My ALS Adventure – April 2018

I had a disturbing incident, upgraded my text-to-speech technology and began taking medicine to reduce the mucus that blocks my nose and triggers coughing.

April 7 – to my family

I try to give an accurate picture in my updates of what’s going on physically and how I’m responding so I’ll describe an incident yesterday.

The day before, I’d spent a couple of late morning hours cutting up fallen trees and carrying the wood to the woodpile.  I was very pleased that I had no acid reflux because even though I squat as much as I remember to do, there was a lot of bending to pick up the wood. I think it was okay because I didn’t start until three hours after eating.  I was disappointed, though, that my energy was lower than it was last Fall.

So, instead of my usual veggies for dinner that night I decided to puree some of the fragrant coq au vin Felicity had made, and complement that with half an avocado.  I know my soy-casein formula is nutritious but it just doesn’t feel that way.  I feel as if I’m on a diet of mac and cheese, hamburgers and fries — as if it’s keeping me alive but really isn’t good for me.  I had an urge for protein in a familiar form.

Next morning, yesterday morning that is, I had my usual 2 containers of formula then read for a bit.  I usually read for at least an hour after each meal but I wanted to check emails and the news so I went to my computer after only about half an hour.

Suddenly, I had a powerful burst of acid reflux.  There was a lot of it, it tasted very nasty and my throat refused to risk inhaling any of it into my lungs.  I was gasping, making horrendous gasping coughing noises, fighting for breath.  It felt like being under water.  I managed to force enough shallow in-breaths to stay upright, I did not vomit as I at first thought I might, and after a while my breathing returned to normal.  My stomach felt disturbed all the rest of the day and to a lesser extent through last night and into this morning.  I had no more food yesterday and nothing for breakfast today except water.  I felt like having coffee late morning today, I had a container of formula around noon, another one mid-afternoon and I’m about to have a third one now.  I feel  normal again 🙂

I think what happened had two causes.  Bending forward while at my computer compressed my stomach too soon over I’d ingested quite a large amount of formula, and that triggered the reflux.  The reflux was so acid and my stomach was disturbed because it no longer knows how to digest coq au vin.

It was scary for Felicity because I couldn’t write what was going on during the time I could hardly breathe, and I couldn’t explain it until I’d had enough time afterwards to think it through.  I’m pleased to report that I didn’t panic.

I’m telling you about this to give you confidence that my usual posts about how everything is pretty much okay are the whole truth.  It will also be part of my update on my website next month for the same reason and to say once again that while ALS is not an adventure I’d have chosen, it’s one I can’t avoid and, like all other adventures, the best way to experience it is as a learning opportunity.

April 15 – to my family

We went to Johns Hopkins on Tuesday to check out products for people who can’t speak.  

We started with a contemporary version of an Etch-a-Sketch because writing on a notepad works well for me but I didn’t like its fat stylus.  Writing will likely remain the fastest, easiest method for me, but my handwriting isn’t always clear so it will be better for others if I type more.

Next I tried an iPad and an iPad mini with Proloquo4tex software.  I liked the iPad mini and Proloquo is much better than the free software I have on my iPhone.  It will take some getting used to but it will be worthwhile.  I also tried some other text-to-speech apps that aren’t as good.

The specific problem an iPad and Proloquo will solve is emergency calling.  Right now I have no way to call an ambulance for myself while Felicity is away, or one for her while we’re both here.  With an iPad I could type what I want to say and have it spoken into my iPhone.  Maybe I could even learn to type fast enough for group conversations which I can’t do with my tiny iPhone.

We also asked a nurse about my reflux and blocked nostrils.  The reflux has pretty much only happened after I bent forward compressing my stomach too soon after eating.  She said I should sit quietly for an hour after eating, which I almost always do already.  She also suggested over-the-counter medicines that combat acid reflux but I believe my problem is just because all the food in my stomach now is liquid.

She had nothing to suggest about my blocked nose but did offer to retest my lung capacity.  I was happy about that, and pleased with the result.  The normal range with the instrument she uses is 80-100.  My score was 84 when I was diagnosed with ALS a year ago.  When it was checked a couple of months ago it was 72.  Now it is 74 and I felt I could have taken a deeper breath.

On Thursday I had my teeth cleaned.  I was dreading it because my teeth are very sensitive and I now produce so much saliva.  Well, my teeth are in better shape now I’m not eating by mouth.  There was much less plaque than usual and it was much less tightly attached to my teeth.  The experience was almost painless!

What else?  I’ve been eating just formula and not exercising since the coq au vin scare but my stomach has felt back to normal for a while so I restarted eating pureed veggies for dinner two nights ago.  I will restart exercise today.  I did some chain-sawing yesterday afternoon.

My main difficulty right now is blocked nostrils and I’m trying a spray for that.  Difficult breathing has made it hard to get to sleep for quite a while and more recently I’ve been having coughing fits that I’m almost certain result from post-nasal drip.  The dental hygienist said “everybody is getting that now because of the pollen”.

I don’t have much energy or strength these days but as I’ve said before, I’m expecting both to improve as I do physical work outside again.  I suspect my mostly-formula diet is also a factor.  I’ll keep you posted 🙂

April 16 – to my family

I tried mom’s CPAP last night. My nostrils were so plugged it could not push air through. My Tibetan doctor is sending meds that counter mucus. Maybe that will help.

April 16 – a reply

I get that with the CPAP too, but after a bit the air finds a way. Either way, you’d be prescribed a small mask that goes over nose and mouth probably, so it wouldn’t matter.

April 25 – to my Tibetan doctor

I haven’t had a recurrence of reflux since I last emailed you.  I think there’s less mucus since I started taking the Kundey — I do put some on my tongue every time.  I think my nose is less prone to blockage.  I feel like an alchemist grinding my various medicines each morning 🙂

Because my bulbar-related symptoms vary from day to day it’s hard to discern trends.  I’ve had a couple more coughing fits where I had great difficulty drawing breath.  They occurred late in the day and I think they were triggered by a problem swallowing saliva but I’m not really sure.  I have spells a few times each day where I produce great amounts of saliva for a while and I’m not sure if that’s getting worse.  I haven’t figured out what triggers them except that I always get one when I first go to bed.

I’ve often been more tired recently, which might be pollen allergy.  I stopped exercising for about a week but restarted yesterday.  I’m careful not to stress my body with too much exercise.  I enjoyed mowing for the first time a couple of days ago.

Consciousness a Feature of the Universe

I try, on the anniversary of my discovery of America, to reassess my understanding of reality.  Last year I saw it as an ever changing energy field where what “we experience as the Earth, our own body, atoms and so on do not in fact have fixed boundaries or any intrinsic nature”.

What, though, is experience?  It’s the product of consciousness, but what is consciousness?

We might say anything is conscious that grows, adapts to its environment and can communicate.  Trees are goal-seeking and communicate with each other, though, and it’s a stretch to declare them conscious.

A more stringent definition includes subjective properties of experience, qualia, that occur inside our minds.  That excludes trees, but what about animals?  We don’t really know  which animals, if any, have qualia.  Explaining how and why we have qualia is the famously hard problem of consciousness.  Why and how is our existence something we experience? 

What in fact is this thing we call mind where qualia arise?  Dictionaries tell us mind is “The element of a person that enables them to be aware of the world and their experiences, to think, and to feel; the faculty of consciousness and thought.”

But the mind also thwarts consciousness.  It shows us things that do not exist.  My mind did that, for instance, high above the Kathmandu Valley, showing me first a man in black, then a bear and then another menacing man, not one of whom was there.

All that’s puzzling enough but is mind a product of our brain or is its substrate outside our body?  Each of us arises from the universal energy field that does not have boundaries.  Could mind be an aspect of that energy field and also be without boundaries?  Could consciousness be a feature of the universe, like gravity?

And if mind is a product of our brain, is its scope localized there?  Do its inputs come only from the body of which the brain is part?  Dreams sometimes seem to incorporate real events we could not be aware of via our traditional methods of perception: taste, sight, touch, smell, and sound.

Also, do actions our mind initiates occur only via physical links in our body?  And are its operations even constrained by time?  The CIA published a summary of a great deal of research indicating that we can both initiate action remotely and see events before they occur.

Most of us have at least some experience of knowing what someone is thinking before they speak or when they are out of contact.  Species that flock communicate with each other so rapidly that shared thought seems the only explanation.  And there’s so much more —  some dogs, for example, know when their human master is about to have an epileptic fit.

There is a range of phenomena related to consciousness that don’t fit with the view that our mind is localized to our body:

  • Remote viewing — the ability to know something that is happening at a distance without the use of the physical senses
  • Remote influencing — the apparent ability to alter physical manifestation in an intended direction without a chain of physically causal events
  • Precognitive dreams — a person dreams about events that happen in the future
  • Survival hypothesis — consciousness continues after physical death

We call those phenomena anomalous because they should not exist if matter is the way we experience it, made up of continuously existent, indivisible atoms located within an absolute space and time.  If matter is that way we could, if we knew all the equations governing the spatial positions of fundamental particles as a function of time along with the initial conditions, know everything about reality including all that happened in the past and that will occur in the future.

Those phenomena are not incongruous, however, with our understanding of quantum physics.  Particles appear and disappear and we can know only the probability of their occurrence, space is not fixed and time is not absolute.  What we categorize as anomalous phenomena are inconsistent with the world we experience but not with the underlying reality.

What that suggests is, phenomena we consider anomalous but which have often been observed could be real aspects of consciousness.

Increasingly over the past year I’ve been puzzling over the Buddhist teaching that names the energy field I wrote about last year dharmakaya and the forms we experience nirmanakaya.  There are three kayas; dharmakaya, sambhogakaya and nirmanakaya.  I’ve been trying to see the nature of sambhogakaya.

My teacher explained sambhogakaya this way, that it manifests as five divine wisdoms:

  • All encompassing space that projects consciousness and is the source of compassion
  • Mirror-like wisdom, the purified form of “form”
  • Equality wisdom, bias toward none
  • Discernment wisdom, perception, and
  • Action wisdom, the purified form of “concept”

I’ve been thinking especially about the first wisdom, all encompassing space that projects consciousness and is the source of compassion.  My Buddhist practice is increasing my compassion, my urge to act kindly.  It just happens.  I also grow more aware of how self-absorbed I still am.

What’s happening is, I’m slowly shedding mental habits that obscure reality.  Our mind matches fragments of what we perceive against its gallery of pictures, stories and concepts, then we act on what it in fact made up.  That’s how above Kathmandu I saw creatures instead of what was there.

But why would fabricating less of what I experience result in compassion growing stronger?  Compassion must be an attribute of consciousness.  As I grow more conscious the natural result is I act more kindly.

When we can’t quite define a word it can be helpful to consider its opposite.   The dictionary tells us that opposites of conscious include unaware and unresponsive.  A related word is alive so another opposite of conscious is dead.  The deepest opposite of consciousness, however, is dreaming.

When we are dreaming our mind is not in touch, or very little in touch, with its environment.  Our fully conscious mind processes its environment accurately, however, providing us with a pure perception in response to which we are naturally happy and kind.

Consciousness was missing from my model of existence last year.  I hope to have fewer questions about it next year.

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.

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

Healthcare — the Fundamental Choices

One of our fundamental choices about health care has moral and practical dimensions.  The other is purely practical.

Let’s first address the practical issue.  Our  appruoach to health care puts our businesses at a serious and growing competitive disadvantage.  US corporations currently spend $12,591 on average for coverage of a family of four, up 54% since 2005.

Our national health care spending, which was 5% of GDP fifty years ago, is now 17 % of GDP.  It has more than tripled.  Meanwhile, Germany’s spending is two thirds of ours and is growing much less rapidly.

We spend half again as much or more on health care as other advanced economies.  And the gap is growing.  Germany now spends 11% of GDP on health care, only increased from 9% half a century ago.  Japan spends 10%,  Britain 9%.

It’s no coincidence that our health care system is fundamentally different from our competitors’.

Our business leaders say their competitiveness is hobbled by corporate taxes, but while our health care spending has more than tripled in the last half century, corporate taxes that were then 4% of GDP are now half that at about 2%.

It’s true we have industrialized nations’ highest corporate tax rate but many of our great multinational corporations pay little or none.  It’s also true that our high tax rate hurts smaller domestic corporations but that’s much less important than our health care system’s costs.

To remain competitive, we must restructure our health care system.  

The choice with both moral and practical dimensions is whether everyone will have health care, or only those who can pay?  

If only those get health care who can pay, the others will suffer and die.  If we favor this approach we should consider, are we okay with that fact?

If everyone will get health care, there must be some rationing.   If we favor this approach, do we recognize that fact?

It’s misleading to think of health care as a human right.  Nations choose what rights their citizens will have and embody them in laws.  Those laws can and do change.

Our current legal system specifies that, with an exception I’ll get to in a minute, those of us who cannot pay for health care do not get it.  Why is that, and could it change?

It is an article of faith with us that we are rugged individuals who take responsibility for ourselves.  We resist anything we think could make us less responsible.

Another of our articles of faith is that competing organizations motivated by profit always get the best results.

But that could be about to change.  The Medicare for All act has 108 sponsors as of May 13, 2017: https://www.congress.gov/bill/115th-congress/house-bill/676

We would get better results from a unified approach to health care.  We do not, after all, provide for our defense with autonomous, competing armies.  We know that kind of service can only be supplied effectively by our central government.  And we know our government has encouraged, not stifled innovation in that field.

Here are links to what I’ve written before about some important aspects of our approach to health care but if you’re out of time, just skip past them to the conclusion — a single payer system works best.

In http://martinsidwell.com/socially-acceptable-healthcare/ I pointed out that we do currently provide not health care but at least medical treatment to all via the Emergency Medical Treatment and Active Labor Act (EMTALA) passed under President Reagan.  That approach means: “We have in the USA universal access to medical treatment via the most costly system possible.”

Data I posted at:  https://usaturnaround.wordpress.com/2011/09/21/healthcare-from-85000-feet/ show that:  “US health care delivers poorer results at higher cost because it is based on the flawed assumption that market based systems always deliver the best results. While in most cases they do, for health care they do not. The incentives are perverse”.

Exploring our Federal deficit at: https://usaturnaround.wordpress.com/2011/07/11/drivers-of-the-deficit/ I noted that: “more important even than getting rising Federal healthcare spending under control is to get rising health care cost under control.  As noted in previous posts, we spend double what other advanced economies do on healthcare without getting better results.”

Examining national spending and results at: https://usaturnaround.wordpress.com/2011/04/19/overall-us-healthcare/ I pointed out some contributors to our abnormally high costs:  “our obesity rate, the highest of all OECD countries and more than twice as high as the 15% OECD average …  The percentage of our adult population considered obese rose from 13% in 1965 to […] 34% in 2007.  Obesity-related medical spending in the USA doubled […] between 1998 and 2008.”  

Focusing at: https://usaturnaround.wordpress.com/2011/04/17/medicare-and-medicaid/ on Medicare and Medicaid I pointed out that: “The primary cause of increased Medicaid spending is that it now services 16% of all Americans, up from 2% at its inception [while] Medicare now serves 15% of the population, up from 10% in 1966 and the percentage will continue to increase as our population ages … The key fact about Medicare is that an aging population, unhealthy lifestyles and technology advances are driving its costs up 8% annually, much higher than Medicaid.”

The conclusion?  Our need to remain competitive means we must restructure our health care.  Our competitors did that long ago.  They all established a unified system for all their people, they all have much lower costs than ours, and they all get the same or better results.

Our current approach to health care is not exceptional in a good way.

When the government acts as the one health care buyer it has the market power to negotiate the lowest price that is profitable for suppliers.

A competitive health care market benefits consumers only for procedures like breast enhancement where they have enough time to make an informed choice.

To remain competitive we must change our health care system.  We must either stop providing care to many millions more of those who can’t afford it or establish a single buyer to negotiate the lowest profitable price for providing care to the largest pool of consumers, which is both the currently healthy and the sick.

Annual Report

My end-of-year statistics from WordPress are — 7,691 page views this year with last month the most active at 973 views by 600 unique visitors.

I’m intrigued that while 575 of last month’s 973 page views were from the USA, others came from surprisingly diverse places — 57 from the UK, 37 from France, 34 from India, 33 from the United Arab Emirates, 30 from Canada, 20 from Qatar, 17 from Germany, 11 from Egypt, 10 from the Czech Republic and smaller numbers from elsewhere.  In January, 31 were from Brazil.  This month, 17 are from Japan.  Globalization is a thing!

My research for posts about Yemen, Syria, Iraq, Turkey, Kurdistan, the Islamic State, Jordan, Kuwait, Lebanon, Palestine and Egypt was to dispel my own ignorance with the hope that they would also help friends here in the USA.  I’m happy they also found an audience in the Middle East.

What motivated me to start that work was Islamophobic propaganda.  I wrote about that here.

I plan to complete that first round of Middle East research in the new year, post about Israel, more about the Islamic State/ISIS, and ideas for Middle East strategies and about terrorism in the USA.

I intend also to return to why we engage in endless war and ever-increasing arms exportsjingoism, and how we can counter relentless propaganda.

My seven posts about depression stimulated a lot of comment.  I will return to that topic with some recent research about averting depression.

My posts about Nepal and Buddhist practice got me thinking about adding a new area to the site for photo-heavy posts about my treks in Nepal, Sikkim and Tibet.

And I will explore how to make some older posts more visible.  This month there were 238 views of my October 30, 2014 Ignorance, Fear and Imaginary Facts and I have no idea what suddenly made that post so popular.

So, thank you everyone who came here this year!  I am encouraged to continue 🙂

 

Happy Birthday Every Day

I was both born and met my death on April 20, 1970.  It also happened on March 25, 1944 when I separated from my mother’s body.  It is happening again in this very moment.

Our universe is energy, in no way fixed, an endless, glorious play of energy.

None of the universe’s energy is created or destroyed.  It simply changes.   That is the first law of thermodynamics.  All energy is conserved.

Physicists have measured the conservation of energy.  It is absolutely consistent across all space and time.

So, along with everything else, what I think of as “me” disappears and is reborn in every instant.  The waves of energy that appeared as “me” when I typed “in every instant” have already changed shape and direction.

Mostly, we notice only the dramatic changes.  Perhaps for a moment we feel the beauty of a flower.  But we do not recognize that our mind-body is always changing.

All the energy that manifested as “me” when I landed in New York forty five years ago remains in this world even though much of it is no longer part of “me”.  Every wave of energy that encountered “me” changed “me”.  The path of every wave that met “me” was changed by the encounter.

How to sense this fundamental truth?  I think of the weather.

The entire weather system is interconnected.  It has no fixed borders yet it is different everywhere and always changing.  The sun is rising in a clear sky above Brunswick Maine this morning.   Yesterday at this time it was gray, windy and raining.  Rain is falling in other places right now.

Tiny actions like the flap of a butterfly’s wing engage with powerful winds that arise seasonally as the positions of the Earth and Sun change.  So many factors change the flow of energy that we experience as weather.

We humans manifest in the same way as weather, all different, all part of the same system, not remaining exactly the same even for a moment.  And, like the butterfly drying its wings, our every action changes the entire energy flow.

Perhaps some of the energy that now creates the appearance of “me” will later join other waves of energy in a summer monsoon to nourish rice in India.  Perhaps a grandchild of a child waking up now in Brunswick, Maine will enjoy some of that rice.  The play of energy makes anything and everything possible.

Our intellect can’t quite understand how our “self” can be imaginary yet cognizant, imaginary but able to choose how it nudges the energy in which it appears.  I’ve learned not to worry about that.

Intellect is what gives us the opportunity to deploy our kindness intelligently.  Becoming better able to do that is my birthday wish.

Our Eleven American Nations

I was quite startled to learn that our Constitution has a stated aim to protect the “opulent minority.”   I was impressed when I studied our system of government for my citizenship exam.  Now I realized that I didn’t understand the system’s history or implications.

I started with Robert Dahl’s excellent How Democratic is the American Constitution?  Daniel Lazare’s The Frozen Republic opened my eyes wider.   Then I read Colin Woodard’s enormously helpful America Nations – A History of the Eleven Regional Cultures of North America.

Woodard began his career in Eastern Europe when the Soviet Union was collapsing.  He noticed that the boundaries of Hungary, Poland and other nations bore little or no relation to the ethnic and cultural realities.  Groups within those countries had always been rivals and people across borders shared a culture and long history.

That got Woodard thinking about cultural rivalry within our nation.  The South versus the North, the coasts vs the heartland, those grossly simplified divisions don’t explain the reality.  Cultures that came from England, France, Spain, the Netherlands and so on were significantly different and those cultures remain powerfully alive.

Our values and the behavior they motivate are much more those of eleven distinct people than of fifty States, or of an homogenous population with shared values.

Eleven American Nations

What are the implications?

The Constitution’s first words are “We the people of the United States, in order to form a more perfect Union.”  Coming in the recent past from very different cultures with very different values, many of the delegates did not want union but to be left alone.  Those who wanted union had very different ideas about its form.  The great majority of the population was not consulted, certainly not those whose land had recently been invaded.

The Constitution that resulted from all the necessary compromises results in an ongoing contest between only two major parties.

My conclusion before I read Woodard’s research was that since the Republican Party has been taken over by a tiny minority of the most wealthy Americans in alliance with fundamentalist Christians and anarchists, “something-other-than-progressives” must take over the other Party.  But that would result in even more extreme gridlock.

The Democratic Party must not shift to the far left to balance a Republican Party that is moving further and further to the far right.  It must find a position that accommodates the diverse values of a majority of people across all our eleven nations.

Our world is constantly changing, so our policies and programs must, too.  Sometimes a conservative brake on changes will be best, other times major changes will have grown urgently necessary.  And the priorities of neither major party will permanently align with those of any of our eleven nations.

Some of us wage war on “invasive species”, plants, insects, fish, rodents, mammals, any form of life that “does not belong here.”  Some of us reject people who arrived recently and “don’t belong.”  But as the world inevitably changes, life forms inevitably move.

Recent linguistic research indicates that the first people in North America did not come directly from Siberia across the Bering Strait 12,000 years ago.  People from Siberia had been living in Beringia for around 85,000 years.  When the ice melted and their habitat was flooded 12,000 years ago, some came here.  Others went back to Siberia where they perhaps no longer “belonged”.

Those who came here formed into tribes, some peaceful, some making war on each other.  We think of those Native Americans as being decimated by “the white man” as if a single invasive species destroyed them.  In fact, it was a variety of new species, eleven major ones, that set up an entirely new form of government which excluded them.

What we need to do now is figure out how we can use that system of government to better represent the people of the eleven nations who we speak of collectively as “Americans.”

We are not alone in facing this challenge and we have had governments that better represented us all in the past.  We can have such a government again.  We’re in a much better position than, for example, Nepal.  Politicians there continue to wrangle without visible progress over what structure of government could represent all Nepalis, not just the Brahmin elite.

Nepal’s politicians cannot even start to learn how to govern until they choose a structure.  Ours could start governing effectively right now.  We must make them do so.