The Devil in the Details

The Devil in the Details
By Jerome Grossman

Despite President Barack Obama's brilliant performance at his primetime press conference on health care, Republicans and some conservative Democrats are balking at the details of the proposed legislation. But the devil is not in the details. It is in the commitment of the nation to the national health. The president needs to activate the conscience of America to take care of all of its citizens.

The president needs to challenge the country to declare that health care is a natural right of citizenship, like the right to an education, the right to vote, the right to police and fire protection, the right to military defense of the homeland.

Once that principle is established, the Federal Government can determine implementation by examining the best practices on cost and efficiencies in other countries. It is no secret that dozens of nations deliver health care to their people at half of the per capita cost in the United States while attaining better health results than the U.S. in the standard measures of longevity, infant mortality, hospital stays, etc.

The cost of universal health care is unsustainable to the average private citizen. That is why the cost must be assumed by the Federal Government. Health care must be a national enterprise because diseases often spread from those without care to the most cared for sectors of the population. What begins as a moral question becomes an issue of self-defense for the total society.

Our political and moral leaders must emphasize the social aspects of taking care of everybody. If Texas or Florida or California or New York or Massachusetts were invaded by foreign armies, would we not rally to repulse the invader? If any army of microbes invaded the bodies of the 50 million Americans without health care shouldn’t we rally to repulse the invader?

The devil is not in the details. The devil is in our failure to act as one people, liberty and justice and health for all 306,985,793 citizens. We can find the money to defend the health of 50 million Americans the way we found the trillion dollars we spent to defend 28,221,180 Iraqis and the trillion dollars we are spending to defend 32,738,376 Afghanis, 6,930 miles from Washington,D.C.

Eliminate Unemployment

Eliminate Unemployment
By Jerome Grossman

7.2 million people have lost their jobs since the start of the recession. The effects of these layoffs have been horrendous on the workers and their families. The recession is making us sick, the employed as well as the unemployed. For most, losing your job means losing your health insurance. You drop your gym membership if you have one. You delay medical care to save the cost. You eat cheaper, less healthy foods. You roam the streets applying for jobs below your skill level, even part-time jobs at low wages just to bring something home. Your skills deteriorate. Your confidence in yourself, in your future and your country begins to melt away.

And it wasn't even necessary

At the office or factory that had trained you in their products and procedures, the decline in business was 20%, so 20% of the capable and trained workers or salespeople or executives were let go. All that experience, all that know-how put onto the street to worry and scrounge and beg the government or another employer for crumbs. Don’t break up an effective organization. Share the pain. Divide the available work among all workers. Prepare for a better future.

The cost reductions to the organization would be the same as the cost reductions realized with layoffs but the organization would remain intact poised for the eventual economic recovery. The cost to the government for unemployment relief would be much lower. Public and private morale would be higher. Increased hope and optimism would improve our mental and physical health. Crime induced by poverty and desperation would decline. Confidence would help to restore our economy. This is the America where we share the pain, help each other out, or do we?

Senator Frankenstein Goes to Washington

Senator Frankenstein Goes to Washington
By Jerome Grossman

Minnesota finally has a new senator. Al Franken, a professional comedian running for office for the first time, overcame Norm Coleman, a professional politician

Franken has a national reputation in show business. In his unique comedy style he covered the 1992 presidential conventions on Comedy Central TV and has delivered his blend of humor, disrespect and analysis at many universities and corporations. He is never at a loss for words, comments, insults and jokes. Franken keeps the listeners awake.

Liberal Democrat Al Franken's best friend and his partner in show business is Ben Stein, a political mirror image, a hard-line conservative. Stein is an actor who was also a speechwriter for President Richard Nixon, and believe it or not, writes a column for the New York Times business section most Sundays.

In their performances, the pair is presented as Stein/Franken, because, as Al jokes, Stein is older and thus gets first billing. However, some critics say that a more descriptive name would be Franken/Stein as depicted in the original book and movie about a horrible creature composed of body parts taken from the dead and assembled by a scientist. Preparation for the Senate?

Of course, Ben Stein will not be a partner in the Senate, but the grimly humorless Republicans may choose to play with the Franken/Stein name of horror, making mistakes on purpose.
“Will Senator Frankenstein yield?”

Will the new Senator use his formidable nickname to intimidate his political opponents? Or at least get Senator Lieberman to behave? If Senator Al begins to strut around the Senate floor in imitation of the strung-together monster, will he be censured for disrespect? Or will the Republicans bring Vice President Cheney to shoot this caricature of a manufactured Senator? In any case, there will be no love interest in this movie as the Republicans try to get Franken to clown while he will be determined to be the most serious senator on the floor. A new day may be dawning in the U.S. Senate, a day with performances interrupting the tedium. And where is Senator Groucho Marx now that we need him?

Put another Frances Perkins on the Obama Team

Put another Frances Perkins on the Obama Team
By Jerome Grossman

When Franklin Delano Roosevelt asked Frances Perkins to be his Secretary of Labor in 1932, she said she would accept only if he would support her social justice agenda: Federal relief and large-scale public works programs to help victims of the Depression, federal minimum wage and maximum hour’s law, a ban on child labor, and unemployment and old age insurance. The New Deal was born. These were revolutionary goals for the time, but Roosevelt agreed. “I suppose you are going to nag me about this forever”, he said. And she did, acting as his conscience when Roosevelt faced difficult political problems with his progressive agenda.

Perkins, born in Boston, raised in Worcester, Massachusetts in a middle-class Republican family, attended Mount Holyoke, majored in chemistry and physics, but a course in political economy changed her life. Sent into local mills to report on the lives of the workers, she was so moved by the experience that she became a social worker and reformer. She helped Jane Adams in Chicago's Hull House; worked with immigrants in Philadelphia, studied sociology and economics at Columbia before working for the Consumer’s League. Heavily influenced by the fatal fire at the Triangle Shirtwaist Factory in New York City, she became a key reformer for worker safety, was appointed by New York Governor Alfred E. Smith to the powerful State Labor Board. When FDR succeeded Smith in 1929, he named her head of the entire department...

Her role in the famous first 100 days of the FDR presidency has been under appreciated. She was the strongest advocate for a federal relief program, led the development of the plan that was implemented, persuaded FDR to support large-scale public works despite his skepticism, fought for the National Industrial Recovery Act, the Works Progress Administration (WPA), and the Fair Labor Standards Act. Allied with Eleanor Roosevelt, she was effective in pushing her very political president to live up to his liberal reputation. Her imprint was so large that political opponents took to calling the FDR administration the Perkins New Deal. And she accomplished all this while being harassed as a liberal and the first woman Secretary of Labor.

President Barack Obama assumes office at a similar time of crisis: instability is in the air, large segments of the population are hurting, relief is needed at every level, unemployment is rising, banks are failing, and Wall Street has lost the confidence of the public. Relief and change are required, especially new approaches to rescue the workers at the sustenance level from the Hoover-like policies of George W. Bush.

But personnel defines policy and Obama’s liberal instincts cannot be implemented by appointees from the center, by definition. To achieve a national consensus, Obama’s selected helpers come from the center of U.S. politics, few from labor, almost none from the liberal wing of the Democratic Party, some from the Republicans, most of them veterans of the Clinton and Bush administrations.

Obama needs advisers and appointees like Frances Perkins, people committed to rescuing the masses of Americans, whose horizons are not limited by corporate bailouts, who are willing to take approaches outside the conventional wisdom, ideas that will find ways to extend the benefits of the richest country in the world to all Americans. Obama understands this approach, the Perkins approach to social and political problems. He has repeatedly said that if he were constructing a health-care system for America from scratch, it would be single payer. Yet his multiple advisers are not even considering a single payer plan, not even putting a single proponent on the health care team.

Louis Gerstner, the former chief of IBM, praises Obama but criticized the way the White House handled restructuring of General Motors and Chrysler. “Who did we pick to figure out how to fix the automobile industry? We picked two investment bankers. It’s sort of like asking the arsonist to run the fire department.”

If Obama had Frances Perkins on his team, the president's proposals would be quite different.

About Health Care

About Health Care
By Jerome Grossman

Dr. Marc Sklar, an endocrinologist in Washington, DC was quoted in the Wall Street Journal, “If we could prevent even a small percentage of people from becoming obese and developing these conditions (diabetes, hypertension, and other chronic problems) the cost of healthcare could go down far enough to cover everyone's insurance.”

Dr. Marcia Angell, former editor-in-chief of the New England Journal of Medicine and now at Harvard Medical School, wrote in the Boston Globe, “The reason our health system is in such trouble is that it is set up to generate profits, not to provide care. We rely on hundreds of investor-owned insurance companies that profit by refusing coverage to high-risk patients and limiting services to others. They also cream off about 20% of the premiums for profits and overhead.”

Paul Krugman, Nobel Laureate in Economics, wrote in the New York Times, “The insurance industry is busily lobbying Congress to block one crucial element of healthcare reform, the public option - that is, offering the right to buy insurance directly from the government as well as from private insurance companies.”

The United States spent more on health care than any other country as a share of gross domestic product in 2006, the most recent year for which totals are available. But the survival rates for American patients on infant mortality and population longevity lag behind other countries.


United States 15.2%
Canada 10%
Australia 8.7%
Brhain 8.2%
New Zealand (2003) 8%

Between 2000 and 2007, the 10 largest publicly traded insurance companies increased their profits 428%, from $2.4 billion to $12.9 billion, according to Securities and Exchange Commission filings

Since its founding, Mayo Clinic has paid physicians with salaries to avoid financial conflicts of interest in clinical decision-making, and to promote multi-disciplinary coordination of care. Less well known, was its principle of billing based on patient’s means.

Senator Ron Wyden, Democrat of Oregon, says,” Democrats always blame the insurance companies, and Republicans always blame the trial lawyers….. A new system also requires tough malpractice reforms….. Cost containment is the Achilles heel of the Massachusetts Universal Coverage plan.”

President Obama said on June 18, “There are already a bunch of liberals who are disappointed because I didn't propose a single payer plan….”

Former Senate Majority Leaders Tom Daschle (D.-S.D.), Bob Dole (R-KS.) and Howard Baker (R-TN) on June 17 unveiled a bi-partisan blueprint for health-care reform that includes a public plan compromise and a requirement that all Americans must purchase insurance. All three men represent private-sector clients in the health-care debate.

The Washington Post wrote about health care holdings of federal legislators: “Nearly 30 lawmakers on committees drafting health-care legislation have financial holdings in the industry, totaling at least $10.8 million dollars and as much as $26.8 million.”

Dr. Abraham Varghese, professor at Stanford University, has written, “All the marvels of science, all the advances of medicine don't replace what patients want of their doctors and what most of us wanted to offer when we felt the calling to medicine: The opportunity to be fully present at the bedside, to bring the human comfort that only the presence of an attentive physician can bring, to convey to patient and family the unspoken promise, I will stay with you through thick and thin.”

The Crisis in U.S./Muslim Relations

The Crisis in U.S./Muslim Relations
By Jerome Grossman

In Cairo, President Barack Obama addressed the world's billion Muslims preaching the values of political freedom, democracy and human rights. Remarkably, he virtually apologized for the repeated Western interference in the affairs of Muslim nations, citing the overthrow of the democratically elected government of Iran in 1953 by the U.S. CIA and its British counterpart, then the installing of a dictator in that country. While this act of contrition was widely welcomed, it had already been performed by Secretary of State Madeleine Albright during the Bill Clinton Administration without improving the relationship. Iran was placed on “The Axis of Evil”.

If President Obama was promising a policy of non-intervention in the Middle East, it did not reflect the operating situation there. The U.S., under Democratic and Republican presidents alike has gone to war, sometimes to protect, sometimes to oust regimes in the area: e.g. in 1991 to protect Kuwait from Iraq, in 2002 to oust Saddam Hussein from Iraq. Another rarely discussed U.S. intervention but high in the consciousness of Iranians is the support the U. S. gave to Saddam Hussein when he attacked Iran in 1980. In this eight year war, Iran lost more than one million lives and suffered Saddam's repeated use of poison gas on civilians and the military.

Obama promises to change the historical behavior of the U.S. in the area. Will his preaching lead to the over-throw of America’s favored dictators? Apart from Israel, the countries we support there are dictatorships, any elections held are merely automatic endorsements of reigning corrupt dictators in Egypt, Jordan, Saudi Arabia, Kuwait, United Arab Emirates, etc. For generations, starting with the administration of Franklin Delano Roosevelt, our politicians, business leaders, military and intelligence staffers and diplomats have found it easier to deal with dictatorial establishments than with the messiness of prolonged negotiations involved in democratic procedures. Guarantees of military support or well-placed financial contributions often produce policies more quickly and efficiently.

Literal adoption of Obama’s good government recommendations would likely impede the U.S. system of dominance in the Middle East, opening it up to competition from other nations now frozen-out. The commercial position of the U.S. oil companies might be in danger. The price of oil might be driven to new heights. The Arab countries might decide to leave the U.S. dollar for better deals with rival currencies and to invest their surplus funds in venues other then American Treasury Bonds. Rival countries might try to play the game of bribing government officials. In a democracy, the possibilities for change and competition are endless when the pool of competitors is expanded.

The crisis in Iran highlights the possibilities for change in all Muslim nations by breaking established patterns of conduct. In Cairo, President Obama set forth the ideals that might not support the current system and world American hegemony. Is the U.S. prepared to sacrifice its preeminence for the ideals of openness and democracy? Will the dominant interests in America, big business and the military, allow such a sacrifice, such a transformation?

The Ayatollahs of Washington

The Ayatollahs of Washington
By Jerome Grossman

As I write this blog on June 17, the streets of Iran's capital are jammed with demonstrators rallying to protest the country's disputed presidential vote. Hundreds of thousands of Iranians defied the country's religious leaders who have the final say on state matters demanding a new election replacing the election of June 12 tainted by charges of fraud and vote rigging.

The Ayatollahs of Iran have offered a limited recount, another concession to the sustained public rage, but reformist politicians would accept only a completely new election under the closest supervision. Public opinion in Iran may force such a solution despite the virtual dictatorial powers of the unelected religious leaders. The sheer size of the demonstrations has been impressive and the protests are not limited to students but include all generations and economic classes.

The United States of America had a similar crisis in the presidential election of 2000 when Florida's decisive 25 electoral votes would decide the contest. Vice President Al Gore, the Democratic nominee, filed suit in state court to begin a recount of ballots in several counties where voting machines were unable to determine the voter's selection. The Florida Supreme Court granted Gore's plea but the U.S. Supreme Court prevented the recount 36 days after the election and with that, Gore's chance of winning the presidency.

The Ayatollahs of Washington had decided and there was no appeal. Nor was there much of a protest. Hundreds of lawyers were involved in legal proceedings, thousands of media personnel carried the news reports around the world, but the American citizens remained remarkably calm. No marches in the cities, little anger on the campuses. The people were not involved despite the flouting of the Constitution, despite the closeness of the 5-4 decision, despite the pyramid of voting irregularities in Florida.

With all due respect to the government of Iran, the importance of their president does not compare with that of the U. S. president, controller of the arsenal of nuclear weapons, leader of a $14 trillion economy, commander-in-chief of the most powerful military in the world, controller of 737 military bases in 130 countries, whose word reverberates everywhere, almost the Emperor of the world.

The U.S. is the oldest democracy; proud of its inheritance, seeking to spread its values to other countries, but in 2000 it was passive. Iran, with a history embracing thousands of years, is a theocracy with a limited tradition of democratic elections mostly at the local level. Faced with the overwhelming power of the Ayatollahs and their control of the military and police, the citizens of Iran refused to accept this particular aspect of religions dictatorship. Whether or not they achieve their objectives, the Iranian people have shown how to overcome a government that has over reached and abused its power. Committed but pragmatic, insistent yet Gandhi-like in its tactics, they set an example of the use of people power.

Goodbye, General Motors

Goodbye, General Motors
By Jerome Grossman

For decades I was loyal consumer of General Motors products. It all began when I graduated from high school and was accepted by Harvard College. My father, who had to leave school after the fifth grade to help support his family, was so proud that he insisted on buying me a tiny Pontiac, “A Harvard man should have a car." I was 16 years old.

The Pontiac had an unusual history. It had been totaled in a crash and then a friend of my father rebuilt it from scratch, painted it startling bright silver with red wheels. The tiny convertible with the exposed rumble seat made me a very popular Harvard freshman.

It also made me a loyal "Buy American" consumer supporting U.S. businesses and the workers of Detroit by purchasing GM products year after year. However, years later, my wife returned from her bridge game with a message, "My friends love the Lexus; why don't we try it."

My answer was a resounding negative: “We must support the American worker and buy American.” But the bridge friends had an answer: "Does your husband know that many American cars are assembled in Mexico, Canada, South Korea and China, where the work is done for two dollars an hour instead of 20?" So I bought my first Lexus in 2001. I still have that automobile and it is a dream, a loyal and healthy horse that seems to go on forever.

Now GM is in bankruptcy, rescued temporarily by the U.S. government. My feelings of guilt for deserting were assuaged when I learned that low wage countries will manufacture at least 25% of GM output under the rescue plan.

While the U.S. government will be the majority stockholder and will supervise the restructuring plan, President Barack Obama says that he does not want to run the company and that it should be operated on classic business principles.

I believe President Obama but some Republicans and conservatives warn of political interference in operations. They may be right. Already Representative Barney Frank, my own Democratic congressman, has intervened with GM management to extend the life of a parts distribution center in his district that was scheduled to be closed. The political motivation is bipartisan. Republicans are just as likely to protect jobs in their districts: Republican Representative Steve La Tourette of Ohio wants congressional review of company and government decisions on the automakers. In the U.S. Senate, Carl Levin of Michigan said he will do everything he can keep the GM plants there open, as will senators across the country.. Their political existence demands it.

Some think that the reduced GM will not survive for long, that the Administration is keeping it alive for political reasons and to keep the United Auto Workers functioning in election years 2010 and 2012. But the world has changed; too many unrectifiable mistakes have been made. General Motors, once the preeminent American company, may become as much of a relic as my silver Pontiac convertible with the startling red wheels

Expand the Supreme Court

Expand the Supreme Court
By Jerome Grossman

The nomination of Sonia Sotomayor to the United States Supreme Court reminds us that politics is paramount in a democracy even when the control of the highest court in the land is at stake. Exercised by both parties, the politics obviously seeks control of the court and also appeals to major voting constituencies for support.

In selecting Judge Sotomayor, President Obama weighed a number of factors. The most obvious were to nominate a “clean” person with a personal record above reproach, a history proving the highest legal ability, membership in a major voting constituency, a record of liberalism that would guarantee support of the Roe v. Wade decision on abortion. In addition, Obama needed to be sure that the candidate had paid all her taxes. The President could not afford another tax delinquent after his unfortunate experiences with Tom Daschle, Tim Geithner and Katherine Sibelius.

The politics was easy. Nominate a capable Latino to recognize an ethnic group without a representative on the court, the fastest growing minority in the nation. This was actually a double benefit: to gain the appreciation of Latinos and to inhibit the Republicans from filibustering the nominee. President George H.W. Bush used the same tactic when he nominated Clarence Thomas, expecting little opposition to an African-American from the Democrats.

Representation in the leadership of a nation is a core value in a democracy. On the Supreme Court, there are six Roman-Catholic justices, two Jewish, two Italian Americans, far above their percentages in the American population. On the court, today, there is only one woman and one Protestant, far below their national percentages. Among these underrepresented groups there are dozens if not hundreds of qualified lawyers and judges. What are we to make of the fact that in the current court, five justices graduated from Harvard Law, two from Yale Law, and one from Columbia Law. Sotomayor went to Yale. Are all the abilities in the Northeast?

Some believe that there should be a larger Supreme Court to satisfy representation, to speed court action, to enable the court to hear more cases. Does the U.S. Constitution call for nine justices? It does not. Congress decides on the number by statute and has changed it repeatedly: 1789 (6), 1807 (7), 1837 (9), 1863 (10), 1866 (8), 1869 (9). Article 8, Section 1 of the Constitution requires that all federal judges retain office during “good behavior” and only one justice, Samuel Chase, was impeached in 1805.

We pride ourselves in our respect for the rule of law, a factor that has given the nation a high degree of stability. Of course, our record is far from perfect but in no other country does the highest court possess such far-reaching power including the interpretation of all congressional enactments and making sure that the federal and state laws conform to the Constitution. Expanding the Supreme Court might make it more representative and therefore even more effective. A Supreme Court with justices appointed to represent geographic areas, sexual populations, economic interests, etc. might unify the nation more than the current system of appeasement of political constituencies.

A Strategy to Exit Afghanistan

A Strategy to Exit Afghanistan
By Jerome Grossman

On May 22, President Barack Obama addressed the graduating class of United States Naval Academy at Annapolis, Maryland. He drew cheers when he proclaimed, " As long as I am your commander-in-chief, I will only send you into harm's way when it is absolutely necessary, and with the strategy and the well defined goals, the equipment and the support that you need to get the job done."

Bravo. But I wish he had applied those sentiments to the United States invasion of Afghanistan. The President has dramatically increased the number of U. S. military forces there, has promised even more next year, and has warned of a multi-year commitment to a war already almost 8 years in duration.

• Is this war “absolutely necessary?”

• Do we have a “strategy” for fighting it?

• Do we have “well defined” goals?

• Do we have an exit strategy?

As recently as May 10, Hamad Karzai, the elected head the Afghan government, said, "Al Qaeda is no longer in Afghanistan." When this was relayed to General David Petraeus, the American and NATO military Commander, he replied," I would agree with that." Obama's National Security Advisor Jim Jones said," I am not sure if Osama bin Laden is alive or dead." Prime Minister of Pakistan Zardari:, stated flatly," Osama is dead." On May 17, Secretary of Defense Robert Gates told Katie Couric of CBS that it will take at least two to four years before Afghan forces begin to take the lead in fighting, leaving unsaid when U.S. troops will leave.

Moreover, Karzai and Zardari have complained bitterly about U.S. military tactics, especially the use of air power resulting in the unnecessary killing of civilians and the consequent increase in anti-American sentiment in Afghanistan and Pakistan.

What is victory in Afghanistan? Will it prevent another brutal tragedy like September 11? We should remember that this attack was made by 19 people, not one of them Afghans, armed with credit cards and box cutters. It is difficult to understand how the conquest of Afghanistan could prevent another group of nineteen from performing a similar criminal act. Defense of the U.S. mainland begins at home with effective police and immigration procedures.

U.S. wars in Iraq, Afghanistan, even Pakistan, coupled with our all-out support for Israel, might motivate some Muslims and citizens of those countries to irrational revenge, what the CIA calls “Blowback”, the unintended consequences of military action and especially of foreign military occupation.

President Obama, give us the answers to our questions. If you don't have them, at least separate yourself from the Afghan policies of George W. Bush and give us an exit strategy so that we can help these nations change their policies through diplomacy, economic help and our soft power while saving American lives and resources.