Thursday, May 31, 2007

Dealing With Debt Collectors

My fellow bankruptcy attorney and new blogger, Elaine Dowling, claims that MarketWatch is playing with her world view.

Elaine gives a hint of the kind of thing we bankruptcy lawyers deal with all the time:

The FTC also alleges that debt collectors who obtain authorization to do automatic debts from checking accounts sometimes take more than the amount authorized. Some have even given debtors an incorrect address so letters disputing debts won’t be received. That’s almost clever, actually.

And then there's the problem with multiple debt collectors on a single original debt. It is also not unusual to have a debt collector try to collect on a debt that has been discharged in bankruptcy years after the fact. Being able to get people's credit reports directly has helped some, but the debts get sold so often that it is virtually impossible to track all the agencies down to notify them of a pending or filed bankruptcy or to try to negotiate a settlement on the debt.

Then there is the issue of the credit reporting agencies not noting all the debts that have been discharged in the bankruptcy. That means an old client will call me years later asking for a copy of the bankruptcy papers to prove the debt was listed. That is always a hassle to deal with.

Basically, what these stories show is how the collection agencies are overreaching in many instances. I realize there are abuses on both sides. There are some people who are just plain deadbeats, and they don't deserve to get credit at any interest rate. "Cash with ID," as we'd say. But at this time in history, most of the abuses are taking place on the side of the credit industry because of their increased bargaining power due to the 2005 BAPCPA changes in the bankruptcy code.

Wednesday, May 30, 2007

Ethicist: U.S. Health Care System "Dysfunctional"

From the Times Leader:

CHICAGO — The U.S. health care system is “a dysfunctional mess” and politicians who insist otherwise look ignorant, according to a medical journal essay by a prominent ethicist at the National Institutes of Health.

“If a politician declares that the United States has the best health care system in the world today, he or she looks clueless rather than patriotic or authoritative,” Dr. Ezekiel Emanuel wrote in the Journal of the American Medical Association.

Quod Erat Demonstrandum.

Tuesday, May 29, 2007

Sicko Official Trailer

Why The Poor Pay More

In a comment left over at Warren Reports, someone mentioned a study done by the Annie E. Casey Foundation that showed how the poor pay more for normal goods and services than do more affluent Americans. Many of these costs are starting to reach into middle class America.

Friday, May 25, 2007

Live Like You Were Dying

It was a weekday before Memorial Day weekend when I received the call from my dad. "Your mother died this morning," my dad said, sounding obviously distraught.

I was having lunch with Richard Berger, the attorney who more or less trained me in the law practice, and Joel "Andy" Henderson, who would often stop by the office to talk and go out to lunch with us. "You go on home" Richard said, "I'll take care of the bill."

I rushed home as quickly as I could. Although both my parents were elderly -- my mother was 77 when she died -- her death from a heart attack still came as a shock.

When I got home, I discovered that my father was not able to take care of the mundane tasks that follow a loved one's passing. At that point, I went into lawyer mode. I made the calls to the funeral home to let them know that my mother was at the morgue. I called my siblings to let them know what had happened. I also went through the paperwork to let the various governmental agencies know that she had died.

After my mother's death, I felt it was necessary that someone move in the house to be with my dad. My father was 86 at that time, and while he was still very active and had a good mind, I felt that due to his age he needed someone there in case something went wrong. My other siblings all had families to take care of and, because I was still single and living in Oklahoma City, I seemed to be the natural choice.

The first night I moved in with my father, I had to rush him to the emergency room at midnight. He was having a problem with vomiting and diarrhea. When they finally examined him a couple hours later, they told me that they would need to admit him. The doctor who was on call informed me that due to his age and symptoms, they first suspected colon cancer.

The tests they ran confirmed the initial diagnosis and after having surgery to remove the tumor that had blocked his intestinal tract, they sent him to an oncologist. My dad started on his chemotherapy and the first round of treatment seemed to be successful. Eventually, the blood tests detected no cancer in his system. They continued to treat him for a few more sessions before releasing him from care.

It seemed he had beaten the cancer, but it was not to be. About six months later he started to feel another large lump in his stomach area. I took him back to the hospital to have it checked out. The tests confirmed that the cancer had returned and more aggressively this time. They tried to put him on a new form of chemotherapy that was designed to actually kill the cancer rather than just treat it, but it turned out that he was allergic to the medication (apparently, a large percentage of patients were also allergic to it).

Fortunately for me, my secretary was also a Home Health Aide. So I was able to arrange it that my law office would be moved into the house and she could work half the day for me and half the day taking care of my father.

The closer my father got to his death, the less he would eat and drink. When I tried to encourage him to do so, he would sometimes get upset with me. When the Medicare-funded nurses came by, they left a book that explained that this is a natural part of the dying process. It is also an insidious side effect of the cancer. You need the nourishment to fight the disease, but the cancer makes you not want to eat or drink.

They started my dad back on the regular chemotherapy, but it wasn't working. We had to wait until there was a diagnosis that the disease was terminal within a year before we would be entitled to Medicare-funded nurses to come by the house.

Once they came by and explained to my father and the family that there was no beating the cancer this time, he passed away very quickly. They brought by the morphine and some other medications, which I was supposed to administer. He had complained about pain a lot, and the pain medication that he had been taking up until then was no longer working so well.

Once he started on the morphine, he went to sleep and rarely woke up again. He died at home in his sleep at about 11:55pm on July 2, 2005. Perhaps it was somewhat fitting for a Marine veteran of the Guadalcanal campaign to die on Independence Day weekend. He was buried with his military honors with my brother, Norman, receiving the American flag from the Marine Honor Guard.

In a lot of ways, this week's Sunday Music reflects a song that sounds a lot like my own experience taking care of my father. The song talks about how the singer goes "Rocky Mountain climbing" after his friend's or dad's death while in his "early forties." After my dad died, that's what I did. I went to the Rocky Mountains and several other national parks in Colorado. "You earned it," my brother Kenny told me.

In honor of Memorial Day weekend, here is Tim McGraw's Live Like You Were Dying:





Have a happy Memorial Day weekend, everyone. Carpe diem.

Thursday, May 24, 2007

A Nice Comeback to the Critics of Sicko

I saw this quote from the Time article on Sicko:

Already, without having seen the film, anti-Moore websites have collected claims that many Cuban hospitals, unlike the one shown in Sicko, are dilapidated and crawling with cockroaches. Uh-huh. That means they're almost as bad as Walter Reed's Building 18, to which Iraq-vet outpatients were sent. Moore doesn't bother to address this point, which helped galvanize public opposition to the war. (Was it too late for inclusion in the film, or too easy a target?) Nor, when he asserts that "18,000 of them [Americans] will die each year simply because they didn't have health insurance," does he trouble to note that that's more than five times the number of U.S. military deaths in the four-plus years of the Iraq occupation.

Congratulations Alex Shabalov


Alex Shabalov, just after Sergey Kudrin resigned and congratulated Shabalov on his tournament victory. Photo courtesy of the USCF site.

Alex Shabalov won his last game yesterday while Alex Onischuk drew to win the 2007 Frank K. Berry U.S. Chess Championship outright. You can read a full article about the last round at the USCF site.

Alex Shabalov is a true gentleman and was easily one of the most approachable players in the tournament. After the awards ceremony yesterday, a throng of the players, organizers and myself went out to Red Lobster (a restaurant managed by a chess master) to eat and celebrate the tournament's end. Frank Berry, for whom this year's tournament was eponymously named, paid for everyone's meal (although he did recommend -- hint, hint -- that everyone leave a $5 tip for the waitresses). Alex Shabalov left a $100 tip. He was feeling generous after winning the big prize, I guess.

On another note, there is some talk of making Stillwater, Oklahoma, the new Lone Pine of chess tournaments. For the uninitiated, Lone Pine, California, is "a small, friendly town half-way between America's lowest point at Death Valley and its highest at Mt. Whitney," according to Jerry Hanken as he wrote it back in 1976. Lone Pine hosted the annual Louis B. Statham International Tournament, commonly referred to simply as the Lone Pine chess tournaments. It was a place where the top players of the world used to always come and play in some of the strongest Swiss-system competitions every year.

Monday, May 21, 2007

New Bill Seeks To Curb Credit Card Abuses

From Credit Slips:

H.R. 1461, the Credit CARD Act of 2007 and S. 1935, the Stop Unfair Practices in Credit Cards Act or SUPCCA has been introduced.

Most significantly, the Senate bill will:

* For consumers not in default, prohibit credit card companies from unilaterally raising the interest rate disclosed at the time a consumer enters into a credit unless the consumer agrees in writing
* For consumers in default, limit the interest rate increase the credit card may charge (called the "penalty rate") to no more than 7% greater than the rate before the default
* Allow interest rate increases to apply only to future purchases, not existing balances on a credit card
* Prohibit credit card companies from charging interest on fees they assessed on their customers
* Allow credit card companies to impose only one over-limit fee if the company allows the customer to exceed the card limit
* Prohibit credit card companies from charging a fee to pay a balance in full

Rare Diseases Get Treated In Amish Community

Blue Light Aids Ill Mennonite Children

But there is more to this story than what the headline suggests:

On a dewy spring morning in Strasburg, strains of Bach drift from a post-and-beam building on a hill overlooking an alfalfa field. Inside, rays of light wash down from rafters, silhouetting the doctor-musician as he cradles his cello.

For Holmes Morton, his daily dawn "concert" is a rare escape from the sadness of sick children and the desperation of parents who come to him for miracles.

There are no miracles, he tells them. For many rare diseases there are no cures.

To the families who travel from miles around, Morton's Clinic for Special Children is itself a miracle.

Here, on what was once an Amish farmer's field, in a building erected in traditional barn-raising fashion by 70 local men, some of the world's rarest diseases are identified. Children who would never have survived in the past are treated with special formulas and dietary regimens tailored solely to their needs. And because the local community helps pay for the nonprofit clinic through annual auctions, costs are far less than at a regular doctor's office.

Geneticists have long studied the Amish and Mennonites, descendants of Swiss and German Anabaptists who settled in Pennsylvania in the 1700s. Forbidden to marry outside their religion, the Plain People, as they are known, have a relatively high risk of being carriers of a rare disease.

But research generally takes place in university laboratories, far from actual patients and their illnesses.

At the Clinic for Special Children, laboratory director Erik Puffenberger studies a mass spectrometer and DNA sequencing machine in one room, while across the corridor an Amish family clusters around Morton to discuss their sick child. Heirloom quilts decorate the walls. A horse and buggy is tethered to a hitching post outside.

And new genes are being identified all the time.

"The real frontier of genetic medicine is in the everyday practice," Morton says, as he bounces over hilly back roads in his silver Jetta, waving at bearded farmers and straw-hatted boys.

With his thinning hair, walrus mustache, starched white shirt and bow-tie, Morton looks every inch the genial country doctor. But the 56-year-old, Harvard-trained pediatrician is far more. In 1989 he gave up a promising academic career to pursue his vision of the clinic, believing that the only way to understand rare diseases was to live in the communities where they occurred. Today, the clinic, which is run by Morton's wife Caroline, treats about 600 Amish and Mennonite children. Morton's work is recognized around the world.

"These children living with the sword of Damocles," Morton says. "They need treatment, not just research."

Morton is speaking not just of Crigler-Najjar syndrome, but of the many other rare disorders seen in the clinic. Maple syrup urine disease. Glutari aciduria. Pigeon breast disease. Pretzel syndrome.

Many of the disorders can be fatal _ or cruelly disfiguring _ if undetected. Like Crigler's, many are so unusual they are simply not recognized by general pediatricians.

The clinic now recommends all Amish and Mennonite newborns be routinely screened for more than 35 genetic diseases. In 2004 it discovered a gene implicated in some cases of sudden infant death syndrome. It has established links between rare metabolic disorders like glutari aciduria and diseases that are more common in the general population, like cerebral palsy.

"God sent Dr. Morton to us," says Norman Burkholder, after leaving his mules and plow one day to bring in his 9-year-old son. The child is dizzy and coughing and he complains, in Pennsylvania Dutch, that his stomach hurts.

Later the boy will be admitted to Lancaster General Hospital where he will spend days on a special formula prepared by Morton's clinic. The child has maple syrup urine disease, a rare enzyme deficiency that causes his urine and ear wax to smell like maple syrup. If he had not been properly diagnosed and the formula had not been available, he could have slipped into a coma and died.

Like Crigler-Najjar, there is no cure. The boy will eventually need a liver transplant.


It is a fascinating article on rare diseases. I certainly recommend anyone in the medical community to become aware of it in case they may come across it in their practices.

Nicholas Kristof: America's Health Care Mess

A Short American Life

By NICHOLAS D. KRISTOF
Published: May 21, 2007

How’s this for a glimpse into America’s health care mess:

The student winner I’ve chosen to accompany me on a reporting trip to Africa next month is a superb medical school student named Leana Wen. She receives her M.D. this month, and will research health care access this summer at a Washington think tank.

I asked Leana about her health insurance coverage, just in case she catches leprosy on the Africa trip.

“Actually, I was going to become one of the 45 million uninsured for the summer,” she said. “The think tank does not provide insurance for ‘temporary’ employees, and my school did not allow extension of health insurance post-graduation. I still haven’t found a reasonably priced insurance plan for this period.”

Aaaaargh! When a newly minted doctor investigating Americans’ access to medical care has no insurance — then you know that our health care system is truly bankrupt.

...

Over all, a person without insurance is less likely to have diseases diagnosed early, less likely to get routine preventive care — and faces a 25 percent greater chance of dying early.

...

The existing medical financing system also creates perverse incentives for expensive procedures; that may be why Americans are far more likely than Europeans to get C-sections. Meanwhile, the burden of paying for these second-rate statistical outcomes is crippling American business. By next year, the average Fortune 500 company will spend more on health care than it earns in net income, according to Steve Burd, the head of Safeway. Mr. Burd and other executives have formed the Coalition to Advance Healthcare Reform, creating a corporate constituency for national health reforms.

There’s evidence that the most efficient financing system would be a single-payer structure, such as that found in most Western countries. Some 31 percent of U.S. health spending goes to administration, more than twice the rate in Canada.

So bravo to Physicians for a National Health Program, a group of 14,000 doctors and other health professionals that favors a single-payer system.


To read the full editorial, click on the link at the top of this post.

Sunday, May 20, 2007

Prior Restraint

Hat Tip to the Huffington Post for this AP report:

On the advice of lawyers, the filmmakers spirited a master copy of "Sicko" outside the United States in case the government tries to seize it. Asked whether the inquiry could prevent the film opening in the U.S. as planned on June 29, [Michael] Moore said: "We haven't even discussed that possibility."


This is just sad. Who would have thought it would come to this? Michael Moore has to send a master copy of the movie Sicko because of the threat that the film will be seized by American authorities.

The legal theory that used to be followed in these cases is called "prior restraint." If you want to read more about this issue, you can find a lot of information on FindLaw.

See also generally "strict scrutiny."

Maybe this will be seen as a publicity stunt (and it might be), but to think that it even has to be considered is cause for alarm. This is America. We are supposed to be secure in our discussions of political matters. Obviously things have regressed enough in the area of civil liberties that some dissenters (such as filmmaker Michael Moore) have to consider extraordinary measures to protect information of political expression.

That should never happen in America. This isn't a potential national security case like the Pentagon Papers, so it should be obvious that an attempt to prevent the movie from opening would be a violation of Moore's constitutional rights.

Sunday Music: Peter Gabriel

Next Week's Sunday Music will be posted on Friday. It will be a special one for Memorial Day weekend.

Starting in June, I will be featuring artists from Oklahoma (or who have some Oklahoma reference in their song) in celebration of Oklahoma's Centennial.

Today's artist, Peter Gabriel, has performed many songs that carry an important message regarding human rights and our responsibilities to the world around us. Today's compilation of videos is only of his better-known songs.

Shock the Monkey


Sledgehammer


In Your Eyes


Steam


These songs and others can be found on his two disc CD Hit:

More News From Cannes On Sicko Movie

From Salon.com:

When asked about his potential prosecution for violating U.S. Treasury sanctions against trade with or travel to Cuba, Moore was uncharacteristically sober. "I know a lot of you have written things like, 'How dumb are they?'" he said, "but I don't take this lightly. The Bush administration may try to claim that my footage was obtained illegally. We haven't discussed this possibility yet, but actions could be taken to prevent this film from opening on June 29. I know that sounds crazy to the Americans in the room. I guess it is crazy."

When Americans do get to see "Sicko," Moore says, "They will understand that this was about helping 9/11 rescue workers who've been abandoned by the government. They're not going to focus on Cuba or Fidel Castro or any other nonsense coming out of the Bush White House. They're going to say: 'You're telling me that al-Qaida prisoners get better medical treatment than the people who tried to recover bodies from the wreckage at ground zero?'"

When Moore interviews Tony Benn, a leading figure on the British left, his larger concerns come into focus. Benn argues that for-profit healthcare and the other instruments of the corporate state, like student loans and bottomless credit-card debt, perform a crucial function for that state. They undermine democracy by creating a docile and hardworking population that is addicted to constant debt and an essentially unsustainable lifestyle, that literally cannot afford to quit jobs or take time off, that is more interested in maintaining high incomes than in social or political change. Moore seizes on this insight and makes it a kind of central theme; both in the film and aloud, at the press conference, he wondered whether some essential and unrecognized change has occurred in the American character.


This sounds a lot like the themes from my blog: healthcare, debt and social values of always chasing that almighty dollar rather than thinking about what it means to live the good life and noticing the natural wonders of Creation around us. Because Americans rarely receive vacation time and have so much debt on 18% interest credit card debt (compounded daily which effectively makes the debt more like 19.72%). If you add in fees, it can jump to double that. How many Americans could afford to take a vacation even if they were given the time off work? How many Americans could afford to take a drive to a national park (although the fees are low or nonexistent)?

I think Michael Moore is absolutely right to ask these questions. We need to ask life is just passing many Americans by simply because our version of Hyper-capitalism and debt loads is detrimental to our enjoyment of life. My point is that if you apply that same Hyper-capitalism to health care, you cause grievous injury to not only the patient who does not receive care, but to society as a whole. That person is less productive. That does not even mention the depression of happiness felt not only by the patient, but also their family, friends and neighbors.

There is a bigger picture here than just health care. It is about the need to change the American character so that we can enjoy, as a country, the wealth that we have created to spend time enjoying life itself.

Continuing with Moore's statements in Cannes:

"I hope this film engenders discussion, not just about healthcare, but about why we are the way we are these days," Moore told us. "Where is our soul? Why would we allow 50 million Americans, 9 million of them children, not to have health insurance? Maybe my role as a filmmaker is to go down a road we might be afraid to go down, because it might lead to a dark place."

Moore's last revelation in "Sicko" is sure to be endlessly debated in the right-wing blogosphere that is so obsessed with him (and may be of little interest to ordinary viewers). Some time ago, Jim Kenefick, proprietor of the especially bilious anti-Moore site Moorewatch, almost shut down his site to focus on his wife's worsening illness and escalating healthcare costs. An anonymous donor then sent him $12,000 to cover his wife's bills and keep the site running. (She has apparently recovered.) Now that donor has been revealed and, as Kenefick now says he suspected all along, it turns out to be Michael Moore.

"I want him to know that it was done with all the best intentions," said Moore, adding that he planned to phone Kenefick personally after the press conference. (According to Kenefick's blog, Moore left him a voice-mail message later on Saturday.) "I went back and forth about whether to use that material," Moore went on. "I asked myself, would you be doing this if it weren't in the film? I decided that I would, and I should, and that that's the way I think we should live."

Moore says he began exercising and lost 25 pounds while working on his healthcare film; "I'm actually a fairly skinny person for the Midwest," he quipped. He says he's tried to maintain a lower public profile since "Fahrenheit 9/11" and would like Kenefick and his many other critics to cut him some slack. "You know, I begin to hope that as I enter the discourse with this film, I might get some kind of a break. As far as the accuracy of my movies goes, I think the record speaks for itself. Maybe people will say: He warned us about General Motors, he warned us about school shootings and he warned us about Bush."

Saturday, May 19, 2007

2007 US Chess Championship Update

I didn't post yesterday because after a court appearance I went to pick up a spectator at the Oklahoma City airport and took them up to the US Championship in Stillwater. The tournament will continue through Wednesday. Here is a group of photos of the players and organizers of the event.

After the first round, I took some of the players out to dinner at Stillwater's famous restaurant Eskimo Joe's. Billed as "Stillwater's Jumpin' Little Juke Joint," Eskimo Joe's is one of Stillwater's famous eating attractions. The players that accompanied me that night were IM Irina Krush (who "Krushed" me in table tennis last night 21-18), IM Joshua Friedel, FM Robert Hess, Irina Zenyuk and IM Alan Stein who is acting as second to Friedel and IM David Pruess.

Last night the players wanted to go back to Eskimo Joe's (again?!). Tagging along were Krush, Zenyuk, Stein, Hess, Friedel, Pruess and Pruess' high-school teammate -- who is a professional poker player in Las Vegas -- although I can't remember his name (but he lost a lot of money playing poker in Tulsa, as we say in Oklahoma "That'll learn ya, darn ya."*), GM Eugene Perelshteyn and IM Bryan Smith. I think I am missing someone, but I can't remember who it is. I will have to ask the players and update it later.

*In Oklahoma, when saying this phrase, you say "darn" to rhyme with "learn."

***Update*** That semi-famous poker pro was Richard Grijalva.

Oklahoma Resident First Responder of 9/11 Praises Sicko Movie

From the AP:

NEW YORK -- It could have been a college reunion: hugs, tears, laughter, photos, and a big friendly guy in shorts and sneakers organizing it all. But the guy in shorts was Michael Moore, whose new documentary, "Sicko," takes aim at the U.S. health care industry with the same fury - laced with humor, of course, and plenty of statistics - that he directed at the Bush administration in his hit "Fahrenheit 9/11."

And the people who'd flown in for this intimate first screening, a day after the film had been shipped to the Cannes Film Festival, included grateful Sept. 11 "first responders," suffering lung problems or other ailments from their days at ground zero. In the film, Moore takes them to Cuba and tries to get them treated at the U.S. base at Guantanamo Bay - where, he contends, terror suspects were getting better medical care than the heroes of 9/11.

...

At his screening Tuesday evening at a Manhattan hotel, however, Moore was focused on the reaction of his invited guests.

"Three years ago tonight, we had the first screening of 'Fahrenheit 9/11,' with victims' families," he told them. "It was a very powerful experience, and now we're honored to have all of you here. We're very proud of this film. We're confident it will have a significant impact."

When the lights came up, Reggie Cervantes, a former 9/11 "first responder" who now lives in Oklahoma, spoke first.

"It was funny. It was real," said Cervantes, 46, who says she suffers from pulmonary ailments, esophageal reflex, post-traumatic stress disorder, ear and eye infections and other problems stemming from time at ground zero. Of the trip, she said: "It feels surreal. Were we really there?"

...

The patients he brought had all struggled at home with health care costs. Some, like Cervantes, had lost their health insurance because they could no longer work, and were navigating the workmen's compensation system.

John Graham, a disabled carpenter and EMT from Paramus, N.J., came to the screening with his daughters. On 9/11 he was at his job at the carpenter's union offices, near the World Trade Center. He rushed over before the second plane hit, spending 31 hours at first, then helping out for months after that. He says he was later diagnosed with lung problems, burns on his esophagus, chronic sinusitis and post-traumatic stress disorder, among other things: "I need a notebook to remember everything."

Graham, who stopped working in 2004, now lives on $400 per week in workmen's comp payments. He split from his wife and says he is unable to keep up with childcare payments.

In Cuba, Graham had five full days of medical tests and received medication for his reflux problems. Cervantes was treated for eye and nose infections, among other things, and in a drugstore found pills for only pennies that cost her more than $100 at home. Maher had the longest treatment, to correct dental problems - he said ground zero-related stress and dreams about "people falling from the sky" made him grind his teeth at night.

Moore hopes his latest film will make people stop and think about what he sees as the tragic ills of the health care industry.

"We are the richest country in the world," the director said. "We spend more on health care than any other country. Yet we have the worst health care in the Western world. Come on. We can do better than this."

Thursday, May 17, 2007

135 MPG Starting At Only $92,000!

Tesla Motors has a new electric car that goes over 200 miles per charge, according to its website. But at $92,000, you would have to keep the car for quite a while to make up the difference in a Honda Civic or Toyota Corolla.

But if you want a fast car (zero to sixty in "about" 4 seconds), and you want to make some sort of environmental statement (besides the damage done by all the extra batteries), and you have an extra $100,000 to burn, then this car might be for you.

Wednesday, May 16, 2007

Is Saudi Arabia Running Out of Oil?

In a report over at The Oil Drum, blogger Stuart Staniford argues that the Ghawar oil fields are starting to get depleted and that this accounts for the recent rise in oil prices. The post comes with a lot of maps, charts and technical analysis. I am reproducing some of them here with some of his analysis.


Visualization of oil saturation in Ghawar, with focus region on 'Ain Dar and Shedgum regions at northern end. This is the "Linux Supercluster" picture (finder's credit Bob Shaw), showing a simulation visualization of the state of Ghawar at some year, probably but not certainly 2004. I have color reversed the original picture so that in this version, the red areas are interpreted to represent dry oil in the reservoir. The dark blue areas are water below the oil. The pale blue areas are interpreted to be swept, with most oil that can be removed already gone. Source: Figure 3 of Linux Clusters Driving Step Changes in Interpretation Simulation (pdf).

Mr. Staniford then asks:
Here the question is: is this an accurate picture of the state of recent depletion of Ghawar? (Ghawar is the world's largest oil field, and source of over half of the oil produced by Saudi Arabia).

And if so, then the second question arises: does that depletion have anything to do with this picture?



Saudi Arabian oil production, Jan 2002-Jan 2007, average of four different sources. Annotations show important events causally influencing production, including all documented megaprojects for new supply in the the time period. Graph is not zero-scaled to better show changes. Click to enlarge. Source: US EIA International Petroleum Monthly Table 1.1, IEA Oil Market Report Table 3, Joint Oil Data Initiative, OPEC Monthly Oil Market Report, Table 17 (or similar) on OPEC Supply.

In particular, Saudi oil production has been falling with increasing speeed since summer 2005, and overall, since mid 2004, about 2 million barrels of oil per day in production has gone missing (about 1mbpd in reduction in total production, and about another 1mbpd in that two major new projects, Qatif and Haradh III, failed to increase overall production). That's 2.5% of world production and, if that production hadn't gone missing, gasoline in the US likely would still be somewhere in the vicinity of $2/gallon instead of well over $3.

I will analyze six or seven separate lines of technical evidence, and argue they all point to a consistent picture, which says that the answer to both questions is "Yes". Yes, the northern half of Ghawar is quite depleted. And yes, this probably explains at least part of recent production declines. Furthermore, it is likely that more declines in Saudi production are on the way.


I don't know if this is disinformation just meant to create panic (and therefore drive up the price of oil), or if the shortage due to this one region is just temporary. I can just tell you that the general feeling is that cheap oil is starting to run out. In any case, I think that the link at the top is worth a look.

Before I go on, I think I should give a disclaimer (which I am borrowing, for the most part, from Mike Shedlock's site):

The content on this site is provided as general information only and should not be taken as investment advice. All site content, including advertisements, shall not be construed as a recommendation to buy or sell any security or financial instrument, or to participate in any particular trading or investment strategy (or an endorsement or recommendation of any product on any ad). The ideas expressed on this site are solely the opinions of the author(s) who may or may not have a position in any company or advertiser referenced above. Any action that you take as a result of information, analysis, or advertisement on this site is ultimately your responsibility. Consult your investment adviser before making any investment decisions.

If Saudi Arabia is truly starting to run out of oil, then we here in America need to get cracking developing technology to make our use of oil more efficient and develop alternative forms of energy. Most of our electricity comes from burning coal; and while we have a 250-year supply of it, it burns very dirty. Different areas of the country are more suitable to other, cleaner, forms of energy production: solar, wind and hydro power. Each of these are renewable and relatively clean forms of energy production. While current technology does not allow for these forms of energy production to be used widely, it would be wise for Americans to put our smartest minds to work creating more energy-efficient automobiles and buildings. Rather than looking toward converting food crops into more oil for our cars, we need to focus on making our cities more fuel efficient and develop more mass transit lines so that we can cut unnecessary oil usage.

It is my feeling that we, here in America, need to use our strength of innovation to solve our energy problems rather than looking for ways to produce more energy. Our real problem is that we are wasting too much energy that we have access to now. Reducing the demand on oil by conserving and increasing energy efficiency would be the smartest and most effective method of driving down our energy costs.

Monday, May 14, 2007

The Purpose of Education

Check out today's great post entitled Educated Eichmanns at Audience of 1.

The Ubiquitousness of Poverty

Today I read a book review by Nicholas Kristof of Poor People by William Vollmann. I found these paragraphs disquieting:

One measure of the ubiquity of these tradeoffs is that today, as every day, 30,000 children will die of hunger, disease, and other consequences of poverty, according to UNICEF. In many cases, those will be daughters, because parents (particularly in South Asia) don't have the resources to keep all their children alive, so they put a finger on the scales on the side of their sons. In India alone, among children aged one to five, girls are 50 percent more likely to die than boys—meaning that 130,000 Indian girls are mortally discriminated against each year.

Poverty both in the US and around the world remains a central fact of twenty-first-century life; a majority of the world lives on less than $2 a day, one common measure of who is poor. Yet we manage, pretty successfully, to ignore it and insulate ourselves even from poverty in our own country. When it pops out from behind the screen after an episode like the Watts riots of 1965 or the New Orleans hurricane of 2005, then we express horror and indignation and vow change, and finally shrug and move on. Meanwhile, the world's five hundred wealthiest people have the same income as the world's poorest 416 million.




I have been thinking about all of the wars that take place in the world today. I have often wondered how many of those wars are fought over such simple things as access to clean, potable water? Many wars, historically, are fought over access to natural resources.

It makes me wonder: how much money it would cost to provide clean, potable water to everyone in the world? How many needless deaths can we prevent just by expanding access to water? Water is life. Where you find water, you find civilization. Many of the diseases that Bill Gates and Warren Buffett want to eradicate probably start from unclean water supplies. I don't think it is enough to go after the diseases themselves. We need to go after their root causes.

How does this tie in to my post? Most of these people cannot afford individually -- even collectively -- to build water treatment plants. They cannot build wells deep enough to reach potable water and bring it to the surface. Some countries might be able to utilize water from the sea if they could afford desalinization plants.

This is the sort of problem that truly does need cooperation from everyone in the world and funding primarily from wealthy countries and individuals.

Building Wealth

I saw this at at Bankrate.com:

Take a 30-year-old earning $30,000. He or she would only have $216,000 in a 401(k) at age 67, assuming he or she was saving 3 percent of salary, the company was providing a 1.5 percent match and their investments were returning 7 percent per year, according to Vanguard.

So, the sad truth is that nine of 10 American baby boomers have less than $250,000 saved for retirement, a 2005 survey commissioned by Merrill Lynch found. As we've seen, that isn't enough. And if you're hoping for a pension, well, good luck, because half of working Americans don't have a pension plan and even if you do, you can't count on it being there later because corporate America has been shifting away from pension promises. As Americans, we've got to take personal responsibility for our financial future and that of our families.


I thought: "This would be a great lesson on why we need a national pension system." But, no; that is not the point the writer, Jennifer Openshaw, could think to make. Instead, she said "buy real estate" because

"it's tangible and, as an investor, you can enjoy both the appreciation and the income generated as rents rise in the future. Plus, you get the power of leverage with your money -- something you don't get with many other investments -- meaning you might put only 20 percent down but you enjoy appreciation on the entire value of the home."


This is a common theme in financial "self-help" books; but really now, how many people can afford a second home on $30,000 per year? How many people can afford their first home on $30,000 per year? What if the home loses value? (You can read about that problem over at The Housing Bubble Blog and Calculated Risk Blog.) These "financial gurus" never seem to talk about that.

She also talks about the need to have adequate health care insurance.

What is it about these financial gurus and the disconnect between the examples they give of the financial situations of the people they use as examples and the solutions they give? They always seem to give millionaire answers to people with immediate cash-flow hundredaire problems. The problem isn't just that Americans are using too many credit cards (although that is a component of the problem); the problem is also that the working class is not being compensated based on their productivity and sharing in the profits thereof.

The answer actually is pretty obvious: pressure businesses to raise their employees pay so they can save adequately and raise taxes on the wealthiest to pay for the social services and programs that the working class is going to need.

Sunday, May 13, 2007

Strong Hand of Love

The song Strong Hand of Love was Mark Heard's biggest "hit." I just found a MySpace page today that will play the entire song online.

If the song doesn't load up when the page first loads, you can just click on the Song title in the upper right hand corner.

Here are the lyrics from MarkHeard.net:

Strong Hand Of Love

Down peppers the rain from a clear blue sky
Down trickles a tear on a youthful face
Feeling in haste and wondering why
Up struggles the sun from a wounded night
Out venture our hearts from their silent shrouds
Trying to ignite but wondering how

We can laugh and we can cry
And never see the strong hand of love hidden in the shadows
We can dance and we can sigh
And never see the strong hand of love hidden in the shadows

Young dreamers explode like popped balloons
Some kind of emotional rodeo
Learning too slow and acting too soon
Time marches away like a lost platoon
We gracefully age as we feel the weight
Of loving too late and leaving too soon

We can laugh and we can cry
And never see the strong hand of love hidden in the shadows
We can dance and we can sigh
And never see the strong hand of love hidden in the shadows

Written by Mark Heard © 1990 Ideola Music

Sunday Music: Chess

Starting Tuesday, the 2007 Frank Berry U.S. Chess Championship starts in Stillwater, Oklahoma. In honor of the U.S. Chess Championship coming to Oklahoma, here are some songs from the rock opera Chess.

From Wikipedia:

Chess is a musical with lyrics by Tim Rice and music by Bj√∂rn Ulvaeus and Benny Andersson, formerly of ABBA. The story involves a romantic triangle between two players in a world chess championship, and a woman who manages one and falls in love with the other. Although the protagonists were not intended to represent any specific individuals, the characters’ personalities are loosely based on those of Victor Korchnoi and Bobby Fischer.

Being a chessplayer, I am somewhat biased; but I think this is one of the best musicals I have ever seen on stage.

Opening Ceremony/The Arbiter:


Nobody's Side:


I Know Him So Well:


One Night In Bangkok:


Pity the Child:


Endgame:


You and I:


Friday, May 11, 2007

SiCKO Movie To Be Released June 29

Controversial filmmaker Michael Moore made a guest appearance today over at DailyKos. According to his post there, his new documentary, SiCKO, will be previewed at the Cannes Film Festival on Saturday.

As my readers well know, the issue of access to adequate affordable (guaranteed) health care is an issue that is important to me. Therefore you can be sure that I will be eagerly awaiting Mr. Moore's new release.

According to Michael Moore's website, the movie is set to be released in the U.S. on June 29, 2007. Mark that date to see it at a movie theater near you.

Thursday, May 10, 2007

Atul Gawande: Curing the System

From the New York Times editorial page:

There are two causes of human fallibility — ignorance and ineptitude — and health system change is at risk of both. We could err from ignorance, because we have never done anything remotely as ambitious as changing out a system that now involves 16 percent of our economy and every one of our lives. And we could err from ineptitude, underestimating the difficulties of even the most mundane tasks after reform — like handling all the confused phone calls from those whose coverage has changed; ensuring that doctor’s appointments and prescriptions don’t fall through; avoiding disastrous cost overruns.

Health systems are nearly as complex as the body itself. They involve hospital care, mental health care, doctor visits, medications, ambulances, and everything else required to keep people alive and healthy. Experts have offered half a dozen more rational ways to finance all this than the wretched one we have. But we cannot change everything at once without causing harm. So we dawdle.


Gawande then suggests two possible public policy initiatives: a Massachusetts-type plan or cover every child starting right now for their lifetime.

Personally, I think each fail -- but for different reasons:

First, a state-by-state plan fails because it fails to take into consideration that people move all the time for jobs. The market needs portability of labor to where it is most beneficial. You won't have that if some workers won't move due to loss of health coverage and we don't want to create first-class and second-class states (rich states that can afford health care and poor ones that cannot). The founding fathers felt it necessary to create a national economy. Health care needs to be uniform throughout the country. This is not an issue of technology, this is an issue of money.

Secondly, the problem of only providing health benefits for children might be more politically palatable, but, on the whole, the real cost of health care is not the young and healthy -- it is the old, sick and frail. Dr. Gawande said he wrote his piece "as I sit with my 11-year-old son waiting for an M.R.I. to check the cardiac repair that has saved his life for a decade." So I can see how helping children is personal to him.

But it isn't just the 11-year sons that are suffering because of our lack of health care coverage, it is all of us. It is the millions of Americans who have filed for bankruptcy over the last 10 years because of their unique health care story. And, ultimately, we all pay for it one way or another: health care costs will rise on everyone else anyway due to the ones who cannot pay. But -- and this is an important point -- creating a national funding system that guarantees payment is far more efficient, fair and humane than the patchwork system that we have now. No more denying of coverage due to "pre-existing conditions" or because a patient goes "out-of-network." The fact is that DNA science is teaching us that we are all born with a "pre-existing condition." And, being an American citizen and seeing a licensed doctor should automatically make you "in network."

The health of our country requires a national health care system.

Former US Attorneys McKay and Iglesias: "There Will Be Criminal Charges."

From the Seattle Times:

Two former U.S. attorneys said today they believe ongoing investigations into the dismissals last year of eight federal prosecutors could result in criminal charges against senior Justice Department officials.

John McKay, the former U.S. attorney for Western Washington, and David Iglesias, the former U.S. attorney for New Mexico, also said they believe White House political operative Karl Rove and his aides instigated the dismissals and ultimately decided who among the nation's 93 U.S. attorneys should be fired. But the White House on Wednesday flatly denied the firings were instigated by the White House.

...

"I think there will be a criminal case that will come out of this," McKay said during his meeting with Times journalists. "This is going to get worse, not better."

McKay cited ongoing investigations into the dismissals by the Senate and House Judiciary committees, and inquiries now under way by the Justice Department's inspector general and its Office of Professional Responsibility.

McKay said he believes obstruction-of-justice charges will be filed if investigators conclude that the dismissal of any of the eight prosecutors was motivated by an attempt to influence ongoing public-corruption or voter-fraud investigations.

McKay said he believes the strongest evidence of obstruction is related to the dismissals of Iglesias and Carol Lam, the former U.S. Attorney in San Diego.


Circling the Wagons

The White House has so far refused to turn over e-mails related to the firings, and has said it may no longer have access to millions of e-mails sent through Republican National Committee servers. Consequently, Iglesias said, "it's hard for us to know who in the White House said what, on what date."

"The people that would have a voice in this would be Karl Rove, [Rove aide] Scott Jennings, [former White House counsel] Harriet Miers, probably, yes," he said. "But it's hard for me to say 'yes,' [without] looking at those e-mails and memos that are probably out there and missing that this is what they said on this date about John and me and my colleagues.

"But that would explain why the wagons are so tightly circled," Iglesias added.


"You Work for the White House"

So much for the independence of the judicial branch of government:

McKay said he began to have concerns about politics entering the Justice Department in early 2005, when Gonzales addressed all of the country's U.S. attorneys in Scottsdale, Ariz., shortly after he took over as attorney general.

"His first speech to us was a 'you work for the White House' speech," McKay recalled. " 'I work for the White House, you work for the White House.'"

McKay said he thought at the time, "He couldn't have meant that speech," given the traditional independence of U.S. Attorneys. "It turns out he did."

He looked around the meeting room and caught the eyes of his colleagues, who gave him looks of surprise at Gonzales' remarks. "We were stunned at what he was saying."

Wednesday, May 09, 2007

Pirate Equity?

Robert Reich over on his blog explains how mega millions of dollars are made by private equity partners.

Way back in the 1970s, newly-minted MBAs with dollar-signs in their eyes wanted to be CEOs. Then in the 1980s wanted to go into investment banking, because the money was even better there. In the 1990s, they went into high-tech venture capital and dot coms. Now it’s private equity. Becoming partner in a private equity firm is also the new dream of every CEO in America.

That's because the average big-company CEO has to do with a measly $7 million a year, taxed at 35 percent. But private equity partners are raking in hundreds of millions a year, taxed at 15 percent – less than the tax rate paid by middle-class Americans.

...

We’re talking billions of dollars here, folks. And it’s only taxed at 15 percent because even though it’s most of their compensation it’s treated as a capital gain. And courtesy of the Bush tax cuts, capital gains are taxed at 15 percent. Of course, those billions are what these guys pay themselves for their work. It's their compensation.

When capital gains are taxed at less than half the tax rate the rich pay on their incomes, you can expect this sort of gamesmanship.

Now that the tax-writing committees of congress are taking a look at this giant loophole, they’re besieged by private-equity partners who are, of course, screaming: No! You can’t do this to us! If you treat the money we’re making as compensation, you’ll reduce our incentives! We won’t work as hard if we’re taking home only 60 million dollars a year instead of 80 million! And that will cripple the American economy.

Baloney.


A commenter by the screen name "RodgerRafter" referred to it as "Pirate Equity":

I'll add that private equity (aka "pirate equity") often involves laying off large numbers of people, cutting costs to the point quality suffers, burying companies under debt, and other economically damaging tactics.

...

Then there's the "inflation tax" that effects everyone. Pirate equity firms borrow new money into existence in order to take these companies private. They inflate the money supply and syphon off huge sums as personal compensation. All the while, the cost of everything goes up as the value of a dollar goes down.

Private equity and hedge fund borrowing are the main things propping up the stock market these days. That won't last forever, but for now it's hiding the real economic damage that is being done.


I am not sophisticated enough to completely understand how this works; but what I cannot understand on the surface is why the company would need to borrow large sums of money if they cut costs and lay off workers. Wouldn't the company borrow money to expand its operations and workforce?

And something is not right when the highest earning members of our country pay a lower tax rate than middle class Americans.

Tuesday, May 08, 2007

John Edwards: End Poverty Within 30 Years

Presidential candidate John Edwards has proposed that we work the end poverty in the United States within 30 years. Senator Edwards sees this as "the great moral issue of our time." I agree. Click on the title above to read his press release.

Estate Tax Reasoning

Over at Warren Reports, a new blogger named Tijana Divornic asked what area of taxation the readers would want to know more about. I wrote that I wanted to know more about the estate taxes. All I could remember from my law school studies is that the purpose of the estate tax was to prevent dynasties.

It is often referred to as the "Death Tax" by conservatives for rhetorical reasons, because it makes the tax so unfair. After all, why would it be right, conservatives argue, to tax a person after they are dead.

Anyway, Ms. Divornic complied with my request. Here are some of my favorite quotes from her article and the responses that followed:

The estate was first created to help fund WWI. Besides the revenue need (collected from those who can afford it), the justification for the tax is redistributive. Congress wanted to prevent the rise of a “leisure class” that would control most of the wealth without having to work, hence the estate tax is meant to achieve equality of resources (making wealth a function of work, rather than status).

Besides property owned at death, the estate tax also encompasses property given away during life in which the decedent had retained certain interests. (The IRS has really complex rules for this). The rates have changed over the years - starting at 10% and growing to 70% in 1935. (It's somewhere around 45% now - not quite sure where we are on the phasedown).

The tax only applies to a small percentage of the extremely wealthy (some studies suggest about .5% of the population). The short reach is because of the size of the exclusion; most people’s estates don’t come anywhere near this amount. And as always, there a lot of ways to avoid a substantial portion of the estate tax (for instance making tax-free inter-vivos gifts).

...

One of the practical arguments often made for the estate tax is that it ensures that the wealthy are being taxed on capital gains. When appreciated capital assets are left to heirs, under current law they get a basis step up. So because the capital gains are never realized, they are never caught by the income tax. The estate tax, however, taxes the transfer. IRS 1014 and 1022.


A comment from aMike said this:

As far as I know, the idea first received wide distribution in the United States from a most peculiar source, the Robber Baron and Philanthropist Andrew Carnegie. Way back in 1889 he wrote a tract called The Gospel of Wealth.

Carnegie argued against the bestowing of large estates upon the children of the wealthy primarily on two grounds. First, it was harmful to those who received the inheritances (I wonder if we'd call this the Paris Hilton effect today?):

Carnegie said:

Why should men leave great fortunes to their children? If this is done from affection, is it not misguided affection? Observation teaches that, generally speaking, it is not well for the children that they should be so burdened. Neither is it well for the state. Beyond providing for the wife and daughters moderate sources of income, and very moderate allowances indeed, if any, for the sons, men may well hesitate, for it is no longer questionable that great sums bequeathed oftener work more for the injury than for the good of the recipients. Wise men will soon conclude that, for the best interests of the members of their families and of the state, such bequests are an improper use of their means.


Second, he argued that largely taxing inheritances away was beneficial to the state and community as well:

The growing disposition to tax more and more heavily large estates left at death is a cheering indication of the growth of a salutary change in public opinion.... Of all forms of taxation, this seems the wisest. Men who continue hoarding great sums all their lives, the proper use of which for public ends would work good to the community, should be made to feel that the community, in the form of the state, cannot thus be deprived of its proper share. By taxing estates heavily at death, the state marks its condemnation of the selfish millionaire's unworthy life.


Then, in response to the argument that people often lose the "family farm" because of the estate tax, ElaineinIN said this:

The thing that the purveyors of the "death tax" garbage don't like to tell us is that there actually already ARE provisions in the estate tax code that give preferential treatment to farms and small businesses. For example, Section 2032A is called special use valuation... if you have land that is being actively farmed, it is valued as farm land, even if it would be worth more per acre if it could be developed. Also, Section 6166 allows certain estates that have concentrations of stock, like family owned businesses, to pay the tax in installments over 10 years at like 2% interest so that the business doesn't have to be forced into liquidation.

And amusingly enough, Section 2057 had a deduction for qualified family owned business interests, which basically excluded certain interests in businesses that were being run by family members. It was limited in value and the rules were really tight, but it was there. What happened to it?

It was repealed as part of the SAME bill that repealed the estate tax. Because they cared SO much for small businesses....


Basically, if you read through the reasoning, the idea is that we, as a matter of public policy, want to encourage wealth created by work rather than simply because someone was born in the right family. It is also considered better if the money keeps getting reinvested in the economy rather than hoarded.

The Perils of Covenant Marriage

Blogger Brian over at Audience of One has pointed out some problems with the Covenant Marriage statute.

Brian says:

How about some hypotheticals? Some people might consider the following reasons to ask for a divorce. None would be legal grounds under the covenant marriage laws. Which ones do you think are legitimate? For all of these, the offended spouse has asked for change, requested counseling, and made great effort to change the offending behavior.

1. Peggy marries Joe and for a few years everything is fine. Then Joe begins to spend more and more time at the casino and a fair portion of the family’s income ends up being spent at the blackjack table. As a consequence they are sometimes unable to meet their financial obligations.

2. Tom marries Sue and the newlyweds enjoy a honeymoon period. Suddenly Tom becomes much more adamant about his religious beliefs, asks his wife to throw out most of her wardrobe for being too provocative, insists that the family give 25% of their income to the church, and insists that she stop a variety of activities that he now considers to be sinful.

3. Jack marries Letha who at the time of their marriage weighs 120 lbs and has long, flowing hair. Three years later she weighs 275 lbs and has cut her hair to a “butch” look. No medical condition is present. He now finds her unattractive and tells her so. She resists all entreaties to lose weight.

4. Joe marries Shirley and they have a rollicking sex life in the early years of their marriage. Shirley becomes totally uninterested in sex and tells Joe she stills loves him but has no intention of having sex with him in the foreseeable future. She states that her libido is just gone.

5. Jenny marries Rick who is an avid outdoorsman. But once they marry his occasional fishing or hunting trips become almost an everyday event. He is either working, sleeping, fishing, or hunting. He is always polite to her but pays her little attention, focusing all his energy on his outdoor pursuits.

6. Jo Ann and Thomas are both married in the church they grew up in. Thomas goes on a business trip and becomes enchanted with an Eastern religion, far different from the faith they shared when they were married. He spends much energy trying to convert her and their children into his newfound religion and she is strenuously opposed to it.

7. John was such a frugal guy when he and Peggy Sue got married. He hits middle age and suddenly becomes an absolutely wild spender. He buys a new Corvette convertible, a Harley Davidson, has plastic surgery on his face, and takes up flying planes. All of his activities are rapidly draining their savings which they had always said would be for retirement. She is afraid that if she doesn’t do something she will have no savings when she retires.


Covenant marriage has been proposed in Oklahoma, but failed to pass by one vote in 2002.

Sunday, May 06, 2007

Sunday Music: Roxette

It is a rare thing when one person or group would be entitled to 4 of their songs on my Sunday Music posts, but Roxette is no ordinary group. They have had a long and distinguished career pumping out great pop/rock songs. In fact, based on what I saw on YouTube, they are still going.

I don't know what it is about Sweden; for such a relatively small country, it seems to produce a lot of big pop stars and groups. From ABBA to Roxette to Ace of Base, Swedish musicians regularly hit the top of the charts in America. They must have a great music school there.

Actually, you could expand that to all of Scandanavia. A-ha was from Norway and the recent winner of Europe's Eurovision music contest was won by Lordi, a Finnish heavy metal rock band wearing ghoulish costumes.

Without further ado, here are 4 Roxette music videos:

From their Tourism CD:



How Do You Do!:


From thir Joyride CD:



Joyride:


Church of Your Heart:


From their Look Sharp! CD:



Dangerous:


Or you can just get all their best hits:

Saturday, May 05, 2007

Atul Gawande: Can This Patient Be Saved?

In a guest editorial in the New York Times, Atul Gawande, a general surgeon at Brigham and Women’s Hospital, a New Yorker staff writer and the author of the new book “Better” analogizes America's health care crisis to a patient who comes to him with a tumor too late to fix:

As a surgeon, I’ve seen some pretty large tumors. I’ve excised fist-size thyroid cancers from people’s necks and abdominal masses bigger than your head. When I do, this is what almost invariably happens: the anesthesiologist puts the patient to sleep, the nurse unsnaps the gown, everyone takes a sharp breath, and someone blurts out, “How could someone let that thing get so huge?”

I try to describe how slowly and imperceptibly it grew. But staring at the beast it has become, no one buys the explanation. Even the patients are mystified. One day they looked in the mirror, they’ll say, and the mass seemed to have ballooned overnight. It hadn’t, of course. Usually, it’s been growing — and, worse, sometimes spreading — for years.

Too often, by the time a patient finally seeks help, I can’t help much.

...

It’s as true of societies as of individuals. We did not muster the will to reform our long-broken banking system, for example, until it actually collapsed in the Great Depression.

This is, in a nutshell, the trouble with our health care crisis. Our health care system has eroded badly, but it has not collapsed. So we do nothing.


Gawande suspects the only way to get reform is for the health care system to collapse:

The only time the country has enacted a large-scale health system change was after a collapse. In 1965, when Medicare was created for the elderly and disabled, some 70 percent had no coverage for hospital costs. We’re not that badly off yet. Our health care system is like one of those tumors growing in my patients. The only questions are: When will it become bad enough to make us act? And will that be too late?

Reformers think we’re on the verge of waking up some morning, looking in the mirror and noticing the size of this tumor with enough alarm to do something radical about it. But isn’t it more likely we won’t?

Malcolm Gladwell has argued that when health care costs drive General Motors into bankruptcy, and 300,000 workers lose coverage overnight, that will be the next big crisis to prompt wholesale change. I thought so, too. But it now looks as if G.M. will instead wither slowly, shedding a plant here, a division there. And faced with a slow withering, we all just muddle on.

The case for sweeping reform — for severing health insurance from the workplace and creating a new system — is undeniable. But it’s going to be a long time before the large majority of Americans with decent coverage are persuaded to risk changing what they have. How then to cure a malignant health care system? Can we act before the patient collapses?


Gawande says "yes," but that, he wrote, will be his next column.

What's that saying? "An ounce of prevention is worth a pound of cure." But a pound of cure is so much more profitable. I suspect that is the real reason we are not seeing real reform.

Here is a link to Mr. Gawande's book on Amazon.com:

Friday, May 04, 2007

DOJ Priorities: Voter Fraud Over Murder Cases

A prosecutor in Washington state sent an email to Josh Marshall of Talking Points Memo:

I've read TPM for years, and appreciate your work. I email you because I read something today about the firing of John McKay that finally put me over the edge.

Apparently during Comey's testimony today he said that one of the reasons McKay got himself in hot water with the DOJ heavyweights was because he was pushing for additional resources to investigate the murder of Tom Wales, who was an Assistant US Attorney in Seattle. Tom Wales was shot and killed in 2001. What nobody has talked about, and what you may not be aware of, is the fact that Tom Wales was extremely active in attempting to get tighter gun control laws passed here in Washington.

Think about that for a second. A pro-gun control federal prosecutor was shot and killed. John McKay was agitating for more resources to bring his killer to justice. That pissed off DOJ, who apparently thought that McKay should spend his time going after bogus voter fraud prosecutions rather than solve the murder of a guy who was in favor of gun control. If you don't think the fact that Tom Wales' political views weren't taken into consideration by the higher ups at DOJ when they decided to punish McKay for fighting to find his killer, you haven't been paying attention to the way these guys have operated for the last 6 years. Every single thing they do is about politics, and the political views of those they help or hurt.

The bottom line of this whole McKay firing could be summed up in this way: try to catch killers, you get fired. File BS charges of voter fraud, you keep your job.

It's a slap in the face to every prosecutor in the country. It's our job to seek justice for those that aren't able to seek it for themselves. None of us should give a damn what the political views are of the victims we try to protect. It's beyond reprehensible for them to punish McKay for doing this. But for this administration, it's par for the course.


You can follow more of this story (with more links) at TPM

***Update***

Here is a video made my Josh Marshall of McKay's appearance on public television:

Tuesday, May 01, 2007

72 Year Old Woman May Have To Live In Car

Elizabeth Warren relayed this story today in The Uninvited Witness:

How did this woman (let's call her Mrs. Norman--not her real name) end up in bankruptcy? She had lost her husband 18 years ago, and she had moved to another state [to] care for her older sisters who had now passed on. She had a small house and was managing the mortgage and her other expenses just fine when she got a call from the nicest lady at the bank about three years ago. The bank lady explained that Mrs. Norman was "in the wrong mortgage" because it was fixed rate and "interest was low." She said she could "switch" Mrs. Norman to a lower cost mortgage. The bank lady promised to call her when interest rates went back up and switch her back to the fixed rate mortgage. But, said Mrs. Norman, "she never called." Now Mrs. Norman's mortgage payments have shot up, and she is about to lose her home. So she filed for bankruptcy.

Of course, bankruptcy won't be able to do much for her. She can't make her mortgage payments and she can't refinance, so she will lose her home. She thinks that soon she will be living in her car. But she was will be required to get approved credit counseling before she can get a discharge.

At today's hearings, the credit industry representative trumpeted that the new credit counseling provisions were a sign of how well the bankruptcy bill is working. It will undoubtedly be a big help when Mrs. Norman's credit counselor explains how she can improve her financial management from the front seat of her 19 year old automobile.


This sounds a lot like the stories I heard today at the Ask-A-Lawyer program. Will any good come out of these stories? How long will middle class people accept such outcomes? Will they recognize who was responsible for this travesty?

Ask A Lawyer

I just finished working the Ask-A-Lawyer for Law Day (May 1st every year) on the public television tonight. I was there all day. I handled most of the bankruptcy questions all day. I made it on TV a couple of times when the TV crews came in started filming (almost always in the background). I participate in it every year. From my perspective, I get to learn from the questions that people ask and the lawyers who answer in their area of expertise. I heard some truly heartbreaking stories from people who are in debt and have no way of affording an attorney of getting out.

The situations would have tough enough under the old law, but now things are virtually impossible for them. One woman cried several times as she told me about how her husband left her with all kinds of credit card debts and now she is going to lose her house because she can't make the payments on it either. In the time since her husband left she has become disabled but it will take two years to get a settlement from the Social Security Administration.

It just goes to show that when it rains it pours.

I heard from a man who used his credit cards gambling at the local casinos. He learned the hard way that they don't build casinos on winners.

Actually, I heard several stories today of people whose husbands, wives, sons or daughters used their credit cards to gamble at the casinos and lost massive amounts of money.

I heard another man whose employee had embezzled massive amounts of money from him.

Anyway, now I'm tired after a long day of answering legal questions.

I want out of this business. I hate not being able to help people. People need to have hope for the future. Under the new bankruptcy law, people can't get out of debt and they can't bankrupt them either. I think this contributes to a casino economy mindset -- as in: "I can't get ahead unless I win a jackpot at the casino."

I honestly wonder just how popular the casinos would be if Okies made higher wages sufficient that they could save for the future.