 22.  The sensory conduction showed reduced right ulnar sensory amplitude (the ulnar nerve runs from the neck to the hand and is our largest nerve unprotected by muscle or bone so injury is common), the motor conduction showed reduced velocity across the elbow segment of my right ulnar nerve, repetitive nerve stimulation was normal and needle EMG showed neurogenic changes limited to the right side of my tongue.  No weakness was detected anywhere else in my body.

Two days later (Mar 24) the first neurologist called to tell me the EMG ruled out Bulbar Myestenia and her colleague had diagnosed ALS.  She ordered a test of the strength of my diaphragm and a spinal tap that would include tests for Lyme Disease because Lyme can cross the blood-brain barrier when there is inflammation as there had been in my reaction to the Brown-tail Moth caterpillars.

On April 7 my speech was very indistinct after a week of very hard work outside.  I rested for a day and my speech was clearer the next day.  My tongue felt less weak but my lips were always weak so I dribbled.  I could still swallow food without difficulty but I hesitated with liquids.

I had the pulmonary test, spinal tap and a consultation with the ALS neurologist on April 10.  He said we had eliminated every other possibility so I definitely have ALS.  Weakness spreads to all muscles of most ALS patients and they die, usually from breathing problems, within a couple of years.

This is long enough for one post.  I’ll describe what happened next in future chapters.

It’s worth noting now, though, that in the eighteen months since my symptoms began, I have experienced no weakness in muscles other than my mouth and throat.  That means I may be one of those whose symptoms do not progress.

Who Does Trump’s Tax Plan Benefit?

 

Who does the Republican tax proposal aim to benefit ?  Let’s examine its intentions, then look at an approach that extends some of its features and is progressive.

Clear intent:  Give more to the heirs of the very wealthy, e.g., President Trump.  The estate tax is eliminated entirely in six years, which greatly benefits the wealthiest 0.2% of the population.

Clear intent:  Continue to take less from wealthy hedge fund managers and private equity executives who will continue to be taxed at capital gains rates that are about half the ordinary income tax rate on profits they pay themselves via the carried interest loophole.

Clear intent:  Give more to the owners of partnerships, S corporations, and sole proprietorships, which are overwhelmingly owned by rich individuals like President Trump.  Income from them that is returned to the companies’ owners is now taxed at the same rates as wages and salaries but it would be taxed at a new 25% rate.   The Tax Policy Center (TPC) finds that the top 1% would receive 88% of the benefit with the 400 households with the highest incomes getting an average annual tax cut of $3.7 million.

Clear intent:  Give all those with high incomes more by eliminating the alternative minimum tax and raising the threshold for the 39.6% top rate on income (which was 70% in 1980) to $1 million for couples, up from $470,700 today.

Clear expectation with unclear intent:  Add at least $1.5 trillion to the federal debt over a decade (many economists think it will be more) by cutting the corporate tax rate from 35% to 20% without raising other taxes.  The cost of this debt will grow as interest rates rise so the intent could be to “starve the federal government of revenues, setting the stage for a frontal attack on core social programs such as Social Security and Medicare.”

Unclear intent:  The corporate tax rate is cut from 35% to 20%, which will save US corporations $2 trillion over the next ten years.  The great majority of economists believe shareholders would be the primary beneficiaries but Republicans say employee salaries would rise.

Treasury Secretary Mnuchin claims: “many, many economic studies show that more than 70% of the burden of corporate taxes are passed on to the workers.”  Congress’s non-partisan scorekeepers — the Congressional Budget Office and Joint Committee on Taxation — as well as Treasury’s Office of Tax Analysis have all assessed the empirical research as showing that only about a quarter or less of corporate taxes fall on workers, meaning that they would receive a quarter or less of the benefit of corporate tax cuts.

The Tax Policy Center estimates that over a third of the benefit would go to the top 1% and 70% to the top fifth.  By 2027, low- and moderate-income families with children would receive little or no tax cuts, and many would see tax increases while 80% of benefits would go to the top 1% of households and after-tax incomes of the bottom 80% would rise by less than half of one percent.

Unclear expectation:  The effect on middle and lower income families.  The plan roughly doubles the standard tax deduction but it repeals or reduces current tax deductions that chiefly benefit workers and middle-class people, including mortgage interest, state and local taxes, student loans, medical expenses, moving costs, and tax credits for retired and disabled people.

  • The standard deduction will be raised to $24,000 for couples and $12,000 for individuals but the $4,050 personal exemption  is eliminated
  • The mortgage interest deduction is unchanged for current homeowners, but is capped at $500,000, down from $1 million, for all future mortgages.
  • The deduction for state and local income/sales taxes would be eliminated.
  • The deduction for state and local property taxes would be capped at $10,000.

The Tax Policy Center (TPC) analyzed the change in after-tax income for the poor, middle class and rich and found the middle class would get a 1.2% boost to their after-tax income and the bottom 40% would get almost no benefit.  Their taxes would actually increase $10 to $20, on average, by 2027.

The Center for Budget and Policy Priorities assessed the intent of the plan in its original form when the top tax rate would have been 35%.  They estimated the overall results of that plan would be:

  • The top 1 percent, who make above $733,000 annually, would see average tax cuts of $90,000 in 2018, increasing their after-tax incomes by 5.9%.  They would receive about 45 percent of the total net tax cut.
  • The top one-tenth of 1 percent, who make over $3.4 million, would receive average tax cuts of $507,000 in 2018, raising their after-tax incomes by 7.2%.
  • This average increase in after-tax income for those in the middle fifth of the income spectrum would be 1.2%.
  • The bottom fifth would gain less than 0.5%.
  • People with annual incomes over $1 million would receive average tax cuts of $138,000 in 2018, compared to average tax cuts of $270 for households making below $75,000. Millionaires’ after-tax incomes would rise 6.4 percent in 2018, compared to a 0.9 percent increase for those making less than $75,000.

The Joint Committee on Taxation estimated the results of every detail of the plan but we do not need more detail to confirm that its purpose is to benefit the wealthy.

So let’s move on.  Is there a way to build on some of the Republican ideas to start reversing our society’s dangerously high inequality?

We use tax revenue to pay for services we want from our government.  The “we” who want those services is, to coin a phrase, “we the people” not also “we the legal entities such as corporations” so it would be more straightforward to tax the income and wealth only of people.

We could then focus just on the relative contribution each economic subset of people should contribute to the cost of government services that benefit us all.  We would still have vigorous disputes about relative contributions but we could better understand each others belief about what is fair.

Making that change might also encourage us to pay more attention to how much our government spends on each of its services.

We know what Social Security and Medicare cost us because we pay for those with dedicated taxes.  But most of us do not know that what we spend on our military activities dwarfs every other discretionary service and includes having our troops in 53 out of the 54 nations in Africa.

A better program might look like this:

  • Entirely eliminate taxes on businesses and tax only the income their owners derive from them.  Replace the lost revenue by:
  • Making income tax rates steeply more progressive, perhaps returning to the 1980 70% rate
  • Entirely eliminating preferred subcategories of income such as capital gains, pass-through and carried interest.  We would tax all income above, say, $12,000 per person, from all sources at the same rates.
  • Making the estate tax very steeply progressive on amounts above, say, $5 million (which my grandfather’s generation did to end the stranglehold of Britain’s aristocracy).

Some other things we could consider:  If we wanted to accelerate cutting the influence of our financial oligarchy we could also establish a wealth tax, similar to property tax but applied to all wealth.

We could also build on the Republican idea of cutting tax deductions that benefit some people over others. and entirely eliminate tax preferences, including mortgage interest, state and local taxes, student loans, medical expenses, moving costs, and tax credits for retired and disabled people.

We could raise the minimum wage if we believe the Republican theory that eliminating the tax on businesses would cause wages to rise.  We might raise them to the level where a head of household could support their family as they did before America needed to be made great again.

We could also explore new taxes such as this one and use those revenues to fund maintenance of the transportation and other infrastructure that we all depend on.

Summing up:  The Republican tax proposal contains some good ideas but the way they are structured would greatly benefit the very wealthy and do little or nothing for everyone else.  It would also greatly expand our debt whose cost will be born by us and future generations.

The promises made to sell the plan are spurious.  It can not be supported by anyone who understands it and is not wealthy and selfish.

But we do need a better tax system.  What do you think of the progressive approach above?  Don’t worry if it seems impossible.  If we are clear on what we want, we can figure out how to get there.

We the Easily Bamboozled – Tax Reform

 

We do need to change how we fund our government’s activities and how our economy distributes the wealth it creates.  But the tax plan now being revealed is not what we need.

Our President and Republican leaders keep telling us it is urgently necessary to lower corporate tax rates so companies can stay competitive.  It has become the party line.  As my Republican Senator Toomey’s website says:

“Our country’s current corporate tax rate of 35 percent is one of the highest in the developed world, far higher than the average 25 percent rate of our economic competitors. Without a significant reduction in business tax rates, the U.S. will never be the best place to invest and create jobs … The best economic stimulus for the middle class, who have seen their wages stagnate and tax bills rise over the last decade, is a well-paying job. Tax reform will help deliver on this goal with its focus on lower rates, investment, and growth.”

Really?  The 20 US companies that accounted for 20% of US GDP last year, meaning all our economic activity, paid taxes totaling only 0.6% of GDP and only 3.6% of all federal taxes (Source: Forbes).

Businesses pay taxes on profits not revenues, of course, but my point is that our theoretical corporate tax rate is not making our businesses less competitive or stifling their job creation.   That is not the motive behind this tax plan.

But before we get to that, what would this budget cost?  The fiscally conservative Committee for a Responsible Federal Budget estimates $2.2 trillion in lost revenue over a decade.  The tax cuts would total $5.8 trillion.  New revenues totaling $3.6 trillion resulting from “base broadening” would allegedly reduce the net loss to $2.2 trillion.

Treasury Secretary Mnuchin told us “The plan will pay for itself with growth”.  But we have seen over and over again, most recently in a multi-year “experiment” in the state of Kansas which its governor trumpeted as a “shot of adrenaline” to the state, that a tax cut plan that will pay for itself is a fantasy.

That fantasy cannot and will not ever come to pass.

So, what motivates this plan?   Who would benefit?  The Tax Policy Center estimates that 80% of the $5.8 trillion in tax cuts would benefit the richest 1 percent.

And who would lose?  55 million Americans would lose their tax deductions on what they save in tax-deferred 401k plans and what they pay in state and local taxes.   They are our middle class.

Those who earn less would be hit harder, losing government services eliminated to pay for the tax cut, which look to include about $1.5 billion in Medicare and Medicaid.

Would anyone other than those with very high incomes benefit from this plan?  Yes — their heirs.

This is a good budget if you want your kids to live under an aristocracy of folks like President Trump whose inheritance installed him among the plutocrats who bought our political establishment.

We do not have the leaders we should want.  Their plan is very far from what we need.

The Wall

 

I love Pink Floyd’s “The Wall”, Trump’s is absurd, and this is about a different kind of wall altogether.

A Zen Buddhist was about to teach a class of six-year-olds meditation.

One of the boys asked: “Does meditation open your Third Eye?”

“Not exactly” the teacher replied.

“Does meditation teach us to levitate?” the boy asked.

“Not exactly.”

I’ve heard,” the boy said, “that meditation teaches us to walk through walls.”

“Yes, it does.”

“But what happens if you lose your meditation while you’re in the wall?”

“You get stuck.  It happens to me all the time.”

[Hat tip — Anam Thubten]

We the Easily Bamboozled – Part 1

 

To understand what’s going on in the USA now it’s helpful to go back a little way.  We could go back to Reagan and Clinton but his successor, G. W. Bush, offers the clearest illustration.

Nobody imagines President G. W. Bush was setting policy.  He was simply the lead spokesman for an agenda set by others.  That’s the important point

We do imagine President Obama set his policies, but let’s consider a few examples.

Obama inherited an economic collapse whose origin was financial deregulation introduced in Clinton’s time.  What was done by the Obama administration?  The collapsing financial institutions were bailed out. Not one of the people who acted criminally was punished.

Obama also went along with the Fed’s ultra-low rate interest policy that destroyed the value of pension funds along with individuals’ savings.  That triggered new speculation, again favoring the financial institutions.  Meanwhile, pension funds that are now paying out more than they earn will fail.

At the start of Obama’s first term Democrats could have established lower cost single payer health care for all Americans.  Instead, we got the highly complex ACA which preserves the central role of insurance companies and perpetuates all other aspects of a system whose primary aim is profit.

Obama was enticed into  ruinous and utterly unproductive war in Afghanistan as well as the destruction of Libya.  He avoided overt war against Syria only at the last moment.

Obama genuinely wanted to make a better future for all.  So why did he lead us into all those disasters?  Because, like his predecessor, his advisers were from the institutions that are in fact in control.

Now we can see why the situation under the Trump administration seems so confusing.  Two things are going on in parallel, one masking the other.

Trump is motivated solely by self-aggrandizement and self-enrichment.  He is a bully and a liar.  He appears also to be to some degree mentally ill but we don’t know about that for sure.

The result of Trump’s personality is what we see, a constant flurry of inflammatory tweets, intemperate remarks and outright threats.

And the appearance that our President is deranged is alarming.  I’ve written elsewhere about the risk his threats may lead to nuclear war on the Korean peninsula and a nuclear arms race in the Middle East.

But, preoccupied by Trump’s incendiary rhetoric, we pay little attention to what’s going on in parallel, what the ever-present advisers to our Presidents and Congressmen are doing in the meantime.

We notice only fleetingly what is actually being done:

  • further weakening of banking regulations
  • destruction of environmental protections
  • astronomical increases to our already overwhelming military
  • additional tax cuts for the wealthy to be offset by cutting Medicare and further expanding Federal debt
  • and so on and so on

These changes are part of an orchestrated program that benefits only those who are in fact in control of our government.

President Obama naively went along with the advice he was given, imagining it was given in good faith.  President Trump has no principals of his own and seems easily manipulated.

But the different character of these men makes no difference to what is being done to we the easily bamboozled– except that Trump’s thoughtless belligerence  may blunder us into WW3.

Our Presidents are now simply figureheads of an oligarchy.

I expect in a future post or two to elaborate a bit on changes by the oligarchy that we should be resisting and I would be delighted to get help with that in any form; guest posts, comments, or emails.

I will also continue thinking if there’s anything we can do short of revolution, which I am not in favor of because, like the French Revolution, it could lead to even greater disaster.

Collective Unawareness

 

It is quiet this morning.  No howl of fast accelerating cars and trucks propelling their drivers to work.

Today we celebrate the accidental discovery of this land whose inhabitants we slaughtered and which we call our homeland.

It is not our true nature to do such things, to brutalize others.  We just have the habit of behaving that way.

So let’s change!  Let’s become who we truly are.  Let’s become more and more the good people we have often been.

We are now spending a trillion dollars a year on things we think of as defending ourselves.

We have for sixteen years been in a “war on terror” that can by definition never be won and which motivates terrorism against us.

We are at war in seven countries, none of which has declared war against us.

We are spending vast sums preventing people whose countries we help destroy from coming here.  We sing:  “This land is our land…”  We say:  “This is the land of the free” while giving up our freedoms.

This would be a particularly good day, since we will not be distracted by work, to take a deep breath, relax, and consider who we really are.

We are a people who desire happiness and often act generously but who have some very bad habits.

We entertain ourselves with spectacles of violence, we fear violence against ourselves, we think that fear justifies our own violence, and we imagine magical solutions.

Our leader told us he would build a huge and beautiful wall to keep immigrants out.  He said Mexico would foot the bill and too many of us pretended to believe him.

Our leader now tells the world we may utterly destroy North Korea.  We already did that to Iraq and Libya, just not yet with “fire and fury the world has never seen”.  I won’t go on with the litany.

What I’m saying is, we really are not bad people.  We are good people with bad habits.

So please, let’s spend some time today noticing our selfish, fearful violent habits and start to shed the collective unawareness that makes it possible for us to do terrible things.

Let’s resolve to become the kind and happy people we really are.  Let’s do it!

Our President is Too Dangerous

 

What if our President is not only unfit to discharge his duties, but is a grave threat to our future?

I happened to disagree with several important Obama administration policies and I disagree with substantially all those of the Trump administration but, with a crucially important caveat, in a democracy the majority view should win.

The caveat is, we must not greatly harm those who come after us, or those in other parts of the world.  An example of what we must not do is making nuclear war on the Korean Peninsula.

Such a war would destroy not only millions of future lives but also millions now.

So, if we consider President Trump likely to do that, we must remove him from office.

Does he in fact seem likely to do that?

President Trump recently announced to the UN that his administration will if necessary “totally destroy” North Korea, he has promised them “fire and fury like the world has never seen“, earlier this week he told reporters we are now in “the calm before the storm”, and he tweeted that his Secretary of State is wasting his time trying to talk with N. Korean leaders.

Now Reuters reports the following tweet by Trump.   

“Presidents and their administrations have been talking to North Korea for 25 years, agreements made and massive amounts of money paid  …  Hasn’t worked, agreements violated before the ink was dry, making fools of U.S. negotiators.  Sorry, but only one thing will work!”

So, yes, he does seem likely to order a military attack on North Korea.  What would be the result?

North Korea would launch missiles carrying nuclear warheads and destroy our base and everyone on Guam.  Perhaps also Japan.  They would certainly destroy Seoul where ten million South Koreans live.

North Korea aims to deter us from attacking them as we did Iraq and other nations, but if attacked, they must respond and that will result in at least 25 million immediate deaths.  How many more depends on how many nuclear weapons North Korea can deploy, and whether we also use them.

What we must face up to is, signalling his intent to attack North Korea means that resident Trump is dangerously unfit to remain in office.

This is not an matter of differing policy ideas or even of how much we value our own lives versus those of our children’s children.  This is a matter of survival.

How can Trump be removed from office??  By invoking the 25th Amendment, which was established in 1965.

Such an amendment was needed half a century earlier when the massive stroke President Wilson suffered in 1919 left him unable, and unaware of it, to continue as President.  Although his incapacity could not be hidden from those close to him, it was hidden from the public.  He remained in office until his second term ended in 1921 so we were in reality without a President for those two years.

President Roosevelt was in declining health from at least 1940 and tests in early 1944 revealed serious problems that forced him to rest for more than two hours a day.  Press reports about his heath were quashed so the public was unaware and voted him in for a third term.  Although still clear mentally, he died in March 1945, two months into his fourth term of office, after a massive stroke.

President Eisenhower served us better after suffering a heart attack in 1955 and requiring emergency surgery the following year.  He established a written agreement for Vice President Nixon to act on his behalf if and when he was unable to do so.

A Constitutional Amendment that would have given Congress the ability to declare a President unable to perform his duties was proposed in 1960.  After concerns about possible abuse of that authority were resolved, the 25th Amendment was passed by both Houses in 1965.

Presidents Reagan in 1985 and G.W. Bush in 2002 and 2007 invoked the Amendment when they underwent colonoscopies.

But this situation is different.  It would be Congress not President Trump invoking the Amendment.  How would that work?  The Amendment reads:

“Whenever the Vice President and a majority of either the principal officers of the executive departments or of such other body as Congress may by law provide, transmit to the President pro tempore of the Senate and the Speaker of the House of Representatives their written declaration that the President is unable to discharge the powers and duties of his office, the Vice President shall immediately assume the powers and duties of the office as Acting President.”

Presumably President Trump would declare that he suffers no such disability.   He could then resume office unless a  two-thirds vote of both Houses declared him unable to discharge the powers and duties of his office.

We are in new territory.  The 25th Amendment was established in case the President becomes incapacitated as Wilson did or others have temporarily.  We have never before had to judge the state of a President’s mental capacity.

Because President Trump seems certain to behave in increasingly bizarre ways, it seems inevitable that enough members of Congress will at some point agree he must be replaced.

But what if he orders nuclear war before then?

It’s possible to imagine Secretary of Defense Mattis saying: “Sorry, sir, that would be wrong.  I must respectfully refuse to carry out that order”.  In that case, Trump would promptly replace him with a sycophant who would go ahead.  So…

I am very far from eager for President Pence but the risk and its consequences are too great  We must replace President Trump now.

Innocence, Habits and Donald Duck

 

We recently remembered 9/11/2001.  We do not, however, remember 9/1/1973 when General Pinochet overthrew Chile’s popularly elected government with our very active support.

Why do we remember only when we were the victims, not when we were the perpetrators?

Ariel Dorfman reflects on that in A Tale of Two Donalds and his conclusion, “We really don’t have to leave this world as it was when we were born”, got me thinking.

Some preamble:  Why did we help to overthrow Chile’s government?   Because the Chilean people had for three years been working to build socialism via the ballot box and our leaders were afraid they might succeed, inspiring the same thing to happen here.

The focus of Dorfman’s book was Donald Duck because: “If there was a single company that embodied the overarching influence of the U.S. — not just in Chile but in so many other lands then known as the Third World — it was the Walt Disney Corporation.”

What was symbolized by Disney’s Donald Duck world?  “a belief in an essential American innocence, in the utter exceptionality, the ethical singularity and manifest destiny of the United States … the inability of the country Walt was exporting in such a pristine state… to recognize its own history”.

What history did we not recognize?  What, as Dorfman puts it, was our sin?  “[our] violence (the enslavement of blacks, the extermination of natives, the massacres of striking workers, the persecution and deportation of aliens and rebels, all those imperial and military adventures, invasions, and annexations in foreign lands, and a never-ending complicity with dictatorships and autocracy globally)”.

Why is Dorfman writing now about what happened almost half a century ago?   Because, he says:  “We are clearly in a moment when a yearning to regress to the supposedly uncomplicated, spotless, and innocent America of those Disney cartoons, the sort of America that Walt once imagined as eternal, fills Trump and so many of his followers with an inchoate nostalgia.”

Now here’s what struck me.  The innocence Disney conveyed is real.  At the same time, the violence, selfishness and greed that Dorfman points to are also real.  How can both be true?

It’s because, in the Buddhist understanding of existence, our intrinsic nature is good; we behave badly only out of habit.

What happens is, our mistaken acts accumulate into conceptual and emotional habits, then our behavior is governed by the things we always think and feelings we always have, not the unique circumstances in each moment.

Buddhists call all that programming karma.  We call the habits we share our culture.

By observing people who have studied, reflected and done Buddhist practices for long enough, we can see they are not on auto-pilot.  They are naturally kind.  The Buddhist understanding of our nature is confirmed by observation.

Buddhism is not the only way to overcome bad habits, of course, and Buddhist leaders in Myanmar are currently exterminating their Muslim Rohingya population.  We first need the right motivation, then whatever way works to train ourselves out of selfishness, greed and violence.

One of our greatest warriors was especially clear about making the right choice.  Three months into his first term President Eisenhower gave this speech:

“Every gun that is made, every warship launched, every rocket fired signifies, in the final sense, a theft from those who hunger and are not fed, those who are cold and are not clothed.  

“This world in arms is not spending money alone. It is spending the sweat of its laborers, the genius of its scientists, the hopes of its children.

“The cost of one modern heavy bomber is this: a modern brick school in more than 30 cities. It is two electric power plants, each serving a town of 60,000 population. It is two fine, fully equipped hospitals. It is some fifty miles of concrete pavement. We pay for a single fighter with a half-million bushels of wheat. We pay for a single destroyer with new homes that could have housed more than 8,000 people.

“This is not a way of life at all, in any true sense. Under the cloud of threatening war, it is humanity hanging from a cross of iron.”

Why did we not heed Ike’s words, or his warning eight years later about our emerging military-industrial complex?

And why did our current leaders just vote for another vast increase in military spending while trying to pay for it and a further tax cut for the wealthy by cutting medical care for tens of millions of other Americans?

Because, despite our intrinsic goodness, we keep choosing not to acknowledge the habits we inherited — our sense that we were entitled to exterminate Native Americans and enslave people of color, the greed, fear and violence that govern so much of what we do.  We keep reinforcing those habits.

We could, as Buddhist and other teachers explain, shed our selfishness, violence and greed.  We would just have to recognize our programming then work diligently and long to get free of those habits.

Castigating others feeds our own self-righteousness, so let’s stop doing that.  Let’s each of us just work at freeing ourselves.

And let’s stop electing leaders who subvert other governments.  In 1973 we worked to overthrow Chile’s democratically elected government.  Twenty years earlier, we’d done it in Iran.   Thirty years later we did it in Iraq, then Libya.  We’re trying it now in Syria and helping Saudi Arabia do it to Yemen.

Let’s elect leaders who will inspire us to act as the good people we are.  But before that can happen we’ll have to work sincerely to overcome our amnesia and purge our programming.

Proposals for Healthcare and Tax Reform

A letter I recently sent to my Democratic Pennsylvania Senator and to Democratic Party leaders:

Dear Senator Casey:

I am growing more and more concerned about the future of our society and the Democratic Party.  We must change course.  I hope these proposals about healthcare and tax reform, top issues for you at this time, will be helpful.

Automation and artificial Intelligence are eliminating more and more jobs.  Making that worse, the profits are going only to the wealthiest of us, and many of our middle and lower income citizens are being impoverished by medical expenses.

We can eliminate that financial ruin with insurance for both the currently healthy and the sick.  Covering every American will also avert a looming Federal debt crisis because that system is much more efficient.

We can best do this is by extending Medicare.  It is an established and popular system that is far less complex and costly than other plans being proposed.

And we must finance it in a way that mitigates our fast growing disparity of wealth.  The very stability of our society is threatened if we allow that trend to continue.

Here’s how we can overcome both huge problems:

Replace Medicare’s 80/20 percent sharing of costs with a progressive Co-Pay amount based on income.  That is the only change for the already retired.

Authorize Medicare to negotiate drug prices with providers to cut costs.

Have working people: (1) continue to pay a progressive payroll tax to cover their Medicare participation when they retire, and (2) also pay a progressive payroll tax for their current medical care, with a progressive Co-Pay amount.

Note:  The tax for current medical care would be less than we pay now for private health insurance because (1) Medicare system costs are lower and (2) costs could be subsidized by other taxes described below.

Allow employers to  pay some or all of this tax to attract employees, but not require them to do so.  They would continue to pay their half of the tax for their employees’ retirement medical care.

Additional funding for this universal health care would come from tax system changes to reduce income and wealth disparity.

Specifically, tax all Personal Income including investment profits in the same way, and return marginal taxes on high incomes closer to where they were in President Eisenhower’s time, perhaps 50% for amounts between $5 million and $10 million, 60% between $10 million and $20 million, and 70% for amounts above that.  The bottom three brackets could be cut by 5% each.

Cut the top Business tax on profits to 25% to encourage re-investment in business instead of taking the money out for personal use where a much higher personal income tax would have to be paid.

Change the Estate tax so distributions are treated as ordinary income with an exclusion of up to $5 million from each person’s share of the estate.  This will reduce wealth disparity over time.

Tax Stock Transactions to reduce High Frequency Trading and increase government revenue.

Eliminate all Tax Expenditures (tax breaks/loopholes) after a five year period during which Congress could individually re-instate any believed to be beneficial with a 2/3 vote from each house.

Drastically cut government expenditures for so-called Regime Change and Nation Building.  We must stop trying to re-invent other nations in our image and destroying them in the process.

Under this Medicare-For-All plan, Medicaid would be eliminated because all citizens would have coverage regardless of their financial situation.  If they were out of work or working a low paid job, they would continue to receive coverage, but their payroll tax and co-pays, based on their income, would be low or possibly zero.

Non-citizens would have to buy their own coverage for the length of their stay, or the companies they work for would have to provide coverage, or there might be reciprocal coverage programs arranged between their country and the U.S.

Does all that sound too radical?  It’s not.  We must take a bold new approach.  Opposition to Trump and the Republicans is simply not enough.  We must win a mandate for sweeping positive change.

We must tell voters what big changes we will make so no American is bankrupted by medical costs.  We must show voters how we will reverse the flow of riches only to the very few.

I hope these ideas can begin to reinvigorate the Democratic Party to be not just a focus for unspecified hope or reflexive opposition, but the agent of great beneficial change.

Sincerely