Monday, December 17, 2007

The Hillary Playbook and How to Counter It

Because I am a junkie of politics I subscribe to email lists of all persuasions. As such, I found myself on Hillary Clinton's email list. (This started initially when I wrote her an email about the absurdity of her mortgage bailout. Because I needed to put my name and email in my address I found myself on her list) Here is an email I just received from her campaign.

Running for president means asking a lot of people to put their faith in you -- and putting your faith in a lot of people. You've never let me down, and my promise to you has always been this: if you put your faith in me, I will fight for you every day when I'm president.

When I get to the White House, I'll end the war in Iraq and bring our troops home. I'll stop the cowboy diplomacy and Bush's war on science. I'll reverse the attacks on our Constitution and civil liberties. I'll ask the Congress to send me everything that Bush vetoed, like stem cell research and the Children's Health Insurance Program.

From day one, I'll be fighting for you, because America needs a clean and decisive break from seven years of George Bush. Not one of the Republican candidates is capable of making that happen. They're all promising four more years of the same failed policies. They see Bush's failure in Iraq and want to continue it. They see failure of leadership on the economy and want to repeat it. They see his assault on civil liberties and the disgraces of Guantanamo and want to carry them on.

Now, since this is meant for Democratic primary voters we can disregard the digs at Bush and look merely at the substance of what Hillary is saying.

She first says this about Iraq...

I'll end the war in Iraq?

My question is immediately when. Here is what Hillary Clinton said in a previous debate about pulling out of Iraq.

"It is very difficult to know what we're going to be inheriting,"

She went on not to commit to pulling out of Iraq before her first term were to end. Thus, while she gives her supporters the impression that she makes pulling out of Iraq a priority, she also doesn't even commit to pulling out of Iraq until after 2013. This dichotomy of positions is so easy to attack that I don't know where to begin. This is of course perfect for any advertisement. Also, depending what she says in any debate, her other position can also be used to bludgeon her.

Then, Hillary points out that Bush has conducted a war on science and mentions stem cell research. Here, like most Bush opponents on this matter, Hillary simply mischaracterizes Bush's position on the matter. Bush is not and never has been against stem cell research. In fact, the Bush administration has been funding stem cell research since 2001.

In a much-anticipated decision on what he called a "complex and difficult issue," President Bush on Thursday night said he would allow federal funding of research using existing stem cell lines.

Bush said there are about 60 existing stem cell lines in various research facilities -- cell lines that have already been derived from human embryos.

The president stopped short of allowing federal funding for research using stem cells derived from frozen embryos, about 100,000 of which exist at fertility labs across the country.

The question for the Bush administration always involved EMBRYONIC stem cells. Clinton doesn't say EMBRYONIC stem cells but rather an all encompassing stem cell research. Bush's position is that he doesn't want the federal government to fund research in which human life is created solely so that it can be destroyed and studied. Since this is a much more difficult position to attack, folks like Clinton try to inaccurately paint Bush as against stem cell research altogether. In this situation, as in any in which someone is not saying something accurate, Hillary needs to be confronted with the truth and see how she deals with it then. First, she must be held accountable for her mischaracterization of Bush's position. She isn't the only one and at this point I am sick of everyone mischaracterizing Bush. If you have to mischaracterize your opponents, then how strong can your position be?

Second, Clinton has to be confronted with this...if she is all right with science creating life solely so that it is destroyed, at what point does she see science as going too far? Is she against cloning for instance? After all, there are a lot of exciting possibilities in cloning? If she has no problem creating life to destroy in the name of science, why would she have a problem with cloning life in the name of science? Where would scientific research stop and morality and ethics start in her administration?

Next, she says that she would end the so called assault on civil liberties and mentions Gitmo by name. Since she doesn't specifiy which assualts, we can only assume that she means things like enhanced interrogations, warrantless wiretaps, military tribunals, and of course Gitmo altogether. Since she finds Gitmo so especially obscene, my first question would be where those prisoners would go. Most of their home countries don't want them. Does she plan on trying them in our own federal system? Does she understand that terrorists routinely kill the friends and families of those that they see as turning against them? Does she understand that any witnesses against any terrorist in any open court would immediately have their lives threatened? Given that, how exactly does she expect any terrorist to be convicted in any federal court?

As for enhanced interrogations and warrantless wiretapping, this creates another opportunity to paint Hillary as weak on national defense. First, I have always found the entire debate about warrantless wiretapping to be quite absurd. I don't know any other time in the history of warfare in which the President needed a judge's permission to spy on the enemy. Thus, proclaiming that the Commander in Chief is destroying civil liberties because he is spying on the enemy without a judge's permission is to me absurd. On a political level, it can be painted, rightfully so, as weak on national defense. Most of the Republican candidates have, rightly so, not identified what techniques they will and won't allow because then you are telegraphing that to the enemy. By coming out against Bush, as she has, Clinton has in fact told the enemy what she won't use. Because she sees anything outside basic police interrogation protocol as an erosion of civil rights, the enemy can prepare for the basic interrogation techniques that she will allow. This gives Republicans yet another chance to paint her as weak on national defense.

Now, anyone of us that knows Hillary knows that this is only scratching the surface as far as attacks on her, however since she has chosen to highlight these things to her supporters we can assume that these are her priorities, and this is how these priorities ought to be countered.

Boiler Room - Telemarketing Scene

Passing Along Some Vital Information on Illegal Immigration

I received this email from Numbers USA over the weekend.

Without explanation, Congress has stripped away $3 billion in desperately needed funds to build the Border Fence that it approved last year and to provide for other border security.

That's right—without telling the public, Congress is pulling the plug on the U.S.-Mexico Border Fence that it voted for with such enthusiasm last year (just before they asked voters to re-elect them).

Help us turn this petition into a national overnight phenomenon. Time is critical—Congress will finalize this funding question before Christmas!

Now, it is important to emphasize again, as Numbers points out, that the fence and its funding was voted on late in the session in 2006. At last check, about eleven miles out of thousands had actually been built.

The fence has become a sort of cause celebe for opponents of tough measures against illegal immigration. Their rallying cry comes in this statement from Governor Janet Napolitano of Arizona.

You show me a 50-foot wall and I'll show you a 51-foot ladder at the border. That's the way the border works

That sort of statement is what I refer to as a strawman arguement. No one is claiming that the border fence will keep out everyone that tries to come in. It will however keep out a lot of them, and that is the point of anti illegal immigration legislation. Everytime I hear this statement, I always point out that a Mexican migrant is going to look awfully funny walking around the desert with a fifty one foot ladder. There is no one hundred percent full proof way of keeping illegals out. If we put together a human wall, someone might ride in in a tank. That doesn't mean that methods aren't effective even if some smart person has figured out a way to theoretically get around them.

The border fence near San Diego is proof that the fence works.

Before the fence was built, all that separated that stretch of Mexico from California was a single strand of cable that demarcated the international border.

Back then, Border Patrol agent Jim Henry says he was overwhelmed by the stream of immigrants who crossed into the United States illegally just in that sector.

"It was an area that was out of control," Henry says. "There were over 100,000 aliens crossing through this area a year."

Today, Henry is assistant chief of the Border Patrol's San Diego sector. He says apprehensions here are down 95 percent, from 100,000 a year to 5,000 a year, largely because the single strand of cable marking the border was replaced by double -- and in some places, triple -- fencing.

Both houses of Congress voted on and approved this fence and the President signed it. If laws aren't followed through on, then our government is nothing more than a banana republic. This is unacceptable and I hope everyone rises up and demands that Congress follow through on what they started.

Sunday, December 16, 2007

The warriors - come out and play

Is There a War on Christmas?

That was the question asked by the Chicago Sun Times in their editorials section. Andrea Sarvady argued that there is no war. Like most secular progressives, she made Bill O'Reilly the issue in her arguement that so called war on Christmas is overblown.

It's the "war" Fox News commentator Bill O'Reilly and his "cultural
warriors" battle every December, trying to save Christmas. Frothing at the mouth for hours of air time, O'Reilly extrapolates from various church vs. state skirmishes and politically correct marketing efforts that there is a national conspiracy to eradicate Christmas.

It's ironic, because what this avowed patriot is actually railing against
couldn't be more American: the First Amendment.

Charles Haynes, a senior scholar at the First Amendment Center, explains the guiding principle -- simply, to "treat people of all faiths or none with fairness and respect." Therefore, holiday programs "shouldn't make any students feel excluded or identified with a religion not their own." Religious music shouldn't dominate a choral program, but can be included. Public seasonal displays should contain both secular and religious elements.

This is a peculiar perspective for several reasons. It starts with her peculiar interpretation of the first amendment. Here is the text from the Constitution...

Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances

Now, I must have missed the part where it is against the first amendment to make someone feel uncomfortable. Second, Christmas is a federal holiday. Now, Ms. Sarvady would apparently have us celebrate this FEDERAL holiday without any mention of it anywhere in public. Third, O'Reilly isn't against displaying religious symbols from all the holidays of the season. He just feels as though Christmas shouldn't be singled out and not displayed. Here is how he put it.

The usual Christmas deniers are appalled the ACLU is not going to sue anybody this year. And that's because they lose almost every time they drag Christmas into court. And even those pinheads are tired of wasting money.

In Wisconsin, the state assembly has voted to restore the name of the
"Christmas tree" to the "Christmas tree". That's because they changed it to the "holiday tree". On Capitol Hill, the House voted yesterday 372 to 9 to recognize the "importance of the Christmas tradition and to condemn bigotry against Christians." And those who voted against that Ackerman and Clarke of New York, DeGette of Colorado, Hastings of Florida, McDermott of Washington state, Scott of Virginia, Lee, Woolsey, Stark of California.

So all over the country, the sights and signs of Christmas are on display. Few department stores are telling employees not to say a "Merry Christmas." And the Taliban like oppression of the holiday has largely ceased, but the SPs are not happy about that.

Sarvady's arguement totally falls apart for me with these next two points...

Some school and city officials choose to excise the holidays completely in order to avoid offense. Haynes, a consultant to school districts, feels that year-round education on various religions is a more effective way to mitigate the "December Dilemma."

Though well-versed on all sides of the issue, he still doesn't understand the attack on more all-encompassing greetings like "Happy Holidays," saying: "People who use that expression are just trying to be kind."

...

One of the more insidious aspects of this trumped-up "war" is an eagerness to blame everything on what Peter Sprigg of the Family Research Council calls "overzealous secularist officials." Clever. Pretend the separation of church and state matters only to secular leftists and the rabid right won't sound like they're trying to propagate a religious crusade.

Isn't it amazing how someone supposedly stands up for the first amendment in one breathe and then finds nothing wrong with schools taking away everyone's ability to express their religious beliefs in the other? How exactly is this in keeping with either the letter or the spirit of the first amendment?

Some school and city officials choose to excise the holidays completely in order to avoid offense...

I guess in the world of Ms. Sarvady taking away every religion's right to express itself is protecting the first amendment. Like I said, I didn't know that offending someone was a violation of the first amendment. Then Sarvady uses this strawman arguement.

Pretend the separation of church and state matters only to secular leftists and the rabid right won't sound like they're trying to propagate a religious crusade.

What's clever is pretending as though the separation of church and state is anywhere in the Constitution. The phrase the separation of church and state is nowhere to be found in the Constitution. In fact, it was first used in a letter by Thomas Jefferson

The phrase "separation of church and state" is derived from a letter
written by Thomas Jefferson in 1802 to a group identifying themselves as the Danbury Baptists. In that letter, referencing the First Amendment of the United States Constitution, Jefferson writes:

"Believing with you that religion is a matter which lies solely between Man & his God, that he owes account to none other for his faith or his worship, that the legitimate powers of government reach actions only, & not opinions, I contemplate with sovereign reverence that act of the whole American people which declared that their legislature should "make no law respecting an establishment of religion, or prohibiting the free exercise thereof," thus building a wall of separation between Church & State." [7]

This so called wall is not and never has meant to be to stop any and all religious expressions in the public square. The first amendment is supposed to keep Congress from favoring one religion over another. Now, some might argue that making Christmas a federal holiday violates that principle, however that is found nowhere in Sarvady's arguement. Since she knows that removing Christmas as a federal holiday is frankly a non starter, she makes all of these other arguements. Arguements that only make sense in the alter universe of the secular progressive.

Saturday, December 15, 2007

Crisis in California

That seems to be the word all around the internet. The buzz is rolling in from all over the place.

Arnold Schwarzenegger will declare a fiscal state of emergency in California after badly miscalculating the deficit condition in the Golden State. Last August, he predicted that the state would have a $4.1 billion reserve at the end of this fiscal year, but a legislative analyst predicted in November that California would have a $10 billion deficit. Schwarzenegger now says it's even worse than that:


Here is another view.

Gov. Arnold Schwarzenegger said Friday he will declare a "fiscal emergency" in January to reduce an anticipated $14 billion budget deficit, pressuring lawmakers to fast-track spending cuts and other solutions. The Republican governor has signaled that he wants to cut spending across the board in state programs, while Democratic leaders have said that both spending reductions and tax increases need to be considered...


Let's get a sampling of California bloggers... First, here is a self described "progressive"

Well, this puts a damper on our ever-so-sunny outlook in Sacramento.
Spending will likely be slashed, but when are we going to address the real problem? We can't keep going on this boom/bust budget roller coaster that we are riding. Maybe we can appoint John Laird as our fiscal administrator. Trust me, things would be way better than they are now.

So...um...John Laird for Fiscal Overlord '08!


Conservatives in Calis blogging world are no less happy...

California Gov. Arnold Schwarzenneger is about to declare a fiscal emergency thanks to a complete mishandling of the budget by he and the legislature: Gov. Arnold Schwarzenegger said Friday he will declare a "fiscal emergency" in January to give him and the Legislature more power to deal with the [...]

Hard to spin this as anything but a problem from the Governor, but stay tuned...

40 Year Old Virgin Sex Ed Scene

The AMT and the Lessons of Taxation and Class Warfare

In 1969, in order to make sure that about 100 fat cats paid their fair share Congress created the Alternative Minimum Tax...




In August 1969 as he was preparing the next year's budget Barr warned that the country faced a taxpayers' revolt. He explained, according to the Washington Post, that in 1967 there were a total of 155 individuals with incomes over $200,000 who did not pay any federal income taxes; twenty of them were millionaires. These individuals successfully used all tax loopholes available to legally evade paying taxes. The revelation attracted wide media attention and led to public shock. As he presented the next annual budget, published in the final weeks of his administration, President Johnson indicated that the problem needed to be addressed...


Unfortunately what started as a tax against fat cats has now begun to affect a large majority of Americans.


For more than three decades, the individual income tax has consisted of two parallel tax systems: the regular tax and an alternative tax that was originally intended to impose taxes on high-income individuals who have no liability under the regular income tax. The stated purpose of the alternative minimum tax (AMT) is to keep taxpayers with high incomes from paying little or no income tax by taking advantage of various preferences in the tax code. The AMT does so by
requiring people to recalculate their taxes under alternative rules that include certain forms of income exempt from regular tax and that do not allow specific exemptions, deductions, and other preferences. For most of its existence, the AMT has affected few taxpayers, less than 1 percent in any year before 2000, but its impact is expected to grow rapidly in coming years and affect about one-fifth of all taxpayers in 2010. In her 2003 report to the Congress, the Internal Revenue Service's National Taxpayer Advocate, Nina Olson, labeled the AMT "the most serious problem faced by taxpayers."(1)

The evolution of the AMT from going after 155 fat cats to one that will hit ten million people if it isn't dealt with is a great example how taxes often morph into something totally from its initial purpose and should be a lesson to all politicians about the dangers of using taxes as a means of fighting class warfare.

Unfortunately, many politicians continue to use taxes as a means of fighting class warfare in hopes of finding themselves on the same side of the table with the majority of Americans against the wealthy. For instance, here is how Hillary Clinton feels about the estate or death tax.

“I am more focused on preventing the repeal of the estate tax and returning to what I think are fairer, more effective tax rates for the wealthiest. There may be an argument to be made, which I would be open to but I think you need to look at the entire tax picture. There isn’t any credible argument that the taxes under the Bush administration have gone down disproportionately on high-income investors and earners.”

So what is the so called death tax and why should everyone be concerned when a politician uses it as a means of class warfare?


The estate tax is technically a tax on the transfer of property to others, generally to children of a decedent. It was envisioned to prevent families from passing on huge fortunes and developing a type of royalty in America.

Once again, we have a tax created to make sure that we punish the fat cats. This time they are actually taxed in death. Unfortunately, while the tax death does punish the fat cats it also punishes another class: the savers. Here is a chart of the bottom line levels of an estate's value before it is taxed. For instance, in 2002, any estate worth one million dollars and more would have been taxed. Keep in mind that an estate is everything you own including your home. It is also any retirement that you may have saved up. Let's suppose you saved $100 per month for 40 years and earned an average of 12% on that money. That savings would grow to just over one million dollars after forty years. Someone saving 100 dollars a month is no fat cat and yet they would likely be affected by the estate tax.


Let's look at another tax used by many politicians as a tool in class warfare: the capital gains tax.


A capital gains tax (abbreviated: CGT) is a tax charged on capital gains, the profit realized on the sale of an asset that was purchased at a lower price. The most common capital gains are realized from the sale of stocks, bonds, precious metals and property. Not all countries implement a capital gains tax and most have different rates of taxation for individuals and corporations.



Here is what Barack Obama would like to do to the capital gains tax.


As part of his "Tax Fairness for the Middle Class" plan, Barack Obama is in favor of nearly doubling the capital-gains tax rate from 15 percent to 28 percent. Leaving the fairness issue aside for a moment—as well as the impact of higher taxes on economic growth—the Obama plan could also be called a "Ways in Which Government Can Collect More Taxes to Pay for New Spending" plan, since Democratic candidates are all scrambling to figure out ways to plausibly pay for
new healthcare, education, and infrastructure spending if elected.

Keep in mind that the capital gains tax taxes an gain in any long term investment including stocks and real estate. So, what percentage of American households currently own stocks?


Dramatically more Americans own financial assets now than in the recent past. As recently as 1980, only 4.6 million U.S. households owned mutual funds; by 2003 the number was 53.3 million.

More than half of American families currently own stocks, bonds or real estate. Nearly half of all U.S. households own stocks or stock mutual funds.

So, when Barack Obama promises to raise the capital gains tax to make the tax system more fair he is actually promising to raise taxes on more than half of American households and growing.

Another way in which politicians use taxes as class warfare is through the nebulous word: loophole. Whether its John Edwards, Barack Obama, or
Hillary Clinton, the word loophole is used as another tool in fighting class warfare.


Every day, millions of working Americans go to their jobs, play by therules and hope to make a decent living for themselves and their families. These workers strengthen our middle class and keep oureconomy going. In turn, the vast majority of American employers holdup their end of the bargain by treating their employees fairly.

But sadly, many working men and women are not being treated fairly because some businesses are using a little-known tax loophole to avoidpaying their fair share. It's workers and American taxpayers who paythe price.

...

New York Sen. Hillary Clinton, the front-running Democratic presidential candidate, on Friday urged closing a tax loophole that she said unfairly benefits a few top Wall Street financiers.

Clinton called the loophole a "glaring inequity" and joined other lawmakers in a push to raise the tax rate on "carried interest" gains made by senior partners in the booming private equity and hedge fund businesses.

...

Sen. John Edwards, D-N.C., told crowds Thursday in Des Moines, Iowa, that he would pay for new programs to benefit the middle class by closing loopholes and tax breaks now benefiting the wealthiest Americans.

Remember, the Alternative Minimum Tax itself was created to supposedly close a tax loophole that was also supposed to affect only the wealthiest Americans.

A tax increase speaks for itself. The problem is that many a politician have used tax increases as some sort of tool to appeal to emotions. We have a country of nearly half a billion people and at any given time there are millions who are less successful than they would like to be. Those millions can almost always be quantified by someone and put into percentages. The unsuccessful almost always have a resentment toward those at the top. Politicians see opportunities in appealing to such emotions. By increasing taxes that they see as primarily applying to the successful, they seek to score points with the masses who are largely less successful. Unfortunately, the reality of tax policy is almost never in line with the perception that is created by politicians.

Whether it is the AMT, the capital gains tax, the estate tax, or the nebulous tax loopholes, these, like most taxes, almost always end working the same: by affecting the majority of people.

Friday, December 14, 2007

Giant - Rock Hudson, Elizabeth Taylor, James Dean

More Action From the Legislature Vis a Vis Mortgages

The Legislature just moved to open up FHA loans for many of the borrowers currently facing hardship.

The Senate moved Friday against the worsening mortgage crisis, voting to make it easier for thousands of homeowners with ballooning interest rates to refinance into federally insured loans.

The legislation, approved 93-1, would allow the Federal Housing
Administration to back refinanced loans for borrowers who are delinquent on
payments because their mortgages are resetting to sharply higher rates from low
initial "teaser" levels.

The bill also tries to make FHA loans more attractive than risky subprime loans by accepting lower down payments and expanding the eligibility for counseling for homeowners having difficult with their mortgage payments.

An estimated 2 million to 2.5 million adjustable-rate mortgages are scheduled to reset in the next year, jumping to much steeper rates that could cost borrowers their homes. The wave could crest during the presidential and congressional election campaigns next year, and politicians have been wrestling with what the government's response should be


A colleague of mine pointed out that there are several things that are currently different and still need to be worked out between the Senate and House version.

Downpayment/cash investment: Senate - 1.5% cash investment w/ maximum loan amount of 100% of sales price/value that includes the upfront MIP; House still has a 0% downpayment provision.

· Mortgage limit for “high cost” areas: Senate - $417,000; House – up to $729,000.

· Seller participation in down payment assistance programs:

· Moratorium on implementation of risk-based pricing: Expect a delay of a year before enactment..

· Broker surety bond in lieu of audit: It is in the House bill only. I will be shocked if this makes it in the final bill…Get those audits ready….


Just like every other government action in response to this crisis, this one is flawed and quite possibly counter productive. The main problem lies in the fact that most politicians have no idea how FHA works, and thus they can't possibly know if it will help. FHA has limits on debt to income that are much more stringent than most of the loans the sub prime borrowers are currently in. In other words, most of the borrowers currently struggling in these sub prime loans wouldn't qualify FHA if it is in its current form. If debt to income limits aren't adjusted this move is largely ceremonial.

If, on the other hand, the limits are adjusted so these borrowers would qualify for FHA, then we could be facing the same sort of crisis in FHA within a couple of years. Much of the reason that FHA has been a successful and profitable mortgage is the very limits that it has on debt to income.

Furthermore, the legislators want to increase the loan limits on FHA. What they don't understand is that FHA is a government bureaucracy. When I do an FHA loan, I am not only dealing with the bank but also the bureaucracy of the government. For instance, the FHA bureaucracy assigns a case number to each FHA loan. By increasing the limits, especially if they are increased dramatically to 700k, they will create too much demand for FHA loans for the bureaucracy to handle. FHA loans are already a bureaucratic nightmare for any loan officer to deal with. By expanding them this much, the nightmare will become obscene.

The limits on down payment are also largely ceremonial. Already, FHA only requires a three percent down payment. Dropping that requirement down to 1.5% is negligible.

Thus, the sixty four thousand dollar question is whether or not the debt to income limits will change. If they don't this is a largely ceremonial bureaucratic nightmare. If they do, this will eventually devastate FHA the way that subprime is currently being devastated.

Gotta love our elected politicians.

The Consequences of Shutting Down Grady Hospital and Its Political Implications

As I mentioned earlier, Grady Hospital has joined a dubious category when the JCAHO threatened to revoke its accreditation. Only King Drew in California was ever threatened with such an extreme measure. An investigation by the L.A. Times that was ultimately highlighted by this story forced JCAHO's hand.

Despite a long history of problems at Martin Luther King Jr.-Harbor Hospital, two things set the Rodriguez case apart: the existence of a security videotape showing the woman writhing for 45 minutes on the floor of the emergency room lobby and the public release this week of two 911 calls in which witnesses unsuccessfully pleaded with sheriff's dispatchers for help.

In the case of Grady Hospital, it was community activists, not the media, that alerted JCAHO to problems. Since Grady won't release the findings we don't know what specific problems there are yet. Of course, one only needs to read these pages to know the sorts of horrors that have happened at Grady Hospital.

One night that is what happened. One time he was left in charge of the entire step down unit from 4 PM to 2AM. The first emergency came from one patient who was recovering from lung surgery. The patient's lung collapsed and Kevin was called in to save his life. The patient was suffocating and time was of the essence. Kevin was panicked and needed to move quick. He needed to find a chest tube, but because of his own inexperience, he didn't know where they kept the chest tubes. In a rush, he did the only thing he could think of at the time. He grabbed the dirty chest tube that had already been used on the patient and injected into their lungs.

Next, Kevin was asked to read an x ray of the patient's lungs to determine if they were stable. This is again not something a medical student is supposed to do on their own and without supervision but since their was no supervision there wasn't much choice. Kevin gave it his best estimation and determined the patient was fine however as it turns out that was just a lucky guess. This patient survived but it had nothing to do with the type of care that was provided them at Grady.

I set this context so everyone understands what a total nightmare Grady Hospital is right now. Keep in mind that Grady's current financial crisis is in many ways divorced from the findings of the JCAHO report. In other words, whatever patient nightmares were going on at King Drew, they didn't also experience a financial crisis concurrently. King Drew was ultimately forced to shut down. That is a distinct possibility for Grady as well.

I believe shutting down Grady would create an even bigger nightmare with all sorts of unintended consequences and frankly a situation no one can predict or control. Let's lay out some numbers. Grady Hospital serves roughly one million patients per year. It has five thousand employees and contributes roughly 1.5 billion dollars to the economy in the area. Despite only serving two of Georgia's roughly 100 counties, Grady provides some or all of the training to one quarter of Georgia's doctors. Ninety percent of the staff at Grady is from Emory University with about 400 residents from there on staff at any given time. The entire medical school of Morehouse is trained at Grady Hospital as well. Grady Hospital has about nine hundred beds available. For comparison, South Fulton, the other hospital primarily for poor folks in the area, has 36 beds.

Its important to understand that Grady serves the poor, the indigent, almost exclusively. More importantly, in Fulton, Dekalb, and to some extent the surrounding counties, the poor and indigent are almost exclusively served by Grady. In the case of King Drew there were several other area hospitals that were also already serving the poor. Not so in the case of Grady. Without Grady Hospital the poor would be unleashed on the entire remaining health care system that remains. As a friend in Atlanta once told me

there's no way they will close Grady because the other hospitals don't want their patients

Keep in mind that most of the folks that go to Grady either have no insurance or Medicare at best. In other words, treating them is in no way a for profit operation. Soouth Fulton is the only other public hospital in the area, and there is no way it could handle the entire indigent population of Fulton and Dekalb Counties. Furthermore, Grady is the only level 1 trauma center for hundreds of miles. Severe gun shot wounds, bad car accidents, dismemberments, and other such traumas are all treated there and there only for hundreds of miles. Many times other neighboring states have their level one traumas treated there. In case of a terrorist attack, it would be Grady that would be the only hospital equipped to handle mass casualties in the area.

Furthermore, since Grady is also the main teaching hospital in Georgia, the entire health care teaching system would be traumatized. With 25% of the doctors receiving some or all of their training at Grady, the impact on the medical training is beyond words. Emory's medical school would be the equivalent Northeast Texas State Community College and Morehouse would cease to exist altogether.

I recently pointed out the absurdity of AJC reporter Mike King's column in which he called Grady board members arrogant for making demands not requests in their time of crisis. I doubt very much that you will find anyone in the Atlanta area media that will ever break down Grady's impact the way I just have, however I am certain the powers that be at Grady know full well the numbers that I have laid out. In other words, crisis or not the powers that be know what a vital part of Georgia Grady is and thus they can afford to be arrogant.

This context has political impact and it is also something that I do not believe the Atlanta media will ever explain properly either. Late last month, the Grady board approved a plan that would infuse Grady with much needed cash and make the board quasi private. The timing of this move is very important because it came right before JCAHO's announcement. While this plan purports to deal with Grady's fiscal issues, it in no way addresses the obvious medical care problems currently going on at Grady. Frankly, given the make up of the task force that recommended this plan, as well as other factors, I have already concluded that this quasi privatization plan is nothing more than a stunt that allows the powers that be to continue running Grady the exact same way only with even less oversight.

Now, I believe that the legislators and the Grady board are playing a high stakes game of chicken. It is frankly difficult to surmise which is worse: allowing a corrupt Grady to continue to operate or shutting it down and unleashing its patients on the rest of the medical system and disrupting the states medical education. It is even more dificult to figure out which is the better move politically. So far the politicians appear to be balking at Grady's proposal.

State Senate President Pro-Tem Eric Johnson (R-Savannah) took issue with the demands that state officials support $30 million more a year in funding to Grady and provide state funding for hospital trauma units around the state.

"What? They didn't require us to fund an ice cream cone for every patient?" Johnson said. "I don't think the Legislature responds well to blackmail. ... Grady cannot be treated any different than any other hospital."

I would have to beg to differ with Johnson on one point. Grady can and always has been treated differently than other hospitals. The reasons for this are numerous however most of them have been laid out in this piece. There are very few hospitals in America and the world that are more vital to the community they serve than Grady Hospital. The powers that be at Grady know this all too well and they are now using that fact to try and force the hands of the politicians in Georgia. The politicians can talk tough however if Grady is shut down, that is a situation no one can predict and control. What's going on now at Grady is despicable, corrupt and frankly evil, however it is done almost exclusively to poor folks who really don't vote. By shutting Grady down, on the other hand, the politicians will unleash a nightmare upon everyone else in Georgia, and most of those people do vote.

Thus, we have this complicated and high stakes game of chicken.

EPILOGUE:

If you would like to know how Grady got to this point, please read this summary. Also, please take a look at the recommendations that my colleagues and I have drawn up to fix Grady Hospital.

Disecting the Mitchell Report

The Mitchell Report is out and there is no doubt that it will have a profound effect on baseball. Players of all shapes and sizes have been implicated: from Roger Clemens, to Eric Gagne, to Len Dykstra, to Matt Franco, and on and on. It certainly only scratched the surface as far everyone involved but it no doubt gives everyone a glimpse into how rampant the problem was. I believe that Mitchell should be commended for his work, which I believe was quite thorough, however his conclusions were clear to everyone a long time ago. That is frankly not an indictment of Mitchell but rather of baseball and its fans.

Mitchell correctly pointed out that everyone shares responsibility: from ownership and MLB which looked the other way, to the Player's Union which successfully fought of testing for a long time under the ridiculous guise of privacy, to the players themselves for obvious reasons, as well as the fans who also looked the other way in order to enjoy more homers.

For the most part, Mitchell's recommendations are sensible however also easier said than done.

The Commissioner should establish a Department of Investigations

The Commissioner's office should more effectively cooperate with law enforcement agencies

The Commissioner's office should actively use the clubs' powers, as employers, to investigate violations

All clubs should have clear, written and well-publicized policies for reporting information relating to possible performance enhancing substance violations

Logging packages sent to players at Major League ballparks

Random drug testing of clubhouse personnel

A hot line for reporting anonymous tips

Top draft prospects should be tested prior to the Major League Draft

The design and implementation of the educational program should be centralized with the Independent Program Administrator

Spring training programs should include testimonials and other speakers and presentations

Explain the health risks in context and provide education on alternative methods to achieve the same results

Players need to understand the non-health effects of buying performance enhancing substances from street dealers and "Internet pharmacies"

Prominently display posters about performance enhancing substance use prevention

The drug testing program should be independent, transparent, with unnanounced year round testing

The biggest problem going forward is developing tests for such banned though currently undetectable substances like HGH. Without a test for HGH, the current testing program is to be kind lacking. The larger problem is staying up with all the new performance enhancing drugs that players will find that won't have a test for them.

I firmly believe that the era of wide spread use that we saw of performance enhancing drugs is largely over. While the sport is certainly not rid of cheating, I don't believe that it is systemic as it was. Still, the questions from that era linger. Questions about the hall of fame, records and more will haunt baseball for a long time.

I believe there must be some sort of a line as far as proof of cheating that will bar people from the hall of fame. I don't know what that line should be and it will ultimately be up to the writers to decide. I certainly don't think that the line is a failed drug test. I don't think that there is much legitimate debate as to whether or not Barry Bonds cheated, with or without a failed test. I think that the 75% threshhold for the hall will keep most suspected cheaters out regardless.

The records are even trickier. A friend of mine once suggested the draconian action of putting an asterisk next to any record set between 1988-2004. That would mean that Orel Hershhizer's record (if he took steroids they were certainly not ones that worked) would have an asterisk. If you think that is too harsh, look at the other side and realize the all time home run king is Barry Bonds.

Finally, there is unfortunately no real lessons learned here. Baseball was on the brink of disaster following the strike of 1994. They looked the other way while many people started to cheat. The cheaters started hitting homers at ridiculous clips and the fans took notice. Many of those players not only received extra accolades and attention but money. Most of the players that played fair lost out on the same thing. Many players that would have never thought of cheating before turned to it out of desire or necessity. (see the case of Wally Joyner) The ballparks filled again and baseball came out from under the weight of the strike. The fans didn't much care that players went from skinny to bulky overnight because they now hit lots and lots of homers. I doubt very much that attendance will be down as a result of this report, and thus cheating saved the game.

Thursday, December 13, 2007

The Prophetic Words of Dick Morris

I remember right after the November election that Dick Morris pointed out how difficult it was going to be for the Democratic Congress to govern. The problem, as he saw it, was the many competing factions that make up the Democratic party: The Blue Dogs, The Congressional Black Caucus, The Congressional Hispanic Caucus, and the group allied with Soros and the Nutroots. While all of these groups fall under the Democratic umbrella, they all have competing and varying agendas. As Morris predicted, the Democrats' problem all along has been getting all of them on the same page. This is the underlying story in their continued fumbling of the Iraq issue. The agenda of the Blue Dogs (called Bush Dogs by the Nutroots) is divergent from that of the Soros wing. Without everyone on the same page, the Democratic majority no longer functions like any sort of a majority.

Some if it has come to a head this week as Democrats are pointing fingers at each other for their lack of any coherent agenda.

House Ways and Means Committee Chairman Charles B. Rangel (D-N.Y.) accuses Senate Democratic leaders of developing "Stockholm syndrome," showing sympathy to their Republican captors by caving in on legislation to provide middle-class tax cuts paid for with tax increases on the super-rich, tying war funding to troop withdrawal timelines, and mandating renewable energy quotas. If Republicans want to filibuster a bill, Rangel said, Reid should keep the bill on the Senate floor and force the Republicans to talk it to death.

Reid, in turn, has taken to the Senate floor to criticize what he called the speaker's "iron hand" style of governance.

Democrats in each chamber are now blaming their colleagues in the other for the mess in which they find themselves. The predicament caused the majority party yesterday surrender to President Bush on domestic spending levels, drop a cherished renewable-energy mandate and move toward leaving a raft of high-profile
legislation, from addressing the mortgage crisis to providing middle-class tax relief, undone or incomplete.

The real problem from the beginning is that much of the Democratic victory came in Republican districts and with many of the Democrats in those districts moving to the right of their counter parts. Their leadership, on the other hand, is almost exclusively made up of traditional Northeast or West Coast liberals. From Nancy Pelosi, Charlie Rangel, to Ted Kennedy, those are the leaders of the party. Their liberal traditional agenda is not something that will get the likes of the Blue Dog Democrats re elected.

On Iraq, this problem is most pronounced. There is a group of almost seventy Congressional Democrats that make up the Out of Iraq Caucus. They are almost exclusively Soros types. Therir goal is the immediate withdrawal of troops out of Iraq as soon as possible. This group willing to cut off funds if necessary, and they are so extreme in their views vis a vis Iraq that many times they are unwilling to support bills with a timeline if it isn't quick enough in their estimation.

On the opposite end of the ideological spectrum for the Democrats lie the Blue Dogs. This is a group of forty plus moderates who's position tends to match that of the Republicans. Here is how their position is described.

With Democrats in charge again, the Blue Dogs have played a key role in halting an emerging plan to place strict conditions on war funding. Their revolt helped beat back that proposal, by Pelosi ally John Murtha, D-Pa. Leaders are now considering a watered-down version.

Without unity from all these groups the Democrat's majority becomes a minority.

The Democrats face the same sort of problems on budget and tax issues. Whether it was Charlie Rangel's so called mother of all tax hikes, or any number of budget proposals from David Obey, the leadership has had difficulty getting the Blue Dogs on board with much of their liberal agenda. Where they have been able to get the Blue Dogs on board, they have then faced the threat of a veto from the President.

The Democrats have given nothing more than a token effort to any social issue besides federal funding of stem cell research. That's because on social issues the leadership's position is no more tennable.

Their ideas about marriage, abortion, and, to an extent, the death penalty, and
Gun Control are sometimes more compatible with the Republican way of thinking. This viewpoint is supported by the Pew Research Center and their study "Beyond Red Vs. Blue"

The Republicans, on the other hand, have become nearly unanimously united. They have almost entirely coalesced behind the surge strategy and have never wavered in their demand for so called clean spending bills.

On the budget, they haven't been quite as united however the President suddenly realized what a tool the veto is. As such, the Democrats haven't been able to get much of any budgetary agenda through. In the most recent battle over the budget, the Democrats have become so frustrated that they are now resorting to threats.

Instead, Obey said, he would rip up the compromise bill and devise a new one using the strict spending ceiling set by Mr. Bush - but would reach it by whacking GOP priorities and stripping the measure of billions of dollars in pet projects for lawmakers in both parties.

Obey's remarks to The Associated Press came two days after White House budget director Jim Nussle promised Mr. Bush would veto Democrats' omnibus spending bill for exceeding Mr. Bush's budget by $18 billion.

Nussle had accused Democrats of "trying to leverage troop-funding for more pork-barrel spending," but Obey said the opposite is true - that the White House was willing to relent just slightly on domestic spending in order to obtain up to $70 billion for the wars in Iraq and Afghanistan.

While the Democrats threaten, I am reminded of the last time a President took on Congress on the budget.

These showdowns were epitomized by the budget conflict with then-Speaker of the House Newt Gingrich in 1995. Gingrich refused to pass Clinton's budget proposal, and the latter threatened to shut down the government as Reagan had done in the 1980s. Clinton did not back down, however, and eventually had his budget passed...

I suspect another President will also win this particular budget showdown. All in all, those words uttered by Dick Morris are quite prophetic.

Caddyshack - Chevy Chase shares his wisdom

The Blogosphere Responds to Greenspan

Invariably, the reaction to this article by Alan Greenspan explaining the mortgage crisis as he saw it has been intense. First, here is a sample of the article...

A large segment of the erstwhile Third World, especially China, replicated the successful economic export-oriented model of the so-called Asian Tigers: Fairly well educated, low-cost workforces were joined with developed-world technology and protected by an increasing rule of law, to unleash explosive economic growth. Since 2000, the real GDP growth of the developing world has been more than double that of the developed world.

The surge in competitive, low-priced exports from developing countries, especially those to Europe and the U.S., flattened labor compensation in developed countries, and reduced the rate of inflation expectations throughout the world, including tSo much so in fact that President Bush has taken the extraordinary step of brokering a deal in which some of these ARMs will be frozen.hose inflation expectations embedded in global long-term interest rates.

In addition, there has been a pronounced fall in global real interest rates since the early 1990s, which, of necessity, indicated that global saving intentions chronically had exceeded intentions to invest. In the developing world, consumption evidently could not keep up with the surge of income and, as a consequence, the savings rate of the developing world soared from 24% of nominal GDP in 1999 to 33% in 2006, far outstripping its investment rate.

I, myself, pointed out yesterday that I believe that most of what he wrote was nonsense and an attempt to skirt responsibility. What he is creating is an intelligent sounding and sophisticated scenario, however it is, in my opinion, totally devoid of reality. First, here is how I saw the roots of the crisis. Greenspan attempts, in the article, to minimize his decision to lower Fed Funds Rates to obscenely low levels. The reality is that he can't and it won't be minimized. By lowering the rate so much, below one percent for a while, he created loose money. Loose money invariably leads to irresponsibility. That irresponsibility manifested itself in the mortgage crisis.

That is my view. Now, let's see how some of the rest of the blogosphere and beyond saw it. First, the WSJ had their own section of reactions. Here is a sampling.

1) You explicitly encouraged “risky” ARMs.

2) You say you raised interest rates but the long rate did not rise. And so it is not your fault. The issue here is nuanced.Your policy of completely telegraphed 25bp interest rate increases meant the fixed income market was on the “one and done” bandwagon from 2004-2006. You knew that the forward term premium was
getting destroyed by the policy and did nothing about it. You are also responsible for completely convincing the fixed income market that the fed policy is disjointed from commodity prices.

...

I also was shocked to hear Greenspan recommend that borrowers take ARM loans instead of fixed rate loans in 2004. The low fixed rates being offered in 2004 were historic, and I can’t imagine that anyone over the age of 12 thought they would remain so - especially the head of the Federal Reserve. However, the ARM loans and the low fixed rate loans did not create the problems we see today. The underwiriting standards lenders were using to qualify borrowers for these loans was definately the problem over the last 7 to 10 years...

it wasn't all criticism though...

It’s easy to sit back and criticize The Chairman, but we weren’t sitting in his chair. Why do we expect interventionist policies to cure all the market ills? There is a reason for market cycles, and in this case the easy money didn’t come from the Fed, but from Wall St. All those clever newly-minted MBAs came up with a “New Paradigm” – financing vehicles that abandoned traditional underwriting standards and generated huge fees for them...

It should be noted because I didn't point it out last time that at the height of the real estate boon Greenspan actually recommended that borrowers choose ARM's over fixed rates.

Federal Reserve Chairman Alan Greenspan said Monday that Americans' preference for long-term, fixed-rate mortgages means many are paying more than necessary for their homes and suggested consumers would benefit if lenders offered more alternatives.

In a standing-room-only speech to the Credit Union National Association meeting here, Greenspan also said U.S. household finances appeared generally sound, despite rising debt levels and bankruptcy filings. Low interest rates and surging home prices have given consumers flexibility to manage debt, he said.

Adjustable Rate Mortgages (ARM's) have become the subject of much controversy. So much so in fact that President Bush has taken the extraordinary step of brokering a deal in which some of these ARMs will be frozen. It is, in my opinion, highly irresponsible to make such a blanket statement recommending a mortgage product. Everything depends on the specific situation as to whether or not an ARM or a fixed rate is appropriate. While I have absolutely no use for his statement, I am not so sure that it had that much effect on the crisis. It is an ongoing debate whether or not these ARMs perpetuated or started the crisis. I am in the boat that they perpetuated it. I believe his obscene rate drop was a much more significant factor.

Now, let's sample what others on the blogosphere said. Let's look at several samples from all around the blogosphere.

In other words, Alan Greenspan wants us to believe that the most powerful Fed Chairman in U.S. history was powerless to stop the greatest housing bubble of U.S. history, despite the fact that he stood at the monetary control button that directly inflated that bubble.But he’s a Republican, and a cagey politician at that, so he’s not going to try to avoid responsibility altogether:

...

Thus Greenspan opens the door to an admission of what any—and I mean this literally—fool knows: that his 1% pedal-to-the-metal interest rate policy during one of the great world economic booms of all-time had everything to do with the ensuing drama.But he opens the door no further, and quickly shuts it with this whopper:

In my judgment, however, the impact on demand for homes financed with ARMs was not major.

...

Here's a more-clear-than-usual article by former Fed Chairman Alan Greenspan in which he makes a few important arguments:

"...bubbles cannot be safely defused by monetary policy or other policy initiatives before the speculative fever breaks on its own."

In retrospect, global economic forces, which have been building for decades, appear to have gained effective control of the pricing of longer debt maturities. Simple correlations between short- and long-term interest rates in the U.S. remain significant, but have been declining for over a half-century. Asset prices more generally are gradually being decoupled from short-term interest rates. "

...

Felix Salmon of Portfolio.com pretty much eviscerates him on his lies. That said, however, the main reason why the housing bust seems to be much worse in the US than elsewhere is surely those ARMs – which, as Greenspan concedes, were a function of low short-term interest rates. They allowed many people to buy houses they couldn't afford, which in turn created a massive solvency crisis.

...


While acknowledging the low U.S. interest rates set under his leadership may have contributed to the bubble in U.S. home prices, Greenspan said he felt the roots of the subprime mortgage crisis actually lie with global economic expansion.

...

Greenspan had what he thought were good reasons to put interest rates very low. One consequence of that was to make ARMs look more appealing to a lot of people. Greenspan could have responded to that in one of three ways. He could have ignored the ARM issue. He didn't do that. He could have tried to warn people about the risks of ARMs. He didn't do that. Instead, Greenspan encouraged people to get ARMs. I think it's never really been clear why he did that, but it was pretty bad advice and he just doesn't mention it at all during his retrospective.

...

he lays the blame for the crisis on almost everything else (including the collapse of the Soviet union) but for his own actions of keeping rates too low for too long as the Fed Chairman, even at times expressing helplessness.

...

Greenspan laments the lack of control that central banks had on long term interest rates, most of the crisis has been caused by loans taken on very low adjustable rate mortgages (ARM) which in turn fueled a rise in asset prices to bubble type levels. ARMs are marked to short term interest rates, which have a more or less direct relationship to central bank policy action.

The consensus appears to lie somewhere near my own analysis. Here is a link to the entire sampling and you can see for yourself.

Wednesday, December 12, 2007

Video Clip 8 Mile - Eminem Freestyle - Final Battle (Shook )

King Drew and Grady: Comparison and Contrast

Last week, Grady Hospital entered a dubious and notorious category when the JCAHO threatened to revoke its national accreditation. Only one time previously had the JCAHO gone to such a dramatic step: King Drew Hospital in California. The conditions at King Drew were something out of a bad nightmare.

It might have gone down as the death of a "quasi-transient" woman with a history of abusing drugs. That's how the May 9 death of Edith Isabel Rodriguez was initially reported to the Los Angeles County coroner's office.

But five weeks later, her demise has become a cause celebre, a symbol of bureaucratic indifference. It is fraught with significance not just for one struggling
inner-city hospital but for political and health leaders in the Los Angeles area and perhaps beyond. The county Sheriff's Department, health officials and the Board of Supervisors all are feverishly trying to determine who was to blame and how to prevent a recurrence.

Despite a long history of problems at Martin Luther King Jr.-Harbor Hospital, two things set the Rodriguez case apart: the existence of a security videotape showing the woman writhing for 45 minutes on the floor of the emergency room lobby and the public release this week of two 911 calls in which witnesses unsuccessfully pleaded with sheriff's dispatchers for help.

While the case of Edith Rodriguez became the most visible and poignant, the L.A. Times did a full investigation including undercover work to expose a great deal of the atrocious patient care at King Drew. This five part series turned the problems at King Drew from abstract and vague to real and personal.

The investigation reveals that King/Drew is much more dangerous than the public has been told.Among the findings:

• Errors and neglect by King/Drew's staff have repeatedly injured or killed patients over more than a decade, a pattern that remains largely unscrutinized and unchecked. Some lapses were never reported to authorities — or even to the victims or their families. And some people learned of the severity of the failings only by suing or, in several instances, from Times reporters who sought them out to learn about their care.

• Although King/Drew opened in 1972 with the promise that it would be "the very best hospital in America," it is now, by various measures, one of the very worst. It pays out more per patient for medical malpractice than any of the state's 17 other public hospitals or the six University of California medical centers.

• Entire departments are riddled with incompetence, internal strife and, in some cases, criminality. Employees have pilfered and sometimes sold the hospital's drugs; chronic absenteeism is rampant; assaults between hospital workers are not uncommon. Despite King/Drew's repeated promises to regulators, the problems have gone unfixed for years.

• The hospital's failings do not stem from a lack of money, as its supporters long have contended. King/Drew spends more per patient than any of the three other general hospitals run by Los Angeles County. Millions of dollars go to unusual workers' compensation claims and abnormally high salaries for ranking doctors.

• The hospital's governing body, the county Board of Supervisors, has been told repeatedly — often in writing — of needless deaths and injuries at King/Drew. Recently the supervisors have made some aggressive moves aimed at fixing the hospital. But for years, the board shied away from decisive action in the face of community anger and accusations of racism.

Because of the reporting of the L.A. Times, the JCAHO was left with no choice but this extreme action.

While we still don't know the exact specifics that lead to the same move vis a vis Grady Hospital, you can be sure that whatever the problems are they are just as serious. (We don't know since Grady hasn't made the findings public) Unfortunately, unlike in L.A., the major media in Atlanta has been asleep at the wheel in reporting any malfeasance at Grady Hospital.

If anyone wanted to read about any specific stories that were similarly nighmarish at Grady, they only needed to read my blog.

One night that is what happened. One time he was left in charge of the entire step down unitfrom 4 PM to 2AM. The first emergency came from one patient who was recovering from lung surgery. The patient's lung collapsed and Kevin was called in to save his life. The patient was suffocating and time was of the essence. Kevin was panicked and needed to move quick. He needed to find a chest tube, but because of his own inexperience, he didn't know where they kept the chest tubes. In a rush, he did the only thing he could think of at the time. He grabbed the dirty chest tube that had already been used on the patient and injected into their lungs.

Next, Kevin was asked to read an x ray of the patient's lungs to determine if they were stable. This is again not something a medical student is supposed to do on their own and without supervision but since their was no supervision there wasn't much choice. Kevin gave it his best estimation and determined the patient was fine however as it turns out that was just a lucky guess. This patient survived but it had nothing to do with the type of care that was provided them at Grady.

I have had many apologists try and claim these stories are inaccurate...

Ok, this story is ridiculous. I graduated from Emory medical school in 2007, and no scenario such as the one Kevin described ever happened to anyone I know. We were never left alone in charge of entire floors; that is completely preposterous. And even if I had been, I would have known enough even as a third-year med student to ASK SOMEBODY WHERE THE CHEST TUBES ARE rather than abandon sterile technique and try to insert a dirty one. My guess is that they dismissed him for some real grievance, and he is claiming to be a whistleblower to cover himself.

Unfortunately for the apologists, the facts speak for themselves. Grady isn't being threatened with revocation of their license because a few machines are broken, or some doctors are occasionally careless, or any other mild reason. The action by the JCAHO is extreme because what is going on at Grady is extreme. If this story is inaccurate, how does one explain what is going on at Grady. Since the JCAHO did what they did, it ultimately doesn't matter whether or not this particular story is true. I can assure you that there have been plenty of nightmarish incidents. I know this because the action of the JCAHO speaks for itself.

This particular story is not the issue. The issue is the reporting, or should I say non reporting, of the AJC and other media outlets in the area. For instance, in 2004 the Dept. of Health and Human Services finished an investigation that concluded,

the conditions at Grady Hospital provide a serious and immediate threat to the health and safety of the patients

This report received little if any attention from the AJC when it came out even though its very conclusions indicated that the conditions at Grady were just as dangerous as those discovered by the L.A. Times at King Drew. Had the AJC made an issue out of that particular report, it is possible that many of the problems that are currently facing Grady could have been resolved then. Instead, they treated this damning report as nothing more than a by line. No one ever fully investigated. The report damned four departments specifically: oncology, cardiology, General Surgery, and obgyn. I know this because I got a copy of the report. Only the powers that be at the AJC know why they never got a copy of it.

King Drew and Grady are connected in other ways. Several high ranking members of King Drew found their way onto the staff of Grady Hospital. For instance, Ed Renford held a high ranking position at King Drew before becoming CEO at Grady. Leon Haley was another former high up at King Drew that wound up at Grady Hospital. He was Chief of Emergency Services. This is frankly the equivalent of hiring the former higher ups at Enron to be CEO, CFO, etc at your company. Yet, this too was not something that the AJC ever paid much attention to.

Even now, the AJC isn't doing very much with the Grady story. No one at the AJC is explaining exactly what it means that the JCAHO is threatening to revoke Grady's accreditation. The layman doesn't know the difference between the JCAHO and the NCAA. If they simply read that the JCAHO is threatening to revoke Grady's accreditation, they will have absolutely no context to the story. Unless the media explains to the readers and viewers what exactly this means they aren't going to know or care.

The biggest difference between the two cases is their respective positions within each of their health care communities. King Drew was a fairly large hospital and it catered to the indigent like Grady. The difference is that King Drew was not the only game in town so to speak when it came to serving the poor folks. Thus, closing it down disrupted the health care system in the L.A. area but not to the point that it couldn't handle it. The same is not true of Grady. Grady is massive among the five biggest hospitals in the country. It serves the overwhelming number of poor folks in Dekalb and Fulton County and frankly serves the poor in other counties as well. Closing it down will unleash these folks on the rest of the medical system in the area, and no one can predict the outcome. The consequences of closing Grady are scary and totally unpredictable. Of course, the Atlanta media has done absolutely no reporting on this part of the story.

Because the L.A. Times took its first amendment responsibility seriously the nightmarish conditions at King Drew were exposed and the hospital was dealt with. Whether through incompetence or worse, the AJC has never taken their first amendment seriously vis a vis Grady Hospital. As a result, we have come to the place we have despite repeated warnings.

EPILOGUE:

For a full summary of the entire fiasco at Grady, Emory and beyond please read this piece.

Also, please take a look at the recommendations that I, and frankly mostly my colleagues, have put together for saving Grady Hospital.

Gilchrist, Huckabee and the Minutemen

Yesterday, Jim Gilchrist, founder and head of the Minutemen, endorsed Mike Huckabee for President.

In Iowa today, former Arkansas Governor and Presidential Candidate Mike Huckabee received a major endorsement from Jim Gilchrist, founder of the Minuteman Project. Huckabee said he was honored to receive the endorsement.

“No one can question Jim's commitment to this country and the immigration problem. He has mobilized a group of volunteers to go to the border and draw attention to the issue of immigration. All of us want a policy where people come to this country through the front door, not the back door,” said Huckabee during a morning news conference. Gilchrist added,

"Governor Huckabee actually wrote a plan that I can embrace. I found his ‘Secure America’ plan would open the dialogue and help begin the process of solving the illegal immigration problem.”


This immediately raised the eyebrows of illegal immigration hawk, Michelle Malkin.

Yeah, you read it right–the founder of the border control group, the Minuteman Project, is endorsing open-borders-turned-expedient enforcement convert GOP candidate Mike Huckabee:

...

Huckabee called the endorsement “providential.” I know many grass-roots immigration enforcement supporters will have far less kind words than that.

Michelle has recently become so critical of every politician's stance vis a vis illegal immigration that I frankly beginning to believe that it is now simply to the point of being unreasonable and unrealistic.

Just two years ago, Huckabee appeared before the open-borders Hispanic group,
The League of United Latin American Citizens (LULAC), preaching an open-door
policy. According to the Arkansas
News Bureau
, Huckabee also criticized state legislation requiring proof of
citizenship to register to vote and enhanced reporting of illegal aliens as
un-Christian, un-American, irresponsible and anti-life — not to mention
“inflammatory,” “race-baiting” and “demagoguery.”

...

Bringing up the false convert rear is Sen. John McCain. Earlier this year, he was the
most vocal critic of grass-roots conservatives who mobilized against the amnesty bill. He now says he has learned his lesson and supports securing the border. He has learned nothing. During the shamnesty debacle, he called Rush Limbaugh a “nativist;” over the weekend, he repeated such contemptuous “straight talk” at the Univision debate by assailing what he called anti-Hispanic rhetoric. In an interview with the New Yorker, he irritatedly dismissed immigration concerns in Iowa as marginal and irrational — just a bunch of “senior citizens” in Iowa caught up in the
“emotion” of a cultural assault.

...

Rudy “I supported sanctuary policies before I was against them, but my sanctuary policy wasn’t really a sanctuary policy, anyway” Giuliani now quotes “the advice of a
great man, Father Hesburgh, who said, ‘We must close the back door of illegal immigration in order to preserve the front door of legal immigration.’” In an interview with Washington Examiner reporter and author Bill Sammon, Giuliani now says he really, truly would have deported 400,000 illegal aliens in New York if he could have...

Well, I knew the campaign season was in full swing when I received this on my email...


For the sake of clarity, it is important to note that the Minuteman Civil Defense Corps (MCDC), the nation's largest Minuteman organization, is a 501(C)4 non-profit organization and cannot and does not endorse any candidate for public office. MCDC is not associated with Mr. Jim Gilchrist, who today endorsed Mike Huckabee for president.

Jim Gilchrist’s erstwhile Minuteman Project is itself an organization which by its own representations as a non-profit civic group cannot legally endorse candidates. It does not have any volunteers who observe illegal border activity. It has no border fence building projects. Jim Gilchrist here speaks only for Jim Gilchrist, he does not speak for the Minuteman Civil Defense Corps, nor is he nationally representative of most patriots in the "Minuteman movement" – who under no circumstances could ignore the failed record nor endorse the duplicitous “plan” recently rolled out by candidate Mike Huckabee. The national media needs to recognize that Jim Gilchrist’s endorsement is his own personal statement, nothing more.

The Minuteman Civil Defense Corps emphasizes policy dealing with national border security. The only "plan" to ensure border security that is acceptable to our constituency would be a candidate policy statement declaring that his first act as President will be to hold a press conference and announce to the American people an executive order to immediately deploy and fund 30,000 National Guard personnel to the U.S. Borders (25,000 to the southern border and 5,000 to the northern border) to complement a massive increase in U.S. Border Patrol Agent field personnel, and a bilateral effort to secure our frontiers, smash the drug cartels, shut down the human smugglers and protect the public safety of the citizens who reside along the borders on both sides of our national boundaries.

Unlike this last-minute opportunism attempted by Huckabee, many of the other GOP presidential candidates have actually helped push the issue of national border security forward for some time. Tom Tancredo’s many years of hard work on the border crisis and illegal immigration issues have all the candidates striving to sound like him. Duncan Hunter can take personal credit for getting the highly effective San Diego border fence built. Ron Paul has been to the border with us first hand and aggressively pushed positive border legislation. Alan Keyes has done more than anyone to support the organizational development of MCDC, and personally participated in the Minuteman Border Fence Groundbreaking – advancing a citizen’s construction effort which has forced Congress to finally get the Feds building physical border fence.

Only one Minuteman group is conducting regular multi-state border security efforts, building fence and aggressively monitoring Washington DC: Minuteman Civil Defense Corps. We would like to extend an invitation to all the presidential candidates, Republican and Democrat, to come to the border and see what is really happening on our nation’s frontier. Not to take the safe little government photo-op helicopter ride, but see the lay-up sites full of trash and debris. See the rape trees. See the violent crime in the border towns. Walk on the pathways of destroyed environmental terrain trampled by tens of thousands of invading foreign migrants. See what the American elites’ support of broken borders, unfettered illegal immigration and sanctuary cities is doing to our fellow Americans who live on our borderlands, and how these failed policies imperil our nation’s safety, security and prosperity.

With your support MCDC continues to make Border Security and Illegal
Immigration a national priority that must be resolved. Now more than ever we
need your help to continue the fight.


Now, I have long been of the opinion that this hyperanalyzing of people's records is useless and misleading. There is no way to govern for any extended period of time without having plenty to criticize on plenty of issues if your record is dissected enough. I am skeptical of Michelle's and others intense and harsh criticism of Huckabee's record, however I do believe everyone should see this email.

The Peculiar, Enigmatic H.R. 1955

I have only recently been made aware of this bill and for now I will reserve judgement besides the observation that it is peculiar and enigmatic. It is called the Violent Radicalization and Homegrown Terrorism Prevention Act of 2007 and it is sponsored and promoted almost exclusively by Democrats led by Jane Harmon. Thus, not surprisingly, this has made it the target of conservative pundits.

Thus, Orwell says, we end up with political language that consists "largely of euphemism ... and sheer cloudy vagueness."

That's how we end up with terms like "surge" for escalation, or "enhanced interrogation techniques" for torture.The language of H.R. 1955, The Violent Radicalization and Homegrown Terrorism Prevention Act, which passed the House on Oct. 23 and is now in committee in the Senate, has that Orwellian quality of sheer cloudy vagueness, and as such lends itself to the potential for 1984-ish Thought Police in the form of a committee.

I have personal experience with the dangerous and corrosive effect of vague legislation in my business, mortgages. Thus, my radar is up to the potential dangers pointed out in this column.

It is also being challenged on civil liberties grounds.

Many scholars, historians and civil liberties experts say they fear that the proposed bill will set the stage for future criminal legislation that be used against U.S.-based groups engaged in legal but unpopular political activism, ranging from political Islamists to animal-rights and environmental campaigners to radical right-wing organizations.

"This bill fits the pattern we are seeing coming out of Congress - both Republican and Democratic - of a continued campaign of fear, which gets into heads of Americans that we now need to start criminalizing ideology," said Alejandro Queral, executive director of the Northwest Constitutional Rights Center. H said he is very concerned about the bill's vague definitions of "violent radicalization," "homegrown terrorism," and the terms within the definitions including "extremist belief system," "violence" and "force."

"What is an extremist belief system? Who defines this?" Queral questioned. "Planes flying into the World Trade Center is an extremist belief, but are anti-abortion activists extremists? Are individuals who liberate mink extremists? These are broad definitions that encompass so much, which need to rather be very narrowly tailored. It is criminalizing thought and ideology, rather than criminal activity."

I think the vague definitions that this bill appears to have lends itself to potential abuses of civil liberties. The bill is certainly well intentioned. Home grown terrorists are a big and bigger problem. That said, it doesn't seem to me to be something that can be legislated. This seems to be a priority law enforcement, intelligence, and homeland security matter. I don't think you can legislate tougher measures against homegrown terrorists. That happens when departments apply more pressure, more focus, and more resources to the matter.

Finally, from scanning the bill, I have found one other big potential problem. Here is the full text of the bill. Here is the part that concerns me.

The Secretary of Homeland Security shall establish or designate a university-based Center of Excellence for the Study of Radicalization and Homegrown Terrorism in the United States (hereinafter referred to as `Center') following the merit-review processes and procedures and other limitations that have been previously established for selecting and supporting University Programs Centers of Excellence. The Center shall assist Federal, State, local and tribal homeland security officials through training, education, and research in preventing radicalization and homegrown terrorism in the United States. In carrying out this section, the Secretary may choose to either create a new Center designed exclusively for the purpose stated herein or identify and expand an existing Department of Homeland Security Center of Excellence so that a working group is exclusively designated within the existing Center of Excellence to achieve the purpose set forth in subsection...

Invariably, whenever Congress identifies a problem they want to study it. Invariably, this group turns into nothing more than an added layer to the bureaucracy that comes to the federal government for money, my money and every other tax payer's money. I have already pointed out the huge potential problem of the added bureaucracy of the SAVE Act. Yet again, Congress has created a bill that will ultimately add to the size of government.

I am not against studying homegrown terrorists, however there are two things that I see to be problematic here. The first is that it is best studied through field work. In other words, the FBI agents, secret service, and police that are out on the street battling homegrown terrorist are in effect engaged in the study of homegrown terrorists. This isn't the sort of thing that academics studying theory would contribute in any reasonable way. We don't need Congress to act to do this. Hopefully, it is already happening. Second, I don't think my tax dollars should go to such theoretical research. If someone wants to fund a university to study homegrown terrorists, let them but it shouldn't be my money.

GoodFellas Full

Alan Greenspan Tries to Rewrite History

One of my least favorite things about the mortgage business is how everytime something goes wrong each party blames another party. Almost never does someone take responsibility and fix the error. Instead, they try to blame someone else and act as though fixing the error is someone else's responsibility.


I bring this up because Alan Greenspan wrote a column in today's Wall Street Journal. Greenspan laid out a very interesting and detailed version of the events that lead up to the crisis...



The root of the current crisis, as I see it, lies back in the aftermath of the Cold War, when the economic ruin of the Soviet Bloc was exposed with the fall of the Berlin Wall. Following these world-shaking events, market capitalism quietly, but rapidly, displaced much of the discredited central planning that was so prevalent in the Third World.

A large segment of the erstwhile Third World, especially China, replicated the successful economic export-oriented model of the so-called Asian Tigers: Fairly well educated, low-cost workforces were joined with developed-world technology and protected by an increasing rule of law, to unleash explosive economic growth. Since 2000, the real GDP growth of the developing world has been more than double that of the developed world.

The surge in competitive, low-priced exports from developing countries, especially those to Europe and the U.S., flattened labor compensation in developed countries, and reduced the rate of inflation expectations throughout the world, including those inflation expectations embedded in global long-term interest rates.

Now, this might be the height of my own hubris, however I find his entire narrative to be nothing more than intelligent sounding nonsense. The reason is that he is trying desperately to avoid his own responsibility in the mess. I pointed out his responsibility in this piece. While Greenspan would like us to take the roots back twenty years, I think we can find something more important much closer to the present.
This is a chart of the Federal Funds Rate which as Head of the Federal Reserve Greenspan controlled until recently. As you can see between the middle of 2001 and the middle of 2003, the rate was absurdly low. It reached below one percent for a period of time. Greenspan can try and re write history however by lowering the rate that much he created loose and easy money. While he may not have predicted the mortgage mess per se, he should have anticipated the law of unintended consequences. He should have known that it was irresponsible to leave rates that low for that long. He should have known that if banks could borrow from the Fed (which is the purpose of the Federal Funds) for so little, that they were bound to act irresponsibly with the money.
He can pin this on some sort of a complicated alter universe in which a sophisticated network of globalization combined with asleep at the wheel credit agencies, arbitrage players, and poor savings. He can do this, but it still isn't going to tell the whole story. To add insult to injury, Greenspan actually tries to justify his irresponsibility while paying nothing more than passing lip service to what it actually caused.
and my colleagues at the Fed believed that the potential threat of corrosive deflation in 2003 was real, even though deflation was not thought to be the most likely projection. We will never know whether the temporary 1% federal-funds rate fended off a deflationary crisis, potentially much more daunting than the current one. But I did fret that maintaining rates too low for too long was problematic. The failure of either the growth of the monetary base, or of M2, to exceed 5% while the fed-funds rate was 1% assuaged my concern that we had added inflationary tinder to the economy.
The entire piece is full of technical language and it is told in a manner only fit for an expert. I don't know if Greenspan hoped to impress anyone or if he merely actually believes the load of bull that he is selling. I do know that China, credit ratings, and poor savings rates played a much smaller role in the crisis than the irresponsible and precipitous drop that the Fed took on the Fed Funds Rate.
The root of the crisis as I see it was loans that were created for irresponsible borrowers. These loans were created because banks suddenly had an infusion of loose money that they were able to borrow from the Fed. Because the rate was so outrageously low, banks felt more room to take risks. They did and that started the ball rolling. While Greenspan painstakingly tried to explain the root cause going back to right after the Cold War, he conveniently overlooked his own responsibility in the crisis. Unfortunately for Greenspan, I don't think that history will have such oversight.