Wednesday, August 26, 2009

Francis, the socialist!

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Wednesday, June 24, 2009 Francis L. Holland is a Socialist! My Own Personal Socialist Manifesto

  1. Like President Daniel Ortega of Nicaragua, President Fidel Castro of Cuba and President Hugo Chavez of Venezuela, Francis L. Holland is a socialist. Francis L. Holland believes that everyone who passes the medical school entrance exam should be provided a free and public education, just as was the case in Nicaragua under the socialist Sandinistas in the 1980's, and continues to be the case in Cuba today. So, Francis is a socialist.

  2. Francis L. Holland believes that all children should be offered a free, public and equal education. As such, he believes in socialized education, although he certainly hopes the United States will not stop offering free and public education simply out of ideological opposition to socialism.

  3. Francis L. Holland believes that the US's oil revenues should be used to support social programs, just as Hugo Chavez is doing with the oil revenues from Texaco in Venezuela today. So, Francis is a socialist.

  4. Francis L. Holland believes that the United States government should institute a national program of neighborhood health clinics where care is free, and frequently staffed by doctors and nurses who have received a free medical or nursing education paid for by the United States Government. So, Francis L. Holland is a socialist.

  5. Francis L. Holland believes the United States should study Cuba's national health care system and implement such parts of it as are necessary to reduce infant mortality in the United States to levels below Cuba's rate of infant mortality. Since the United States is so much wealthier than Cuba, it ought not be impossible to beat Cuba's infant mortality rate, if health care resources are allocated more equally and appropriately.

  6. Francis L. Holland further believes that the United States Government should expand and improve the system of Veterans Administration Hospitals until every person in the United States - not just veterans - can receive free medical care from these Government-run hospitals. These hospitals should be available in every city and area of the country, just like in Brazil. If this is socialism, Francis L. Holland is proud to call himself a socialist.

  7. Francis L. Holland believes that all medically necessary drugs should be available from the US Government for free, with the cost paid for by Government production of generic medications (like in Brazil) and bulk purchases of medications from pharmaceutical companies, as Wal-Mart does, and as the government of Brazil does. If believing that everyone who needs medication should receive it is a socialist concept, then Francis L. Holland is proud to be a socialist.

  8. I believe that garbage collection and dumping in a central government-designated location is an appropriate government function and I strongly oppose anyone who suggests that each of us should hire a garbage collector in the free market. If we had private garbage collection as our principle means of removing garbage, then we would have massive illegal dumping, courts clogged with cases related to the failure of these private operators to do what was expected of them, and massive transaction costs associated with weighing garbage and billing for garbage collection.

  9. I think garbage collection is analogous to health care. We all have health care problems from time to time, and the Government should be there to collect and dispose of those problems. When so many people need the same thing on such a regular basis, it only creates chaos to have hundreds of thousands of free-market profiteers doing what the central Government should do. Only small towns can survive without centralized garbage collection and disposal, and a nation of three hundred million people cannot possibly meet the health needs of its populace through individual contracts and private enterprise.

  10. Francis L. Holland is not a socialist as a result of his participation in any local, national or international socialist party. Francis L. Holland is a socialist by virtue of his own adopted political and economic beliefs, which are socialist rather than capitalist or anarchist in nature.

  11. Francis L. Holland believes that the role of the Government is to provide for the needs of the people. The Government's role ought never be to maintain a free market that provides for the opportunity for individuals to become rich by manipulating, exacerbating and capitalizing on the needs of the people and the markets.

  12. Francis L. Holland believes that the Government should represent the people, and the elected leaders should be representatives of the people. However, Francis L. Holland does not believe that United States' form of government is necessarily the best or only way to achieve this result. For example, the United States has 13% Black residents and only 1% Black representation in the US Senate, because every US state has a white majority and US Senate elections are statewide, majority-wins elections. In this sense, processes that are supposedly "democratic" can result in manifestly undemocratic results.

  13. Francis L. Holland does not believe that market forces should govern the distribution of a country's wealth unless those market forces result in a relatively even distribution of wealth. Where market forces result in grand differences between the wealth of rich and poor, with the poor lacking basic necessities while the rich have thousands and millions of times more resources than are necessary for their basic necessities, then these market forces are perverse and should be be disallowed.

  14. Capitalist market forces should not be allowed unless they result in a distribution of wealth that meets everyone's basic needs. As a matter of fact, purely capitalist market forces as a means of distribution of resources never meet the basic test of providing for everyone's basic needs, and that is why Francis L. Holland rejects purely capitalist free markets.

  15. Francis L. Holland supports those aspects of US Government policy that tend to distribute resources more evenly; such as free public schools; free public libraries, free streets, roads and highways that are paid for by the government from tax revenues instead of being privately owned; Government-owned national parks; nationalized military defense; national postal service, the national Centers for Disease Control, NASA, national baseline regulation of pollution and product qualiity control; and national efforts toward epedimiology.

  16. (By the way, why should we have national efforts of epedimiology and private capitalist treatment for disease in individuals? Why should the federal government concern itself with identifying diseases of national scope while rejecting responsibility for treating diseases of national scope? Why is it permissible to nationalize the identification of disease but not the treatment of disease?)

  17. The measure of representative Government is not the processes that are used to elect leaders but the results of those processes. If the processes do not result in representation of the people, then calling them "democratic" does not render them representative.

  18. Needless to say, neither the US's Democratic Party nor the Republican Party espouses the ideology explained above, and so Francis L. Holland is neither a Democrat or a Republican as those terms are used today in the United States. Francs L. Holland is a socialist who votes for the party and candidate that most approximate and least offend his views.

  19. In practice Francis L. Holland votes for Democratic candidates and not Republican ones because the Republicans favor unbridled capitalism and greed, with local, state and national police forces to assure that the unequal distribution of wealth is not overturned by popular revolt. Meanwhile, the Democrats believe in bridled capitalism with programs to ameliorate the results of unbridled capitalism, and with local, state and national police forces to assure that the unequal distribution of wealth is not overturned by popular revolt.

  20. Francis L. Holland believes that police forces, be they private, local, state or federal, ought never be used to impose or perpetuate upon a populace an economic or social relationship which does not meet the needs of the populace. And so, Francis L. Holland is neither a Democrat nor a Republican. He is a socialist.

  21. As a Black man, Francis L. Holland has considerable experience with being called derogatory names aimed both at him personally and at his demographic group as a whole. Like being called "Black", Francis L. Holland does not object to being called a "socialist"; he objects only to the negative and derogatory connotations that America's society and ideology have associated with the terms "Black" and "socialist".

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Sen. Kennedy Given Painful, Futile and Expensive Cancer Therapy


In May of 2008, we learned that Senator Edward Kennedy had brain cancer. We were told by CNN and other news outlets that:

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After a seizure caused him to collapse in May 2008, Kennedy underwent a 3½-hour operation at Duke University Medical Center in Durham, North Carolina, to remove a malignant tumor from his brain. Surgeons reported the surgery was a success and that Kennedy should suffer no permanent damage from the procedure. See more on malignant brain tumors »

Kennedy's follow-up treatment plan was to include radiation and chemotherapy.

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This was falsely reassuring.  Kennedy was suffering from a "glioma,", a type of brain cancer normally has a "grim prognosis," with or without brain surgery and chemotherapy.

A seizure is often the first symptoms of the "glioma" type cancer that took Kennedy's life.  In January of this year, Reuters reported,

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Sen. Edward Kennedy, who is battling brain cancer, was recovering at a Washington hospital on Tuesday after suffering a seizure at an inaugural lunch for President Barack Obama.

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Upon announcing Senator Kennedy's death today, the New York Times reports,

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Mr. Kennedy had been in precarious health since he suffered a seizure in May 2008. His doctors determined the cause had been a malignant glioma, a brain tumor that often carries a grim prognosis. As he underwent cancer treatment . . .

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Nonetheless, doctors performed various medical procedures on him in what they knew was a vain attempt to save his life. The likelihood is that the treatment he received significantly increased his discomfort on the way to a predetermined death, and one that will be felt deeply around the country. The issue that arises is, "What is the point of the cancer chemotherapy therapy when doctors know the cancer cannot be cured; the chemotherapy will hardly prolong life if at all; the patient will experience as much stress and pain from the treatment as from the cancer itself; and the medical resources expended will not result in better outcomes? One study, "Malignant cerebral glioma--I: Survival, disability, and morbidity after radiotherapy", says:

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Malignant glioma is the most common primary brain tumour in adults. It generally presents with epilepsy, cognitive change, headache, dysphasia, or progressive hemiparesis.Nonetheless, doctors performed various medical procedures on him in what they knew was a vain attempt to save his life. The likelihood is that the treatment he received significantly increased his discomfort on the way to a predetermined death, and one that will be felt deeply around the country. The issue that arises is, "What is the point of the cancer chemotherapy therapy when doctors know the cancer cannot be cured; the chemotherapy will hardly prolong life if at all; the patient will experience as much stress and pain from the treatment as from the cancer itself; and the medical resources expended will not result in better outcomes? One study, "Malignant cerebral glioma--I: Survival, disability, and morbidity after radiotherapy", says: [q url=""] Malignant glioma is the most common primary brain tumour in adults. It generally presents with epilepsy, cognitive change, headache, dysphasia, or progressive hemiparesis.Nonetheless, doctors performed various medical procedures on him in what they knew was a vain attempt to save his life. The likelihood is that the treatment he received significantly increased his discomfort on the way to a predetermined death, and one that will be felt deeply around the country. The issue that arises is, "What is the point of the cancer chemotherapy therapy when doctors know the cancer cannot be cured; the chemotherapy will hardly prolong life if at all; the patient will experience as much stress and pain from the treatment as from the cancer itself; and the medical resources expended will not result in better outcomes? One study, "Malignant cerebral glioma--I: Survival, disability, and morbidity after radiotherapy", says: [q url=""] Malignant glioma is the most common primary brain tumour in adults. It generally presents with epilepsy, cognitive change, headache, dysphasia, or progressive hemiparesis.1 Diagnosis is usually achieved by appropriate imaging studies (figs 1 and 2) followed by biopsy or surgery.2 3 A randomised trial shows that the median survival after surgery for patients on steroids alone is only 14 weeks compared with 38 weeks after radiotherapy.4 The two year survival after treatment is only 5-10%.5 6 Although radiotherapy to the brain prolongs life, neurologists and others remain uneasy about the trade off between survival and quality of life.7 8 9 For most patients, even after treatment, increasing disability and death occur by one year. Furthermore an economic appraisal has shown that the cost of achieving one quality adjusted life year (QALY) is over £100 000.1011

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Various newspapers now report that Senator Kennedy has died after "battling" and "fighting" brain cancer, but there is something wrong with the battleground metaphors in case where cancer is inevitably and shortly going to take the victim's life:

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The treatment the senator received appears to have extended his life, bestowing precious additional months to spend with his family and to witness glimmers of the health care overhaul he so fervently sought. “From the patient’s point of view, that year is invaluable,’’ said Dr. Keith L. Black, chairman of neurosurgery at Cedars-Sinai Medical Center in Los Angeles. “People can live a lifetime in that year.’’

But, in the end, brain cancer - an implacable, insidious foe - claimed another victim, despite all the privilege and power the senator could bring to the fight. From the frightening seizure in Hyannis Port last year that heralded the tumor’s existence, to the senator’s death yesterday, months had passed, a period that mirrors the average life expectancy after diagnosis.

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Having seen the battle against terminal cancer from up close, 

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Monday, August 24, 2009

Anti-Gay, Color-Aroused Crimes Demand More Sophisticated Analysis

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Most understandings of amtigay and color aroused crimes
are too superficial to be useful.

On of the reasons that it is extremely difficult to make progress against antagonisms against others based on the others' group membership (i.e. gay, Black), is that those who most want to end these antagonisms oversimply the problem.  Like a measuring tape only broken down only into yards, an understanding of anti-group antagonisms that is oversimplified is unuseful and may, in many cases, lead to "solutions" that do more harm than good.

An example of the complexity of homophobia comes from a relatively new study that confirms something many of us already know.  A study of heterosexual men by psychologists found that men who most hate or fear homosexuals, as measured by standardized and objectove physiological measures (e.g. penile engorgement), showed the men who were the most sexual arousal when viewing films of two men having sex. are also the men with the most anti-gay sentiments. 

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Men in both groups were aroused by about the same degree by the video depicting heterosexual sexual behavior and by the video showing two women engaged in sexual behavior. The only significant difference in degree of arousal between the two groups occurred when they viewed the video depicting male homosexual sex: "The homophobic men showed a significant increase in penile circumference to the male homosexual video, but the control [non-homophobic] men did not."

Broken down further, the measurements showed that while 66% of the non-homophobic group showed no significant tumescence while watching the male homosexual video, only 20% of the homophobic men showed little or no evidence of arousal. Similarly, while 24% of the non-homophobic men showed definite tumescence while watching the homosexual video, 54% of the homophobic men did.

When asked to give their own subjective assessment of the degree to which they were aroused by watching each of the three videos, men in both groups gave answers that tracked fairly closely with the results of the objective physiological measurement, with one exception: the homophobic men significantly underestimated their degree of arousal by the male homosexual video.

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How can studies such as this one help us to decrease societal homophobia and color-aroused antagonism?   We have to recognize, for example that anti-gay "hate crimes" are often really crimes of homosexual attraction that the perpetrator may only feel comfortable acting out through crimes that seem, superficially, to be evidence of " hate".  Males who target gays for teasing, bullying, ridicule and physical attacks may need help dealing with homosexual arousal that they are unable to accept in themselves. 

Perhaps rather than hate crimes laws, we need laws against crimes of violence and discrimination based on homosexual arousal, whether the arousal result in hate, fear, attraction, envy, jealousy or other emotions. Hate is only one of many emotions that may drive people to commit crimes against people associated with the victim's group membership.

For example, when men in a car see gays walking hand in hand in the street, and then the men in the car get out of the cars to beat the gays unconscious, the perpetrators are aroused by perceiving gayness and gay love in and between others.  How and why they are aroused is something for psychiatrists, prosecutors and triers of fact to understand and decide.  

Subconsciously, these many crimes that target openly gay couples may be crimes of envy rather than hate. By focusing exclusively on evidence of "hate", we may preclude prosecutions in other cases aroused by the perception of gayness, gay interaction and gay love based on envy.

Certainly all of society would learn more by prosecutions based on a more sophisticated understanding of the motive(s) than we learn from prosecutions exclusively of "hate." 

Meanwhile, the fear of being revealed as someone with homoerotic feelings might deter many attacks on gays, simply because the attackers don't want to be suspected or discovered to be experiencing homoeroticism.  "If I attack these gay men, people will suspect me of also being gay."  Counter to the arguments of many gay advocates, a more subtle understanding, more subtle legislationa against and prosecution of these crimes might lead to more convinctions and more deterence.

Likewise, the assumption that crimes by whites against Blacks, and Blacks against whites, must be based on "hate" to be color-aroused is a destructively narrow  perspective.  Many whites behave aggressively toward Blacks not at all or exclusively out of "hate", but also out of fear of the competition that Blacks represent; fear of liking or loving Blacks and being rejected by other whites for doing so; attraction to Black men or women in a society that does not accept such attraction and relationships.  "How Does Extreme Color Arousal Relate to Criminal Offenses," AMJCA, October 26, 2007.

A Black woman wrote to American Journal of Color Arousal and said that she has physically confronted white-woman-and Black-male couples in bars not because she hates white women but because she is envious of their relationships with Black men and jealously desires the attention of Black men. Black Woman Struggles with Color-Aroused Emotion, Ideation and Behavior, with a Bi-Chromatic Couple Cue This Black woman reported that she feels diminished when Black men choose to pair off with white women, and she wonders, 'What's wrong with me that Black men don't want me?'  In fact, this Black woman's confrontations with Black/white couples are motivated as much by anger at Black men as by envy of white women.

Most observers would say that this is not a hate crime, because the woman is not motivated by hate; she's motivated by envy, low self-esteem, jealousy, and a desire to regain her self-worth.  And so although a Black woman confronting a Black man would be presumed to "obviously not be a hate crime", nonetheless, the crime is aroused by the color of the aggressor, and the color of the Black man in combination with the color of the white woman.

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"Gays, White Women, Controversy and Acceptance in the Black Family"

Many readers may say, 'Oh, this is so terribly complicated that it makes my head hurt.' While that would be an understandable reaction, emotions such as envy, jealousy, self-hate, low self-esteem, and anger are subject properly taken up by psychiatrists, whose training should help them to identify, understand and treat people who experience these emotions so strongly that they commit criminal behavior based on the ideation and emotion they experience.  Certainly, insisting that all crimes that are color-aroused are aroused by "hatred" is so simplistic an understanding that it obscures far more than it reveals, and discourages prosecution of criminal behaviors that occur when the agressor is aroused by color and then finds herself dealing with other overwhelming feeling states, like envy, jealousy, fear, and low self-esteem.

If this all seems terribly complicated, that's because it IS terribly complicated.  It is no more simple to understand color-aroused criminal behavior and homoerotically aroused criminal behavior than it is to understand pedophilia, anorexia, arachniphobia, and fear of heights.  What all of these mental disorders have in common is that they are proprer subjects for psychiatric diagnosis and treatment, while some are also proper targets of law enforcement.

The more we insist on simplistic understandings that any layman jurist and judge can grasp without expert witnsesses, the longer we will find that progress in fighting gay bashing and color aroused crimes is beyond are reach.  The sooner we accept how complex the ideation, emotion and behavior is that results in identity arousal crimes, the sooner we will achieve greater success in diminishing the prevalence of these crimes.

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Sunday, August 23, 2009

Brazilian Public Option Health Beats USA "Market" Hands Down


Brazilan Health Options Beat USA Hands Down

Brazilan Health Options Beat USA Hands Down

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uploaded by francislholland

Subsequently published at the Francis L. Holland Blog and the Public Option Health Care Now blog.

Because of chronic depression and diagnosed bipolar illness, I have been an intense medical consumer for the last 24 years in three countries, including my native USA; France and Brazil. I've also traveled through seventeen countries and had opportunities to discuss medical care with many different people, including two weeks as a medical translator in Nicaragua.

Every day from Brazil, as I watch the health care debate going on in the United States, I mentally compare the US health care “market” with the Government health systems I experienced in France for thirty months (2001 -2003), and now in Brazil for the last five years.

In this article I offer statistical evidence and then first-hand experience to show readers how awful the US health care "market" is compared to what other countries offer. Although many people here are happy with their health care, few of them know what they could get overseas for a quarter of the price.

Too many people who pontificate about the terrors of "socialist" health care and the deficient care in other countries versus the wonderful care in the United States simply have never been outside the United States and therefore, frankly, have no idea what they're talking about.

They are like childless men who would nonetheless describe the experience of pregnancy and delivery in great detail, comparing hospitals to midwives. They simply have no idea what they're talking about from personal experience and probably will never bother to confuse their ideological certainty with actual statistical evidence. So, they offer their opinions and profer any half-baked "proof" they can muster to show that they know something about which they are actually utterly ignorant (like the 67% white male US Supreme Court that determines when women can get family planning care and how and why.)

Such opinions offered by laymen would be considered "hearsay" and therefore inadmissable as evidence in courts of law, and they certainly would not qualify under the Federal Rules of Evidence as "expert opinions", or as any opinions at all.

The [Federal] Rules - especially Rule 702 - place appropriate limits on the admissibility of purportedly scientific evidence by assigning to the trial judge the task of ensuring that an expert's testimony both rests on a reliable foundation and is relevant to the task at hand. The reliability standard is established by Rule 702's requirement that an expert's testimony pertain to "scientific . . . knowledge," since the adjective "scientific" implies a grounding in science's methods and procedures, while the word "knowledge" connotes a body of known facts or of ideas inferred from such facts or accepted as true on good grounds. The Rule's requirement that the testimony "assist the trier of fact to understand the evidence or to determine a fact in issue" goes primarily to relevance by demanding a valid scientific connection to the pertinent inquiry as a precondition to admissibility. Pp. 9-12. DAUBERT v. MERRELL DOW PHARMACEUTICALS

And yet many talking heads and professional lobbyists' pontifications are having a weightier role in our health care debate than actual statistics from reliable and neutral sources, or first hand accounts from people with personal and unbiased experience.

There are all too many paid hacks who oppose public option medical care, prefering to argue motivated by their investments, their lobbying fees and/or their own "free market" ideologies and the baseless fears, instead of looking at the experience and statistics from other countries and interviewing people from overseas to see what their actual experiences have been. Or they argue against public option medical care for patients based on the negative effect that public option medical care could have on insurance companies! Pardon me, but I couldn't care less whether my access to effective health care hurts somebody else's stock portfolio.

Television is full of pontificators, but has any reader of this article actually seen ANYONE on television from a foreign country describing how their health care system works and how it compares to ours?

If they have, it will surprise me and I would love to hear about it in the comments. It would normally be considered unpatriotic to tell the real truth about this, the truth being so sad and maddening, but I'm going to do so here anyway, based on personal experience, in the hopes that the USA can someday (if President Obama has the manhood) improve to the point where we can be proud of our overall health care even when we tell the truth about it.

I will acknowledge that there are many people who are happy with their health care in the USA, but I would also observe that (1) most of them have had no opportunity to compare it with what is available overseas for a quarter of the price, and (2) anyone can find fresh salmon in a supermarket if they are willing to pay forty-five dollars a pound for it. Those who can't pay that are the ones who either go without or eat sardines with a fork from an oval can.

I'm getting to the actual comparison, but I must also observe that in the USA there are far too many conservative and media talking heads who prefer to offer excuses (without supporting statistics) for the fact that the infant mortality rate in the USA is twenty percent higher than that of Cuba, instead of looking at what Cuba is doing and trying to learn from it.

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The USA infant mortality rate is actually almost three times higher, if you compare Blacks in the American South to Latin Americans in Cuba. Yes, "We have the best health care in the world in the USA," but for some reason there are 32 countries in the world with infant mortality rates lower than ours. Actually, the truth may be worse. The CIA's World Fact Book says there are 45 countries in the world with less infant mortality (death in the first year of life) than the United States.

Nicholas D. Kristof of the New York Times observed,

Babies are less likely to survive in America, with a health care system that we think is the best in the world, than in impoverished and autocratic Cuba. According to the latest C.I.A. World Factbook, Cuba is one of 41 countries that have better infant mortality rates than the U.S.

Let's suppose that we refuse to believe Cuba's infant mortality rate as mere Communist propaganda. That still doesn't explain why 32 to 40 other countries still have less infant deaths than the United States. Is this a worldwide conspiracy to bake statistics in order to make the USA look bad - including help from our own CIA Factbook? It is worth noting that many websites look for ways to discredit the Communist success of Cuba with infant mortality, but they offer no excuses for the other three dozen countries that do better than the United States does.

After eight years of presidential advocacy for the "rights of the unborn," you would think that children actually born in the United States would be healthier, rather falling farther behind children in other countries where abortion is perfectly legal.

So, let's take a moment to compare US health care with that of Brazil, which many Americans associate only stereotypically with tree-dwelling monkeys, Rio de Janeiro prostitutes, the Amazon and the drug trade:

Public health care in Brazil is a constitutional right. Even though I am not covered in Brazil by any private insurance, and only by Brazil’s public option health care, ("Systema Única de Saude" or "SUS", which means "Unitary Health System"), the public care available to me here is better than the private care that was available to me in the United States, even when I worked as a managing attorney for a five-office legal consortium.

I will not even bother to compare the USA to France, where I lived for thirty months, since that would be like comparing the ski slopes in Bermuda to the ones in Vail, Colorado.

Instead, I’ll just compare in bullet points the differences between two alternatives:

  1. The USA's “free market” and

  2. Brazil's public option “system”, which I call a "system" in all seriousness, since the USA has a health care “market”, but lacks a health care “system”.

(A "system" includes a series of integrated parts that interact to create a whole, yet no one would argue that the USA's health care includes everyone in a "system" or that what parts there are are integrated or that they create a whole (unless it's a whole mess), or that its accessibility behavior is predictable in any particular case.)

Some people venerate the "free markets" but markets are notoriously chaotic and unreliable, as everyone's 401k plans are now showing, and as the sub-prime mortgage market, and trading in derivatives have taught over the last two years.

If a diabetic's medical care and blood sugar swung for two years as the real estate, money market and bank stocks have, the diabetic would be in a casket right now, six feet under the grass in a cemetary.

And yet our American access to medicical care is based on just such a "free market," with insurance companies no more reliable than CNN stock prognosticators and snake oil salesmen.

So let’s compare Brazil’s public option care to the US’s private market medical chaos:

  • First of all, US private interests, including medical schools, the AMA, insurance companies and pharmaceutical interests have so smothered the “free market” with pro-industry federal regulations that , for example, Americans cannot import drugs from overseas that are made by the same companies but cost 75-80% less at Brazilian pharmacies;

  • US medical schools are not increasing the number of medical school graduates relative to the number we will need if there are 15% more people with medical insurance, requiring regular checkups. The monopoly market is assuring that the supply of doctors will not meet the demand, and therefore prices will increase when new insureds enter the market. Medical schools and the AMA control the number of doctors trained, but they clearly are not acting in the public interest.

  • In contrast: “The number of graduates from U.S. medical schools has remained roughly constant at about 16,000 a year since the 1980’s. But the number of new doctors has fallen as a percentage of the population. The population rose by 50 million from 1980 to 2000, according to the census.” NYT, 2009

  • In the United States, an increase in the number of doctors trained “would be welcome news to the Association of American Medical Colleges, which is calling for a 30 percent rise in admissions. According to a 2008 report co-written by Edward Salsberg, director of the Center for Workforce Studies with the medical association, the gap between supply and demand for doctors could be 125,000 to 159,000 by 2025, if the training of doctors fails to keep pace with population growth and a rising need for specialists catering to the aging demographic.”  New York Times

  • Brazil has opened many new medical schools, and has even seen a need to block the opening of new schools to maintain their quality. According to Brazil’s National Institute for Educational Research, the number of medical schools increased from 98 in 1998 to 123 in 2004, which means that more doctors are available, it’s easier to get appointments and it’s harder for doctors to charge outrageous fees.

  • Meanwhile, the US is number 23 in terms of practicing physicians per thousand population, among OECD countries . OECD Statistics

  • No wonder we can’t get an appointment in the USA with a doctor!  The number of doctors is stagnant while the population increases and ages!

  • It is hard to justify the claim that the USA has "the best medical care in the world,' unless we acknowledge that we simply have the most expensive medical care for the 85% of the country that has any access to medical care at all, while we have among the worst care for those 15% without any sort of medical insurance.  And that's why we're somewhere beneath little old Cuba in infant mortality.  (I once asked one of my Cuban political asylum clients what was the nature of the persecution he experienced when he was in Cuba.  He told me indignantly that the Castro government cut off children's free milk allotments when they reached the age of ten!)

  • I was born in New Bedford, Massachusetts which, last I heard, had one Public Health Service medical center and one mental health center for the 100,000 population. For two years, my sister worked there as a General Practitioner physician and personally delivered all of the babies in the city that were not delivered by private practice doctors. When she left the Public Health Service she said that one of her greatest frustrations was that patients for whom she painstakingly identified their illnesses could not afford the medication that would make them better. Meanwhile, private practice doctors refused to cover for her, so she worked seven days a week delivering babies at all hours of the day and night.

  • Compare that to Brazil's public option services, where medications are available, for free, at each public health clinic and hospital.  It's true that the US has the Public Health Service, but it would need to be massively expanded, its services increased, and a national system of VA like hospitals included, available to everyone, to even begin to compare with what Brazil offers to each member of the population, regardless of income.  Every Brazilian city has one or more hospitals that delivers babies free of charge, with no $30,000 hospital bill awaiting the new mother as she brings her baby home.

  • Now, I compare my experiences in the United States to those I've had in Brazil: I live in a Brazilian city of 100,000 population that has one free Government medical center per neighborhood. There are so many free neighborhood health centers that lifetime residents of this city literally cannot count them all. But I can say, having visited some of them and used their many services, that within a ten minute walk from my home, there are two free medical centers; a free adolescent mental health center; two free adult psychological centers; and a free full-service hospital; all with free pharmacies; plus a free-standing Government pharmacy where no medicines dispensed cost more than five dollars per month.

  • The free medical centers provide dental care as well, including fillings, dentures, cleaning and other basic care. It doesn’t take a genius to predict that more free medical centers, hospitals, and free pharmacies closer to where people live will help increase accessibility and improve outcomes.

  • Based on personal experience, I know it is possible to visit a dentist here with no appointment in various areas of the country. Moreover, you can get a root canal or crown here for half of the monthly minimum wage, and many dentists will accept post-dated checks, and IOU’s for their services. When my step-daughter broke a large piece off of her front tooth, a dentist fixed the tooth impeccably, with no evidence that it had ever been broken, and he charged us one fifteenth of the monthly minimum wage for the service. Is there ANY service you can receive from a US dentist for 1/15 of the monthly minimum wage?

  • My wife had two moles which she was afraid might be precancerous. At a private clinic, we saw a dermatologist who charged us one fifth of the monthly minimum wage for a consultation. He said he did not believe the moles were cancerous and his fee would be one half of the monthly minimum wage to sample and test the cells. Instead, we went to a local public hospital where a doctor sampled the moles, sent them for testing and pronounced them noncancerous, all at no cost whatsoever. We discovered that it would cost two thirds of the monthly minimum wage to tests the moles through the private doctor. Even though the moles were not cancerous or precancerous, the Government doctor offered to remove them and did so, as elective surgery. It took about three months to complete this round of services, but the Government services were entirely free of charge.

  • Brazil has excellent private hospitals and is well-known for medical tourists traveling here for plastic surgery, because it is so much quicker and less expensive here than in the United States. "Changing the "Face of Cosmetic Surgery, Brazil Leads the 'Plástica' Revolution." Obviously, it would not be possible for Brazil to be an international center of private market cosmetic surgery unless their medical schools trained a lot of doctors.

  • Brazil's public option doctors work for a (moderate) salary, which makes it possible to have so many clinics without creating trillions of dollars of government debt.  In fact, Brazil has a positive foreign exchange right now and low federal debt, in spite of national public option health care.

  • It is not as well-known that dentistry tourism is also very cost effective and pleasant in Brazil. “The most popular and well-known place that Americans go to get inexpensive but quality dentistry is Los Algodones, Mexico, which is just over the border from Yuma, Ariz. However, Costa Rica is among the top five countries where Americans seek dental work. The other hot spots are Argentina, Brazil, and Malaysia,” says AARP.ORG.

  • In fact, one of the major holes in the French national health care is that it doesn’t cover dental work except extractions and reconstruction after serious accidents. In comparison, Brasil’s public option covers fillings, cleanings and dentures. But the real savings are to be had at private dentistry clinics in Brazil, where even people earning minimum wage can afford to wear braces on their teeth. When I left the United States in 2000, I had a desperate need for a crown. A dentist gave me an appointment a week away and charged me $250.00 for a temporary crown that soon fell out. In France, a dentist offered to provide the crown for the equivalent of two thousand dollars. Four years after the need for the crown became apparent, I found an excellent dentist in Brazil who installed a crown for the equivalent of one hundred and twenty-five dollars. A root canal on another tooth cost me another one hundred and twenty-five dollars. And because dentists and dental office time are far more plentiful in Brazil, I was able to have the entire process finished within one week, with the initial cleaning and ex-rays done on the very same day on which I first contacted this dentist.

  • Because there are more dentists in Brazil per one thousand patients and far more competition, it is possible to see a dentist and receive complete or significant care immediately. Even wealthy people cannot access care as easily in the United States.

  • There are plenty of stories on Brazilian television about people who were harmed by long lines and callous doctors. This occurs without doubt, but remember that these are complaints about free medical care and not about insured care whose premiums gobble up a fifth of their salaries, as is so common in the United States.

As I said above, I suffer from chronic depression and diagnosed bipolar disorder. I know what it is to need medical care and have a lot of experience trying to find it. Under no circumstances would I want to trade the access to health care that I have now under the Brazilian Government's public option for the access I had when I worked in the United States as a managing attorney and had private market HMO care, as well as other various makeshift non-profit or quasi-public options.

If you have suffered as I have trying to access consistent and acessible mental health care in the United States, I urge you to move to the South of France or Brazil, where medical care is more easily accessed and the climate might do wonders for you. If it doesn't work, you can always return to the United States. You already know what that's like.

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Thursday, August 20, 2009

Can Barack Obama be Re-Elected in 2012?


Can Barack Obama be Re-Elected in 2012?

Can Barack Obama be Re-Elected in 2012?

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uploaded by francislholland

Horrifying statistics have just been released by the Mortgage Bankers Association, which finds that:

About 13.16 percent of mortgage loans were delinquent or in the foreclosure process during the quarter, according to the group. That is the highest level ever recorded by the survey, which has been conducted since 1972, and breaks a record set last quarter.  WaPost

This means that when the Democratic members of the US House of Representatives is up for re-election in fourteen months, many more Ameicans will have lost their homes,including many from the middle class, who never expected to find themselves in this situation.  

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Wednesday, August 19, 2009

Michelle Obama's Bermuda Shorts Attract Attention on Many Levels

White Supremacist Website Reaction Sheds Light
on Fury at Health Care Town Halls


Today, NowPublic intern Alia-D  published an article here entitled “Michelle Obama Shorts: First Lady in Shorts Draws Attention,” reporting the fascination and controversy in the United States over the bermuda  shorts that First Lady Michelle Obama and 'Malio O' wore while diembarking from a plane.   While opinions that run the gamut have been expressed, Alia-D quoted MSNBC commenting approvingly, saying,

The mid-thigh jeans shorts Obama sported are something most American women would wear without a second thought.  

( . . .) 

Any first lady’s fashion choices are closely watched, but interest in Obama’s style has bordered almost on obsession. When Obama showed her spectacularly toned arms in a sleeveless gown at the Inaugural Ball, it sparked such a media maelstrom, you’d think she’d shown up in the nude.

Judging by the over seven hundred views of this article at Now Public, quite a lot of people are at least curious about this “issue”.  However, at MSNBC an unscientific polls found that 83% percent of nearly 150,000 respondents agreed with the statement that,

It's fine. People are overreacting! There's nothing immodest about shorts during an outdoor family vacation.

Americans today were apparently so fascinated with Michelle Obama’s shorts that they didn’t even notice or mention that “Malia O” was wearing Rasta Locks and a tie-died t-shirt, both symbols of a progressive attitude rather than rigid conservatism, as well as a determination, at least on Malia O’s part, to, as one article put it, “Free Your African Hair!” 

There is intense interest in the Obama women’s style and what it means to consciously, unconsciously, metaphorically and symbolically.  An article entitled Malia O., President Obama's Daughter, Frees Her African Hair” drew over one thousand views at NowPublic on June 12, 2009. So, why all of the interest in the fashion choices of First Lady Attorney Michelle Obama and her two daughters? 

On the negative side, there’s clearly some color-aroused hatred and contempt for Michelle Obama among a small minority of Americans whose writing is visible at the white supremacist Stormfront website.  A commenter there by the name “Anti-Communist” says:

Michelle Obama tries to look like a White woman every day. If she took off that pink blush and didn't use 1000 chemicals to straighten her nappy hair, she'd look like any other ape from the jungles of Africa. As it stands now, she just looks like a Negress who wishes she were White.  Stormfront

For those like the above commenter who are so extremely color-aroused as to hate Michelle Obama simply because her skin is brown, the aghast fascination with her appearance is associated with resentment at her role as the first Black and brown-skinned First Lady.  And yet even the extremely color-aroused Stormfronters find themselves comparing Michelle Obama to President John F. Kennedy’s wife, Jacqueline Onassis.  The mere fact of being compelled by President Obama’s election to make this comparison infuriates the Stormfronters all the more. 

As one Stormfront commenter said,

Absolutely pathetic. 

To make any comparison between this near-illiterate, anti-White Negress and a realfirst-lady, Jackie Kennedy, shows how classless, illiterate, and frighteningly delusional her supporters are.   Stormfront

Among the extremely color-aroused antagonistic set, the interest in Michelle Obama is inseparable from the anger, hatred and resentment they feel when they perceive her skin color.  If some of these people are appearing at health care forums of Congresspeople and president Obama, it makes the fury and open hatred they express much more comprehensible, and shows that those extreme emotions are, for some, more associated with Obama’s skin color than with his politics.

When I was a child in the 1970’s it was unusual to see any Black women on television at all, and those who did appear were in the stereotypical roles of nannies and Aunt  Jemima, none of whom had the freedom to wear the same Bermuda shorts that white women wear while on vacation.  

In fact, based on the media portrayal of Blacks at that time, many whites might have found it shocking to learn that Blacks took vacations at all. If television showed Black women wearing shorts, they were in the role of prostitutes and sex objects.

Against this backdrop of embarrassingly and antagonistically color-aroused and stereotypical  portrayals of Black women, it is actually a tremendous relief for most Americans - Blacks, whites, Latinos, Asians and Jews – to see a Black woman who defines herself on her own terms rather than being defined by contemptuously color-aroused Hollywood producers or by a police blotter. 


Michelle Obama's Bermuda Shorts Attract Attention

Michelle Obama's Bermuda Shorts Attract Attention

see larger image

uploaded by francislholland

THIS Black woman, First Lady Michelle Obama, is obviously very comfortable with herself as an assertive, self-defined, corporate lawyer and public servant.  She has an enviably well-toned and healthy physical personhood that sets an positive example for all of us in a nation where the Centers for Disease Control says that 38% of Black women and 21% of white women were obese in 2003.  Michelle Obama, simply by being who she is, stands as a role model for millions of others, and she is obviously comfortable with it.

Rather than primly wear a metaphorical corset to the beach and on walks in the Grand Canyon, she dresses as most American women do while on vacation, rather than follow rules that would apply on the beaches of conservative Arab countries.

Many of us are simply proud that our First Lady is able to be herself, rather than a caricature, and wear her clothes like a loose blouse rather than a corset.  If First Lady Michelle Obama can do it, and first First Girl Amalia O can do it, then other women and girls all over America have new choices and freedoms as well.  I think many of us are celebrating that our First Lady is a human being, rather than a mannequin in the window of an expensive and stuffy store from the era of the corsets.

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