More on the Liverpool Care Pathway Controversy

Lost in the news about the election yesterday was an article in the Daily Telegraph on the uproar surrounding the Liverpool Care Pathway, or as it is known to some, Crematorium Lane. Over 1,300 doctors, nurses, and caregivers wrote to defend the policy, which is used in almost all UK hospitals today.

Since the inception of the concept in the 1990’s, doctors have been struggling with end of life care. The LCP is a multidisciplinary process of assessing and treating seriously ill patients with little hope of recovery. Solutions include cessation of treatment, withholding of food and water, and even of IV drips.

It is not an evil process in itself, but rather in its application. death comes to us all and death with dignity is a right.

But it has been revealed that many hospitals stand to reap performance bonuses for “Commissioning for Quality and Innovation” (CQUIN), or setting targets for the number of patients who are treated using this regimen.

In 6% of all cases, the families were never informed that their loved one had been placed on the Liverpool Pathway, and in 25% of the hospitals participating doctors and nurses had failed to inform the families in half of all cases. Strange statistics indeed. Consultation with the family is a centerpiece of the Pathway as written. There have been several calls for a parliamentary inquiry.

Statism is a way of life where bureaucracy takes over the simplest and most complex of decision making processes. In an article only the day before, the Telegraph reported on the case before the High Court of accident victims being placed on “do not resuscitate” orders without their families consent. There has been a litany of similar cases in the UK press of late.

In an article only a few weeks ago, family physicians are being asked to identify patients likely to di, which really, is all of us, in order to make the process more efficient. from those guidelines:

“Doctors are told to pick out such patients during routine consultations that show ‘indicators of frailty and deterioration’ and are told that ‘older people are a priority to consider”.

They are also told to use feedback from district nurses or hospital consultants, while patients in care homes should be “actively considered for your register”, the advice states.

So it is up to you. The brother of Rahm Emmanuel, Dr. Ezekiel Emmanuel, has argued eloquently for patient rights and against euthanasia. The Liverpool Care Pathway recognizes that same human dignity, but is failing in its application. When the sorts of abuses and potential abuses reported in the UK press are considered, we must once again reconsider state sponsored medicine.

 

Advertisements

Bush vs. Obama – Disaster Edition

There is another strange disconnect just before this election. As some New Yorkers dumpster dive and many Jerseyites spend another cold night without basic services, the president has been bouncing across the map like a pinball trying to shore up his election chances. What is more strange is how the press have given him a hall pass for doing so.

In 2005 in the aftermath of Katrina, the media made it its mission to blame Bush for every hiccup in the relief efforts. Whether it was the response of the National Guard or the New Orleans Police or FEMA, it was “Bush’s Fault”. On the other side of the Mississippi though, Governor Haley Barbour and his team quietly went about rebuilding his equally damaged state and never was the breakdown in leadership in Louisiana mentioned.

In New Jersey this week non-union power crews were shunned and went to Pennsylvania instead. 1,000,000 homes and businesses are without power in New Jersey. Rescuers are still finding new victims as of this morning.

400,000 homes and businesses on Long Island are without power with temperatures in the 30’s and 30,000+ are homeless in New York City. There are few if any television cameras. The election is sucking up all the air time.

The President on the other hand left the White House this morning for stops today in New Hampshire, Florida, Ohio and Colorado. He will not be back in Washington until Tuesday night. How can he have time to deal with the crisis if he is spending all of his time campaigning?

And the response from the media? crickets……

A new storm is moving in on New York and New Jersey and temperatures are in the icebox. Hundreds of thousands of people need shelter now. Would that the media might hold the President’s actions up to scrutiny, but we can be certain that isn’t going to happen. They have proven themselves completely partisan.

What will it take to force the media to do their job? How many people will have to die before they shine the spotlight on the limited efforts and engagement of our government?

Senator Coburn’s Government Waste List – The new phone book’s here!

Oklahoma Senator Tom Coburn has come up with his latest Waste Book listing many of the wonderful, bizarre spending projects our federal government funds. The preface points out that since the last budget was passed on April 29, 2009, our government has spent $11.2 trillion and added more than $4.8 trillion to the national debt which is now over $16 Trillion.

One of the first takeaways is that the NFL, and many other sports leagues are classified as non-profits, costing the economy approximately $91 Million/year in tax revenue. Roger Goodell and Jerry Jones have the best of all possible worlds; rapacious ticket prices; stadiums financed by local government; and no taxes on the partnerships that are the major sports leagues. I guess we should have pity on the poor NHL owners, but the PGA is right in there as well. There’s nothing quite like subsidizing professional golfers.

Burger King, KFC, Godfather’s Pizza, and McDonald’s all accept food stamps and while cities and school districts are waging war on soft drinks, over $2 billion in Food Stamp money was spent on these products last year. In Seattle, Starbuck’s is a popular food stamp item.

Parque Alegria, a series of 10 minute telenovelas being broadcast on Spanish language stations at a cost of $3-8 Million, including time buys, instructs viewers on how much healthier the Food Stamp program is, weaning them from El Pollo Loco to Burger King, I guess.

An unused airport in the Senator’s home state comes in for over $750,000 in subsidies over tha past few years. Morroccan pottery classes for $27 Million, Alex! Yep, we funded a series of useless classes in Morocco, where they have a ceramics tradition dating back over 1,000 years. There is also funding for NASA to develop pizza on Mars.

In another project called “Look! Squirrel!”  San Diego State University and UC Davis have developed a robotic squirrel that  “will help perform public outreach, mentor students, and develop the next generation of robot animals.”

For the 1%, the government is also funding marketing programs for American caviar producers.In Alaska, $3.3 Million was spent subsidizing a ferry to nowhere in Alaska. This is not the ferry the bridge to nowhere was supposed to replace.

Senator Coburn also points out that it now costs us $0.02 to produce a penny. And we’re supposed to believe that the Health Care Bill will bring costs down? And yes, there is a program funded by the NSF to test gaydar.

Pepsi got $1.6 million to build a yogurt factory in New York. USC in Los Angeles got $40K to develop a Henry David Thoreau video game. Apparently the user simply contemplates the screen for months at a time. The Army spent $1.5 million last year to develop combat ready beef jerky.

The GSA, that hard partying junketeering fun-loving crowd, spent $24 Million on trophies and awards. Everyone gets a trophy at the GSA!

The list goes on, but during this hard-fought election season, some light reading helps break the tension.

 

 

 

 

 

 

 

The elephant in the living room in Benghazi

Yesterday, Hillary Clinton fell on her sword according to the national media, but without actually taking responsibility for the lies regarding who and why and how the Benghazi assassinations occurred. She took blame for the security failure, but not for the mischaracterization of the attack as from a spontaneous reaction to an obscure movie rather than its true source, Al Qaeda.

From the outset, Ms. Clinton, the President, and U.N. Ambassador Susan Rice hewed to the party line that it was the rioters and not the radicals; at the U.N.; on “The View”, and on the talk shows a lie was propagated.

In the meantime, after the president spiking the ball on Osama Bin Laden and after hundreds of Hellfire strikes in Pakistan and Yemen, Al Qaeda was supposed to have rolled over and died. Instead, not only were Ambassador Stevens and his team killed, but also a senior security officer at our embassy in Yemen a few days later. They know who we are and where we live. Al Qaeda is alive and well.

And this is the President’s problem.  The facts don’t fit the narrative.

The Administration has a problem with the truth. But they have an even bigger problem.

11 years after 9/11, Al Qaeda and our enemies still have the ability to penetrate our intelligence and security and carry out complex attacks based upon that information.

Just like they did on December 30, 2009 when a Jordanian double agent went through 5 layers of security and penetrated a top security CIA facility at Camp Chapman in Afghanistan and detonated himself, killing 7 top analysts trailing Al Qaeda.

Just as the Taliban did in penetrating Camp Bastion in a complex attack on September 14.

There is a message being sent with these attacks that the Administration is desperate to cover up. The enemy have penetrated our security and can strike when they feel the time is right.

Our government and those of our allies have erected an Orwellian security apparatus costing hundreds of billions of dollars. This apparatus violates our civil liberties as it taps pretty much anything it pleases; traces financial transactions all over the globe, and stares at us through the cameras on the street or drones 60,000′ in the air.

And now we find that there are basic security leaks. The watchers have been penetrated. The all-powerful Oz, in this case our President, is a man behind a curtain peddling lies. And we are less safe than we were 11 years ago.

 

Krugman’s harmonic dissonance on UK economic policy

Paul Krugman today ripped into the British Government’s efforts to get the country’s economy back on track, calling austerity fundamentally mad. As one of the world’s most prominent Keynsians I am not surprised, but as a rational thinker I am deeply disturbed.

IMF Managing Director Christine Lagarde has also expressed her reservations regarding deep government cuts. And yet profligate spending policies without corresponding balance have drained government coffers around the world and we are standing on the edge of a deeper crisis than in 2007 based upon exactly the economic policies so strongly advocated by Mr. Krugman. The fundamental rule that at some point governments run out of other peoples money has still not sunk in.

John Maynard Keynes was reacting to the Great Depression when he formulated his policies and they began to be implemented. His work on government stimulus assumed that  structural deficits were acceptable in the short-term but did not address a long-term in some cases running for decades with interest compounding along the way.

The postwar economic boom funded the extension of the social welfare state. Huge and incredibly expensive promises were made that Mr. Keynes would not have comprehended. Keynes argued that nations avoid deflation even at the cost of allowing their currency to depreciate in order to keep internal prices stable.

But now we are faced with core commodity inflation. There simply are not enough resources to go around. There are deep structural changes occurring in the global economy.

Both the ECB and Federal Reserve have been running the printing presses at an accelerating rate which has set off the first salvos of currency wars. Mr. Krugman and respectfully, Ms. Lagarde have also failed to note the results of expansive monetary policy and public spending in their host country. The Yen continued to rise in value from the ¥180/$ level of the early 90’s to ¥78/$ today, making their economy uncompetitive. The massive shift of manufacturing in China partially driven by the currency shift not only in Japan but elsewher has also had a deep impact on the pillars of the global economy.

Since the early 1990’s after the Japanese banking collapse, that government has engaged in a Keynsian stimulus program aimed at reviving the economy. The Great Tohoku Earthquake was in many ways another Keynsian  economic event, but the result has still been deeply damaging economically. Imports are cheap, but there are no jobs and the debt burden of the Japanese government is growing, not shrinking.

Japanese national debt as a percentage of GDP is the highest in the world with the United States and the UK right behind. This is financed primarily by Japanese savings, which mitigates the damage somewhat, but the reality is that the government is still teetering on the edge of its own abyss, but simply owed to its rapidly aging citizens, who are now putting an even greater strain on retirement funds.

The horrific debt of the United States was one of the other primary topics of the IMF meeting.

While Keynes argued for government spending to even out the depths of financial crises, the constant reliance by modern governments on public debt not only creates the environment in which we find ourselves, but sucks the oxygen from private capital markets where the real engines of growth reside.

Krugman has been hectoring world leaders for more stimulus for the past year just as he has ignored the economic realities staring him right in the face. The bill must eventually be settled and government does not create value; it simply redistributes and regulates economic activity.

He has gotten the stimulus he sought in the world’s two largest economies; Europe and America. But he seems to have forgotten the study of history. Massive stimulus is a very limited weapon with unintended consequences.

The news out of this weekend’s Tokyo meeting is not good. There are many brushfires in the global economy and the tinder for a major economic event is very dry. Every night I pray for some answer, for if we do not find new answers, we are doomed to repeat the past.

 

Twitiots threaten riots if Obama loses

The media has begun to pick up stories of thousands of Twitter tweets threatening riots and mayhem should Barack Obama lose the upcoming election. Among them are:

“If obama dont get re-elected & romney wins .. on life every white persons getting pistol whipped and im startin a riot.” (SOURCE)

“If Obama don’t win lets start a riot so Romney know what he’s getting himself into.” (SOURCE)

“You know you ain’t shit if you gotta “MAKE” Mafukas vote for ROMNEY ! …. Mannnn OBAMA better get back in office . Or BLACK FOLKS will riot.” (SOURCE)

“If Romney wins im goin on a rampage.” (SOURCE)

“If Mitt Romney wins the election I think its our duties as Black folks to riot and fuck shit up.” (SOURCE)

“If every action IS met with an equal and opposite reaction ..what should workers do to employers if Romney’s elected? #Riot in the streets!!” (SOURCE)

“If Romney becomes president let’s all start a riot.” (SOURCE)

“I Heard Mitt Romney , Tryna Take Away Food Stamps , If He Do .”IMA START A RIOT , IMA START A RIOT.” (SOURCE)

“If romney wins, imma start a mf’n riot! Rns.” (SOURCE)

If Romney wins I’m Starting a Riot….Who’s WIT ME???”

“I Hope The USA Is Well Aware That If In The Event This Character Romney Wins The Election, The People Will Start A Country Wide Riot! #Power”

“If Romney is elected president, its gon be a riot its gon be a riot.”

“If ROMNEY GETS IN THE WHITE HOUSE …U MIGHT AS WELL KILL ME NOW …..CAUSE ITS GONNA BE A ************ RIOT !!!”

“If Romney became President and took away welfare Downtown Cincinnati would become a riot”

“If Romney takes away food stamps 2 Chainzz in this bit IMMA START A RIOT”

“If Romney wins. (which i highly doubt) THERE WILL BE A RIOT—”

In this age of instant communication there is no mute button for the most inane comment, much less insane. In this age of Homeland Security where a huge surveillance network is now in place and hundreds of millions of rounds of small arms ammunition have been purchased recently by government agencies ranging from Homeland Security to the Weather Service and police departments around the country are better armed than the Belgian Army, it is foolish to say the least to make such comments.

Having experienced Watts first hand and the Rodney King riots from nearby, mob violence is a terrible thing and hurts those communities most which can least afford it.

The only solution is for leaders in the communities affected take to the internet and the media to condemn such action forcefully now.  Such idiocy needs to be nipped in the bud. We are all Americans. We are all Americans together and want the best for our country.

We face difficult times and tough choices, but we can only succeed if we work together in our mutual self interests. The language of division and demagoguery have already taken a toll on civil society. It is time to grow up and get back on track.

 

Following the breadcrumbs on the Libyan cover up

Last night, Vice President Joe Biden was adamant that the responsibility for the Libyan fiasco and subsequent deception lays everywhere but the White House.

First the Director of National Intelligence’s office misinformed them, and then the State Department didn’t have the answers and then the FBI was sent in 2 weeks after the incident to try to apply some sort of Jedi forensics on a “crime scene” that had been completely compromised.

Let’s look at the facts:

On late Tuesday night, September 11 (mid afternoon Washington time) the Ambassador was kidnapped and found dead at a Benghazi hospital early Wednesday morning, September 12.

The New York Times in their article on the event on September 12, a few hours after the attack raised the specter of Islamic militants armed with RPG’s and anti-aircraft missiles. According to the article:

“American and European officials said that while many details about the attack remained unclear, the assailants seemed organized, well-trained and heavily armed, and they appeared to have at least some level of advance planning.”

On  September 12 our president and Secretary of State stated unequivocally that it was a spontaneous riot triggered by an obscure film no one had heard of until September 11. Our UN Ambassador Susan Rice, not the Secretary of State, went on a number of talk shows that weekend and was quoted in all of the mainstream media delivering the Administrations version of events.

On September 14, the Libyan government had 4 men in custody. On September 19, the president of Libya in an interview with Al Jazeera, Libyan president President Mohamed al-Magarief stated that the attacked was planned well in advance and that Al Qaeda was responsible.

On September 24, the President appeared on “The View” instead of attending the U.N. General Assembly or perhaps even working to find the facts of the case, and once again stated that our government was still investigating the case.

The Daily Beast released the story which truly upset the apple cart first on September 26, which was when the coverup started morphing.

On October 3, Reuters reported that the Administration knew within hours that the attack was tied to militants, and that the CIA had this information.

“Officials familiar with them said they contained evidence that members of a militant faction, Ansar al-Sharia, as well as al Qaeda in the Islamic Maghreb, or AQIM, were involved in the assaults.

So our president expects us to believe that 2 days before the facts went public and a week after the president of Libya identified the attackers he still knew nothing about the true nature of the assassination. There is such a thing as plausible deniability. This is implausibly deniable.

U.N. Ambassador Rice has an interesting position. She is a direct report to both the Secretary of State and the President. This month’s Foreign Policy Magazine has a fascinating article on Ms. Rice and informs us that she has placed her relationship with the president well ahead of that with Secretary Clinton. So whose version was she reporting? Has anyone asked her? Who wrote the version reported? Who was the author of the deception?

The House Committee investigating the attack established yesterday that the Department of State failed to protect Ambassador Stevens adequately. So what next?

As they said back in 1973; “What did the President know and when did he know it?” I would add to that, “why did he lie to us, and what did he hope to gain?”