Self-interested in Liberty

For years it has rubbed a raw nerve whenever some pontificating pundit has put forth the idea that red-state individuals vote against their self-interests, but the discussion has been perverted so far that it took Frank Rich’s 4000+ word screed in New York magazine bashing readers about their heads with an almost mechanical redundancy to make me realize precisely where the problem lay. His extended article fired my imagination about what the true self-interests of the voters actually are, for I believe that Trump voters made a statement that does, per se, express their self-interest, but in so doing showed a preference for ideas which fly right over the pointy and outsized heads of the misguided unfortunates on the left.

Rich’s extended naval-gazing exercise regarding the arguments among many ‘progressives’ about the recent election was one of the most depressing pieces about America that I have read in a while (and that is time I will never get back). Not because of his premise, that working-class white Trump voters are all just bigoted rubes too dumb to realize that they need government to help them get ahead in life. No, the depressing part about this article was just how far the left has allowed the frame of the discussion to shift over the past few decades. Milquetoast conservatives of the Bushie brand have certainly contributed to this apocalyptic shift, but the distortion has largely been driven by ‘progressives’ and their toadies in the press, the government bureaucracy, and colleges and universities throughout this land.

So what is this seismic shift that has led to increased partisan divide and an inability of blue-staters to comprehend the thought processes of half of our population? It unfortunately has become part of the accepted narrative of our current politics that people who vote for less government are voting against their own self-interest.

Now this supposition may not seem remarkable to many of you, and in fact this new narrative may seem like just an ‘obvious’ statement – certainly to more ‘progressive’ readers. Many people may even believe that this is just a self-evident ‘fact’ and may even reject my hypothesis that this is a ‘new narrative’. But for those of us in the enlightened ‘traditional liberal’, i.e. conservative, camp this is a point that remains highly in doubt and one that should not be accepted without vigorous opposition.

Rich makes an argument that Trump’s working-class voters are so lost in their own red-state bubble that it may not even be worth the trouble for the Democratic party to try to reach out to them:

The most insistent message of right-wing media hasn’t changed since the Barry Goldwater era: Government is inherently worthless, if not evil, and those who preach government activism, i.e., liberals and Democrats, are subverting America. Facts on the ground...do nothing to counter this bias.

The ‘facts on the ground’ he refers to are the loss of working class jobs (which he attributes to greedy free market corporate robber barons) and the opioid epidemic (undoubtedly the fault of greedy pharmaceutical robber barons). He then goes on to say that:

The notion that they can be won over by some sort of new New Deal — “domestic programs that would benefit everyone (like national health insurance),” as Mark Lilla puts it — is wishful thinking.

But herein lies the fallacy of his thinking: believing that the only thing important in the lives of these people is the number in their bank account, health insurance, and the accumulation of material things around them. He makes the case that great unwashed hordes of hillbillies are really just out-of-work losers who don’t have enough brain cells to realize that the government has freed them from work (via NAFTA) and furnished them with financial aid and cheap imports from China, and that instead of being grateful and taking the blue pill for more of the same, they have opted for OxyContin induced bliss and early death. Only their always benevolent betters in government can save them from themselves.

By voting for Trump, however, they have cried out for a change in the national course. Glenn Reynolds’ article in USA Today makes a strong argument for one of the reasons why they have done so – the abject failure of so-called experts to solve our problems. The people want to be free of their overseers and provide for themselves. And one of the biggest barriers preventing these people from pulling themselves up has been the heavy hand of government, enshrining in regulation a Rube Goldberg apparatus of occupational licenses which purports to ensure competency of virtually every working person but instead offers a government provided protection racket to those lucky enough to already have a job while simultaneously reducing ‘expertise’ to the lowest common denominator.

Rich laments that Reagan’s dictum “The nine most terrifying words in the English language are: I’m from the government and I’m here to help” ‘remains gospel’ on the right, but it does so because for so many regular people it rings true. The media has repeatedly lambasted Trump and his supporters as anti-immigrant and used the words on the Statue of Liberty “Give me your tired, your poor, Your huddled masses…” to try to rebut his policy proposals but usually stops there without finishing out the phrase. It is instructive that to examine the rest of the poem, “The New Colossus” by Emma Lazarus, to see that Lady Liberty stands in contrast to the fallen Colossus of Rhodes, the “brazen giant of Greek fame, With conquering limbs astride from land to land”. She is not a monument to empire, or to what government has built. The “huddled masses” do not yearn for a handout from some self-titled ‘elite’, but yearn to breathe free: free from tyranny, free from the heavy hand of an unelected bureaucracy, free from self-righteous, patronizing, and smug pronouncements from urban pomposities who know nothing of the way of life or the values of half of their countrymen.

 

A Thought Experiment

A thought experiment: everything about you and everyone else is made public knowledge. Anyone can look in on your life and see everything you do. They can see what you eat, they see all of your interactions with other people, and they even see all of your sexual peccadilloes and when you masturbate. All affairs are revealed and all theft, fraud, and corruption free for anyone to sort through. The only things that you can hold secret are those things you keep in your own brain – never expressed to anyone or written down. Your diary is open.

 

What would you be ashamed about? What would you not want other people to know? This goes straight to what you consider to be right and wrong. This dives deep into religion and even sense of self.

 

This is essentially the state we find ourselves in with the most recent revelations of the extent of the spying ability of the United States government. And with the exponential advancements being made in technology – artificial intelligence, ubiquitous cameras and drones, aerial surveillance, facial recognition software, DNA storage capabilities – it is only a matter of time before all of our activities all of the time from birth to death will be captured in some huge database. Of course the spymasters will say that the only access to that database will be through judicious use of warrants. But if the policeman can get access to the database, certainly hackers will get access to the database, and sooner or later it is going to be fair game for everyone.

 

There are people who say ‘I have nothing to hide. Only people who have done something wrong need to worry.’

 

I fear the implications of this are much more dire. When employers can know all the employees’ medical results, when businesses can pull up the dirty laundry on the executives of their competitors, and when governments can monitor any activity that they may not approve of, where will we be? Forget about negotiations and market tactics – useless. Economies would crumble.

 

There are fundamental questions here. It all has to do with the power some people hold over other people. I wonder whether humans can live and work together without any personal privacy. I don’t know that I would want to live in that type of society. I don’t know that I will have any choice. This may solve the question of why we have not been contacted by other advanced civilizations. This may be why civilizations die.

Old school

A recent post at db’s medical rants addressed the question of whether or not the skills of history taking and physical exam have declined in recent years, and he asked the question ‘What does old school mean to you?

To me ‘old school’ means taking a good history and then performing a focused physical exam. So what exactly does this entail?

History:

Old school:

Questions are asked regarding the patients known medical conditions and the problem at hand. Relevant information is discussed, often but not always including some details about the patient’s occupation and family. If I am sewing up a laceration on someone’s leg from a chainsaw accident, I don’t need a family history, (but I might want to ask if any substances were involved). Treating a swimmer’s ear does not require much history at all, unless this is a recurrent problem or unusual presentation. On the other hand, a patient presenting with heart failure may need an hour’s worth of history, exploring other medical problems, current and past occupations, extensive family history, living conditions, and any history of substance abuse. The history adapts to the situation. I personally do not take notes or use a computer when taking a history – talking with the patient and looking them in the eyes

Modern reality:

In order to bill for the visit you need to make sure that you have checked enough items under the history of present illness, that the past medical history is documented, a social history is documented, a family history is documented, and an extensive review of systems is documented. Most of this is clerical data entry and is done by nurses or medical assistants. If you are very efficient you can click through the boxes to get a level 4 visit paid in a few minutes.

Physical exam:

Old school:

Hands on exam including (for me) listening to the heart and lungs of every patient, and then a focused exam regarding the issues that need to be addressed. In patients with diabetes or hypertension, a (gasp!) fundoscopic exam can be very useful. Looking at a patient’s hands can provide an encyclopedia’s worth of information. When patients complain of gout we actually have them take off their shoes and socks and (double gasp!) touch their feet.

Modern reality:

Too many doctors do not even examine the patient. They look at the electronic health record and click off the boxes. The entire physical exam section of the clinical note is boilerplate to fulfill billing rules. Patients tell me that they have seen doctors who did not examine them at all but stood by the door and diagnosed them based on what was in the computer. Some doctors seem to think that their patients are ‘icky’ and do not want to touch.

The problem of modern medicine

The problem today is a mentality that the history is all you need and then technology – lab tests and imaging – will make the diagnosis clear. This mentality has been driven by a number of forces. The most important force that drives everything in medicine is money. The way doctors are paid is insane. Take, for example, a challenging patient with a rare medical condition seen by two different doctors:

Doctor #1

Doctor #1 was the top of their class, well educated, sharp, engaged, and takes time to do a thorough history and physical exam on the patient. The doctor comes up with a presumptive diagnosis and sends a lab test to confirm or exclude the condition. After one hour, doctor #1 bills for 1 level 5 visit and a lab test. The insurance company refuses to authorize the lab test because it is for a rare condition and the bean-counter there has never heard of this test. They also question whether doctor #1 is billing too many level 5 visits. The patient then gets a huge bill from the lab company and makes an angry phone call to the doctor. The doctor’s practice goes broke and he burns out.

Doctor #2

Doctor #2 was at the bottom of their class and has no clue as to what could be wrong with the patient. He spends five minutes with the patient, orders 100 lab tests, and refers the patient to a specialist. He then goes on and treats eleven other patients that hour in the same way. After one hour, doctor #2 bills for twelve level 4 patient visits, 1200 lab tests, and laughs all the way to the bank.

 

Which doctor do you want? Doctor #2 may be just fine if you have pink-eye or a stubbed toe, but what if you have amyloidosis and need a heart transplant? Why does the system favor doctor #2 so much?

 

Old school

You must put hands on the patient. There is a tremendous amount of information that is gathered by simply listening to the heart and lungs. Patients often do not tell everything up front. You can take a history that you think was complete and all of a sudden you see a scar and ask about it. A patient will then spill out ‘Oh I had heart surgery as a kid’ or something similar. (it would have been helpful if they had mentioned it before)

Check-boxes and past medical history forms are not sufficient to obtain a medical history –they are only tools to get paid.

What ‘old school’ seems to mean is actually being a doctor. Taking time with patients, touching patients, and examining them is essential to medicine.

Some doctors think that it is OK to not learn about different heart murmurs – just get an echo. What a waste of resources! This is why medical care is so expensive. Yes, an echo can tell you more about the heart, but the way the medical system is now this requires time, money, and lots and lots of paperwork – er, computer data entry.

If we were paid a salary as doctors instead of fee-for-service everything would be much easier. Then we could use echo machines for diagnosis and not worry about what billing code we need to use and making sure that we have a complete study. If our payment system were different we would all be using mini echo devices just as we (well, at least some of us) use a stethoscope today.

This is why doctors switch to concierge practices. Unfortunately this is not an option for most specialists.

Medical Thinking

There are two main ways of thinking in today’s medicine. One is the mentality of Obamacare and the use of business techniques – specifically from manufacturing – to improve throughput of the system and reduce cost. The goal is to improve ‘justice’ in the system by proving care to the most people possible. The quality of the care is measured by population metrics – cost, number of infections, mortality, etc. Doctors and patients are essentially interchangeable widgets in this system, and all medical problems can be reduced to a basic set of algorithms that will dictate care. Actually, because thinking is no longer required in this algorithmic, guideline driven system, the role of the doctor is not that important, and physician ‘extenders’ may be used as interchangeable parts. If some patients fall through the cracks and are misdiagnosed, mismanaged, or ultimately die, that is the cost of increasing ‘justice’ throughout the population.

 

The second way of thinking is ‘old school’. Each patient is considered unique, and every doctor/patient interaction is precious. Time must be taken to get a good history, which will then guide a hands-on physical exam, lab tests, and ultimately diagnoses and a plan of care. The process cannot be rushed, but takes the amount of time needed to come to a good outcome. Extensive training is required to be able to consider the multitude of possible diagnoses. This way of thinking is clearly better for the individual patient (and for the doctors) but is resource intensive.

 

If I were to devise a health care system for this country, I would take a cue from business and the way technical support is handled. This approach would maximize the benefit of both approaches above. Young and/or generally healthy patients would use a ‘level 1’ system which is the first option above. NPs, PAs, and primary care MDs would handle the vast majority of complaints (URIs, UTIs, minor injuries) in an urgent care type setting. Patients with multiple problems or who have failed treatment at ‘level 1’ would then be elevated to ‘level 2’ where experienced general internists would see the patients, optimally no more than ~8 per day, and take time to go through all of the medical problems, take time to educate, and diagnose more severe problems. ‘Level 2’ internists would then consult specialists as needed.

Anyone concerned about bathrooms is an idiot

I honestly cannot understand what all the fuss about transgender people and bathrooms is all about. It seems to me that common sense should prevail. Tonight on the Tucker Carlson show, Zac Petkanas, a democratic pundit, was interviewed and stated repeatedly that gender is determined by how people self-identify. This is absolutely absurd on it’s face. Tucker then asked him the entirely reasonable question whether race is determined in the same way, but Mr. Petkanas said no. This is clearly incongruous. If we are going to put aside biology and use self-identification to determine gender, then the same logic should be applied to race. And therefore logically any white man should be able to claim to be a black woman for the purposes of, say, getting into a University. This is insanity.

Biology is biology, despite people wanting to deny that. Men are men, and women are women, but I believe that gender biology as well as gender identity exist on a spectrum, and for a very small portion of the population in the middle of this spectrum gender is ambiguous. Still, other than a very tiny fraction of people who are hermaphrodites or have mixed gonads, the biology is clear. The majority of people in the world are men who identify as men or women who identify as women. There are a small number of people for whom this does not apply, but this still does not change biology. A man who identifies as a woman is not a woman, but a man who identifies as a woman, and vice versa. Anyone who says otherwise is a nitwit and a biology denier.

That being said, what any one person wants to call himself or herself makes no difference to me. If a man wants to go around saying he is a woman, or a woman wants to say that she is a man, that is fine with me. All I ask is that if I am going to be accepting of you and be sensitive towards you that you do the same for me. If you appear to be a man and I address you as a man, please do not take offense if you want to be addressed as a woman. I will try to be sensitive, but please do not go out of your way to take offense.

As far as bathrooms are concerned, what I want to know is where are the bathroom police who are checking? If you identify as a woman, use the women’s bathroom. If you identify as a man, use the men’s room. I certainly am not going to check whether you are what you say you are.

People who want to be divisive are ginning this entire issue up, and it serves no one any good. People who are ignorant or bigoted about transgender people may have irrational fears about these people being ‘dangerous’. I think this is a personal problem for the people who are afraid, and education and kindness can overcome this problem. But I believe that there are more people on the left who are just looking for ways to take offense in order to push their agenda.

If everyone would just mind their own business and stop trying to tell other people how to live the world would be a better place.

Climate Shame

Once again we have revelations of data manipulation and false information in the ‘settled’ science of the global climate. This reveals what I have long argued: ‘climate change’ is a scam.

Now before you dismiss me as a ‘climate denier’, please, hear me out. I am an environmentalist and hope that we continue to work to manage our pollution better. But this entire issue really has nothing to do with the environment.

I have a few points to share that may upset the sensibilities of people who are convinced of the coming climate catastrophe:

1) Climate changes, life goes on

The climate of this planet has changed over the eons and will continue to do so in the future. Wishful (magical) thinking on the part of activists will not cause the climate to suddenly stop changing to suit their tastes. Human activity likely is contributing to that change, but how much and what to do about it remain topics of hot debate.

I hate to break it to you bleeding-hearts, but the planet will continue to do just fine for the foreseeable future. One hundred, five hundred, one thousand, or one million years from now there will be life in abundance on this planet, whether human or not. Whether we blow ourselves up with nuclear bombs or trash the planet with poly-cyclo-benzo-whatevers, life will find a way.

2) Species go extinct

Look at the fossil record and you will see countless species that have developed and then gone extinct over the ages. But now all of a sudden because some econutballs have ‘awareness’ of the environment, everything is supposed to remain static. If I understand the green fringe elements, any species that roams the earth at this moment is sacred and it would be a tragedy if we let any of them die out. This not only goes for the large mammals, but also for the left-handed-green-spotted-wharf-snail in Kalamazoo. I am all for preserving areas where wildlife can live, but I think the way to go about it should be for the environmental groups to buy land and then keep it natural. Bringing government into the equation is only a power play by the weak – they can’t get their way through persuasion so they must hire (elect) people with guns to enforce their way of view. And expecting all living species today to continue on in perpetuity is a pipe dream.

3) Science is messy

Science is never ‘settled’. In fact, the majority of scientific advancement is achieved by disproving previously known ‘truths’. Trying to predict the future is a fool’s errand. Just look at your local weather: models have gotten quite good at predicting the next few hours or even days of weather, but is it going to rain where you are one month from now? Who knows? There are just too many variables for us to be able to comprehend this system entirely.

I know what science is like – I have published a number of papers myself – and anyone else who has published a peer-reviewed scientific paper will know the magic of statistics. You can take raw data and analyze it by many various methods, you can fill in gaps in the data in many different ways, and you can drive the outcome of a study towards a desired goal in the process, if one were so inclined. Every scientist makes personal justifications for these manipulations, and every one will find their position on the spectrum of what is and is not allowable. The more manipulation of the data that takes place, the further from ‘pure’ science we go. And this brings us directly to the next point:

4) Many climate scientists have an agenda clouding their judgment

What are these agendas? They are different for each individual, whether it is a desire for tenure, status, and respect among peers; righteous indignation towards polluters; disdain for American capitalism; or some combination of these, the agendas of the individual may drive them away from ‘pure’ science and allow them to justify data manipulation to the point of a reversal of the true findings of the study.

So deeply ingrained is the ‘global warming’…err ‘climate change’ paradigm that many scientists cannot see their data objectively. They resist change fiercely, and will go to great lengths to defend their theory. As Thomas Kuhn puts it:

The source of resistance is the assurance that the older paradigm will ultimately solve all its problems, that nature can be shoved into the box the paradigm provides. Inevitably, at times of revolution, that assurance seems stubborn and pigheaded as indeed it sometimes becomes.

Kuhn goes on to say that the ‘assurance’ of scientists allows science to proceed, but the resistance to change is often so strong that it takes the dying out of an entire generation for new ideas to take the place of the old way of thinking.

5) It is all about money and power

Most of the powerful players in this game couldn’t care less what the temperature of the planet will be in fifty or one hundred years. What they do care about is money and power and how to manipulate people, governments, and corporations. The only proof you need: were climate activists and government officials so concerned about carbon they would set up internet tele-conferences instead of flying on their private jets to conferences in Paris, Geneva, and Davos. Everyone wants clean air and clean water, so this serves as a useful front for their bait-and-switch game.

that, ladies and gentlemen, is the Inconvenient Truth.

Leeches!

 

In ancient Greece an imbalance in the proportions of the human body’s four “humors” — blood, phlegm, black bile, and yellow bile — was believed to be the cause of ill health. Bloodletting using leeches was one method used by physicians to balance the humors, and this practice continued through the ages.

 

Modern medicine continues to use the leech in a few ways, mostly through the use of hirudin, lepirudin, and bivalirudin, but for most people the lowly leech (Hirudo medicinalis) is viewed with horror and disgust for the blood-sucking parasite that it is.

 

And this brings us to the American Board of Medical Specialties (ABMS) and its ‘Member Boards’ and the Maintenance of Certification (MOC). In ancient times the ABMS had its place, and hopefully we can take the best parts of MOC and use it in new and different ways. But it is time for all doctors to see the ABMS for the blood-sucking parasite that it has become.

 

And it is with horror and disgust that we see all that Westby Fisher and Charles Kroll have uncovered.

•  It is time to pull off the leeches that are sucking us dry!

•  I call for all Board positions to be held by practicing physicians – no ‘professional class’.

•  I call for a federal law to mirror the Oklahoma Law to free all physicians to practice without the dark shadow of MOC looming over them.

Trump Derangement Syndrome

We have once again preserved our tradition of a peaceful transition of power and a new president has been sworn in, but the Washington bubble has not even begun to comprehend what has actually occurred. It has been with some amusement that I have watched the machinations of the media trying to put together complete sentences without betraying either their utter contempt for middle America or their stunning obliviousness.

 

My personal thoughts on Trump are as yet not fully formed, but on day 1 it seems sporting to give him a chance. We still haven’t quite hit on the right term for the collection of people who have been so dismayed by the election results that they are still sputtering sneering sophistries two months on; bubble inhabitants, coastal elites, and Washington insiders each leave something to be desired.

 

Of course we all knew this group would include most of the liberal ‘mainstream media’, but what a disappointment to see how many of the more conservative pundits have seemed to have lost their lucidity in their rush to judge the new man at the helm. This serves as another reminder of just how far the chattering classes have gone off into their collective delusion.

 

Trump said:

For too long, a small group in our nation's Capital has reaped the rewards of government while the people have borne the cost. Washington flourished, but the people did not share in its wealth. Politicians prospered, but the jobs left, and the factories closed.

The establishment protected itself, but not the citizens of our country. Their victories have not been your victories; their triumphs have not been your triumphs; and while they celebrated in our nation's capital, there was little to celebrate for struggling families all across our land.

And…the media blathered, froth foaming from the mouth, not even realizing that they themselves had just been called out for their part in the damage that has been done.

 

So what is this damage? It has been repeatedly reported over the past few days that unemployment is low, the markets are up, and the Donald’s poll numbers are so low that there ‘clearly’ must be ‘no problem’. But anyone outside of the bubble knows what is wrong, and anyone who knows something about statistics knows that there are ways of cooking the books.

 

I know many people don’t want to think about math and statistics and there is a little danger of getting lost in the weeds here, but let us delve into the numbers just a bit to see what exactly I mean when I say “cooking the books”.

Unemployment

First of all we have unemployment. Here is the graph all of the media want us to see:

 

 

 

At the left side we see the effects of the 2007-2008 financial and housing crash with a huge jump in unemployment. Then from about 2010 forward we see a slow steady decline in the unemployment rate back to under 5% today. Looks great, doesn’t it?

 

But what about this graph depicting the labor force participation rate?

 

 

There has been a major drop in the percentage of the population that is working since a high in the late 1990s. Here is a closer look at just the past ten years of that graph:

 

 

There has been a slow and steady fall of the percentage of the population that is working. Well, you may say, this must be due to the aging population and all of the retiring Baby Boomers, right? Well…maybe…but if that were so would we not also expect to see these effects consistent across multiple data sets?

 

Take a look at the next few graphs – first, here is the US population:

 

 

…then we have the raw number of employed people in the US:

 

Now let us look at the upper right corner of these two graphs. I have taken the curves and scaled them in order to plot them together, but the raw numbers have not been changed. Feel free to try this yourself with the data available from the US Bureau of Labor Statistics.

We see that something really funny happened around the time of the Great Recession. All of a sudden, the graph of employed people took a big stutter step down and it has not returned to the historical average line. The ‘renormalization’ of the data explains much of the funny business in the unemployment numbers, and when the BLS says it is all due to population shifts you can just drop the L from their acronym: BS.

Markets

Now we go to the markets. Here is a quick snapshot of the Dow Jones Industrial Average over the past thirty years or so:

Looks great, doesn’t it? Fantastic growth! Wow! And big growth during the Clinton and Obama years! How can you dispute that? Well, if you are someone like Paul Krugman, you don’t, you simply pass on the lies and get applauded by the clueless for ‘astute observations’.

 

But disputing the graph is simple, if you dig below the raw numbers. Let’s take a look at the components of the DJIA towards the end of the Reagan era:

1987

Allied-Signal Incorporated Eastman Kodak Company Navistar International Corporation
Aluminum Company of America Exxon Corporation Philip Morris Companies Inc.
American Can Company General Electric Company The Procter & Gamble Company
American Express Company General Motors Corporation Sears Roebuck & Company
American Telephone and Telegraph Company Goodyear Tire and Rubber Company Texaco Incorporated
Bethlehem Steel Corporation International Business Machines Corporation Union Carbide Corporation
The Boeing Company International Paper Company United Technologies Corporation
Chevron Corporation McDonald’s Corporation USX Corporation
(fmr US Steel Corporation)
The Coca-Cola Company Merck & Co., Inc. Westinghouse Electric Corporation
E.I. du Pont de Nemours & Company Minnesota Mining & Manufacturing Company F. W. Woolworth Company

 

Some big companies there…lots of manufacturing…aluminum, steel, cars, tires, airplanes, paper, utilities…companies that make things.

 

But that is quite different from the list of companies which make up the DJIA today:

2017

3M Company General Electric Company Nike, Inc.
American Express Company The Goldman Sachs Group, Inc. Pfizer Inc.
Apple Inc. The Home Depot, Inc. The Procter & Gamble Company
The Boeing Company Intel Corporation The Travelers Companies, Inc.
Caterpillar Inc. International Business Machines Corporation UnitedHealth Group Incorporated
Chevron Corporation Johnson & Johnson United Technologies Corporation
Cisco Systems, Inc. JPMorgan Chase & Co. Verizon Communications Inc.
The Coca-Cola Company McDonald’s Corporation Visa Inc.
E.I. du Pont de Nemours & Company Merck & Co., Inc. Wal-Mart Stores, Inc.
Exxon Mobil Corporation Microsoft Corporation The Walt Disney Company

 

So when viewing the DJIA graph, you have to take into account that the data points over time do not measure the same things. We are comparing apples to oranges. But what has changed? you may ask and the DJIA would argue that it has normalized company stock values (i.e. fudged the numbers) to try to keep the measure historically consistent and stable. In reality the entire universe might well have changed!

 

We see some things that you would expect. Some of the giants have remained (e.g. GE, du Pont, 3M with a new name, Proctor & Gamble, and IBM), and Coke and McDonalds still make the list. Old merchants such as Sears Roebuck and F.W. Woolworth have been replaced by competitors that helped take them down: Wal-Mart and Home Depot. Some technologies (e.g. Kodak) and habits (e.g. Phillip Morris) have fallen by the wayside and have been replaced by new ones (e.g. Apple, Intel, Pfizer).

 

But what is stunning is that the DJIA is now filled with a bunch of companies that really don’t make anything! American Express, Goldman Sachs, JPMorgan Chase, Travelers, Visa. We could also argue that Walt Disney doesn’t really make much that is tangible, and what about UnitedHealth?

 

Gone are Allied-Signal (aerospace, automotive and engineering, now part of Honeywell and off the DJIA), Navistar International (trucks, buses, harvesters, defense contractor), ALCOA (aluminum), Union Carbide (part of Dow Chemical), Bethlehem Steel, USX (US Steel), International Paper…

 

Yes, yes, I hear you: it’s the ‘service economy’. But most of the so-called ‘service’ of these companies is being done in a call center in Bangolore! And even the companies that build things like Apple and Intel don’t do their manufacturing in the US.

 

So the DJIA is a sham! Nothing more than shells remain where there used to be strong American assets, and these companies are owned and controlled by a tiny fraction of a percentage of our population. Let me be clear: this is the American carnage that Trump spoke about.

 

All of this became stunningly apparent to me after some of the uproar caused by the inaugural remarks. In his speech Trump stated:

“We will seek friendship and good will with the nations of the world. But we do so with the understanding that it is the right of all nations to put their own interests first.” (emphasis mine)

 

This statement seems self-evident to me – of course this is true. No country could survive long if it did not place its own interests first. But it is high time to bring back Spiro Agnew’s alliteration for the media because this statement was met by a bewildering barrage of buffoonery by the nattering nabobs of negativity.

 

The frenetic fisticuffs included words like ‘racist’ and ‘Hitlerian’ and paltering pundits had the United States withdrawing from NATO, shuttering bases in Korea, and sooner or later nuking Canada.

 

That a statement this plain and simple can ring true to untold millions of real-life Americans yet draw the scorn of the media ‘elite’ lays bare the truth of the disconnect: someone has moved. And I dare say that it was not the American people who moved, but the bubble inhabitants – off into ‘La La’ land.

 

And don’t tell me about the Marshall plan, and the Cold War, and the intentions of the late twentieth century deep state, because I grew up with knowledge of that world and know what it meant. What we are being told today about that the path the country was put on after World War II is a great lie brought to us by the worst generation this country has ever seen – the Baby Boomers, the ‘me me me’ generation that never grew out of its Woodstock dreams and still does not have this country’s best interests at heart.

 

While we are at it can we finally put to and end of the use of the term ‘elites’, whether they be political elites, corporate elites, media elites, or coastal elites? That is to say if we are to take traditional definitions of the term meaning choice, or best, or highest class, there is nothing elite about them.

 

One last thing (and this will really get their goat): Trump has essentially overturned the tables of the moneychangers…I wonder will they kill him for it?

The Deepening Problem of Truck Violence

With the news of the latest truck attack in Jerusalem it is fair to say that a pattern has developed and it is high time that we have a serious discussion about truck control laws. We need Congress and our new president to work together to develop a plan for keeping trucks out of the hands of terrorists. Too many people have been killed already for us to sit around and do nothing about this major problem.

I know that there are many people who think that trucks are not a serious problem, and many arguments will be put forth for the continued widespread availability of trucks in our society, so before the debate begins I would like to comment on some of the more common points that are brought up in the defense of trucks:

There are legitimate peaceful uses for trucks

This is one of the most common arguments for trucks today. But are there not alternate means for transportation of goods? We could expand the use of shipping, trains, and airplanes. New technologies such as drones will be used in the future for the sending of parcels. Why do we need to use such an outmoded method of transportation? Some people will insist on bitterly clinging to their trucks, along with their Bibles and hunting gear, but it is time to bring these people into a more modern age. A more progressive enlightened world view can herald a new era for such backwards folk.

Existing trucking licenses are enough to restrict the use of trucks to responsible owners

If this were true we would not be seeing the rash of truck violence that we are today. Just because someone carries a Commercial Drivers License does not mean that they are not violent or a terrorist. The existing requirements for health exams and driving tests are not enough. At a minimum the programs need to be expanded to include background checks for all drivers, and we need to prevent people with a history of felonies or violent crime from owning a truck. But recent terrorism cases have shown that even trucks under the possession of licensed truck owners/operators may be hijacked and used by terrorists for violent acts. Therefore the only way to meaningfully prevent more truck violence is to stop the sales of all trucks and take measures to get existing trucks off the streets.

People in a free society should be free to own trucks without government intervention

There are many precedents for the outlaw of general use of trucks. Do we not prohibit people from carrying automatic weapons or nuclear bombs? Should trucks get a pass because they are considered less dangerous? How many more people need to die before we do something about this terrible problem?

Trucks don’t kill people, people kill people

This is a silly argument put forward by people who want to continue to allow the free availability of trucks. Of course trucks, by themselves, are just physical objects and do not have minds of their own. However, just because a truck sitting by itself is not necessarily dangerous does not mean that a truck, in the wrong hands, is not a threat to society. People would not be able to kill other people with trucks if they didn’t have them in the first place.

People who didn’t have access to trucks could still hurt people

This is another of the foolish arguments given by the pro-truck lobbyists. Yes, people intent on hurting other people could still use knives or other weapons to hurt them, but that does not mean that we should go on allowing people to freely own such dangerous items as trucks that can be used to harm so many people so quickly. This goes back to the above mentioned limitations on the free ownership of automatic weapons and nuclear bombs.

Let us take the opportunity in this year of great political change to take a stand: let 2017 be the year we finally pass sensible anti-truck legislation. Do not let the demagogues in the pro-truck lobby sway you with foolish arguments.

That was easy…

I sent an email…

To Whom It May Concern:

I recently paid my dues for 2017 but on reflection I would actually like for you to refund my dues. I no longer wish to be associated with an organization that repeatedly undermines its members interests in order to enrich itself. The horrible way in which you have handled the MOC issue only reveals you to be part of the corruption. I hope that with our new president the Attorney General will investigate the ABMS, the ABIM, and the ACC and tear you all apart. Many of you need to go to jail.

Please issue my refund for my 2017 dues of $935. If you refuse to do so, I will get claim fraud with MasterCard. I will then file suit against the ACC for fraud.

Thank you

 

and it was granted…

Good morning, As requested, we have issued a refund in the amount of $935 to your MasterCard account, and will forward your resignation request to our member services department.

 
Kind regards,
 
Marcy Gregory
Resource Center
American College of Cardiology
2400 N St NW
Washington, DC 20037
202.375.6000 x5603
mgregory@acc.org
www.acc.org

Now if more people would do this it would turn some heads!