The REAL Problem Is NOT Healthcare

Why can’t all the really smart people in this country solve the healthcare crisis?

The democrats tried and it didn’t work out to well. 

And now the republicans are trying and sort of the same thing so far.

Is it politics?

Sure, that is what it can easily look like. 

One side wants to give more to these folks and less to someone else, and the other side vice versa.

But I don’t think that is the truth!

Wouldn’t we all like to give health coverage to every single man, woman, and child in this country!

Seriously…doesn’t everyone have a heart and soul somewhere in there.

And we all know and/or fear what it’s like to be at risk, without proper coverage, and without the medical care and medicine that can be lifesaving!

So here’s the real problem folks:

It’s not healthcare, nor any of the other social or national security issues we face–whether the military, space exploration, environmental concerns, jobs, or anything else. 

This is what it is…

It’s called the national debt, which stands art $20,000,000,000,000. 

And that doesn’t even include ANOTHER 127,000,0000,000,000 of unfunded liabilities for things like social security and medicare etc. 

This is a nation that collectively doesn’t save–it spends–and it spends not only it’s current purse, but it’s future one too!

In fact, total U.S Household wealth in aggregate of $90,000,000,000 is eclipsed by our overall national debt!

True, this doesn’t include trillions of dollars of other significant business or national assets, but it does point to the overall severity of our highly-leveraged financial position.

So where does this leave us?

We can’t really solve healthcare or any of our other problems–if we are BROKE, busted, and a debtor nation. 

Yes, it takes money to invest, and money to pay for solutions for now and for the future. 

But how can you possibly solve anything, if your pockets are not only empty but have a big f*ckin’ hole in them. 

So folks, the lousy decisions of the past and present are coming back to haunt us. 

It’s a tidal wave, a tsunami of debt–of unbelievable corruption and kicking the can down the road–of fraud, waste, and abuse–of shortsightedness and lack of real leadership–and the time is coming to pay the piper!

If you think the political infighting–liberal and conservatives–tea party and progressives–alt left and alt right–socialists and dictators–is bad now?

But unfortunately, unsolvable problems lead to accusations and recriminations–finger-pointing all around–calls for impeachment–calls to let the other party or some independent lead us out of this mess.

Do you think being in such a challenging situation could also lead us to make rash and stupid mistakes or even go to war? 

In the end, how do you lead us out of a dead-end caused by generations of recklessness with our country’s finances?

Some say perhaps we can grow ourselves out of the debt–maybe we need to go back to school and all get our MBAs and start the whole messed up story all over again?

(Source Photo: Andy Blumenthal)

Restraint or Recklessness?

Like many of you, as I watch the events unfold with the Russian military invasion of Ukraine, I am amazed at the “restraint” being shown by the West.

But I can’t help asking myself why a military invasion by the Great Bear into a sovereign nation that is leaning toward democracy is being met with restraint.

Sitting in Starbucks, I overheard one young women saying to an older gentlemen that she did not understand the reaction of the President in saying there would be “consequences” and that no one took that seriously as there was no specificity, almost as if their where no real consequences to even threaten Russia with.

So why all the word-mincing, dancing around the subject, and restraint by the West in light of this very dangerous escalation in eastern Europe:

1) Surprise – Was the West completely taken by surprise by Russia’s military intervention? Didn’t something similar happen with Georgia in 2008–less than 6 years ago? Did we not foresee the possibility of Russia lashing out against Ukraine to protect its interests when Ukraine turned back toward European integration and away from the embrace of Russia that it had made only weeks earlier? After Pearl Harbor, 9/11, and with all our “Big Data,” intelligence, and military planning–how did we miss this (again!)?

2) Duped – Were we duped by the misinformation from Russia saying that the 150,000 troops they called on a “training exercise” was planned months ago and it just happened to coincide with the toppling of Ukraine’s President? Also, were we fooled when the “mysterious” soldiers showed up without national markings and Russia said they weren’t their military–uh, where did they come from–did they float down from the heavens?

3) Apathetic – Are we just apathetic to Ukraine’s plight? Are they just a poor country of little strategic value to us? Are we so war weary from Iraq and Afghanistan that we just want to place our heads in the sand like ostriches even when democracy and freedom is threatened in a European nation of some 45 million people?

4) Fear – Are we afraid of the military might of the nuclear-armed Russian Federation? Is America, the European Union, NATO, the United Nations all not willing to stand up and hold Russia accountable even if that means a military confrontation? Not that anyone wants World War III, but if we don’t stand up and defend against wanton aggression, how can any country or anyone be safe going forward?

5) Optionless – Are we just out of options? Russia got the upper hand on this one and they are logistically right there on the border and in the country of Ukraine now and what can we do? Despite the U.S. assertion that it can project military power anywhere around the world and a defense budget bigger than the 10 next largest combined–how can we be out of options? Are we out of options because we tacitly understand that one wrong miscalculation and we could end up with WMD on our homeland doorstep?

6) Butter Over Guns – Have we retrenched from world affairs, downsized our military, and emphasized domestic issues over international ones? Have we forgotten the risk that comes from a world without a superpower that helps to maintain stability and peace? Are we just under so much financial duress with a growing mountain of national debt, a economic recovery still struggling, and the lowest employment participation in over 30 years that we can’t even entertain spending more treasure to fight again?

7) Leadership – Who is managing the crisis? We’ve seen our President speak, various other government officials from the U.S. and European Union, the Secretary General of the U.N., the Secretary General of NATO, and more? Who is in charge–setting the tone–deciding the strategy? Who has point so that we and Russia know who to listen to and what is just background noise?

What is so scary about this whole thing is how quickly things can escalate and seriously get out of control in this world, and this despite all the alliances, planning, and spending–at the end of the day, it looks like we are floundering and are in chaos, while Russia is advancing on multiples fronts in Ukraine and elsewhere with supporting dangerous regimes in Syria, Iran, North Korea and more.

Whether we should or shouldn’t get involved militarily, what is shocking is: 1) the very notion that there wouldn’t be any good military options, and 2) that the consequences are not being spelled out with speed and clarity.

In the streets, at the cafe, on the television, I am seeing and hearing people in shock at what is happening and what we are and are not doing about it.

Even if we get Russia to stop advancing (yes, based on what happened with Georgia, I doubt they will actually pull back out), the question is what happens the next time there is a conflict based on how we’ve managed this one?

I do want to mention one other thing, which is while I feel empathy for the plight of the Ukrainians seeking freedom from Russia now, I also must remember the events of Babi Yar where, between 1941-1944, 900,000 Jews were murdered in the Soviet Union by Nazi genocide and their Ukrainian collaborators. This is history, but no so long ago.

All opinions my own.

(Source Photo: here with attribution to Utenriksdept)

Debt Default–Now Or Later

So reopening the government, narrowing our deficit spending, and raising the national debt ceiling is coming together in planned negotiations this week.

Despite all the talk, we continue to spend beyond our national means and basically we must raise the debt ceiling or else the game of borrow and spend is over.

Almost like insatiable gamblers, we use up our money at the table, head to the pawn shop to sell our watch and car to replenish for the next game, and then borrow against our credit card to fuel our addiction to the game some more.

Eventually though the house always wins and the borrower must pay up (or they get their legs broken or something nasty like that).

So while the question posed by the pundits this month is whether the U.S. will default on its debt now, the real question is whether a default is just a matter of time anyway–as we continue to spend more than we generate in revenue as a country.

Sure can we raise the debt limit again–hey, why not borrow more, if others are willing enough to lend to us (and for little to no interest too)?

And can we through sequestration or more surgical spending cuts, decrease the rate of our deficit spending–however actually balancing our budget is not even on the table anymore, as booming entitlements for Social Security and Medicare are expected soon with the aging baby boomers to drastically increase our spending again.

The hope that we will somehow, magically grow our way out is fanciful thinking–almost rising to delusions of national grandeur–that just don’t mathematically add up (since we have a median GDP growth rate over the last 80 years of just over 3%).

Perhaps, we don’t care if we can’t pay our debts, because we are the superpower and what is anybody going to do to us about it anyway?

Or perhaps, we rely as a backstop on our ability to print more money and pay off old borrowed sums with worthless new money galore?

Maybe it’s not a default if no one acknowledges it or we just get away with it…but somehow, someway, no one and no country can spend more than it generates in perpetuity.

If you believe in the endless virtual cycle of borrow and spend, then the mind control program is working just great, indeed. 😉

(Source Photo: Andy Blumenthal)

Balancing The National Books

Bret Stephens had an interesting opinion piece in the Wall Street Journal (28 May 2013) called “The Retreat Doctrine.”

He argues that America’s retreat militarily from Iraq and Afghanistan may not mean revitalization for us by refocusing on domestic issues, but rather decline by prematurely ending a war with enemies that may not have ended their hatred and hostilities to us.

Interestingly enough, it is not just on the battlefield that we are retrenching, but on many other fronts as well, for example: economically, we are cutting federal budgets; monetarily, we are anticipating cutting the $85 billion per month bond buying by the Federal Reserve; social entitlements like Social Security and Medicare are on the butcher block, defense cuts are imperiling military programs, and employment cuts have resulted in a labor force participation the lowest in 30 years.

While many cuts are beneficial in terms of beginning to get our arms around the over $16 trillion deficit we’ve accumulated and in forestalling another rating downgrade by the big three credit rating firms, it is as Stephens implies, perhaps not a sign of health and renewal, but of national illness and a retrenchment of a global power.

I remember in Yeshiva learning (Exodus 34:7) about the sins of the fathers being visited on the children and grandchildren–3 and 4 generations–and I always wondered how could a just G-d hold future generations responsible, accountable for what the prior generations did?

But perhaps, the answer is evident here, where we cannot blame G-d for our own actions, where we live big, beyond our means, and cause future generations to pay the piper.

When the stock market is rallying–up almost 17% year to date and about 27% over the last year, while our GDP growth is only about 2.4% annually, something is very off-Kilter.

You can argue that retreat is renewal or you can see retrenchment as leading to decline, but either way we will be paying the national bill coming due and all our children will be on the hook for cleaning up after the party is over. 😉

Either Way A Fiscal Cliff

Okay, so here’s the dirtly little secret…

The “Fiscal Cliff” that everyone is supposedly working on to avert–is really unavoidable!Yes, the Sequestration that was put in place that eliminates the broad-based tax cuts from a decade ago and reduces spending across military and domestic government spending–can be replaced by more surgical tax increases and spending cuts.But with a National Debt of more than $16 trillion dollars and one which has been trending up over a trillion dollars a year, we have gorged ourselves and spent beyond our means for too long–and the time to pay up is fast approaching.For example, critical entitlement programs likesocial security and medicare are running out of funds and will not be able to cover benefits by 2033 and 2024, respectively.

What is even worse though is that the money you have been paying into “the system” from yourpayroll taxes for decades hasn’t been put aside in trust for you, but has been spent on other things–sort of like robbing Peter to pay Paul. And now what?

At a time when national competitiveness is suffering, jobs are going overseas, test scores in science and math are trending down, and we have the lowest percentage of Americans working in 30 years, we are saying that we’ve essentially spent our last dime decades ago and have been doubling down with more and more borrowing–that we don’t really know if we can ever pay back.

While we would like to “grow” our way out, by having more people working, earning more, and paying more into the system, our growth projections of slightly more than 2% next year and a historical average from 1947-2012 of just 3.25%–this seems more than wishful thinking.

More likely, as the percent of our national debt to GDP continues to rise and our national credit ratings are are at risk of falling, interest rates will start to rise first slowly and then faster to elevated levels to compensate for the increased borrowing risks, and we will see inflation rear it’s ugly head–it is ugly because inflation will mean your savings are worth less or potentially even virtually worthless.

This will make the $16+ trillion deficit also worth less, so we pay it back through inflation as Germany did with hyperinflation after WWI, and the essential wiping out of our personal savings. Viola, deficit paid down, but pay attention to at what personal costs!

Unfortunately, the fiscal cliff is here and will happen whether spending is cut here or there and taxes go up on some or everyone. This is just the negotiation of how to spread the pain and spin the tale.

And either way the fiscal cliff is going to hurt, because you have to cut spending and increase taxes leaving people with even less money in their shrinking pocketbooks, and if you don’t, the credit agencies will continue cutting our national credit rating leading to higher interest rates on the debt and higher inflation–so either way, our creditors will get their pound of flesh.

In the E.U. now, we are seeing the effects with countries from Greece to Spain, Portugal, Italy, Ireland, and more reeling from the impact, but this is only the beginning, because the lending spigot instead of being turned off, has been opened up further to kick the can down the road. But who will be the lender of last resort, when there is no one that can reliably pay it back?

In the end, you can’t raises tax or cut your way out of decades of financial mismanagement, overnight. In the corporate sector, we say Chapter 11–what do you say for Western civilization? And what do we tell our children and grandchildren?

(Source Photo: Andy Blumenthal)

Go Curly!

This was a funny picture hanging around a local eatery in D.C–at election season.

Curly for President–sort of reminded me of when I was in grade school and had a head full of curly hair and some of the other kids (especially the females in the class) fondly called me “chief curly chicken”–yeah, it stuck for about a year or two. 

Anyway, maybe this is something both Democrats and Republicans can agree on: the three Stooges–Moe, Larry, and Curly–were pretty darn funny. 

With the big looming issues facing America today (exploding national deficits, high unemployment, endangered social programs, declining global competitiveness–now 7th, and more), we can certainly use a little humor to get past it, along with a good dose of strong leadership and breakthrough solutions. 

Whoever you vote for–keep smiling!  🙂

(Source Photo: Andy Blumenthal)

To Die or Not

Yesterday, I read in the Wall Street Journal (7-8 July 2012) about end of life decisions.

With healthcare costs spiraling out of control, driven especially by the care given to those in their final year of life, as a society we are confronted with horrible decisions.

When do you do “everything possible” for the patient’s survival and when do you make the call to “pull the plug.”

The article was about one man specifically–age 41, I think–who needed a heart transplant–which was expensive but successful, but then infection and complications set in over the course of the year and resulted in doctors removing part of his lung, his left leg above the knee, his gallbladder, and with the patient eventually living off of a ventilator.

The medical staff described the patients wincing in pain and the horrific image of at times with the tube down his throat, his screaming with no sounds coming out.

Doctors and the hospital’s ethical counselors spoke with the parents of the man (as his wife had divorced him prior) about discontinuing care.

Part of the conversation was about the practically futile attempts to keep the man alive, the pain of the patient, but subtly there was also the notion about the high cost of care and the patient having reached Medicare limits.

When the father was told that the nurses were having ethical questions about treating the man, the father wanting to keep his son alive at virtually all costs said, (rather than his son being taken off of the medical care he was receiving) maybe these nurses who had an issue with it shouldn’t be working on his ward!

The patient died within the year and at a cost of something like $2.7 million dollars (and the man leaving behind a 9 year old son himself).

There is no question that we want to provide the best care for our families and loved ones–they mean everything to us.

But when does the greater cost to society (i.e. the greater good) outweigh the benefits to the individual?

Yes, can we come up with hard and cold actuarial calculations about what a person contributes into the system, how much value they bring the world, what the anticipated cost is to keep them alive, and what are the chances of success–and then we can draw a line of what as a society we are willing or able to spend to save this person.

That is very matter-of-fact–objective, but practically devoid of feeling, compassion, and hope.

What if the calculation is wrong and the person could’ve been saved, lived longer, at lower cost, and/or would’ve been a great contributor to society–how do we know how to really figure individual life and death decisions.

And what of the cost–the meaning–to the family that relies and loves this person and needs him/her–the cost is priceless to them.

But what about others who don’t, can’t, or won’t receive proper care because others ended up taking more than their “fair” share–aren’t they also human beings deserving as well of proper care–and to their families are they not also invaluable?

From an ethical standpoint, this is one of those horrible dilemas that plague our consciousness and to which answers do not come easy.

An almost insane question– but can we be, in a sense, too giving to an individual, too generous societally, and with some things trying too hard to be ethical?

Like we are seeing now with the financial decline of the European Union and the frightening fiscal challenges ahead for America–how do maintain the traditional “safety net” (Medicare, Medicaid, Social Security, and more) without bankrupting the system and underlying society itself?

In essence, what happens when in our effort to be humane to people and give them a basic standard of living and care, keep our country safe, drive research and innovation, and secure human rights and democracy around the world–we overextend ourselves.

Like many a great society before us that flourished and then declined and even disappeared–do we get overconfident, overly ambitious, and ultimately become self-defeating?

No one–a family member, a compassionate and caring human being, and especially an elected politician wants to say “no” when these decisions hang over us.

But the reality is we will soon be faced not only with the life and death decisions of today, but also generations of built-up overspending and borrowing to finance generous, and yes even corrupt, spending habits.

This will affect present and future generations requiring harder and longer work lives to get a lower standard of living and care, and could even result in our noble society’s decline.

The result is we not only face individual life and death decisions every day, but we also are facing a potential existential threat to our way of life.

Expect gut-wrenching decisions over the next decade(s) and prepare for life to change in painful ways for all of us–on and off the deathbed.

While no one wants to face these questions and make the hard decisions, this is exactly what will need to happen–sooner or later.

Fiscally-speaking, there is no longer one way to freedom, but through a collective fight to secure our nation’s future.

(Source Photo: Andy Blumenthal)

Those In The Know, Sending Some Pretty Clear Warnings

There have been a number of leaders who have stepped up to tell people the real risks we are facing as a nation.

They are not playing politics–they have left the arena.

And as we know, it is much easier to be rosy and optimistic–let’s face it, this is what people want to hear.

But these leaders–national heros–sacrifice themselves to provide us an unpopular message, at their own reputational risk.

That message is that poor leadership and decision-making in the past is threatening our present and future.

Earlier this week (15 May 2011), I blogged about a documentary called I.O.U.S.A. with David Walker, the former Comptroller General of the United States for 10 years!

Walker was the head of the Government Accountability Office (GAO)–the investigative arm of Congress itself, and has testified before them and toured the country warning of the dire fiscal situation confronting us from our proclivity to spend future generation’s money today–the spiraling national deficit.

Today, I read again in Fortune (21 May 2012) an interview with another national hero, former Admiral Mike Mullen, who was chairmen of the Joint Chiefs (2007-2011).

Mullen warns bluntly of  a number of “existential threats” to the United States–nukes (which he feels is more or less “under control”), cyber security, and the state of our national debt.

Similarly, General Keith Alexander, the Director of the National Security Agency (NSA) and the head of the Pentagon’s Cyber Command has warned that DoD networks are not currently defensible and that attackers could disable our networks and critical infrastructure underpinning our national security and economic stability.

To me, these are well-respected individuals who are sending some pretty clear warning signals about cyber security and our national deficit, not to cause panic, but to inspire substantial change in our national character and strategic priorities.

In I.O.U.S.A., after one talk by Walker on his national tour, the video shows that the media does not even cover the event.

We are comfortable for now and the messages coming down risk shaking us from that comfort zone–are we ready to hear what they are saying?

(Source Photo: here with attribution to Vagawi)

Getting Off The Debtor Highway

I.O.U.S.A. (2008) is the best explanation of our nation’s financial problems and the deep severity of these that I have ever seen.

This video is a 1/2 hour condensed version of the full almost 1 1 /2 hour award-winning documentary.

David Walker, the former Comptroller General of the U.S. (1998-2008) is the star of this movie.

The documentary, with Walker’s steadfast warnings, describes the 4 ominous deficits that are driving this country to Financial Armageddon:

1) Budget Deficit

2) Savings Deficit

3) Trade Deficit

4) Leadership Deficit

What is incredible is how rather than listening to Walker’s exhortation, when the National Deficit was $8.7 trillion in 2007, just 5 years later now, there is a deficit going on nearly double that of $15.7 trillion.

We are facing a financial ticking time bomb that could result in huge inflation, economic stagnation, and the undoing of our economic and national security.

Moreover, towards the end of this year, we are facing the economic one-two punch of rising taxes and reduced national spending that could easily send our economy spiraling into recession or even depression.

Add to that rising interest rates, a financial crisis in the  European Union, a continued housing crisis and high unemployment at home, and a true economic reckoning is at hand.

Watch I.O.U.S.A. and become proponents for financial discipline for ourselves and for the country.

Returning From The Brink Of National Suicide

It is not only because we are in an election year that politics in Washington D.C. has become more cutting, oppositional, and unproductive.

Unfortunately, there has been a downward trend for some time and we saw this recently with everything from confrontations to raising the federal debt ceiling, passing a federal budget, near government shutdowns, and what has now become regular showdowns over every major legislation from healthcare to deficit reduction.

We are a nation with government at the crossroads of neuroticism where situations get treated as virtually unsolvable by oppositional political movements who themselves appear hopeless of genuinely working together.

Harvard Business Review (March 2012) in an article titled “What’s Wrong With U.S. Politics,” described the “ineffectiveness of America’s [current] political system,” where instead of opposing sides coming together to craft compromise positions that bring together the best of multiple points of view to find a balanced approach and prudent course for the American people, now instead compromise is seen as surrender, and “the fervor to win too often appears to trump everything else.”

While traditionally the source of political parties and politics itself in America is founded in the opposing views of Thomas Jefferson and Alexander Hamilton–one who opposed strong central government and the other who favored it, these diametric opposites where a source of national strength, because they strived ultimately to find an almost perfect compromise to whatever ailed the nation.

However, something has profoundly changed–from where “rigorous rivalry between the two political philosophies used to be highly productive” to the current situation of absolutism, where like in July 2011 debt-ceiling crisis, “some politicians even suggested that a government default or shutdown would be less damaging than compromise.”

When last August, Standard and Poor took the historically unprecedented step of downgrading U.S. debt from AAA to AA+, they cited “that the effectiveness, stability, and predictability of American policymaking and political institutions had weakened.”

This should be of dire concern to everyone in this nation, because we all depend on government to solve problems and do what is ultimately right for the people.

One of the suggestions that HBR makes is grounded in the techniques of negotiation, where we facilitate and help each side “not merely split the difference,” but also “articulate their highest parties, with an eye toward facilitating the best of best of both over time.”

While this is certainly an important element in moving to compromise, there is another core element that is missing and needs to be addressed and that is a mutual respect for all parties and points of view, one where we see ourselves first as one nation, and only second as political parties and positions–in other words, we recognize that our common values and goals obviate the more subtle differences between us.

This coming together as a nation can only happen when there is basic trust between the all sides, so that each knows that the other will not take advantage of them when they wield power, but rather that the views of all will be respected and duly represented in any solution, and moreover that the core beliefs of each will be protected at some fundamental level, even when they are not in power or outvoted.

What this means is that compromise, balance, and fairness prevail over whichever political party resides in power in at the time, and assures each side of the same treatment and protections under the other.

Violating this ultimate balance of power is tantamount to taking the first shot in a situation akin to Mutually Assured Destruction (MAD), when each side wields destructive nuclear capability.

With critical decisions coming up again on deficit reduction, federal debt ceiling, and social entitlements and national defense spending, and each side digging in, we are fast approaching the equivalent of a thermonuclear showdown in politics, and it is time for both sides to pull back from the brink of national suicide and to once again reinforce the basic principles of mutual respect and enduring compromise–even when one side, or another, has the upper hand.

As a next step, let each side of the aisle demonstrate true compromise in negotiations with the other to reestablish confidence and trust that neither will be wholly overrun or defeated in the political wrangling and fighting that ensues.

The important question in politics must not be which side will wield power, but who can bring the best leadership to the nation to forge a path of sensibility, balance and mutual respect to any solution.

(Source Photo: here with attribution to Elvert Barnes)