Immigration [#6]

#6 Democratic Party Principles
Immigration
The first thing Democrats should say about the immigration problem is there is no immigration problem.

There is a perception problem.

The first thing Hitler and his buddy Goebbels did was to dream up a problem to blame all the other problems on: The Jews!

Trump and his buddies have done the same thing. 
Joe Arapaio and Paul LePage have ridden to prominence singing the same song.
Oh, those nasty immigrants!

Fact is, we had much more immigration of people who were less likely to succeed in the past: Look at those pictures from Ellis Island.

We had the Irish wave, the Italian wave, a Jewish wave from Eastern Europe, a Scandinavian wave. 

Each new group was vilified at first, then assimilated. All contributed big time.

No, we cannot throw our borders wide open.

If we allowed every person who wants to enter the USA from India alone, we'd like have close to a majority Hindi speaking population. Same for China.

We do not want to see sudden, huge shifts in our ethnic, linguistic, cultural makeup.

But if we do it gradually enough, carefully enough, we can celebrate diversity rather than fear it. 

And diversity is our strength. It gives us an competitive edge over every other country.  

Diversity should not be allowed to stay in silos, however. Anyone coming here has to agree to try to assimilate and most of all, to tolerate every opinion, no matter how foreign, no matter what his/her religious beliefs. 

Tolerance is the basic requirement for living in America.
The last thing this country needs is a lot of superpatriots who think they are more American than anyone else.

Drugs and the Opioid Crisis [#5]

#5 Democratic Party Principles
Opioid "Crisis"

Did you ever wonder where this new pestilence of opioid deaths came from?
Did it come to surface the way the Black plague does, occasionally, with a reservoir of disease living in fleas which live on rats?
Or did we invent it?
Or was it always there, but nobody noticed until it was not just Black inner city kids dying but beloved White suburban kids?

I do not know the answers to this question.

I do know that if we really want to address the two separate problems of 1/ Drug addiction  2/ Opioid overdose deaths, we will need to make some basic choices, not just use ban-aides. 

We will first have to decriminalize drug abuse and treat this problem as a public health problem.

We will have to commit billions to the part of the health care system which treats drug addiction, just as we devote resources to the treatment of other life long problems like diabetes and alcohol addiction. 

We will have to ask the hard questions we ask of all medical therapies and programs: What is the evidence they work? What better solutions might be out there.

Right now, we've got programs which work to keep people "clean" only for as long as the patients remain in the programs, but the relapse (recidivism) rate is nearly 100%

Guns and Gun Violence [#4]

#4 Democratic Party Principle
Gun Violence
Gun violence is not one problem and it cannot be solved with a single solution.

The man who mows down scores of people with an automatic (or semi automatic weapon) in a school yard is not going to be deterred by the law meant to prevent a seven year old from killing his brother accidentally at home when he finds his father's pistol.

The death of a citizen at the hands of a punk with a Saturday night special is not going to be prevented by laws requiring "smart guns" which prevent the seven year old from shooting his brother.

The man who shoots his teen age son by mistake when the kid is sneaking back into his home late at night is not going to be affected by the law which prevents the sale or ownership of an automatic rifle.

We already have over one gun per human being, right now, out there in the U.S. of A. If we stopped selling guns tomorrow,  people can bury a gun in a back yard and dig it up a year from now.

The Australian experiment of requiring guns to be turned over to the government would not have a prayer in this nation.

The fools who claim the solution to the maniac shooter at the church or government building or hotel is to arm everyone should be run out of town. If every member of that crowd in Las Vegas had a gun, just as many, if not more would have died.  For the most part, the problem of the mass shooter is the element of surprise, not the delay of bringing deadly force to bear on him. 

Each one of the many problems of gun deaths needs, likely, a separate solution. 
We should be willing to try new laws, and we should be willing to admit when they do not work.

But, in general, the principle governing our approach should be like that of Marshall Matt Dillon in Dodge City. Once you come into town, you hand over your guns. You get them back again when you go out into the country side.

But in general, the more guns, the more accidental shootings.

No woman walking her dogs should be shot down by her half witted neighbor thinking he's shooting a deer. 
Guns too close to where people live in close quarters a recipe for disaster.

Wealth Disparity [#3]

#3 Democratic Party Principles

Wealth Redistribution

There is no way a democracy, or even a republic hoping to do the greatest good for the greatest number can allow the winners in the economic game to win so much that others cannot thrive.

The British tried this and the collapse of their Empire and their economic power and their own well being ensued.

The Republican Party tells us we should believe in social Darwinism: The fittest survive, the fittest prosper. If you lose, that's on you.

We know the rules of the game. The game is fair. If you lose, you deserve to lose. If you win, you deserve to win and you deserve all you win.

The fact is, this is the Big Lie.

We all start from different places: Some are born on third base and believe they hit a triple.

All you have to do is to look at the current tax bill in the Republican Congress. If you own a business you pay a much lower tax rate than if you are a wage earner. This is only fair, say the Republicans: The guy who takes the greater risks gets the greatest reward. The wage earner chooses safety over the adventure and risk of entrepreneurship. But the fact is, the guy who takes the risk most often can afford to take the risk. He's got a safety net provided by his family.  The wage earner cannot afford the risk.

You can think of many exceptions in your own world to this, but the fact is, the guys who are really rich in this country, who are in the top 1-10% of that pie graph started rich and used their head start to get richer. 
They were never going to starve or become homeless if they failed. 

Health Care [#2]

#2 Democratic Party Principles
Health Care

Everyone, save the most libertarian or Tea Party of Republican, would likely agree, that in an ideal world, a utopia, every citizen would be provided with health care from cradle to grave.

Only the most ardent absolutist would argue that the man or child brought bleeding to the Emergency Room should be denied life saving help if he has not made an investment in his own or his child's heath care.

If we all agree emergency care should be provided we ought to ask ourselves why? 
We agree on this not only because we might sympathize with the patient in need but because we do not like to think of ourselves as hard hearted enough to turn away a suffering person, to walk by the child drowning in the pond and make no effort to rescue him.

If we feel this way about emergency care, then why do we not feel that way about all medical care which may prevent people from reaching the point where they need emergency care?

Here we get to the idea of the grasshopper and the ants. It's a matter of deserving. Those who will not invest in insurance get what they deserve. That's the essence of the Republican line. We don't owe any human being anything. Take responsibility for yourself.

But if people want to take the risk, that's on them, the Republican argument goes. Thus, no individual mandate to buy health care.

Practically, what that has meant is those who gambled and lost, wind up in the Emergency Room, getting admitted and the whole system sags under their burden.

Then there is the second half of the Republican argument: Government run health care is always inefficient and poorly done; if you want efficiency, innovation, first class health care, the best health care in the world, power it with private enterprise, make it a profit center.

Trouble with this argument is history: Private enterprise has been a dismal failure when it comes to American healthcare. American healthcare demonstrates just the opposite: Compared to the government run systems of Western Europe, American health care is like the American automobiles in the 1960's--dismally low quality. That's why the Hondas and Toyotas blew the American auto companies out of the water. America had become complacent, stopped improving while the rest of the world blew by us. That's where we are with healthcare today.

We keep telling ourselves the fairy tale that we have the best health care system in the world because that means we don't have to do the hard work of changing it.

It also allows the profiteers (big pharma, big health insurance companies) to keep making billions in profit.

Profit is a poison when it comes to running a health care system. Health care should not be a profit center. It is more like electric power, and infrastructure. It should be designed to deliver the greatest good to the greatest number at the lowest cost.

We have examples of the Veterans' health care system,  the military health care system and Medicare. For all the complaints about specific facilities, specific problems, these are marvels of efficiency and models of what American medicine and surgery can be.

We need a system more like England's: You can fly first class, with your private, union insurance or you can fly economy on the national health system, but you get to the same place, when you land in the end.

Abortion [#1]

A Democratic Manifesto: 
Democratic Party Principles
#1 Abortion

Getting past the trivial and puerile, to which President Dotard wants us to focus our undivided attention, Mad Dog has decided to begin a discussion of the six issues which should define the Democratic Party:

1. Abortion: When is it infanticide? 
2. Health Care: Is it a right or a profit center?
3. Wealth disparity: Should the government play a role in redistributing wealth?
4. Guns, gun violence: Is this a single issue solvable by one law or a nexus of problems?
5. Drugs and the Opoid crisis: Is this a public health crisis or a criminal problem; is there an effective set of options?
6. Immigration: Do we really have an immigration problem or a perception problem?

I believe every Democrat, given enough time in any setting, platform, meeting, TV appearance ought to say these are the key issues which define Democrats. 
There are some things so fundamental they define discussion.
That freedom of speech is in the first amendment is no accident. It is the most fundamental of all rights, without which there can be no other rights, the sine qua non of all other rights.

So, Mad Dog will discuss each these 6 basic issues in a separate post.  

Mad Dog begins with ABORTION.

Blackmun, a Republican

Have you actually ever read Harry Blackmun's Supreme Court Opinion in Roe v Wade, written in 1973? 
Few people I know have.
Nor have many read William Requist's dissent nor Whizzer Byron White's dissent.

These are good places to start, but the ultimate argument comes down to a decision in the mind of man when life begins.

The justices addressed the less important problem first--who has the right to decide whether or not abortion should be permitted? They did this because this is a matter of law, of jurisdiction, or who has "standing." 

But it all comes down to is the fetus a person? Like the Dred Scot case, in which the justices decided the slave had no standing to sue in court because he was not a person, or, at best, on 3/5 a person, so nobody could intervene from the judiciary or any other part of government on his behalf, if the fetus is not a person the whole debate dissolves.
And deciding about when the fetus becomes a person is treacherous water for a judge.
Blackmun goes through all the arguments, but in the end, if you are an absolutist, you cannot be persuaded. If you believe the moment the sperm penetrates the egg, it is a human being in the eyes of God or should be in the eyes of man, there is no arguing faith.
Like slavery, this is one of those disputes which, for some, has no middle ground.
But for many people, for Mad Dog in particular, there is a middle ground.
Mad Dog well remembers witnessing a "salting out" in medical school--in which a 28 week fetus was expelled from the womb and quickly shunted to a utility room off the operating room, where Mad Dog examined it, visually, with a nurse. It did not draw a breath. It did not move, beyond perhaps a spasm here and there. But it looked a lot like a human being to Mad Dog, in a gut check sort of way. In those days, 1971, two years before Roe v Wade, that fetus could not have survived out of the womb given the state of neonatal medicine then. 

But it sure looked almost human. It's lungs made not have been fully formed; certainly its brain was not, but it looked human. Looking human, of course, Mad Dog realized even then, did not make it human. He'd seen models of babies which looked human.
But that thing on the stainless steel tray looked, to Mad Dog, a third year medical student, like a victim of  infanticide.
But Mad Dog also saw suction curettage of 6 week fetuses which looked like nothing more than smudge on a gauze pad, and he saw fetuses, sometimes spontaneously expelled, at 14 weeks which looked like skinned newts, not human at all, although fetuses on ultrasound, magnified as they are by the technology--those images look pretty human. 

Not yet a human being

Ultrasounds of fetuses, one must remember are very deceptive--they make something look alive and human, but they are cartoons.  Donald Duck and Roger Rabbit look alive on screen, too. Just because something looks human doesn't mean it is really human--clouds can look like people, too.

Not human being

Clouds can look like angels, too, but that doesn't make them angels. 

Cloud, not angel

Ultimately, the judges in Roe v Wade chose not to believe the Catholic or Bible Belt belief that a 2 cell conceptus is alive, has a soul and commands the same right to life as a 28 week fetus. They said there is a progression toward becoming a human being, and that until 12 weeks (end of the first trimester) the fetus has virtually no claim to protection, after 24 weeks it may well have full claim to protection, it's for all intents and purposes, a person, and during the 2nd trimester, well, that's up for discussion, but since it's not viable outside the mother, it's her call.

All the arguments about who has the right to make this call are secondary--arguments the mother has the right because the Constitution implies a "right to privacy" are pretty weak. You don't have a right to kill your four year old in your home because that's a right to privacy. 

It all comes down to belief and the justices in Roe said, we have to draw the line somewhere. Legislatures don't have that right, mostly because they have made such a goddamn mess of that, so we'll do it.
They drew the line at the end of the 2nd trimester.

Mad Dog believes that was the right place to draw that line, at least in 1973.  Up to that point the fetus is like  a car frame on an assembly line--it has the shape, but still is not a functional, realized thing. 
But somewhere it does cross a line, and is more realization than simple potential. Early on, it may have the frame of an automobile, but it does not have a working engine, electrical wiring, gas lines, transmission or even tires, but somewhere along the line, it crosses over into being enough of a car to be called a car. 

Cloud, not human being

And that's where Mad Dog thinks the Democratic Party should plant its flag: We do not believe in infanticide. We do not believe a two cell thing is a human being. We acknowledge as technology changes and makes it possible for a fetus to survive outside the womb, we might draw the line a little earlier, but for now, we agree until the fetus is 24 weeks, abortion is permissible. 

If you believe differently, vote against us. That's where we are.

Preservation of Self in Everyday Life

When I was an intern, there were no female interns. There were very few female doctors in the hospital outside pediatrics and obstetrics/gynecology. That all changed during my residency and the advent of more women physicians had a civilizing effect on the training programs.


When we were told to "suck it up," and work a 70 hour weekend on call, or to run up and down flights of stairs to the blood bank to fetch bloods for transfusions for your bleeding patient, or to run down to the emergency room get back in time for rounds to make your presentation, you did it. You knew you were an intern and by definition of that job, you were going to be abused. Don't be a wuss, don't be a weenie. Just do it.

Discouraging protest

Women didn't buy all that and things started to change.


The Chief of Neurology humiliated and terrified students  with his grilling on rounds, and we all said, "education by humiliation" was his technique. My brother always said the reason he and I did so well in our neurology rotation was because our father was cut from the same cloth and we were accustomed  to that sort of abuse and just pushed ahead. while others, whose fathers were more indulgent, just fell apart.

Shaming was widespread. You don't know your patient's hematocrit? And you call yourself a doctor?  What if the patient undergoes cardiac arrest because you failed to check that? Should we call your mother and tell her to come pick you up because you are flunking out of internship?

Hostile work environment

A "hostile work environment" was not a phrase in those days.


It's true, none of this sort of hazing involved authorities caressing our breasts or genitalia or insisting on sex, or locking the door to the office from a button under the desk. And we were beyond adolescence.


But abuse of power by authorities was and likely still is part of some work environments. And when women get into positions of power, they often behave just like men, attempting to put subordinates in their place, asserting their dominance while underlings have to simply take it. The Devil Wears Prada. Nurse Wratched.


When I was 13 or 14 if a boy got too aggressive with his hands in places they were not welcomed, the girl could be counted on to issue a quick rebuke, possibly accompanied by a stinging slap across the face. Nobody objected that this was a provocation to further violence by the boy. Mostly, boys treated to this simply slinked away, lesson learned.


So I'm a bit mystified why Al Franken who was reported to have caressed the bottoms of women or attempted to kiss them, was not quickly treated to a right cross across the face.


I'm not educated in this discussion, which is why I ask now. But the question occurs to me.


Why did women not respond more forcefully at the time of these transgressions? Why do they come out only years later?


In the case of the District Attorney in an Alabama town in the car with a 14 year old, I can understand the silence and the passivity. But what about the journalist or the woman at the County Fair?
Not to say they should have behaved differently.
 Just asking.