Medical expense is an almost universal problem (except for those who are making a fortune on it).  You who are reading this essay have had to face outrageous medical expense.  You don’t need horror stories about them, but those stories are as common as fleas.  I recently had to pay $5000 for a test to see if I could get a new sleep machine to replace the one I had been using for twenty years.  The machine cost under $300.  Medical expense has become the most common reason for personal bankruptcy.  And then there are the hedge fund folks buying up medical providers and tripling and quadrupling the cost of life-saving devices like Epipen.

So we are all desperate to solve the problem, and yet a viable program to solve it has become a political football.  That makes no sense.  Republicans are suffering just as badly from the outrageous cost of medical care as Democrats or Libertarians or whatever.  Yet they yell at each other across the aisle, nothing gets done, and the folks profiting from this madness smile complacently and plan another price hike.

There is only one solution, because there is only one problem.  The cost of health insurance rises only because the cost of medical care rises.  The problem is the rising cost of health care, and the solution is to stop those rising costs.  We have to stop providers from building one hospital on top of another.  We have to stop drug companies from playing patent games to keep the cost of common drugs irrationally high.  And we have to streamline the insuring of medical cost so as to eliminate double and triple and even sextuple insurance premiums for the same bills.

So, smarty pants, you might well ask, what is this one solution you think you have?  Okay, here it is, but you have to think a bit here.  First, install truly universal coverage.  Cut the country into grids, auction off the sections to existing medical insurers, and let them provide the coverage for their sections subject to a public service commission to supervise their profits.  In other words, make health insurance a utility, like water and electricity and gas.  Then, take coverage for medical expense out of every other kind of insurance and every other kind of claim.  Since medical expense is covered for all, there is no need to provide for it in worker’s compensation claims or auto claims or products liability of medical malpractice claims.  There would be a sharp reduction in the premiums for these items.  Finally, allow the companies, either alone or in concert, to negotiate the cost of medical expense.  Let them negotiate with drug companies for a better price on drugs, with the providers of medical machinery for a lower cost for expensive machines like MRI and CT scan machines.  Let them negotiate the price of a hospital stay.  Let them, in other words, have the power of collective bargaining that will reduce the cost of medical care across the board.

The real insanity of the present situation is that the medical industry has control of both supply and demand.  It tells us what we need, and it supplies what it tells us we need, and it sets the prices without discussion.  It is as if a car dealer would call you and tell you that you need a new car, and then, after he delivers the new car, hands you the bill without ever having discussed it.  We are consumers with absolutely no rights as to what we are supposed to consume or how much we are supposed to pay for it.  That is nuts, and it is damaging all of us, regardless of our politics.  It is up to all of us to go pound on political doors left and right and tell them to stop playing this lunatic game and solve it together.


The most confounding part about the success of Donald Trump in getting a very large part of the American electorate to support him is just that — that Trump has a very large part of the American electorate supporting him.  Despite his almost complete ignorance of foreign affairs, his almost complete lack of specific plans for the major issues facing Americans and his almost complete lack of respect for minorities and women, the core elements of the Republican political brokerage continue to give money and send out their spinners to try to salvage this bleakest of candidacies.

Those segments of the Republican constituencies that have continued their support for Trump will find it more and more difficult to support the man when every day brings new revelations of his open disdain for minorities and women and his almost complete lack of fitness for office.  Evangelicals, Republican women, minority Republicans are all having whatever motivation they had for supporting him eroded to non-existence.  The poll numbers in swing states, and even in states solidly within the Republican family, tell the tale of desertion from the disaster that is now Donald Trump.

Yet still the money comes.  Still the Kochs and the Adelmans keep pouring in millions to keep Trump in the race.  And still the spinners are showing up on the news shows and doing their dogged pivots, answering questions about Trump’s disgusting statements with the same tired attacks on Clinton’s record.

Why?  And, once we ask that question, we have to ask about all the rest — voter restriction laws, legislative obstruction, refusal to do their constitutional duty on Obama’s Supreme Court appointee. the blatant gerrymandering, etc.:  what is the overarching principle driving all of this?  It can’t be anything spiritual, because this man has insulted the very notion of spirituality.  It can’t be the conventional principles that define true conservatism — smaller government, commitment to family values, etc. — because this man routinely insults every one of these.

What then?  I suggest that there is only one possible explanation:  money.  For some time now, the money behind Republican candidates have had three goals:  reduce income taxes for the wealthy, reduce the capital gains tax, and eliminate the inheritance tax.  They have succeeded, and have likely done so beyond their wildest dreams.  In doing so, they have driven the American economy to the edge of bankruptcy, and they know it.  Their single thought now is to hang on to their fleecing of America as long as they can.

So, they will support even this most disgusting of people to the very end, and, I suppose, when the people have finally come to their senses and restored on the wealthy a reasonable income tax, capital gains tax and inheritance tax, they will console themselves with the observation that they gained more than they ever thought possible.

More perhaps than any other event in our time, more even than the massive fraud perpetrated by Wells Fargo or the even more massive fraud perpetrated by the entire financial industry with subprime mortgages, the continued financial support of Donald Trump illustrates, nay more proves beyond any doubt, the single-minded commitment of the Trump money men and their ilk to a policy of unadulterated self-interest.  Nothing — not the middle class, not the religious communities, certainly not the poor and needy, and most of all not the American ideal — outweighs their determination to feather their own nests by accumulating wealth beyond measure.

The great and terrible fear, apparently irrelevant to these money mongers but stomach-grinding to the rest of us, is that this obsession with self-interest would eventually bring down the country itself.  There is, however, hope too.  Trump is the natural consequence of the years of greed.  By his conduct, he leaves the façade of sincerity that greed has forced upon the Republican party in irreparable tatters.  It also, one can only hope, will drive those who supported Trump to this bitter end to do a bottom-up examination of conscience about what they really want America to be.  Our nation was founded on the absolutely unquestionable obligation that we have to the rights of every human being.  We have, for these and other reasons, wandered far from that defining first principle.  Maybe, just maybe, the disaster that is Donald Trump will haul us back to a recommitment to that founding ideal.  And maybe the Republican party will rise from the ashes of this election to once again pursue policies defined by the true meaning of conservatism.

Let us hope.


I live a pretty quiet life.  I walk through streets of my town, and I walk through parks in my town without any fear.  I walk among people of different ages and races and gender without much thought of our differences.  Cars and trucks and bikes go by in generally good order and without much difficulty.  It is, as I said, a pretty quiet life.

Yet in my town there is crime.  There are gangs, and there is trafficking in drugs, and there are robberies and burglaries and shootings and murders.  There are traffic accidents that cause injury and even death.

I, however, see almost none of that except in the newspaper.  Why?  Because my community has hired and trained a large group of men and women to stand between me and those gangs and crimes.  Were it not for those police, I would likely see, and would likely be the victim of, those gangs and those crimes.

We ask a great deal of our police officers.  We ask them to stand between us and the world of crime and violence.  We ask them to spend their days and nights facing the brutal world, the ugliest underside of our society.  There are those who take advantage of the freedom intrinsic to our society, the freedom that defines what it is to be an American, in order to serve their own perverted interests.  We ask our police to deal with such people day in and day out so that we can live our lives in peace and exercise that freedom for ourselves.

Street crime (as opposed to white collar crime, about which another day) is by and large a function of poverty.  Nothing would do more to reduce street crime than to give those in poverty-stricken communities the opportunity to get better education and better opportunities for meaningful employment.  So the most glaringly obvious solution to street crime is to concentrate on improving the lives of our poorer citizens.

What is most definitely not the solution is to ask our police forces to solve the problem.  It makes no sense at all to try to reduce crime in our poorest areas simply by putting more police in those areas.  At best, that only suppresses rather than solves the problem.  We already ask a frightening amount of our police officers.  We ask them to deal with the ugliest and meanest side of our society so that “we others” don’t even have to see it.  We cannot expect that these men and women would at the same time create in those poorer communities the opportunities and atmosphere in which street crime is no longer acceptable.

How do we create such atmosphere and opportunity?  I haven’t the foggiest notion.  It rests with the whole community to make it happen.  It rests with the politicians and with the leaders of the community and with educators and with entrepreneurs.  In sum, it rests with all of us to raise up the poorest of us.

One thing is sure.  We cannot add such an enormous burden to the already staggering role of our police forces.  We need to thank every one of them for letting us live our quiet lives, and we need to all work together to make sure even the poorest of us can have that same kind of life.