Saturday, April 05, 2008

Wealth And Politics

Yea....so?
Senator Hillary Rodham Clinton and former President Bill Clinton released tax data Friday showing they earned $109 million over the last eight years, an ascent into the uppermost tier of American taxpayers that seemed unimaginable in 2001, when they left the White House with little money and facing millions in legal bills.
In his book, Superclass: The Global Power Elite and the World They Are Making, David Rothkopf notes that one of the quickest ways to fabulous wealth is to serve in government, and that Presidents, by dint of their international connections, are poised to become immensely wealthy.

Hey, you didn't really think Obama or McCain, nevermind Clinton, were running because they wanted to do good, did you?

But something odd about the Clinton's wealth should be stressed:
The bulk of their wealth has come from speaking and book-writing, which together account for almost $92 million, including a $15 million advance — larger than previously thought — from Mr. Clinton’s 2004 autobiography, “My Life.” The former president’s vigorous lecture schedule, where his speeches command upwards of $250,000, brought in almost $52 million.
(emphasis added)

Most former government officials sign on with boards of directors of multinational corporations to achieve this kind of wealth. Indeed, it is a testament to President Clinton's popular appeal and his moral fiber that he hadn't accepted the kind of cheap wealth that his predecessor had, and successor likely will.

Like his Vice President Al Gore, Bill Clinton could easily have sat on any number of boards of directors for companies as diverse as Wal-Mart, Citigroup (Robert Rubin, his Treasury Secretary, once served there ex-administration), the Red Cross, and MicroSoft (as a thank you for his help in keeping Bill Gates from off-shoring his entire company).

But he didn't. He decided to try to leverage his popularity and more important, his Rolodex into something positive: The William Jefferson Clinton Foundation, and as its centerpiece, the Clinton Global Initiative, a kind of "Davos That Does" in that Clinton doesn't just ask his participants to indulge in rhetoric, but to make concrete valuable pledges of resources to tackle the world's problems.

Being a rich ex-President is not a sin. Wasting that power and influence is. It's nice to see that the Clintons not only made it, made it big, but didn't forget where they came from or whom to help.

Friday, April 04, 2008

For All Men And Women

Friday Cat Kitten Blogging


Dadby es bizzee at da dockers today. Hem's noze wuz bleedin, so hem nawt hab a chance to pose today.

So I tuke a pitcher of me composerin ma moosic!

Thursday, April 03, 2008

PostNATO Care

Well, some interesting developments in foreign relations today...
NATO has decided not to include the Ukraine and Georgia among its new members after strong objections from Russia. However, the alliance pledged that the two countries would eventually become members.

President Bush was a supporter of the Ukraine and Georgia's bids to become members of NATO.

Former Soviet republics Croatia and Albania were invited to become members in the decision announced Thursday.[...]

Macedonia was denied entry to the alliance after Greece blocked its invitation because of objections to the country's name. However, leaders said Macedonia can join as soon as it resolves the dispute, AP said.

Greece has a northern province that is also called Macedonia, and argues the former Yugoslav republic's insistence on being known as Macedonia implies a territorial claim.
The denial of Macedonia is a pretty silly matter, unless of course, you're Greek, or Turkish, for that matter. It's a little like denying York, Pennsylvania full American rights because it sounds like New York City.

However, the Georgia/Ukraine as well as Croatia/Albania questions...there's an interesting little bit of chemin de fer amongst the NATO allies. Russia, which of course was most decidely NOT a charter member of NATO, set up to defend against the Soviet Union's hegemony into Europe.

One almost gets the sense that Bush got the split difference: he lost out on Georgia and Ukraine, countries he had explicitly asked membership for, but was granted Albania and Croatia, which, while not former Soviet republics, certainly were under USSR influence in the old Warsaw Pact country of Yugoslavia. He had not lobbied for these. Give the baby his candy, perhaps?

This indicates the rise of Vladimir Putin's profile in European matters in tandem with the decline of American prestige in such affairs, even amongst our staunchest allies and pledged defenders.

In his book, Superclass: The Global Power Elite and the World They Are Making, David Rothkopf makes the observation that the 21st Century will see a kind of global government arise that will subsume national governments, and it won't be led by America.

While this was likely inevitable before the Bush administration fumbled foreign affairs so badly after the sparkling diplomacy of Bill Clinton, Rothkopf points out that only the Bush administration could have the world hating us...for being the victim of a terror attack!

This "New World Order," to use a hackneyed phrase, will originate in Asia, and be led by China, India (which is poised to become the most populous nation on the planet shortly) and-- you guessed it!-- Russia.

Indeed, several nations which have been mulling admission into NATO have not aggressively pursued admittance simply because they view NATO as not "European enough" (code word for "too dominated by the US").

Keep in mind that Russia, China, and India all possess nukes, and all have shall we say, close working relationships with Iran?

Wednesday, April 02, 2008

Healthcare Proxies

It seems to me that, when the American healthcare system works, there's not much room for improvement. It's when it doesn't work, or is non-existent, that things get cocked up.

I'll relate my story from yesterday as anecdotal evidence of how it can and should work:

As many of you know by now, I was diagnosed with a basal cell carcinoma on my nostril three months ago. Two months ago, I had it excised, and needed same-day plastic surgery to close the wound. During that procedure, another nest of suspicious cells was found, excised and biopsied.

Yesterday, I had the surgery to close everything up, since it was determined that I no longer had malignant cells in this region.

I arrived for surgery at 1PM at a New York City Catholic hospital, on an ambulatory basis. Surgery was scheduled for 2PM.

I filled out a couple of forms: a consent to allow the insurance company to pay the hospital, and a patient's bill of rights acknowledgement. I was then ushered to the pre-op area, where I might change into a gown and have my clothes secured. In that area, I was interviewed by two nurses, an anesthesiologist, and the surgeon. Two orderlies took my temperature. The area of concern was examined, and the surgeon initialed my nostril.

In the course of the interview with the first nurse, along with questions about what medications I might be on and what previous surgeries I had, the fact that I had eaten 7 hours ahead of surgery instead of eight was revealed (I misread the directions. My bad!)

So we waited an hour. No problem. At the appointed time, I got my IV unit inserted, and walked into surgery with the anesthesiologist. I laid down on the operating table, and was conscious for quite a while after that, which is a good thing, since the IV unit has jostled slightly out of position, wetting the linens I was on.

All three nurses walked in and interviewed me separately: what are you here for? Specifically where is the incision to be made? Who is your surgeon? Is this your name on the name tag?

The surgeon came in, and we spoke briefly, again, about my options for being out cold v. being groggy. The "late" meal was not a crisis, it turns out, but to be on the safe side, we agreed to put me out, but if I started to come to, it would be OK.

Precisely what happened.

I should explain. I'm not big into medication. I don't like to even take aspirin if I can avoid it. When I've had surgery in the past (not recently, admittedly), I've asked for local and pain meds.

This time, I wanted to be out given the proximity of a sharp object to my eye. I've always had problems with things flying at me. That's probably why I was such a good goaltender: I didn't want to get hurt!

By the time I woke up, however, the knifey part was done, and the doctor was into stitching. Needles and my eyes don't get along, but I was too groggy to really give a crap. But it was fun to listen to the surgical team talk about how I was awake and to even get off a one liner or two ("Hey, doc? Did I get Heath Ledger's nose like I asked?")

The other advantage to this strategy was I was practically able to get up and walk when we left the operatory. I was released on schedule, pretty much, despite being in surgery nearly ninety minutes later than planned.

So what went right here?

Well, for one thing, the rules were followed. There was great communication all around, no one fumbled for the next question. Information was passed on efficiently, and I was given as much choice as possible in my treatment options. The surgeon had already consulted with me about two possible options for closure, and I picked one, which we went over in the hospital. He said that one option would require less work to do, but might leave my nose slightly misshapen (as in you couldn't tell unless you looked closely), and one would require a graft of both skin and cartilage, which is what we ultimately decided on. Good thing, too, because the wound turned out to be a bit more complex than we thought.

The staff worked quickly and as a team. No one was asking questions they didn't need to ask and everyone understood his or her role. I confess that, after the last encounter, I was very scared going in, but by the time I was in the operatory, I felt very at ease, despite my own error.

What went wrong here, however?

Ahhhh, and there's the rub: if you re-read all this carefully, so much of what transpired, while for my benefit, was not done out of concern for my well-being, necessarily. I'm not saying that this doctor, or these nurses and orderlies, or any doctor, nurse, or orderly, does not have the best interests of the patient first and foremost in his or her heart.

What I am saying is that a lot of this communication is generated for one reason and one reason only: to stem lawsuits.

By putting the onus on me for decisions, by making sure that I understand each and every choice and decision that has to be made, but more important, by confirming that I am fully aware and vested in each step of the operation, the hospital is mitigating their risk.

This was brought home to me today, when the hospital called for a follow-up: are you in pain? Are you satisfied with the results? Did you receive post-operative counseling?

As the healthcare system in America becomes more and more profit-driven, as hospitals and HMOs have to answer first and foremost to their stockholders as opposed to the public weal, we are all going to be forced to deal with the downsizing of authority to the patient, who in many cases may be the least informed party.

Think about it: I had a simple operation, and yet underwent grueling questioning of my understanding of what was to happen. I was fortunate in that my surgeon and his team were all communicative and helpful, and more important, understandable.

Imagine if I hadn't understood what was to take place. Imagine if my procedure was complex and risky. Imagine if I was of even average or below average intelligence.

Such enormous risk to place on the shoulders of a civilian, as opposed to leaving it to the expert. And if you've spent anytime in doctor's offices lately, this trend continues in there.

Exhibit A: The original lesion itself, which I've had for nearly thirty years now. In that time, literally hundreds of doctors have seen it, yet it took an urgent care doctor in a clinic to mention "You oughta have that looked at", nevermind how many doctors have stuck a probe up my nose or looked directly in my eye.

If you have a question about your health, even while you're standing there in your underwear, it's next to impossible to get taken seriously in an awful lot of doctor's offices, a circumstance I suffered two years ago when I had chest pains and trouble breathing, until I basically called a doctor and said "Look, if you can't help me with this stuff, I'm going into a hospital."

Which clearly triggered his self-preservation mechanism. He might have imagined that I was a bit upset over his inability to listen to my complaints.

I'm glad this ordeal is over because through it, I gained a new-found respect for the medical professions and confidence that not everytime I see a doctor, I get sicker.

But let me say this: It shouldn't have taken this long for just one doctor to prove me wrong

Tuesday, April 01, 2008

Well....



....see for yourself!

They had to partially deconstruct my ear in order to rebuild my nose, and these bandages are hideous, but....IT'S FUCKING FINALLY FINISHED!

I'm bushed. I'm off to bed....

Monday, March 31, 2008

Housekeeping

OK, a couple of updates and some news:

1) I have my final surgery to reconstruct my nose tomorrow. I'm hoping things go smoothly, of course, but this story didn't put my mind to ease. I know, not bloody likely, but given the screw ups from last knifing...

2) ThumbPer is fine. A few of you have asked about him this weekend. He's just angry with me because he found out how much an accountant makes to prepare taxes and told me "But I spended all dai accounting papahs foah you! Dere wuz 47 of dem!"

And now, to the news...next Monday, I will be live and nationwide on Sirius 110 at five PM, on a show called "The Blog Bunker".. that's right, I'm...


Assuming, of course, that I don't develop some mysterious surgical malignant hyperthermia...planted there by some Obama-leaning lefty loon....

Proving A Point

There's a curious dynamic involved in this story, one I haven't fully contemplated yet:
Iraqis returned to the streets of Baghdad after a curfew was lifted and the southern port city of Basra appeared quiet on Monday, a day after the Shiite cleric Moktada al-Sadr called for his followers to stop fighting and in turn demanded concessions from Iraq’s government.

Mr. Sadr’s statement, released Sunday afternoon, came at the end of six days in which his Mahdi Army militia had held off an American-supported Iraqi assault on Basra.
OK, the most obvious bit of information we can glean from this story is that al-Sadr is establishing that he is firmly in control of the Shi'ite faction in Iraq. Is this a prelude to his taking over the parliament? Or worse? Is this a signal that Sayyid al-Sistani is preparing to rule over Iraq the way Ayatollahs in Iran have for decades, as "Expwert Jurist"?

After all, he's basically turned on, and then turned off, the faucet of violence, keeping American and British troops dancing in the background while he held off allied-armed Iraqi forces to a standstill.

Clearly, he wanted to demonstrate that the nation will dance to his tune.

He also demonstrated the abject impotence of the American-chosen president, Nuri Maliki, who apparently couldn't crush an uprising any more effectively than the American-led Coalition of the Bribed!

There is an allegory about the lion and the fly, which applies to Iraq: In a fight between a lion and a fly, the fly cannot land a killing blow, while the lion cannot fly.

So it goes with Iraq and the insurgency: we are fighting a fight that we cannot win, despite our overwhelming force, and the Shi'ites know this lion cannot fly.

The ironic thing about this is, this was a fight, and still is a fight, that we didn't have to fight. The sponsors behind this fight, the Iranians, are perhaps the most sophisticated democratic government in the area, just behind India. Yes, the Ayatollah in Iran has supreme power, but if you look at society, even Khameni hasn't been able to stifle all dissent, or make women wear the burqa, or...well, you choose the field, and Iran has advanced fairly far in it, comparatively speaking.

That's not to say we should be holding them up as a model of the Middle East we'd like to see, but we could try working with them to bring them into the fold, so to speak.

Ahmadinejad may come off as a fucking loon, but if you carefully look at the ripples that he sends out, there's a very deep logic to his insanity and it is very profitable to Iran and to its peer nations. And I have no doubt that he speaks for the Ayatollah.