Let's Just Ignore the 14th Amendment

Defending America Against the 14th Amendment

Amendment XIV

Section 1.

All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the state wherein they reside. No state shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any state deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.
--United States Constitution, 14th Amendment

"The question of whether our forefathers meant for birthright citizenship in all circumstances to be the law of the land is far from settled," Bob Goodlatte (R-VA) said at the hearing. "In any event, we must still determine if it is the right policy for America today."

Steve King (R-Iowa) was the most adamant that it was not the right policy. He questioned what would happen "to the demographics of America if this policy is not reversed," and implied that Democrats may support birthright citizenship because they want to win elections.

--Huffington Post

One thing about the 14th Amendment, among all the amendments, it has a ringing clarity. You're born in in the United States, even if you were just passing through on a horse from Mexico on your way to Canada, you are a natural born citizen of the USA.

Republicans, every last one of them, take their responsibility to uphold and defend the Constitution of the United States very seriously. They begin almost every discussion with an affirmation that whatever they are about to say, it's all part of their ardent desire to defend the Constitution against  frontal attacks or  back stabbing assaults launched by Democrats, or, as they say, "That DemocRAT" party.

But for some Republicans, it's a case of we are for the Constitution, except when we are not,  which is when that Constitution would drive this country in the direction of the wrong "demographics" which is to say, not white, not Christian, and you know what we are talking about--all those Hispanic Muslims massing on our Southern border trying to swim the Rio Grande and rape our white, Christian women. 

I've just got to get Texas Senator Louie Gohmert on the phone and hear what he thinks about this.  You remember Louie. When those kids were flooding across the border it was he who stood up for American womanhood.

“And they’ve committed at least 7,695 sexual assaults,” Gohmert insisted. “You want to talk about a war on women? This administration will not defend the women of America from criminal aliens! By the thousands, and hundreds of thousands!”

Actually, it may be a good idea for American women to practice an escape route North. The Canadians are not rapists, ordinarily. And, in any case, they tend to be, well: White.  I think we ought to practice evacuation from Hampton, say along Route 89 to that lake and north from there. 

Be prepared, that's my motto.

Baltimore: When Fiction is More Real than the News. The Wire Instructs

Inner Harbor, Baltimore, Maryland 

Okay, you knew it was coming.  Baltimore is burning. How do we understand it? This is not what you had in New York or Missouri--the mayor in Baltimore is Black  and the police in Baltimore are predominantly Black. 
NPR interviewed local citizens and they all said the hatred of the police has nothing to do with race. They said, in their own way, the cops are seen not as people who protect and serve but as men who harass and abuse. and David Simon, who did the most thorough and insightful study ever done of an American city, "The Wire," says the troubles stem not from race but from the "Drug War," which has given full license to any Baltimore cop to do anything he wants, and a lot of those cops have, to put it mildly, a "mean streak," or, to put it more bluntly, they became cops because they are sadists and wanted a free hand to abuse people. 
           Police are now driven by "statistics" and what that means is the old cop who walked a beat on a street and stop to chat with people in his neighborhood, who could then go back to his friends in the neighborhood when someone got shot and expect to be told by his local friends what actually happened--that cop no longer exists. The cops out there now do not walk among the citizens--they drive by in their cars with the windows up, with the computer going and they have to write a certain number of summons a day and that means they have to dream up some crimes and pin those on locals. 
          They do not stop and chat; they stop and frisk.
          Police careers are now built on statistics not community relations. As Howard Colvin, the quintessential good cop, says, "These statistics, these numbers, they just ruined this job."
          They ruined more than that.

Street Cred

Anyone who watched all five seasons of "The Wire" knows exactly what is happening in Baltimore right now and why and understands all the forces and dynamics of psychology, personality, anthropology and sociology driving the otherwise incomprehensible scenes you see on the nightly news. 

You can also see what fools the news media types are, as they hardly bother to ask the people on the other end of the microphones actual questions, but simply state their own, ignorant assumptions about what the story ought to be rather than what it is.  The evening news: the clueless instructing the uncomprehending.

They are asking the wrong questions of the wrong people. 

One of the most satisfying things about great literature--which "The Wire clearly" is--it allows you to look at the world and  see through the tangled woof of fact to the truth, to see a scene in a way which you could not possibly have seen it before the experience of assimilating that literature.  So, you read Animal Farm and you can never hear a Communist say, "all Workers are equal" without hearing in the back of your mind, "all animals are equal, but some are more equal than others."   Watching the police, the mayor, the governor, the deacons, all the institutional representatives speaking into the microphones before the cameras now  and you've seen and heard all this before, courtesy of David Simon and company and you know what it all really means. 

In one great scene, from the 5th Season, you are watching a City Hall press conference on TV in the offices of the Baltimore Sun and as the Mayor says something like, "We are first and foremost concerned about public safety, about protecting neighborhoods and ensuring the safety of all our great city's wonderful citizens," and an editor in the group narrates the subrosa, true translation, "We are first and foremost concerned about how this riot affects my job security and we wish to Hell we could beat these scumbags into a bloody pulp and dump their bodies where they'll never be found."

So, we are seeing played out in Baltimore exactly what David Simon showed us must happen, given the dysfunctional  institutions and the misapprehensions of elected officials and the alienation of private citizens. 

When you have children growing up without parents, or worse, with parents who prey on their own children to support their own dissolute lives, you've got Baltimore dystopia. You are watching some completely clueless white reporter giving you his  understanding of why these people are acting they way they are acting and predictably, he is simply making the story up as he goes along. 

 Many people have tried to watch "The Wire" but could simply not keep watching. It is pretty depressing and although it is one of the funniest series ever to appear on TV, the humor is very dark.  Truman Capote tried to write a "non fiction novel," In Cold Blood . David Simon succeeded in accomplishing that goal--using the freedom fiction affords, he gave us a clearer picture of the real world of Baltimore than any non fiction work has ever done. 

 Some Jeremiads are prophecy:It was all there, if only more people had listened. 

The War We Have Now: Mr. Obama vs Alberich the Craven Dwarf Nibelung

He's got to deal with the shooters.

"There are the adventure seekers--those who think this will enhance their masculinity, the gang members and the petty criminals too; and then, of course, the die hard radicals."
--From "Why Do They Go" NY Times Magazine article Mary Anne Weaver 4/19/15 about why there are more British Muslims fighting in Islamist groups than serving in Her Majesty's armed forces.

That description could describe the motivations of major groups of young men who left New Hampshire to fight in the Civil War. Wars are fought by young men for many reasons, but as Boris Pasternak observed, men do not leave home, voluntarily,  if they are happy at home. Men who go fight are looking for something. 

So now, we have left anthropology, sociology and political science behind and we are into that great wobbly netherworld: Psychology.

We are certainly not in economics: For the most part the Brits (and likely the American Muslims) who hop a plane to Turkey on their way to ISIS are in no way impoverished. They are typically high school graduates, often in college and they leave behind immigrant families pushing upward from the middle class in Michigan or London.

They are off to help establish the great Caliphate in the sky, earthly location: Syria, Iraq and wherever else in the fertile crescent ISIS can gain a foothold. They are excited by youtube videos of brave ISIS fighters chopping off heads of hapless captives, or burning a Jordanian pilot alive. How could you not want to be part of that?

Where does that sort of alienation come from? 

Intriguingly, there is the flip side of the coin: The girls. Girls are going to become concubines/wives/ baby makers of the brave killers in the Caliphate, in the great tradition of the Third Reich, where blonde, nubile German girls went happily off to camps to get impregnated by blonde, clean limbed, virile Aryan boys before they shipped out to the Eastern front to annihilate the Slavic hordes.

Alberich, the Craven Dwarf Nibelung

Really thrilling, such a mix of testosterone, masculinity, a desire for perfection--after all there is the strong narrative of wanting to join your fellow killers in paradise, where you great reward will be VIRGINS. 

(Personally, the prospect of virgins would not get me tying my shoe laces. But, maybe that's just me.)

I don't get it. Well, maybe I do. There is also the sense of grievance. Where could that come from? Well, from the immigrant experience, the problem of being the new arrival, scrambling to catch up, to gain acceptance and feeling put down by those already well established. 

After WWII, neighborhoods in the suburbs of Washington, D.C. were filling up with the families of all the government workers who would be part of the great expansion of the federal government.  Many of these neighborhoods were "red lined" which meant WASPs only. Sometimes Catholics were excluded, but certainly no Jews or Blacks allowed. You could never know if the Jones family you sold the house to was Catholic, but there was little question about the Rabinowitz's  and certainly, you had only to look to know about Blacks. 

Helga's Antecedants

I grew up in one of the "mixed" (Non WASP) neighborhoods and at school I experienced what Alberich the crave dwarf Nibelung had. You remember Alberich, the dwarf who comes across the beautiful, naked, voluptuous Rhinemaidens, who tease him:  invite him then reject him and taunt him for being, well, a Nibelung, short, dark, not at all Siegfried.   Alberich does not take it well. If he had had ISIS to run off and join, I'm sure he would have, but he seeks revenge in his own way.

But I digress. I was trying to get inside the mind of the British son of a Pakistani merchant, the Michigan son of a Somali Ford worker, who goes off to school and something happens and, poof, he's off to Syria to join ISIS.

It's dangerous to extrapolate, but I remember when I first beheld the girl I'll call Helga, all five feet seven inches of blonde, pale blue eyed perfection: flawless skin, sparkling white teeth and boundless energy, and I knew, in an instant, I didn't stand a chance with her. The local Siegfried, captain of the basketball team got Helga. Then the captain of the football team, named "Trevor" or "Hunter" or "Biff" with a roman numeral III after his name, got Helga. I was never going to get Helga. 

Rhinemadens Not for Nibelung

My friends from the hood discussed all this and concluded we did not rate. Many years later, I saw a movie "Bread and Chocolate" about a man from Southern Italy who moves north, near the Swiss border and he is faced with the same thing--there is one indelible scene when he looks out from a chicken coup, with his fellow Southern Italians, at a group of tall, blonde, immaculate, gorgeous teenagers, as they strip off their clothes and plunge into a waterfall and its basin in a coed celebration of celestial beauty, and all the short people in the coop can do is adore them from afar and loathe themselves. 

Rhinemaidens in Switzerland

The View From the Chicken Coop

Can it all come down to this?  Aryan envy? Got to be more complicated than that. But when I look at the guy who shows up to the state legislature packing a gun, I have to think--this is a guy who does not feel his own, native, flesh and blood equipment is adequate.

Welfare, Charity and Virtue

Daniel Patrick Moynihan

One of the people I most admire recently revealed she was driving from her seacoast home to Manchester to teach English and life skills to  an immigrant who had never had the opportunity to go to any sort of  school where she grew up, in Africa.  To say this is a busy woman would be an understatement, so why does she add this effort to all the other things she does for her family (which are many) and for her town?  Because, she explained, the program  in Manchester serves those with the most profound needs.

After teasing her, calling her Major Barbara (George Bernard Shaw's Salvation Army heroine who was born to privilege but devoted herself to helping the underprivileged) I realized the problem was not with her, but was my own.

Home Base

I realized that when it comes to the central issue of what those of us lucky enough to have been born into circumstances which allow us to flower ought to do for those who are not, I am very parochial and limited in my perceptions.

Most of us, who live in the suburbs do not see impoverished people much. We do not walk past sidewalk panhandlers, do not come into contact with unemployed people, or at least people who are obviously unemployed. The most disadvantaged people we see are working behind the counters at McDonalds. We live in bubbles and we are insulated from seeing suffering here in small town New England or in suburbia. We form our impressions of the "undeserving poor" from very limited experience. 

For 13 years I ran a clinic in inner city Washinton, D.C. and that formed most of my attitudes about welfare and the impoverished.  I was struck by two things which I've mentioned on this site before:  
1. Immigrants from Africa--Nigeria, Liberia, Kenya and Zaire were the most common sources in our clinic--were typically very bright, very inquisitive, quick learners, very well spoken (especially when they had those cool British colonial accents) and they were hard working. They had strong families and all the virtues of the "ideal immigrants" which we typically attribute to  Asian immigrants. Nobody had ever told these Africans they were stupid or shouldn't ask questions or were incapable of learning. 

No Room for Girls in Their Hometown School

The other group visiting the clinic: 
 2. Immigrants from the American South (Georgia, South Carolina, Alabama and Mississippi) had a different typical profile. They were often nearly mute. It was difficult getting even the most basic information out of them, like, for instance, why are you here today?  One of the most common patients at the clinic would be a 12 year old pregnant girl. When I asked how she intended to support the child, she would shrug and reply with a single word, "Welfare." The social workers told me the newborns were typically handed off not to the 12 year old child's 24 year old mother but to her 36 year old grandmother, who collected all the government checks for dependent children, Medicaid and other programs. In fact, the family benefited financially in many ways with the arrival of this new source of revenue.

Now, in Massachusetts,  I see a different population.  One group is the immigrant from the Dominican Republic, or El Salvador, and the patient typically comes from a family of twelve or more children.  Education typically stopped in grade school and the patient had gone to work in the D.R., but arriving in Lawrence, Massachusetts, prospects for employment became dim and Mass Health covers the doctors' bills. They work as landscapers, construction workers, jobs which require little English and little education.  Or they are unemployed.

At some level, especially when I'm having trouble with the "translator phone," which often squeaks and blips and runs out of power, nasty feelings bubble up from within. This person comes from a family of 14: How much effort could his mother and father have put  into raising, training, preparing this person to become self sufficient in life?  So now I'm stuck with trying to help him understand how to take care of his diabetes, because his parents just popped him out and set him lose to wander about the streets and fend for himself.  But then I get to know the person, and there is that amazing moment when he says, very sincerely, "Thank you, " in English, or in Spanish. There is such real gratitude. How many times a day do you get that in any line of work?  

From Africa: Europe or Bust

And it's not this guy's fault his parents had 14 children. He is now here, doing the best he can. 

So I have to work past my own frustration and resentment to a different place. My own parents put a great deal of effort into training and civilizing me. Their own parents did not speak English.  The best thing, by far, my grandparents ever did for me was to get on the boat to America. 

 Once I got into the idea of having children, once I found out how rewarding it could be, I wanted at least three, but had to stop at two because, doing the arithmetic, I realized there was no way I could afford college for more than two.  My good friend from medical school had four kids. How will you afford to send them to college? Oh, it's all in the financial aide system--you show your income and how many kids you have in school and you get financial aide. So this Ivy League educated surgeon anticipated his own version of welfare--welfare for the rich--in the form of college financial aide. It actually did work out for him--three kids went to Ivy League schools, and one to an Ivy League law school and one to an Ivy League medical school, and all this on a Navy salary. "Financial aide," he said. "It's all in the system."

The history of welfare since the 1970's is a discussion fraught with notions of the "other."  For the most part, white Americans thought of welfare as a system designed to give free hand outs to the Blacks, although 2/3 of those receiving benefits were actually white. Ronald Reagan slyly fed into this with his famous rant about the welfare queen from the South Side of Chicago--if she was from there, of course, she had to be Black.

But before Reagan, Daniel Patrick Moynihan saw what I was seeing in my inner city clinic:  Black girls and women getting pregnant with no plan for raising the children and a system which actually discouraged them from finding a job because once they started working at minimum wage jobs, they'd lose benefits and actually come out behind, financially.  His report on the damage welfare was doing to the Black family and community was seen by many liberals as "blaming the victim" as validating the impression that welfare served the "undeserving poor." Welfare from the early 20th century was designed to serve (white) widows who had no job skills and were left threatened when their husbands died. It was not typically available to Blacks. When it did become available to Blacks, it was portrayed as a free hand out to shiftless, lazy people.

When Clinton faced Newt Gingrich and his Contract with America Republicans, Clinton rejected the first Republican forays into stripping away benefits from poor Blacks, but he ultimately signed a law which required young mothers to go to work and limited the total number of years of benefits to 5. It was called, "Personal Responsibility and Work Opportunity Act."  Ah, doesn't that say it all?

Spending on welfare did decline.

But, as Senator Whitehouse (D-RI) pointed out this morning on CNN, the total outflow of dollars from welfare programs pales in comparison to the outflow of dollars in tax breaks to those owning private jets, to hedge fund managers whose tax rate is lower than that of most truck drivers--more welfare for the rich, an old Republican ploy.
As the good Senator from Rhode Island pointed out, the total number of dollars which leaks out the back door of our federal budget actually exceeds the number of dollars coming in the front door--and it's the Republicans keeping that back door open, all the while complaining about the deficit created by their own give aways to the rich.

We have corporate welfare in many forms--allowing American companies to open an office in Ireland and claim to be Irish companies not subject to American taxes. Make your money here in the USA and don't pay a dime for all the infrastructure and educated work force, just make the profit.  And welfare for the rich? Well, that's easy. Just keep everything you make--only small people pay taxes. 

DUKE DEFEATS WISCONSIN: WISCONSIN GOVERNOR BLAMES OBAMA

Reacting to Wisconsin's loss in the NCAA championship game, Wisconsin Governor Scott Walker immediately blamed the outcome on President Obama, according to an exclusive interview with Rolling Stone magazine. 

"The referees are unionized," Mr. Walker reminded us. "Need I say more?

Senator Rand Paul, (R-Ky), Mr. Walker's rival for the Republican presidential nomination when asked for comment replied, "The First Amendment says 'Keep government out of religion,' not 'Keep religion out of government.'" 
When asked to explain  the relevance to the basketball game, the union movement or really anything else, Mr. Paul, who is in New Hampshire, said, "And I intend to ask the Kentucky Derby Commission to restore the crown to Dancer's Image." 

Dancer's Image, a New Hampshire horse bred in North Hampton, was stripped of his 1968 crown after his owner, Mr. Peter Fuller, contributed the Derby purse to Martin Luther King's Southern Leadership Conference in the wake of Rev. King's assassination.

"I just don't know how Mr. Paul can play politics with sports," Mr. Walker retorted. "After all, it's obvious where Mr. Paul is coming from, having seen Kentucky's undefeated season go down in flames to, guess who? The University of the Great State of Wisconsin!"

Full Disclosure: Mad Dog wants to clarify he has not done any fact checking on this story, but he does hold a degree in journalism from Rolling Stone University.

Iran Nuclear Deal: Litmus Test for Crazy

Chamberlain Waves Munich Accord:
Never Trust a Treaty

"We are not stopping them. We do not have an administration that wants to stop them. That's what everybody seems to have trouble realizing or admitting here. We do not have an administration that wants to stop Iran. It's just the opposite in fact. There's a reason that Iran's running rampant. It's that nobody's stopping them. I take that back. The French are trying to. Imagine that. The French are bigger hawks than we are. Of course the Israelis are trying to stop it."

--Rush Limbaugh

He Knows All

One thing about this Iran Nuclear negotiation, whatever its merits or dangers may be, it has provided us with a test for crazy in this country.
I cannot hope to understand this proposed deal, depending as it does on so many hairy technical issues; you may not need to be a rocket scientist to understand it but it would help to be a nuclear scientist.  The thing is structured on being able to trace the elements needed to make nuclear weapons from mining uranium to placing the thing in a war head.  The very complexity of the process, apparently, aides in detection. In order to get a bomb, the Iranians cannot simply dig a hole in the ground, build a construction site and work at it--they need things which provide a trail to follow.

But there are some Americans who know, even at this intermediate stage, what the Iranians intend to do which is to fool us and get the bomb. 

The Iranians, or at least some Iranian officials, have not helped by saying things like, "Israel is a one bomb country. That's all we need to wipe it off the map."

And the old men who still rule Iran are revolutionaries, apparently driven by the hot passions of ideology, despite the demographics of the nation, of which 50% of the population is under the age of 35 and cannot even remember the revolution.  This means the numbers are shifting in the direction of people who want to live in a real country, not some revolutionary eutopia.

But, here in the USA we have people who have made no effort to learn what is being negotiated; they simply KNOW President Obama is making a huge mistake, AS HE ALWAYS WILL, and he is the next Neville Chamberlain, signing on with a madman and waving the document as proof of success.

If Mr. Obama is for it, then, ipso facto, it must be a bad thing, a dangerous thing, something which will result in the destruction of Israel, and the continue decline in the power of the United States, and place us at risk for nuclear annihilation from Iran. (President Obama did point out we have a $600 billion dollar defense budget compared with Iran's $30 billion budget and they are unlikely to attempt to defeat us in a war.)

If you are wondering about someone who you are thinking about asking over for dinner, just ask this person about the nuclear deal. If they erupt with a stream of invective, you will know you  have to look elsewhere for a dinner companion. 

If we have any hope, it may be in the younger generation in Iran. During the Iran/Iraq war, my secretary came running back to find me: It seemed we had inadvertantly scheduled an Iranian and Iraqi patient too close together and they were sitting out in the waiting room and she expected World War III was about to erupt and I had better get out there and stop it. When I got to the waiting room, I found them chatting amiably in Farsi, having a wonderful time. 

This Gets Them Crazy

One thing about the Iranians, they are wild about wrestling. The most excited I ever saw Iranians was at a wrestling match when the Iranian team was in town. That got them worked up. Israel, the Great Satan, not so much. 

US vs Iran 

Maybe if we just wait them out, the old revolutionaries will die off and we can deal with the younger generations. Our own crazies, we will have to continue to watch.

INDIANA'S FREEDOM OF RELIGION LAW: When The Service Is Speech

"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."

--First Amendment, United States Constitution

When a restaurant owner refuses to serve a couple at a lunch counter because they are Black, we can all see that is wrong, on many levels, not the least of which is it violates various Constitutional guarantees. We've settled this long ago: You can't claim you've heard the voice of God telling you Blacks are bad and you ought not allow them in your restaurant or in your hotel. If God has told you that, then you'd better find another line of work, in the United States.

When a businessman who makes wedding cakes refuses to make a wedding cake for a gay couple, that is little different from the restaurant owner; the business is open to the public and offers a product and if its owner withholds this product from some class of people because he doesn't like them, because he finds homosexuality offensive or he claims his God is speaking to him, telling him to have nothing to do with homosexuals, and to not bake them cakes.  Well, then it's case closed. The cake maker is violating all sorts of American values and using God as his excuse. I strongly suspect God would find this most offensive.

Gail Collins will make mince meat of the wedding cake guy.

But when the service is speech, we have a different matter, as a Baptist minister pointed out this morning on NPR.

What, after all, is the minister supposed to say at the wedding?  He could simply stand up and speak the words, "And now, by the power invested in me by the state of Indiana, I pronounce you man and man," and then turn on his heels and leave the stage and collect his fee.   But the two  grooms (or brides) and the assembled guests ordinarily expect some words from the minister conducting the ceremony, blessing the couple, extolling the idea of marriage, placing marriage in the grand scheme of God's will, what have you. So this would strike some people as a withholding of service. Depends on what you expect the preacher to say.

Can the government compel the minister to say any of this stuff, if the minister believes, for whatever reason, this is not what he believes, not what he wants to say?

Of course, in a practical way, no law currently can compel the minister to say anything, and you wonder why any couple told by a minister, "Look, I wish you well, but I cannot say, in public, I approve of your marriage," why any couple  hearing that would say, "Well, but we want you to preside over our wedding anyway." 

If the couple sues the minister for violating their rights by not saying what they want him to say, could any jury find for the plaintiff couple? What right has the minister violated by refusing to speak? What right has the couple to force the minister to speak the words they want to hear him say?

I have to agree with the minister: He ought not be compelled to speak, i.e., to perform the wedding service, saying all the things which are part of that.

I cannot see that Indiana actually needs a law to protect any minister's  right to not speak--it's already protected. 
I do not see how we can compel speech. The First Amendment means we are free to speak or not to speak.

OBAMACARE: WHO CONTROLS THE NARRATIVE ABOUT HEALTHCARE?

Every day someone tells me he has been screwed by Obamacare: The costs of his medications have risen; the MRI machine was so loud it made his ears hurt; his flood insurance went up; he got a smaller refund on his income tax; his daughter's cheerleading team cannot afford to go to the national competition in Oklahoma City this year. It's all Obamacare, or at the very least government. Government has replaced Satan as the catch-all for what ails us. 

Where does this come from? You know very well: Mr. Limbaugh and fellow travelers including but not limited to Mr. McConnell and Mr. Boehner and all those Republicans federal and local, all reading from the same hymn book. They have seized control of the brains of the masses. They rule the waves, the airwaves that is, and they have as much penetration into gray matters as Big Brother ever dreamed of.

Paul Krugman recently illuminated how wrong Republican doomsday sayers have been about Obamacare, which they have been trying to convince us is a disaster.

He is correct, of course, Obamacare is way better than what we had, despite its bizarre complexity, a chimera of private health insurance and public funding which is a reflection of the way our government works: All the players are payers and as long as everyone gets his cut, the bill becomes law.

So people like my self-employed son in Brooklyn now have really good health insurance for half what really terrible health insurance used to cost him. That means if he gets sick, he may not drag the entire family, his parents and everyone, down into bankruptcy.  So, as far as payment systems go, it has been a success. 

But American healthcare is structurally disordered, and no Obamacare or any system of payment has yet steered its boat away from the rocky hazards toward which it is sailing.

Older doctors have always carped about how the system is going to pot, but there are signs this time their criticisms of current trends are on the mark now.

The structural problems are:
1. Doctors are motivated by profit and profit is generated by fee for service which drives the system into ever expanding services in search of fees.


2.  The English, decades ago, figured out how to use generalists and non physicians effectively. We have not learned from the Brits nor from anyone else who might be doing medicine better than we are,  because, in  our hubris   we have convinced ourselves we have  the "best medical system in the world." That declaration might make John Boehner feel all proud, but it means we have not learned from others. 

3. Innovation, which once came from university medical schools, now comes from profit centers, from drug and device companies and the kind of innovation which emanates from these profit driven sources  is not likely to benefit the public health, no matter how much it improves the bank accounts of those corporations.

Someone once said, "Medicine is too important to be left in the hands of doctors." Our problem currently may be that the hands of the doctors are nowhere felt now, and in their place are the hands of the bankers, the MBA's, the politicians and the entrepreneurs. Not that these people have nothing to offer, but whose hands should be on the steering wheel?

At root, it's a problem of values. The high energy, hard edged entrepreneurs, who think that the world, all parts of the world, ought to be run by dollars look at public health as a soft and fuzzy and inefficient ideal of commonweal and they want to apply principles of natural selection to doctors and patients.  They want "lean and mean" and they abhor socialized medicine and look at healthcare in Britain, Sweden and all those "welfare state"  European nations as failed programs. The Europeans know better: They look at our system and see a system that fails 90% but serves 10% admirably.  

The inner city clinic I ran for 13 years  in Washington, D.C. provided low cost care to people who could not afford to see doctors, during the 1980's and 1990's as a quid pro quo mandated by the DC government. The hospital from which it ran was in a swanky part of town, a maternity hospital which delivered the babies of the affluent. Well, the DC government said, if you are going to make money in this territory, you have to pay the rent.

That, of course, was, as Mr. Limbaugh would say, is just another example of the nanny state taking from you and me and the hard workers and giving to the undeserving slackers.  

Does Ms. Clinton, or any other Democrat, save Elizabeth Warren, have an answer for this?