Lucy in the Sky with Diamonds or “How did our drug laws get so crazy?”

drug abuse

I wrote this blog four years ago about our ignorant policy and attitudes towards drugs and drug users.  I started it with a satire comparing obese people to drug addicts. You may not like the satire but the problem and analogy is spot on. We have an arbitrary drug policy in this country which hurts millions of people. Witness the incarceration rates for drugs. This article is about the reasons for this stupidity and why we need to change our thinking.

Just this week, I heard two candidates for sheriff in my county talk about the need for stronger drug enforcement and more SWOT teams. The answer is always more police and more arrests. When will we wake up and address the real problems of drug addiction and drug abuse?

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Aging Capriciously

Picture yourself in a boat on a river
With tangerine trees and marmalade skies
Somebody calls you, you answer quite slowly
A girl with kaleidoscope eyes  —- (From the Beatles)(Click here to listen)

lucy_in_sky_with_diamonds_by_weirdplushie-d5r2kziHave you ever wondered why we do not arrest obese people?  What if we treated people who abused food like we treated people who abused drugs?  We could argue “Why don’t we arrest obese people since we arrest drug addicts?”  Do not both of them abuse their bodies?  If you look at the five most common reasons given for drug control policy:  Morality, Health, Profit, Discrimination and Social Control, it could be argued that obesity violates at least four of these principles.  As yet, we do not see too many obese people running amok, but who knows, maybe cases of “Crazed” obese people are just being under-reported.

It seems unfair to me that obese people are…

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Is the War on Drugs Real? — Drugs, Medicine and Pharmaceuticals

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Introduction:

Perhaps few subjects are more complex than the relationship between drugs and medicine.  While the word drug often denotes something “illegal”, medicine comes across with very benign connotations.  Drugs are bad for you.  Medicine is good for you.  However, what is the difference between a drug and a medicine?  Do you have to be sick before it is medicine?  Does everyone occasionally need medicine but no one ever needs drugs?  Why are some drugs legal and others illegal?  Why is it that some legal drugs are illegal unless we have a prescription?  In this blog, I will try to provide you some “divergent” views on drugs and medicines and the Pharmaceutical industry.

Pharmaceuticals:

First, we need to define the term pharmaceutical.  We can find the following definition online:

Adjective:  1.  relating to medicinal drugs, or their preparation, use, or sale.

Noun:  1. a compound manufactured for use as a medicinal drug.

It is important to understand the distinction between the medicinal use and the non-medicinal use of drugs.  Obviously, any drug can be used for either purpose.  However, the “moral” authorities which include the government, your neighbors, various religions and others who believe they have a right to dictate human behavior have used this distinction to decide when it is a crime to use drugs and when it is perfectly okay.  Thus, in many states I may now use marijuana but only if it is for a bona fide medicinal purpose.  If I want to simply use it like I use alcohol or caffeine or nicotine for recreational purposes, it is illegal and I will find myself in jail if I get caught.

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This distinction between drugs and medicine is further complicated by the fact that some drugs are simply considered “bad” drugs whether they have a medicinal use or not.  This category of “bad” drugs once included alcohol when (as many of you are aware) the 18th amendment to the US Constitution was passed to ban its legal use.  Prohibition was perhaps one of the most misguided episodes in American history.  However, it does have the unique distinction of being perhaps the only time in our history when a substance was banned strictly on moral terms.  The prohibition against alcohol was primarily based on the idea that drunkenness was a threat to the moral fiber of the nation.   Since then, our “War on Drugs” has been based on several reasons but morality is no longer a major reason.

Let’s get one thing clear from the start.  There is no “War on Drugs” in the USA.  If there were a war on drugs, then bars, cigarette shops, coffee shops, liquor stores, drug stores and doctors’ offices would be raided and closed.  Doctors, baristas, druggists and Pharmaceutical CEO’s would be arrested along with the rest of the drug pushers on the street.  We would need to build an entire prison system to house all the pharmaceutical executives, managers and workers who routinely make and sell drugs.

The “War on Drugs” is a sham, a myth and a hypocrisy of epic proportions.  There are two reasons for this so-called war.  The first is prejudice and the second is monetary.  These two reasons are curiously intertwined.

Docs and Big Pharma

Prejudice as a Factor in the Drug Wars:

Our prisons today are overflowing with people who have used or sold illegal street drugs.  Drugs like heroin, cocaine, marijuana and methamphetamines make up the bulk of illegal drugs sold on the street.  The majority of people selling these drugs are poor.  Minorities make up a disproportionate number of the poor in America.   Consider the following facts:

war on blacks

Poverty rates for blacks and Hispanics greatly exceed the national average. In 2014, 26.2 percent of blacks and 23.6 percent of Hispanics were poor, compared to 10.1 percent of non-Hispanic whites and 12 percent of Asians.National Poverty Center

Of course, if minorities are a large percentage of the poor and if the drug war is really an attack on the poor, then it should follow that minorities will make up a larger percentage of those convicted of drug crimes and sent to prison.  The facts support this:

  • African Americans now constitute nearly 1 million of the total 2.3 million incarcerated population
  • African American and Hispanics comprised 58% of all prisoners in 2008, even though African Americans and Hispanics make up approximately 25% of the US population
  • About 14 million Whites and 2.6 million African Americans report using an illicit drug
  • 5 times as many Whites are using drugs as African Americans, yet African Americans are sent to prison for drug offenses at 10 times the rate of Whites

The facts support that the so-called “War on Drugs” is really a war on the poor.  Why war on the poor?  Because they are regarded as a threat to the lifestyle of the wealthy.  The wealthy in America are of course predominately White.

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“96.1 percent of the 1.2 million households in the top one percent by income were White, a total of about 1,150,000 households. In addition, these families were found to have a median net asset worth of $8.3 million dollars.”  — America’s Financial Divide: The Racial Breakdown of U.S. Wealth in Black and White, Huffington Post, 2015

It is seldom mentioned but wealthy people are fully aware of the fact that healthy non-drug addicted citizens make better workers.  Furthermore, non-drug addicted people who are addicted to hard work are less likely to break into your house in the middle of the night and steal your Gucci purse and your Rolex watch.

On the other hand, if you are poor and uneducated, drugs might seem like a decent way to spend a day rather than knocking on closed doors for a job.  I spent four years in the military from 1964 to 1968.   Any war is an ideal breeding ground for drug use.  Consider the daily effects of stress, confusion, attacks, wounds, death and uncertainty.  The military was rife with drugs when I was in.  Would anyone like to guess how much illegal drug use there was during the Vietnam War?

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“In 1971, a report by the House Select Committee on Crime revealed that from 1966 to 1969, the armed forces had used 225 million tablets of stimulants, mostly Dexedrine (dextroamphetamine), an amphetamine derivative that is nearly twice as strong as the Benzedrine used in the Second World War. The annual consumption of Dexedrine per person was 21.1 pills in the navy, 17.5 in the air force, and 13.8 in the army.”  — The Drugs That Built a Super Soldier, The Atlantic, 2016

 The above article concerns speed only and does not deal with marijuanaMy own personal experience was spending many weekends high on pot mixed with copious amount of whatever liquor we could get our hands on.  Beer would do if liquor was not available.  There were also many who simply sniffed glue and destroyed their brains.  To the best of my knowledge, I knew of no one who was ever busted for drug use on any base I was stationed at.  The moral is that it is okay to use drugs if they help you kill people but not simply to feel good about yourself.

The sanctimonious politicians who make drug laws in this country should be shot.  Am I being too “divergent” in my condemnation of these hypocrites?  Believe me, I could not be too hard on them.  Consider the damage that their greedy misguided policies have done to our nation and our citizens.  Millions of people have languished in jail only to serve their sentence and find that when they come out, they are even worse off than when they went in.

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Consider the effects of a felony record for drugs in America:  A convicted felon in Connecticut faces the following array of restrictions and constraints:

  1. Loses the right to become an elector and cannot vote, hold public office, or run for office, although he can have these rights restored
  2. Is disqualified from jury service for seven years, or while he is a defendant in a pending felony case (CGS § 51-217)
  3. Loses the ability to have firearms
  4. Could lose a professional license or permit,
  5. Employers can ask job applicants whether they have been convicted of a crime although federal anti-discrimination laws place some restrictions on the use of criminal histories.
  6. The State Board of Education (SBE) cannot issue or renew, and must revoke, a certificate, authorization, or permit to someone convicted of certain crimes. The SBE can also take one of these actions if the person is convicted of a crime of moral turpitude or of such a nature that the board feels that allowing the holder to have the credential would impair the credential’s standing.
  7. The Department of Children and Families must deny a license or approval for a foster family or prospective adoptive family if any member of the family’s household was convicted of a crime that falls within certain categories, which can include felonies.
  8. Landlords can evict a tenant who was convicted of a violation of federal, state, or local law that is detrimental to the health, safety, and welfare of other residents. Federal and state law for public housing allows eviction based on conviction of certain felonies. Different rules apply to elderly people.
  9. Someone convicted under federal or state law of a crime involving possession or sale of a controlled substance is not eligible for federal assistance for higher education expenses for certain periods.
  10. State law bars anyone convicted of a drug possession or use felony under federal or state law from receiving benefits under the temporary assistance for needy families or food stamp programs unless the person (1) has completed his court imposed sentence, (2) is satisfactorily serving probation, or (3) completed or will complete a court imposed mandatory substance abuse treatment or testing program (CGS § 17b-112d).

You have served your sentence for possession of a marijuana joint.  You might have served between one and five years.  You are now ready to return to society and be a hard-working honest citizen.  Regard the above list!  No one will hire you. You cannot get a student loan.  You cannot get certain licenses and even some landlords will be legally able to not rent you a place to live.  What would you do?  What would Jesus do?  Well, unfortunately, many of these people are not you and they are not Jesus.  Thus, a life of crime on the street seems to offer more preferences for some than begging for money with a cup.  Besides, every business endeavor has certain risks and the gains from drug dealing may seem to far outweigh the risks, particularly when you consider the alternatives.

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What Role Does Greed Play in the So-Called War on Drugs?

Pharmaceutical companies are huge and make huge profits.  They are consistently listed among the top most profitable companies in America.  Here are the top ten most profitable drug companies by market value:

  • Johnson & Johnson: $276 billion (market value)
  • Novartis: $273 billion
  • Roche: $248 billion
  • Pfizer: $212 billion
  • Merck: $164 billion
  • Sanofi: $134 billion
  • Bayer: $123 billion
  • Novo-Nordisk: $118 billion
  • Bristol-Myers Squibb: $115 billion
  • AbbVie: $110 billion

In 2016, the Pharmaceutical Industry was at the top of the list for most profitable industries.  Forbes, citing data from Factset, recently released its list of the 10 most profitable industries of 2016. “Pharma: Generic” led the way as the most profitable industry with a 30 percent net profit margin”

  1. Pharma: Generic: 30%
  2. Investment managers: 29.1 percent
  3. Tobacco: 27.2 percent
  4. Pharma: major: 25.5 percent
  5. Internet Software and Services: 25 percent
  6. Biotechnology: 24.6 percent
  7. Savings Banks: 24 percent
  8. IT Services: 23 percent
  9. Regional Banks: 23 percent
  10. Major Banks: 22.9 percent

https://www.surepayroll.com/resources/blog/the-10-most-profitable-industries#sthash.rVW6a7fs.dpuf

big-pharma-mafia

Please note where the tobacco industry is on this list.  Now ask yourself this question.  Do you think either big Pharma or Big Tobacco wants competition in the form of legalized drugs?  I hope you answered NO! to this question because there is ample evidence that both industries spend a great deal of money lobbying against drugs that would pose competition to their industries.

“Both pharmaceutical companies and alcohol brands are spending money to keep prohibition around, too.  As we reported last year, certain anti-cannabis academics are funded by big pharma.  Alcohol companies are also lobbying against legalization.  In one example, the California Beer & Beverage Distributors made campaign contributions to a committee dedicated to preventing marijuana legalization and taxation. 

 To summarize, police unions, prison guard unions, for-profit prisons, and drug and alcohol companies spend huge sums of money each year to keep cannabis illegal, and why?  Because it ensures job security and profits.”  — The Top 5 Industries Lobbying Against Cannabis Legalization Will Infuriate You by Sara Lilley in Leafly

Perhaps you are inclined to think that the prejudice and greed fueling the drug industry is not that bad.  Perhaps you do not mind that America has one of the highest rates of incarceration of any developed country.  Perhaps you do not mind that millions of your citizens are in jail for smoking or selling a joint.  Perhaps you are happy smoking and drinking and do not want any other drugs.  Maybe you feel that “Big Pharma” is on your side and helps you with all the new medicines they have coming down the pipeline.  If so, you are living in a fools’ paradise.  Big Pharma is more likely to steal from you and or kill you than the drug pusher on your street corner.  In fact, they do so every single day.

ethical-criteria-for-medicinal-drug-promotion-schedule-g-17-638

They steal from you with exorbitant profits.  Who do you think pays for all their advertising and research?  They actually spend more money on advertising than they do on research.

“Prescription drug companies aren’t putting a lot of resources toward new, groundbreaking medication, according to a recent report in BMJ, a medical journal based in London. Instead, it’s more profitable for them to simply to create a bunch of products that are only slightly different from drugs already on the market, the reports authors said.  The authors go on to say that for every dollar pharmaceutical companies spend on “basic research,” $19 goes toward promotion and marketing.” — Pharmaceutical Companies Spent 19 Times More On Self-Promotion Than Basic Research: by Alexander Eichler

Big Pharma also leads all industries in spending your money on lobbying.  From 1998 to 2016, they spent over 3.5 billion dollars on lobbying.  This was more than a billion dollars higher than for the next highest industry which was insurance.  — Top Industries.

ee545df3eb331cc722ed7088791e9a5eAre you still wondering why drug costs are so high? Did you really think it was all research and development costs?  The three major factors are:  Profits, lobbying and Marketing.  How much do you think these all add to the costs of your prescription drugs?

Well, perhaps you still do not care.  After all, if the drugs do their job, what do you care if they cost a lot.  Perhaps your insurance pays it all anyway.  Well friend, what if you knew some of these drugs were going to kill you?  Do you think I am exaggerating?

Here are some examples of potentially lethal side effects:

“Baycol, which lowers cholesterol, was strongly linked to a potentially fatal breakdown of muscle tissue.  Approved in 1997, it was voluntarily withdrawn four years later.  The anti-inflammatory drug Duract spent just one year on the market. Approved as a strictly short-term use product, the FDA found serious liver problems with people taking the drug for longer than what was recommended.

In 1985, employees of two drug companies were fined and/or sentenced to community service for not reporting adverse events involving the blood pressure drug Selacryn and arthritis drug Oraflex.” — Drug Side Effects Explained

Of course, drug companies do not want to kill you because that could result in costly litigation and even worse, bad publicity.  Thus, most drugs come with a lengthy disclaimer and long list of potential side effects.  These are more designed to protect the drug company than you or your health.  You will probably not be able to read the small print on the label and even if you are able, you will probably not have a clue what they are talking about.  On the odd chance that you do know what it all means, it would not matter anyway, since what is your recourse?  If you are in pain and have gone through the process of obtaining your prescription how likely are you to decide that you will not take the risks associated with the drug?  But, and here is the important “but”, all drugs, even over the counter drugs have potential side effects.

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And this brings us to another major factor affecting the cost of drugs.  This is the cost for Big Pharma to cover its butt when caught doing something wrong.  A report by Pubic Citizen noted the following information:

In December 2010, Public Citizen published a report that, for the first time, documented all major financial settlements and court judgments between pharmaceutical manufacturers and the federal and state governments since 1991.  At the time of the report’s publication, almost $20 billion had been paid out by the pharmaceutical industry to settle allegations of numerous violations, including illegal, off-label marketing and the deliberate overcharging of taxpayer-funded health programs, such as Medicare and Medicaid.  Three-fourths of the settlements and accompanying financial penalties had occurred in just the five-year period prior to 2010.  At the time of the report’s publication, there was no indication that this upward trend was subsiding.

adhdThere are many other egregious practices that go on in Big Pharma and which are beyond the scope of this blog.  My point in writing this was first to help alert you to the hypocrisy of the so-called drug wars and second to bring to your attention the inordinate amount of effort and money that Big Pharma spends in trying to get you to buy their drugs.  If you watch TV or read any mainstream magazines, you cannot help but become inundated with ads for drugs to cure any problem you can think of.

larrythecableguyprilosecThe drug companies are the biggest pushers of drugs in the world today and all for a profit.  The fact that these drugs may help your condition is very secondary to Big Pharma’s primary goal which is profits.  The fact that many drugs should not be taken long-term and may have life threatening side effects is also not particularly important to the drug industry.  Between the ignorance of many medical doctors anxious to provide a fast treatment and the greed of the drug industry, you had best become a very informed and cautious consumer of any drugs you are going to take.  You should also be skeptical of any information provided by the drug industry.

Time for Questions:

What medications do you take?  Why?  What has been your history with drugs?  How informative has the drug information you have received been?  What do you think about all the drug advertising on TV and in magazines?  Do you think we live in an addicted society? Do you think the Drug War is real?

Life is just beginning.

 “People use drugs, legal and illegal, because their lives are intolerably painful or dull. They hate their work and find no rest in their leisure. They are estranged from their families and their neighbors. It should tell us something that in healthy societies drug use is celebrative, convivial, and occasional, whereas among us it is lonely, shameful, and addictive. We need drugs, apparently, because we have lost each other.”  ― Wendell BerryThe Art of the Commonplace: The Agrarian Essays

 

 

 

 

 

Is Chiropractic an Art or a Science? 

When I grew up on the East Coast, I had little or no contact with chiropractors.  Back then, most people I knew and most medical centers did not regard them as real medical practitioners.  Years later, after I came out to the Mid-West, I found a much wider acceptance of chiropractors.  Over the past 40 years of living in Minnesota and Wisconsin, I have known many people who have gone to chiropractors and who firmly believe that they were being helped.  Most of the people I have known were suffering from back problems.  Here is one comment regarding chiropractors from an obviously very satisfied patient:

“I go to a chiropractor irregularly, usually when my neck is bothering me.  He uses heat, ultrasound, and massage therapy to undo the tension in my back and neck, caused by two vertebrae in my back that have been out of alignment since I was 16.  I go away, and am usually good for another 6 months.

I’ve never had a chiropractor offer to cure anything, from gallstones to depression by cracking my back; I’ve never had one suggest I needed to try any homeopathic remedies; I’ve never had one claim my bipolar disorder was all due to a misaligned spine. When I did have gall bladder trouble, my then chiropractor told me to see my primary care doctor post-haste.”

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If chiropractic medicine has any single claim to fame it is in dealing with back and skeletal muscle problems.  Chiropractors are famous for treating such problems with spinal manipulation and “adjustments.”  Often the diagnosis given to the patient will include the claim that the patient has a “pinched” nerve or some type of “subluxation”.  The patient spends an hour or so with the doctor getting an adjustment to treat the problem.  Many patients will then leave feeling much better then when they arrived.  They will also be out between 65 to 200 dollars per visit.  In most states, Chiropractic medicine is recognized and eligible for insurance reimbursement.

“Medicare does cover medically necessary chiropractic services.  According to the CMS,  Medicare Part B now covers 80% of the cost for ‘manipulation of the spine if medically necessary to correct a subluxation.’  There is no cap on the number of medically necessary visits to a chiropractor.”  — Does Medicare Cover Acupuncture or Chiropractic?, Senior 65

OK, so far, we have happy patients, insurance reimbursement in most states and Medicare coverage for chiropractic service, so what is my problem with chiropractors?  What if it is an art, what’s wrong with that?  Well, an art is something that as opposed to a science does not have objective reproducibility.  There is little or no evidence for cause and effect in an artistic relationship.  From an art, we would expect a much wider variation of results then we would get from something that has demonstrated scientific reproducibility.

“Chiropractic theory and practice are not based on the body of knowledge related to health, disease, and health care that has been widely accepted by the scientific community.

 Most chiropractors believe that spinal problems, which they call “subluxations,” cause ill health and that fixing them by “adjusting” the spine will promote and restore health. The extent of this belief varies from chiropractor to chiropractor. Some believe that subluxations are the primary cause of ill health; others consider them an underlying cause.” —- Twenty Things Most Chiropractors Won’t Tell You  by Dr. Preston H. Long

Another way of looking at the difference between and an art and a science lies in the ability to assign risk factors.  With a science, we should be able to assign a probably of risk in terms of outcomes.  With an art, we cannot reliably assign risk factors since they have no bearing in empirical outcomes.  What difference does this make to a potential chiropractic patient?  It should make a great difference since their chances of getting an accurate diagnosis for many potential problems is much less with chiropractic medicine than with traditional medicine.  Here are two comments from people who have gone to chiropractors.  These comments are from the http://www.spine-health.com forum and website.  The subject was: “Does chiropractic treatment help with pinched nerves:”

“Chiropractic “medicine” deals with the musculoskeletal system. However, many chiropractic offices use TENS therapy, which stimulates the nerves. Most of my back problems come from nerve issues and I have personally never found relief from chiropractic, in fact, it made me worse. But this is only my personal experience. My portable TENS unit helps me; I would ask the doctor who is managing your condition if TENS therapy may be right for you. Good luck!”

“In my case, I made the biggest mistake in my life, I was complaining about little pain in my knee but my chiropractor damaged my upper back T5 and T6 which I’m suffering now with a lot of symptoms nerve pain in between my shoulder, legs , arms , headache ….., I’ll never advise anybody to go to the chiropractor , and this is my own  experience.”

Anecdotes and grievances do not prove a case against chiropractic.  However neither do testimonials from satisfied patients prove the efficacy of chiropractic treatment.  It can be argued that the placebo effect will explain much of chiropractic’s reported success.  I have often argued that massage therapy will produce the same results with lower cost.  Some evidence exists to support my contention.

“A study called Patterns and Perceptions of Care for Treatment of Back and Neck Pain appeared in 2003. The studied questioned over 2,000 people on how they dealt with their aches and pains. Massage took home the gold with people preferring it to chiropractic for any kind of back pain or general body pain, but chiropractic led the race in upper-back pain and neck pain. Even with these results, visits to chiropractors were much more common than visits to massage therapists.”  — Chiropractor Vs. Massage

The above study notes that more people go to chiropractors than massage therapists.  You might wonder why?  Especially since seeing a massage therapist will cost you about 1/2 to 1/3 the cost of seeing a chiropractor.  I propose that the reasons for this propensity of people to prefer chiropractors to massage therapists lies in the more successful lobbying and marketing that chiropractors have done.  A second and related reason is that massage therapy will generally not be covered by most insurance plans or Medicare.  The following applies to Medicare coverage for massage reimbursement:

“Original Medicare does not cover massage therapy. Services that are not covered by Medicare are the sole responsibility of the patient.  In some cases, Medicare Part B will cover chiropractic services if they are medically necessary and are meant to correct a subluxation of the spine. In most cases, Original Medicare pays 80% of the cost for this treatment, but the patient is responsible for the other 20% and all other tests and services performed by the chiropractor.” —  Does Medicare Cover Massage Therapy?

Note that in the above description that chiropractic care is covered but massage therapy is not.  The lobby for chiropractors is much more powerful than the lobby for massage therapists.  This latter fact demonstrates that the type of medical care and medical coverage you are eligible for will be determined not by objective scientific facts but by political persuasion and money spent by lobbyists.  How does that make you feel?  But let’s get back to chiropractic treatments and look more specifically at “adjustments”.  This is the bread and butter treatment for chiropractic patients.  Do you need them?  Will they help you?

Chiropractic Adjustments:

chiro with an adjustmentIf homo sapiens have a weak link in their skeletal structure it is the back.  It has been argued that the problem arose when we switched from hanging in trees to walking upright.  Whatever the cause, back problems are easily the most common and perhaps one of the most painful problems faced by Americans today.  I have heard it said that the “opioid epidemic” is really a “pain epidemic” as more people age and have to deal with back problems, knee problems and hip problems.  No one beset by continuous pain can be blamed for wanting to find an escape from that pain.  However, as I noted in the previous blog, this desire to escape pain often leads to bad choices.  Surgery is too often prescribed when other treatment modalities would be more effective with less side effects.  This brings us to the issue of chiropractic adjustments for back pain.  How effective are they?  Here is another comment from Dr. Preston H. Long regarding the effectiveness of spinal manipulation:

“Research studies that look at spinal manipulation are generally done under strict protocols that protect patients from harm. The results reflect what happens when manipulation is done on patients who are appropriately screened—usually by medical teams that exclude people with conditions that would make manipulation dangerous. The results do not reflect what typically happens when patients select chiropractors on their own. The chiropractic marketplace is a mess because most chiropractors ignore research findings and subject their patients to procedures that are unnecessary and/or senseless.”Chiropractic Abuse: An Insider’s Lament Paperback – 8 Oct 2013, by  PhD. Preston H Long D.C

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I highly recommend you read the book by Dr. Long.  If you are going to go to a chiropractor, you should have a realistic assessment of finding out your chances of getting help and relief.  Too many people leave their medical treatment entirely in the hands of so-called experts.  This is a big mistake.  I will discuss this later in another blog, but you need to be a strong advocate for your health care and not trust any one medical practitioner too much.  How much is too much?

 

  • It is too much if you are uninformed and have done little or no research into the causes and treatments of your illness.
  • It is too much if you expect that your treatment will take the place of discipline and hard work on your part.
  •  It is too much if you would rather get surgery than lose weight or exercise.
  •  It is too much if you expect that your doctor will advise you to pursue less invasive treatments before surgery or pills.
  •  It is too much if your doctor is overweight, has no exercise program of his/her own or smokes.
  •  It is too much if you have not pursued a second or third opinion.
  •  It is too much if your doctor cannot show you fairly persuasive evidence of a diagnosis and an empirically related treatment modality.

Conclusions:

For the record, I have no vendetta or grudge against chiropractors.  However, it has been my observation that they often treat many problems that they are not competent to treat or that have not had a proper diagnosis.  I have seen too many friends go to a chiropractor and not have a long-term fix to their pain or problem.  Chiropractors may offer a good short term fix to some pain problems but usually no long-term fix.  For the record though, massage, surgery and pills do not usually provide a long-term fix and with surgery, there will usually be consequences that the patient was probably not aware of.

(For more facts on the pro’s and con’s of chiropractic treatment see “Evidence for Chiropractic Treatment“) 

Chiropractors are no better than regular medical doctors when it comes to dealing with the underlying cause of pain.  Sadly, some of the problem for hasty diagnosis must be laid on the patient’s doorstep.  Many pain sufferers want either instant relief or relief that will entail little or no effort on their part.  Doctors too readily give into this desire either because of the financial remuneration that awaits them for treatment or laziness or perhaps simple ignorance.  My skeptical side says that giving a patient an exercise program or diet program is not nearly as lucrative as treating the patient with adjustments or surgery.  Back surgery will generally cost between 50k and 100k.  Spinal adjustments may take place for up to 6 months and final costs may total nearly $5000 dollars (computed as 50 treatments multiplied by an average cost of $65 dollars per treatment.)

On the positive side, there are many chiropractors who offer an alternative to the pills and surgeries so often recommended by mainstream medical doctors.  Perhaps because they have been viewed as less professional by traditional medicine, many chiropractors have considered a variety of non-traditional treatment options.  Many of these treatments are not very scientific or have no proven scientific effectiveness but this does not mean that they may not be effective.  Scientific proof has often taken many years to prove things that traditional folk medicine long knew was true.  However, there is a drawback in delaying some treatments to pursue unscientific remedies.  For instance, when I was diagnosed with prostate cancer, I decided to pursue a “wait and see” or “active surveillance” policy.  I was not ready to accept either the PSA reading or the biopsy or even the MRI results.

During my wait and see time, I opted to try some herbal remedies that were reported to have some success with prostate cancer.  I started taking several of these remedies each day in the hopes that a future biopsy would show a decrease in cancer cells or even the disappearance of my cancer.  No luck.  My next biopsy and a third biopsy all showed increases.  In addition, my Gleason score and PSA scores kept going up.  I now risked the danger that the cancer would spread out of my prostate and migrate to other organs.  It was time for surgery.  Not to pursue surgery at this point would have been foolish and even hopeless.

Thus, there is an ever-present danger that pursuing treatment programs that are a dead end might endanger your life and prevent you from going down more fruitful paths.  There is a reason that many people pursue such options.  It is called “hopefulness.”  I cannot blame anyone for this outlook.  I too was hopeful that I could keep my prostate and continue to pursue a normal life.  Many people go to chiropractors rather than medical doctors in the hope that they will find a cure beyond pills and surgeries.  Some do and some don’t.

Time for Questions:

Have you ever been to a chiropractor?  Why or why not?  Did you find them helpful?  Why?  What evidence did your doctor provide to show why he/she gave you the diagnosis you received?  What kind of exercise program do you follow?  Do you think people without an exercise program are higher risks for medical problems and pain?

Life is just beginning.

“The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease.” – Thomas A. Edison

 

 

 

 

 

 

 

 

 

 

 

 

Should We Be Cautious When Seeing Our Family Doctor?

can you trust your doctor

This is the first of the ten perspectives I am going to discuss about medical care in the United States in the 21st Century.  Before I begin, I have already warned you that if you regard physicians as gods or if you love your MD for saving your life and cannot bear to hear anything wrong about the medical profession, you should probably not read what I am going to say.  One of my friends on Facebook sent me this message or caveat:

“I practiced medicine for 30 years. Be careful about generalizing. I got burned out, I cared. I saw the whole person. I’m not unusual. Medicine is hard. You are always looking over your shoulder. Afraid to be sued. We go into this not for money but to help. Really. Believe it.”

I am quite sure that what she says is true.  True for some.  Not true for others.  Is it the majority?  I don’t know.  But there are a lot for whom the medical system is not working and even more importantly for whom it is dangerous and harmful.  Let’s start with some specifics.

After writing and publishing this blog, a good friend of mine reviewed it.  He had a very different perspective on things than I present.  Together, we are like the Yin and Yang. I see the negative side of things and he sees the positive side of things in the medical profession.  It is my belief that we need to see more of the problems with our medical practices and bring them out so that they are more transparent.  Nevertheless, I realize that there are thousands of medical people who work hard and try to do their best to help their patients.  Thus, I am going to print Fred’s letter to me following my comments.  I hope this will “balance” out my negativity somewhat and create a more balanced view of American medical practice in the 21st century.  (Thank You Fred for taking the time to send us your thoughts.)

  1. Number of Needless Surgeries that are Done

There are many people who are enamored with surgery.  There are an equal number of doctors who are enamored with surgery.  When anyone in the first group goes to anyone in the second group, you can bet that surgery will be the answer to all their problems.  AbracadabraAnd like magic, their hip pains, knee pains and back pains will go away.  The patients are joyous, (unless they die on the operating table like my friend did last summer after going in for a hip replacement).  The doctors are joyous since they are thousands of dollars richer and of course the hospitals are also joyous since they too are also thousands of dollars richer.

signs-that-you-should-see-a-doctor-physical-therapyHave you ever heard of a doctor turning anyone down for back surgery, knee surgery or hip surgery by telling them that they are overweight and would be better served by an exercise program or by physical therapy?  If so, I can guarantee they are not typical of most medical practitioners.  How many doctors look at the major cause of back, knee and hip problems and try to deal with that?  Impossible, because doctors do not treat you over a lifetime.  You don’t see a doctor until you have a problem and by then it may be too late.  Surgery is the fastest solution because exercise, dieting and physical therapy take discipline and time.  Doctors do not want to tell you the truth because it is an inconvenient truth but many problems should not be treated by surgery until it is a last resort.  Too often, it is the first resort.

  • Data show that 10% to 20% of some common surgeries are done unnecessarily – USA Today – June 20th, 2013
  • “I think there’s a higher percentage who are not well trained or not competent to determine when surgery is necessary, Santa says. ‘Then you have a big group who are more businessmen than medical professionals — doctors who look at those gray cases and say, ‘Well, I have enough here to justify surgery, so I’m going to do it.” — USA Today

Here per the study reported by USA Today are the six leading surgeries that often performed and just as often not needed:

  • Cardiac Angioplasty, Stents
  • Cardiac Pacemakers

Pacemakers are used to correct heartbeat irregularities, but research shows that more than 22 percent of these implants may be unnecessary.

  • Spinal Fusion Back Surgery

lumbar-spine-surgeryIf you have low back pain and see different specialists you will get different tests: rheumatologists will order blood tests, neurologists will order nerve impulse tests, and surgeons will order MRIs and CT scans. But no matter what tests you get, you’ll probably end up with a spinal fusion because it’s one of the “more lucrative procedures in medicine,” author Shannon Brownlee says – even though the best success rate for spinal fusions is only 25 percent!

  • Hysterectomy
  • Knee and Hip Replacement, and Arthroscopic Knee Surgery

Patients who were informed about joint replacements and alternative treatments had 26 percent fewer hip replacements and 38 percent fewer knee replacements than those who did not. Arthroscopic knee surgery for osteoarthritis is also one of the most unnecessary surgeries performed today, as it works no better than a placebo surgery.

Proof of this is a double-blind placebo-controlled multi-center (including Harvard’s Mass General Hospital) study published in one of the most well-respected medical journals on the planet, the New England Journal of Medicine (NEJM) over 10 years ago.

knee surgeryRecent research has also shown arthroscopic knee surgery works no better than placebo surgery, and when comparing treatments for knee pain, physical therapy was found to be just as effective as surgery, but at significantly reduced cost and risk. And yet another study showed exercise is just as effective as surgery for people with chronic pain in the front part of their knee, known as chronic patellofemoral syndrome (PFPS), which is also frequently treated unnecessarily with arthroscopic surgery.

  • Cesarean Section

According to the World Health Organization, no country is justified in having a cesarean rate greater than 10 percent to 15 percent. The US rate, at nearly 32 percent, is the highest rate ever reported in the US and is higher than in most other developed countries.

The USA Today article went on to talk about many diagnoses that were based on limited medical knowledge and that doctors often lacked the expertise to explore alternative treatment modes.  This is an issue of incompetence and it seems to be a major problem in the medical field with many doctors getting their information from their pharmaceutical representatives.

I have not even touched on the issue of malpractice.  But I will say a few words about this.  No one is perfect.  Everyone makes mistakes.  Medical treatment and diagnosis is a very difficult process.  I will not blame any doctor for an honest error committed with good intentions and not simply out of ignorance or greed.  This is one area where I sympathize with the doctors and hospitals more than I do the lawyers.  Nevertheless, there are some egregious examples of medical practice and a lawsuit might be the only recourse for such cases.

I use the information from the USA Today article, but none of it surprises me.  I have had many friends who have undergone surgery for the situations noted above. I have often tried to counsel them as to other solutions but it is generally a waste of time.  I have had two notable successes though and they have both expressed their gratitude to me for sharing my opinions and thoughts with them and preventing them from getting surgery.

drugs

  1. Pills, Pills and more Pills

If life were fair, many doctors would be in jail right alongside of other drug dealers.  Doctors do not have the violence associated with illegal drugs because they have a license to prescribe drugs.  However, doctors prescribe drugs that are no more needed than heroin or cocaine and at much greater rates than your street drug pusher.

The size of the illicit drug trade (2012 data) in the USA including Marijuana, Heroin, Cocaine and Methamphetamines was estimated to be about 100 billion dollars a year.  —- How Big is the U.S. Market for Illegal Drugs?  We can assume that street dealers and drug pushers are responsible for most of these drugs.  So how much do doctors push?

If we look at the following fact, we can extrapolate from it the total amount of prescription drugs sold each year in the USA.

“In 2013, per capita spending on prescription drugs was $858 compared with an average of $400 for 19 other industrialized nations. In the United States, prescription medications now comprise an estimated 17% of overall personal health care services. —  The High Cost of Prescription Drugs in the United States (2016). 

deaths from over druggingSo if we assume roughly 326,000,000 (USA Population in 2016) people and we multiply that by $858 dollars per capita, the total amount should equal the total amount spent on prescription drugs.  This amount equals = $279,708,000,000.  This is almost three times what is being spent on illegal drugs.  I am not even going to talk about caffeine, alcohol, nicotine, and other “legal” drugs.  Given that doctors love to prescribe pills and many patients love to take them, is there any wonder that we have or are currently experiencing an opioid epidemic in the US.

“Americans are in more pain than any other population around the world. At least, that’s the conclusion that can be drawn from one startling number from recent years: Approximately 80 percent of the global opioid supply is consumed in the United States…. The 300 million pain prescriptions equal a $24 billion market.”  — Americans consume vast majority of the world’s opioids (2016).

I say again that if life were fair, many doctors would be called drug pushers or DP’s rather than MD.’s   They would also be in jail.  Who should be responsible for the opiate epidemic if not doctors.  When and where do they stand their ground.  Even if people are stupid or lazy enough to want surgeries to cure problems of obesity and diet or if they want pain killers to mask the problems from their obesity and lack of exercise, who is the expert here?  Do parents give their children everything they ask for?  You go to an expert on medicine to get help and not to have them take advantage of you for their own benefit or pander to you because they are afraid to tell you the inconvenient truth.  What is this inconvenient truth?  I will talk more about this truth later in this series but to be quite direct and blunt it is this:

“British businesswoman and columnist Katie Hopkins has a controversial view on the obesity epidemic: that the solution is simply to eat less and exercise more — and that fat people have no one to blame for their weight issues but themselves.” — I gained 43 pounds to prove obese people are lazy

I had a friend that I used to ride motorcycles with.  He died in a motorcycle crash a few years back.  He was a great guy.  He always had a smile and something nice to say to someone.  His name was Gary.  He was also obese and exercised little.  He had chicken legs and bad knees.  Well, what would you expect if you weighed 100 lbs. more than you should and you let your leg muscles go to hell.  Of course, he went in to see his doctor with knee pains.  The doctor was more than happy to suggest Gary should lose some weight but in the meantime, he would schedule the surgery for knee replacement.  To my mind, this is criminal, irresponsible and ignorant behavior on the part of his doctor.  Gary got the surgery.  Never lost much weight and died not too long after from other causes.

Doctors pushing pills, pushing surgery.  It is like the Yin-Yang of American medical practice.  Throw into the mix a lot of lazy people who do not exercise or take care of themselves and you have a health care system spending tons of money on acute care when preventive care would be a much more sensible solution.

  1. Me Doctor, Me Busy.  Who are You?

Some of you might remember the skit on Saturday Night Live with Martin Short playing a doctor.  When asked what his badge that said MD meant, he would reply somewhat superciliously “Me Doctor, You Patient.”  When I was working as a consultant to some hospitals, it was not uncommon to hear nurses complain that doctors were like gods whose every word should be obeyed.  They seldom came to team meetings because “their time was too valuable.”

I will stay away from the subject of how much money doctors rake in since they often ascribe their high incomes to the length of time it takes to finish medical school and all of the attendant costs.  This sounds like a reasonable explanation but an alternative theory might mention the strangle hold that the AMA had on medical admissions and the role that restricting the supply of doctors has had on the cost of their services.  The law of supply and demand says that if you have fewer doctors, the cost per care will be higher.  For years, the AMA did all they could to help keep the supply of doctors down.

  • But the entities that will be most injurious to the nation’s health are not so much in the evil-mongers’ group but the first group, including the American Medical Association–a doctors’ cartel that has controlled the medical labor market in the U.S. like its personal fiefdom for a century. — The Evil-Mongering Of The American Medical Association (2012)

So, doctors come to regard themselves as the elite who know more than you do and who must be smarter than you since they make a great deal more money than most of their patients.  Doctors used to do house calls many years ago; back then, a doctor might have known something about your family and you personally.   My wife Karen told me the following story about her family doctor.   It generated the following conversation:

Karen —

“When I was married, and raising four children, my ex-husband Ron and I became good friends with a local White Bear doctor.  He became a family friend as well as our family doctor.  We knew him for over thirty years and he knew me and my family personally and really cared about us.” 

John —

“Okay, so now you have been seeing a doctor in Frederic for about seven years.  How much does she know about you personally or really care about you?”

Karen —

“I think she really cares about me.”

John —

“But how much does she know about you personally.  Your goals.  Your dreams.  What you did this past winter?”

Karen —

“Well, at first, she used to take more time to talk to me but the past few years she has seemed much busier and anxious to keep our meetings short.  I suppose the clinic has a quota for how much time she can spend with a patient.” 

Again, there are numerous anecdotes and articles describing the lack of time doctors have to spend today with patients.   Here is an excerpt from one:

“Joan Eisenstodt didn’t have a stopwatch when she went to see an ear, nose and throat specialist recently, but she is certain the physician was not in the exam room with her for more than three or four minutes.

‘He looked up my nose, said it was inflamed, told me to see the nurse for a prescription and was gone,’ said the 66-year-old Washington, D.C., consultant, who was suffering from an acute sinus infection.

When she started protesting the doctor’s choice of medication, “He just cut me off totally,” she said. “I’ve never been in and out from a visit faster.” — You’re on the clock.  Doctors rush patients out the door (2014)

I can guarantee you that if your doctor only takes a few minutes with you, once or twice per year, there is not much they can know about you personally regardless of how caring and concerned they are.  You might ask “well, why is this important.”   Here is the reason stated very well I think in Wikipedia:

“The quality of the patient–physician relationship is important to both parties. The better the relationship in terms of mutual respect, knowledge, trust, shared values and perspectives about disease and life, and time available, the better will be the amount and quality of information about the patient’s disease transferred in both directions, enhancing accuracy of diagnosis and increasing the patient’s knowledge about the disease. Where such a relationship is poor the physician’s ability to make a full assessment is compromised and the patient is more likely to distrust the diagnosis and proposed treatment, causing decreased compliance to actually follow the medical advice.”  — Wikipedia

Conclusions:

I promised some solutions to each truth that I am telling you.  Here are some that might help you to deal with this first truth.

  1. Get a second opinion for any surgery.
  2. Use the Internet to search for alternative treatment modes. Get advice if you are not Internet savvy. Remember, there are many opinions and not all are right.
  3. Exercise and have a health care plan. Follow it.
  4. Don’t take any pills unless you must. Try to unwean or get off them as soon as possible.
  5. Beware side effects from pills. Every pill has a side effect.  Make sure you are aware of any that might affect you and be cognizant of any changes in your life while taking these pills.
  6. Take a friend with you whenever you go in for an appointment or treatment. Talk to your friends to get their insights and opinions.
  7. Don’t assume your doctor is God and knows what is best for you. Be a skeptic but be realistic.  Modern medicine is better than sorcery but not always much better.
  8. Don’t assume that your doctor is your friend or has your best interests at heart. They might not have enough time to care.

Fred’s letter to me:

I read your blog on medical practice and it was indeed thought provoking.

I’ve had good results with doctors over my lifetime. Not always perfect but usually satisfactory and in some cases, it was excellent.

Medical care is a process and requires the same attention as any process. It seems especially complex today because of how rapidly technology and all the stakeholder’s needs and expectations are changing.

Overall, it’s greatly improved in its capabilities. My main concern for medicine is the same as I’ve had for years in business. My business life became more and more controlled by the bean counters and the lawyers. The same is true of medicine. Blaming doctors is blaming people, which is always a red flag to me as one who has a bad habit of judging others without knowing them. Like the driver for quality improvement, expectations always move to higher and higher expectations. And based on what I’ve heard from friends over my life, expectations are often unrealistic.

A friend recently died. He was an old school, oil field production engineer and didn’t trust any of his doctors. He’d get pissed at one and then begin to “doctor hop”; never telling one what the other had done or prescribed. I questioned him many times, always inquiring why he’d not share his history. His reply: “I ain’t telling them anything.  They make good money and are supposed to tell me what’s wrong.”

I see the process much as we viewed our manufacturing and service processes ..with customers, suppliers, inputs and outputs being carefully considered. A critical output is the result when your illness is diagnosed and this is too often a major problem source. My friend tends to expect this to be an exact outcome but in reality it isn’t. It’s only a statistical prediction that too many older doctors failed to point out to naive, uneducated patients.

In recent years, our doctors point out the statistics and involve us in the decisions for corrective action. My wife’s breast cancer surgery was a good example. Years ago, the doctor would have made the decision for which surgery, mastectomy or lumpectomy. Sandra made the decision armed with various study statistics and discussion with the Doctor. The Internet was a source for me to verify the statistics but that isn’t easy because there are often many studies,

The surgeries are complex and the statistics often work out for the worst. Records on lawsuits and doctor reviews are more readily available today. I recall a bad experience with my dad years ago. Our family doctor became a friend from making many house calls as 3 kids were raised. Dad was a merchant seaman and would provide Porte Rico rum for our good doctor. They were the best of buddies and talked about the old days during visits. Dad visited him yearly but when dad’s tobacco tarred lungs became late stage cancerous it was too late. Doctor “Tom” as an individual practitioner didn’t have the computer technology that red flags today’s doctors. Doctor Tom was as heartbroken as my dad. He and his wife nurse apologized that they’d not x rayed dad 6 months earlier. We probably could have sued but dad would never have agreed to such.

The body of knowledge has expanded too much for any one doctor to master it all, so now we have multiple knowledge based “Specialists” having to deal with the directives from medical organization bean counters and their lawyers.

I consider our medical providers to be leading edge. They seem to focus on continuously improving to meet customer expectations. I’m hoping, but doubt the doctors and staff will be given additional support. They track customer satisfaction inputs so I should be more confident.

I can email any of my doctors and I can access historical results. I especially like being able to take a picture of a physical observation and sent it in.  A couple of years ago, I tore a muscle on the back of my leg and a huge blue area surfaced overnight.  It scared the heck out of me. I emailed a picture and he emailed back telling me what it probably was, how to treat it and to see a doctor if it didn’t heal. My expectations are now at an even higher level which puts more load on the doctor. He not only has to live up to corporate standards on office visits but he must respond to patient emails. Just yesterday I received a corporate email announcing that they have decided to do “Face Time” appointments for $25!

Overall, I have concerns for the profession but I think problems are “process” related. To think otherwise would go against what I’ve believed for a long time.

Fred

Time for Questions:

How satisfied are you with your medical care?  Why or why not?  Have you ever had a loved one die?  How were they treated by the medical profession?  What do you think could be done to improve medical care for you and your family?  What would you like to change in the American medical care system?

Life is just beginning.

“We have really good data that show when you take patients and you really inform them about their choices, patients make more frugal choices. They pick more efficient choices than the health care system does.” — Donald Berwick

 

 

 

 

Let’s Play “Whack a Mole” with the World

whack-a-mole-cartoon

The saying is often noted but just as often ignored that “Those who forget the past are condemned to repeat it.”  — Santayana.   To this profound advice, I would argue that my following observation is equally true and that it has resulted in an equal number of policy disasters and misadventures.  To wit:  “Those who do not recognize the patterns around them are doomed to failure.”   I came by this observation in the middle of a night while pondering the intricacies of playing the “Whack a Mole” game

There is a game that children play and it is called “Whack a mole.”  Have you ever played this game?  If not, view the game at “Whack a Mole”.  Basically, it involves a series of plastic moles that keep randomly popping out of different holes.  You get points for each mole that you whack before it drops back into its hole.  No sooner do you “Whack” one mole then another one pops up again.  [If you would actually like to play the game, you can play a free fast paced version of the game at “Whack a Mole.”]  They call it Smack and Bash at this site.

As I thought about this game, I began to see how it applied to numerous efforts that we undertake to bring about change.  Understanding the game, I could see how futile many of these efforts are and clearly why they are doomed.  Let me give you four examples that will show you how pervasive the “Whack a Mole” game is in politics and US policy:

  1. Eliminate the Mafia
  2. Win the war on drugs
  3. Defeat terrorism in the Mideast
  4. Stop the arms race

 1.  Eliminate the Mafia:

The Mafia may have begun in the United States in the second half of the 19th Century.  The US law establishment has been waging a war to eliminate the Mafia for well over 100 years.  During that time they have killed or arrested the following Mafia leaders:

large_movie_mobsters

It should be noted that this list includes only the leadership in just one crime family.  There are at least a dozen or more Mafia crime families in the USA.  Each one has a history of crime bosses since the early 1900s.

treeCrime bosses get eliminated or changed in a number of ways. Some die.  Some are murdered.  Some are arrested.  Few if any ever simply retire.  This last fact is good for our law enforcement agencies, since it helps keep them occupied with finding and catching Mafia leaders.

So for over 100 years now, the FBI, the Justice Department and every police department in the USA have been playing the “Whack a Mole” game with the Mafia.  They no sooner whack one Mafia leader down and another pops up in his place.  What fun!  At the taxpayers’ expense of course.

  1. Win the war on drugs:

Drugs starting becoming a major problem in the USA with the competition between cigarettes, alcohol and other substances designed to give someone a feeling of either being up, down or out of it.  We know that in 1920 the US passed the Eighteenth Amendment to the Constitution making the manufacture, transportation and sale of alcohol illegal.  Few who have studied any history can forget the fiasco that Prohibition entailed.  Alcohol continued to flow while crime, murder and mayhem associated with alcohol increased dramatically.   Did we learn anything from this?  Following is a short list of the major drug laws and “banned” drugs in the USA.  (By the way, alcohol and nicotine and caffeine are all drugs and at one time or another have all been banned someplace in the world)

1906 The Pure Food and Drug Act was passed, forming the Food and Drug Administration and giving it power to regulate foods and drugs, and requiring labeling of contents on foods and drugs. The most important effect on the drug problem was the demise of the patent medicine industry. Drug addiction began a dramatic drop.
1914 The Harrison Tax Act was passed, effectively outlawing the opiates and cocaine.
1915 Utah passed the first state anti-marijuana law. Mormons who had gone to Mexico in 1910 returned smoking marijuana. It was outlawed at a result of the Utah legislature enacting all Mormon religion prohibitions as criminal laws.
1922  Narcotic Drug Import and Export Act – Intended to eliminate use of narcotics except for legitimate medicinal use.
1924  Heroin Act -Makes it illegal to manufacture heroin.
1937  Marijuana Tax Act

1938    Food, Drug and Cosmetic Act

1942    Opium Poppy Control Act

1951    Durham-Humphrey Amendment

Established more specific guidelines for prescription drugs: habit forming, safety, and evaluation of new drugs

1951    Boggs Amendment to the Harrison Narcotic Act

1956    Narcotics Control Act

Intends to impose even more severe penalties for narcotics violations

1965    Drug Abuse Control Amendments (DACA)

Strict controls over amphetamines, barbiturates, LSD, etc.

1966    Narcotic Addict Rehabilitation Act (NARA)

1968    DACA Amendments

Provides that sentence may be suspended and record expunged if no further violations within 1 year

1970    Comprehensive Drug Abuse and Control Act

Replaces and updates all previous laws concerning narcotics and other dangerous drugs. Empasis on law enforcement.

1972    Drug Abuse Office and Treatment Act

1973    Methadone Control Act

1973    Heroin Trafficking Act

1973    Drug Enforcement Administration (DEA)

Remodels Bureau of Narcotics and Dangerous Drugs into DEA

1978    Alcohol and Drug Abuse Education Amendments

Sets up education programs within Department of Education

1984    Drug Offenders Act

Sets up special programs for offenders and organizes treatment

1986    Analogue (Designer Drug) Act

Makes use of substances with similar effects and structure to existing illicit drug illegal

1988    Anti-Drug Abuse Act

Establishes oversight office: National Drug Control Policy

So here we see the efforts of over 100 years of drug policy to stop people from using, enjoying and abusing drugs in the USA.  What has been the result?

“America is at war.  We have been fighting drug abuse for almost a century.  Four Presidents have personally waged war on drugs.  Unfortunately, it is a war that we are losing.  Drug abusers continue to fill our courts, hospitals, and prisons.  The drug trade causes violent crime that ravages our neighborhoods.  Children of drug abusers are neglected, abused, and even abandoned.  The only beneficiaries of this war are organized crime members and drug dealers.” — Stanford University

2fc723fa35b08b711797709df3d9235b

For an excellent article on the costs of the drug war in the US, please see:  (“The Hidden Costs of America’s War on Drugs” by Joseph D. McNamara, The Hoover Institution, Stanford University)

As it should be clear, the US Government, the FDA, the FBI and most mainstream churches in America have been playing the “Whack a Mole” game with drugs since the Puritans first landed at Plymouth Rock.   First they “Whack” one drug down.  Then another one pops up.  Then they eliminate one drug lord and then another one pops up.  They defeat one drug cartel and then another one takes its place.  Our drug enforcement agencies are so busy playing “Whack a Mole” that they don’t have any time to deal with the reasons behind the influence and attraction of drugs.  Instead they just keep on “Whacking Moles.”

  1. Defeat terrorism in the Mideast:

The beginning of terrorism in the Mideast can be traced back to the Assassins sect that began in the eleventh century.  Wikipedia notes the following:

“Assassins (Persian|حشاشين}} Hashashin) is a name used to refer to the medieval Nizari Ismailis.  Often described as a secret order led by a mysterious “Old Man of the Mountain”, the Nizari Ismailis were an Islamic sect that formed in the late 11th century from a split within Ismailism – itself a branch of Shia Islam.”

wac-a-terrorist

Modern terrorism is actually a form of asynchronous and asymmetric warfare.  One side being more powerful than the other side (asymmetric) forces the other side to avoid one to one confrontations or pitched battles in favor of random unpredictable strikes (asynchronous).   Terrorism is a means of striking back at a more powerful enemy and avoiding what might be an assured defeat by not confronting your opponent in a pitched battle.  History is full of episodes where fighters and even entire armies engaged in such warfare.  In the US, the Indian Wars often followed such methods of warfare.  The battle against Geronimo being a prime example.

Terrorism in the Mideast since George H.W. Bush and through the Obama administration seems to be following the pattern that I have called “Whack a Mole.”  Using drone attacks, surgical strikes, clean bombing, decapitation strikes, discriminant deterrence, hunter killer teams, kill boxes, and counterinsurgency attacks, the US military attempts to “neutralize” the power of the “terrorists” who have their own panoply of attack methods.

If you look at what has happened over the past twenty years in the Mideast in terms of the War on Terrorism, you can clearly see the “Whack a Mole” game at work.  We eliminate one of their leaders, they destroy some of our soldiers with bombs, IEDs or suicide attacks.  We then strike back at their leaders and then it is their turn again to kill us.  We “Whack” them and then they “Whack” back.

whack-a-moleEach time we kill one of their leaders, another one pops up to take their place.  Each enemy group we defeat seems to be immediately replaced by another enemy group.  Our Army, Navy Air Force, Marines, armament industries and politicians never seem to get tired of playing the “Whack a Mole” game.  Keep in mind, that while the game might be great fun for these groups, there is a cost to the game.   To date the financial and human costs are:

Financial Cost of the War on Terror : 

“A recent Brown University study, for example, pinned the cost of the wars in Iraq, Afghanistan, Pakistan and Syria at about $3.6 trillion from 2001 to 2016, using the $1.6 trillion operations costs as a baseline but also accounting for counterterrorism costs.

Adding in money appropriated for war spending and on homeland security in 2017, the total reaches $4.79 trillion. This figure also includes future obligations for veterans medical and disability costs ($1 trillion through 2053) as well as interest on borrowing for wars.” — Politifact, Linda Qiu, October 27th, 2016.

Human Costs of the War on Terror:

Afghanistan and Pakistan:  173,000 dead and 183,000 seriously wounded.  (2001 to 2016)

Iraq:  1.9 million killed (1991 to 2003) and 1 million killed (2003 to 2015)

For the figures I used above as well as for other estimates and detailed breakdowns of casualty figures, see the following sources.  The above figures are low compared to some estimates.  None of these figures include the deaths in Libya, Syria, Israel, Turkey, USA or Palestine which should also be considered as deaths from the War on Terrorism.

  1. Stop the arms race:

The final example of a “Whack a Mole” game that we are caught in deals with our oft stated goal to stop creating more dangerous and more expensive weapons of war.  We call this the “arms race” and we have played it with Great Britain, France, Russia and now China.  I will briefly explain how the game works.  You will readily see that it is a version of the “Whack a Mole” game.

arms-race

Step 1, we conceive of a weapon that nobody else has or has even dreamt of having.  It must be dangerous, expensive, frightening and have the potential to kill millions or at least thousands.  Step 2, we spend billions of dollars on R&D to develop the weapon.  Step 3, we then spend billions of dollars to produce the weapon.  Step 4, we then sell the weapon to any military agency in our own country that will buy it.  Step 5, after a sufficient period of time has elapsed (but before the weapon is obsolete), we sell it to other friendly countries that will buy it.  We must start with the highest bidder.  Step 6, after we have sold it to all our allies or potential allies, we wait until they have sold it to any potential enemies.  This might take a year or so.  Finally, after our enemies have now acquired the same weapon potential (even if in a slightly modified form) we then loudly proclaim that:

“Our nation’s security and ability to defend itself is being undermined by the weapons that our enemies have.  We must build new and better weapon systems.  We must increase defense spending.  We risk falling behind in the ability to defend ourselves.”

Then we start the process all over again from Step 1.  

It is the “Whack the Mole” game, albeit a modified version of the game.  We build the weapons to whack our enemies and then they buy the weapons or build similar weapons to whack us back.  Then we build weapons to counter their weapons and then they build or buy weapons to counter our weapons.  We have been engaged in this game since 1776 with every single weapon system that has ever been devised.   Think of the Atom bomb.  How long did it take Russia to develop a similar bomb?  Think of the Hydrogen bomb.  How long did it take the Russians and others to develop a Hydrogen bomb?

Here is a list of rifles that have been used in the USA since the War of 1776.  The following list does not include carbines.  For a full list of weapon systems and their history see:  List of individual weapons of the U.S. Armed Forces – Wikipedia

  • M16A3 (5.56×45mm NATO) (USN SEALs and USN Seabees)
  • M16A2 (5.56×45mm NATO) (USAF, USCG, and US Army)
  • M27 IAR (Infantry Automatic Rifle) (5.56×45mm NATO) (USMC)
  • Mk 16 Mod 0 (5.56×45mm NATO) (USSOCOM)
  • Mk 17 Mod 0 (7.62×51mm NATO) (USSOCOM)
  • M14 SMUD (Stand-off Munition Disruption rifle) (7.62×51mm NATO) (USAF)
  • M39 Enhanced Marksman Rifle (7.62 NATO) (USMC)
  • XM8 (Lightweight Assault Rifle system) (never issued) (5.56×45mm NATO)
  • XM29 (Kinetic Energy and Airburst Launcher System; 5.56×45mm NATO and 20 mm airburst munition (XM1018)(early)/25 mm airburst munition) (experiment canceled)
  • Advanced Combat Rifle entries (concluded 1991)
  • Future Rifle Program entries (canceled)
  • Special Purpose Individual Weapon (SPIW) entries (concluded/canceled)
  • FN FAL (battle rifle, trialled as T48 against the T44 and T47 to replace the M1: lost to the former)
  • Olin/Winchester Salvo Rifle (battle rifle, 5.56mm duplex)
  • M14E1 (Selective Fire Rifle, 7.62×51mm NATO) (never standardized)
  • M16A1 (5.56×45mm NATO)
  • AR-15/Colt Model 601/602 (5.56×45mm NATO rifle) (USAF and SOF use only)
  • XM22/E1 Rifle (Selective Fire Rifle, 5.56×45mm NATO)
  • Mk 4 Mod 0 (Suppressed Rifle, 5.56×45mm NATO)
  • M1 Garand Variants (E1-E6 and E9-E14) (Semi-Automatic Rifle, .30-’06)
  • Mk 2 Mod 0/1/2 (Semi-Automatic Rifle, 7.62×51mm NATO)
  • M1 Garand (Semi-automatic rifle, .30-06)
  • M1941 Johnson rifle (Semi-Automatic Rifle, .30-’06)
  • Model 45A
  • M1946 rifle (never used in active duty)
  • M1947 Johnson auto carbine (Semi-Automatic Rifle, .30-’06)
  • Gyrojet rifle (13 mm) (never issued)
  • Pedersen Rifle (.276) (competed unsuccessfully with M1 Garand to become primary service rifle)
  • Pedersen Device (attachment for Springfield M1903, .30 conversion)
  • M1918 BAR (.30-06)
  • M1903/A1/A3 (Bolt-action rifle; .30-03, .30-06)
  • M1917 Enfield (Bolt-action rifle)
  • Model 1907/15 Berthier rifle (Bolt-action rifle)[14]
  • M1916 Mosin–Nagant (Bolt-action rifle)[15]
  • M1895 Navy (Navy Lee, 6 mm Navy)
  • M1892/M1896/M1898 Rifle (a/k/a Krag Bolt Action Rifle; .30-40 Krag)
  • M1885 Remington-Lee (Bolt-action rifle; .45-70 Gov)
  • M1882 Short Rifle (.45-70 Gov.)
  • M1882 Remington-Lee (Bolt-action rifle; .45-70 Gov.)
  • M1879 Remington-Lee (Bolt-action rifle; .45-70 Gov.)
  • Remington-Keene rifle (Bolt-action rifle; .45-70 Gov.)[16]
  • M1875 Officers’ Rifle (.45-70 Gov.)
  • M1873/M1879/M1880/M1884/M1888/M1889 Springfield (a/k/a Trapdoor Springfield;.45-70 Gov..: .45-55-405 & .45-70-500)
  • M1872 Springfield (a/k/a Rolling Block Springfield; .50-70 Gov.)
  • M1865/M1866/M1868/M1869/M1870 Springfield (a/k/a Trapdoor Springfield; .50-70 Government)
  • Sharps carbine/rifle (Breech-loader; .42-60-410) (.52 caliber issued to Berdan’s 1st and 2nd US Sharpshooters in the US Civil War)
  • Henry rifle (Lever-action; .44-26-200)
  • Spencer rifle (Lever-action; 56-56 (.52-45-350))
  • M1863 Springfield
  • M1861 Springfield (.58)
  • Colt revolving rifle (Colt Model 1855; 6/5-shot revolver rifle;.44/.56)
  • Greene rifle (Bolt-action breech-loader)
  • P53 Enfield (.577 (.58))
  • P51 Enfield Musketoon (“Artillery Carbine”; 24″ barrel, .69)
  • Model 1854 Lorenz rifle (Rifle-musket, .54, .58)
  • M1859 Sharps (‘New model 1859’, breech loader; .52, .56)
  • M1855 Rifle-Musket
  • M1855 Rifle (Percussion muzzle-loader; 58-60-500)
  • M1847 Musketoon (Springfield, .69)
  • M1842 Musket (Percussion musket, .69)
  • M1841 Rifle “Mississippi Rifle” (percussion muzzle-loader;.54, .58)
  • M1840 Musket (flintlock musket;.69)(later percussion)
  • M1835 Springfield (flintlock musket; .67 cal)
  • M1819 Hall rifle (Harper’s Ferry;Breech-loader)
  • Model 1822 Musket (Flintlock Musket) .69 (later percussion)
  • Model 1816 Musket (Flintlock musket; .69) (Later Percussion)
  • Model 1817 Rifle (‘Common rifle’;Derringer, Johnson, North and Starr; Flintlock rifle, .54) (later percussion)
  • Model 1814 Common Rifle (Deringer, Johnson; Flintlock rifle; later percussion; .54)
  • Springfield Model 1812 Musket (Flintlock musket; .69)
  • Model 1808 Contract Musket (Flintlock musket; .69)
  • Harper’s Ferry Model 1803 Rifle (Flintlock rifle; .54)
  • Model 1795 Musket (Flintlock musket; .69)
  • 1792 contract rifle (Flintlock rifle; .49)
  • Charleville musket (Flintlock musket; .69)
  • Brown Bess (Musket; .75)
  • Kentucky Rifle (Flintlock rifle)
  • Ferguson rifle (Flintlock breech-loader; .69)

not-safe-yet

Do we call this progress?  Do you call this progress? 

Conclusions:

I started this blog off with the comment that if we fail to connect the dots and see the patterns in our lives, we are doomed to keep repeating them and failure will never be far away.  It is almost but not quite the same as forgetting the past.  There is indeed a similarity between my comment and Santayana’s famous quote.  However, I see it as a pattern that I have described as “Whack a Mole.”  How long will we go on whacking moles, killing people, spending money that could go to education, health care or eliminating poverty?

Time for Questions:

Do you think that we should be playing “Whack the Mole?”  How do we stop playing this game?  Do you think it is human nature to keep fighting and killing others?  Should we really be trying to ban every substance that people want to take?

Life is just beginning.

Falken:  Did you ever play tic-tac-toe?

Jennifer:  Yeah, of course.

Falken:  But you don’t anymore.

Jennifer:  No.

Falken:  Why?

Jennifer:  Because it’s a boring game. It’s always a tie.

Falken:  Exactly. There’s no way to win. The game itself is pointless! But back at the war room, they believe you can win a nuclear war. That there can be “acceptable losses.”

may_june_2014_cover_of_foreign_policy_magazine

Social Legacy Systems: How They Block Change and Prevent Progress: Part 2- The Legal Correctional System

Responsible_Prison_Reform-e1373996928213No set of institutions in America are more in need of reform than our legal correctional systems. No systems in America cost the taxpayer more money with less return or value to the taxpayer than our prisons and correctional related systems. No institutions in American cause more misery and heartache than our courts, legal system and correctional institutions. Together, our courts, legal systems and correctional systems cost the American taxpayer well over $100 billion dollars a year. The Economics of the American Prison System”  (Listen to Wake Up Dead Man) as you read my blog today. 

And what do we get for this “investment?”

  • Within three years of being released, 67% of ex-prisoners re-offend.
  • Within three years of being released 52% are re-incarcerated
  • The rate of recidivism is so high in the United States that most inmates who enter the system are likely to reenter within a year of their release.
  • In 2008, one of every 48 working-age men (2.1 percent of all working-age men) was in prison or jail.
  • In 2008, the U.S. correctional system held over 2.3 million inmates, about two-thirds in prison and about one-third in jail. 450px-Incarceration_rates_worldwide
  • Non-violent offenders make up over 60 percent of the prison and jail population. Non-violent drug offenders now account for about one-fourth of all offenders behind bars, up from less than 10 percent in 1980.
  • The total number of violent crimes was only about three percent higher in 2008 than it was in 1980, while the total number of property crimes was about 20 percent lower. Over the same period, the U.S. population increased about 33 percent and the prison and jail population increased by more than 350 percent.
  • Crime can explain only a small portion of the rise in incarceration between 1980 and the early 1990s, and none of the increase in incarceration since then. If incarceration rates had tracked violent crime rates, for example, the incarceration rate would have peaked at 317 per 100,000 in 1992, and fallen to 227 per 100,000 by 2008 – less than one third of the actual 2008 level and about the same level as in 1980.

These facts are from “The High Budgetary Cost of Incarceration” by Schmidt, Warner and Gupta, 2010

US_criminal_justice_cost_timeline

These facts have not gone unnoticed by state legislatures and politicians.

“In 2013, 35 states passed at least 85 bills to change some aspect of how their criminal justice systems address sentencing and corrections. In reviewing this legislative activity, the Vera Institute of Justice found that policy changes have focused mainly on the following five areas: reducing prison populations and costs; expanding or strengthening community-based corrections; implementing risk and needs assessments; supporting offender reentry into the community; and making better informed criminal justice policy through data-driven research and analysis. By providing concise summaries of representative legislation in each area, this report aims to be a practical guide for policymakers in other states and the federal government looking to enact similar changes in criminal justice policy.” Vera Institute of Justice     US_incarceration_timeline-clean.svg

I have written about this problem before. See my blogs (The Law Enforcement Legal-Judicial Correctional Complex and Lucy in the Sky with Diamonds or “How did our drug laws get so crazy?” It is not a new problem and in the years since I published my first article on it, it has only gotten worse. I published my first article on this issue back in 1995. In it, I applied the concepts of process and quality improvement to the criminal justice System. My article was published in a journal of pro’s and con’s on the justice system. Subsequently, I was asked to speak at a correctional conference in Minnesota and to explain the concepts that I had outlined in my paper.

The conference was attended by hard Right and hard Left people: Correctional Officers, Wardens, Prison Reform Advocates, and Relatives of both victims and prisoners. The Right wanted stronger sentencing guidelines and tougher police policies. The Left wanted more humane treatment for prisoners and more focus on rehabilitation. Each group had read my paper and each group thought I was “on their side.” The fact of the matter was, each side was wrong. I was not on either side. Tougher sentencing (which seems to have won out) has only resulted in prison reasonshigher levels of incarceration, less feeling of safety in society, higher costs and no appreciable decrease in drug usage or correctional costs. The Left may have lost in terms of policy but their solutions would not have fixed the system either. You do not get a better system by fixing defects after they are created. Process improvement focuses on going upstream and preventing defects, not warehousing and reworking them. It became clear as I tried to explain concepts of process control, six sigma system capability, rework, redesign and systems analysis, that I was speaking Greek to the participants, both Left and Right. Neither side had a clue as to what I was talking about. I suspect each side was disappointed that they had not found a new advocate.

“A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it.” ― Max Planck,

People in the old paradigm cannot see the new paradigm. Both sides might as well have been deaf and mute while I was speaking since the concepts I introduced were so foreign to them. I noted that the Correctional System needs reform. This was an understatement. The Correctional and Legal systems in America need nothing less than a major paradigm shift. Or to put it another way, we need a revolution in thinking about crime, incarceration and justice. Einstein noted that: “We cannot solve problems by using the same kind of thinking we used when we created them.” We need new thinking and new ideas. We need creative inspired leaders who are willing to break with conventions and boldly go “Where no one has gone before.” This kind of courage is sadly lacking in our political leaders today.

If I had to give my talk over again today, I would not talk about process control or process improvement. I would simply talk about the need for a paradigm shift. I would try with all my might to get the fish to see the water, to get the birds to smell the air and to get the people there to see the failure of the present paradigm. I do not need to recite the facts again. They have been repeated ad nausea. The problem is getting people to open their eyes. More prisons do not mean more safety. Longer sentences do not mean less crime. Tougher policing does not mean less violence on the streets. Witness the wave of protests rocking America today following the Eric Garner, Michael Brown, Akai Gurley, Tamir Rice and John Crawford III shootings by police. Every one of these names represents a killing by a police officer of an unarmed Black man or Black child. To date, not one killing has resulted in the indictment of a single police officer. The apparent message this sends is that: “Black men are guilty until proven innocent and that that they are so dangerous that they need to be shot first and asked questions of later.”

Bill James in his book “Popular Crime” provides the following observation:

“What we are doing, in a sense, is making ourselves constantly more aware of the threats and dangers around us, and then erecting security walls as if these threats were closing in on us, when in reality, we are pushing them further and further away.” P-96

James consistently provides evidence that we are safer and crime is lower than it has ever been in the history of this country. A point I made in my blog Are We Living in More Dangerous Times?  , see Part 1 and Part 2 with numerous statistics from the FBI and other agencies. Nevertheless, as the media treats us to a steady crescendo of violence and terror on the news, radio and TV, it is hard for anyone to feel like they are really safer or that they are less likely to be murdered in their sleep. Gun sales, concealed carry weapons and ammunitions sales have increased dramatically in the US in the past ten years. Smith and Wesson’s stock price has gone from 1.65 per share in 2004 to over $9 per share in 2014.

“The “Concealed Carry Permit Holders Across the United States” report from the Crime Prevention Research Center released Wednesday (July 10, 2014) analyzed parallels between a 22 percent drop in the overall violent crime rate in the same time period in which the percentage of the adult population with concealed carry permits soared by 130 percent.

The report finds that 11.1 million Americans now have permits to carry concealed weapons, which are up from 4.5 million in 2007. This 146 percent increase parallels a nearly one-quarter (22 percent) drop in both murder and violent crime rates during the same time period.” —  Number of Permits Surges as Crime Rate Drops

Citizens, police, homeowners, retired people, elderly, minorities and even children are walking the streets with their weapons in Condition O. That is cocked and ready to fire. Only the slightest provocation is needed to shoot. A dark figure lurking in a hallway, a man running towards us down the street, someone knocking on our front door late at night and the response is “shoot, shoot and shoot.” The reaction is even more rapid when the “allegorical” assailant is a minority or a stranger.

We need a paradigm shift. We are going in the wrong direction. We are safer and more secure than ever before, but we are walling everyone away who pose even the most minimal threat to our security. We are walling ourselves away behind security fences, gated communities, threat detection systems, private police forces, concealed weapons and reduction of liberty and spontaneity. We don’t feel safer and we are more suspicious of outsiders and strangers. We resent immigrants and foreigners and anyone who is different from us. Send them all back. The hell with sanctuary or diversity! America for people that look like me, act like me and think like me.

Build more prisons!  Invoke the three strike rule!  Make it a two strike rule!  Get tough on crime!  Platitudes like these get voters on the side of security and restraint. No new taxes does not apply to building new prisons. The contradiction between liberty and safety is ignored. Fear drives irrational behavior. Everyone develops blinders as the police go about harassing would be criminals or even suspected criminals or anyone who even looks suspicious.  “Thank God, once we lock them away, we can throw away the key and not have to deal with them anymore!  If only we could put all the “suspects” away, we good people could go about our lives feeling safe and free from the possibility of crime and violence.”

“By age 23, almost a third of Americans have been arrested for a crime, according to a new study that researchers say is a measure of growing exposure to the criminal justice system in everyday life.” — http://www.nytimes.com/2011/12/19/us/nearly-a-third-of-americans-are-arrested-by-23-study-says.html?_r=0

Time for Questions:

How safe do you feel: On the street, in your home, late at night, at a movie concert? What makes you feel safe? Have you ever been arrested? Do you know anyone in jail? Can you think of a way that prisons could be eliminated? Do you know how many people are in prison for non-violent crimes? What if they were doing public service instead? What can you do to help bring about prison reform? Are you happy with the present system?

Life is just beginning.

“A moment’s beginning ends in a moment” ― Munia Khan

 

No Time for Immigrants: Part 3

SIx months of the year I am what they call a “Snow Bird.”   Karen prefers we are called “Winter Residents.”   We live in Arizona City.   It is south of I-8 and just west of I-10.  It has been a major corridor for coyotes, drug runners and illegal or undocumented immigrants. There is hardly a week goes by that we do not have coffee shop stories of found pot bales, abandoned vehicles, spotters hiding in caves and illegal’s coming to homes asking for water or food. These stories are supplemented by our almost daily observations of border patrol vehicle searches and regular high speed police runs. One of our visitors commented that she had never seen so many police vehicles in her whole life as in our area. Last fall, one elderly resident who lived out in the desert was found murdered in her home. Nothing was missing but no suspects have been found. There are many folks in my area who will not venture out in the desert without being armed and there are many areas where you are warned to stay clear of. I routinely jog in the Casa Grande Mountains and while relatively safe, there have been drug busts and roundups of drugs and illegal immigrants within the past few months.  A short time ago,  I found a rifle with a telescopic site and a sawed off butt behind a cactus. I turned it into the police station where they were not too concerned about it. To date, my biggest danger has been a cactus that is known as a “jumping Cholla.” These things seem to magically find a way to get attached to you and their barbs are quite painful. I have had at least six attacks by them during the past few months.

The picture I am trying to paint for you, coupled with the fact of the ongoing drug war in Mexico, which is only about 120 miles from our front door (47,000 deaths and counting), is designed to give you some idea of the context in which many Arizonians find themselves. Gated communities, suspicion of neighbors, fear of criminal break-ins and an overall worry about the poor economy, housing foreclosures, and jobs (Arizona has led the nation in many of these problems) gives rise to a citizenry which is far from tolerant of anyone coming over illegally into this country. There is a great deal of fear in the nation as a whole ever since 9/11 and nowhere I think is it more evident than in Arizona. Fear and tolerance do not go hand in hand. However as Ben Franklin noted “Those who would give up their freedom for safety will soon find they have neither.” It is difficult to counsel this advice though when neighborhoods cannot be made safe and people are afraid they will become victims. So what does this have to do with stopping illegal immigration? Let me turn the clock back to help answer this question.

In 1963, I was sent to an Air Force station located in Osceola, Wisconsin. Coming from the east coast, I could not have told you where Wisconsin was if my life depended upon it. Furthermore, to be dropped into the middle of “Dairy Farm USA” was a major culture shock. Nevertheless, I adapted by marrying a woman from Thorp, Wisconsin and having my daughter Christina born in Osceola. Life was good for me in the service but money was short. I found local work doing migrant farm work and finally getting a part-time job (to supplement my service income) at a local nursery called Abrahamsons. It was at this place, that I had my first meetings with Mexican farm workers. Each season, Abrahamsons’s would bring in workers from Mexico to work at the nursery. The work involved digging, balling, burlapping, loading and then digging to replant trees for wealthy buyers in Edina and the Twin Cities. It was hard work. We dug and loaded from 6 AM to often after 9 PM at night. I was paid one dollar per hour. I do not know what my Mexican counterparts were paid because they could not speak English, I could not speak Spanish and my bosses warned me to never discuss salary with the other workers. Thus, I spent my days working in the fields, sharing food but no conversation with the other workers. Believe me when I say there were few local non-Hispanic people applying for these jobs. I have since been to other areas of the USA including Mackinac Michigan and Door County Wisconsin, where they rely on immigrant workers to provide services to locals and tourists. To say that illegal or legal immigrant workers are taking jobs and bread from the mouths of Americans is a shallow and false bit of rhetoric. I have heard it said that if these undesirable jobs were not taken by immigrants then the wages would go up and US workers would then apply for them. This bit of fantasy ignores two possibilities: 1.The work could go overseas to even lower wage workers or 2, The Law of Substitution says that other higher value added services could replace services that become too costly.  In any event, I have yet to see the “older” immigrants from America who are now second generation citizens clamoring for these hard dirty and low paying jobs.  

So year after year, from the middle 40’s to the late 60’s, immigrants came over from Mexico and South America on a seasonal basis. Each year millions of these Bracero program workers would come and work in the USA. Most would go back home after the work was over. Some would apply for citizenship and stay in the US. The Bracero program favored Hispanic workers (there did not seem to be many Canadians or Europeans looking for farm work) and it seemed to create a rather orderly and neat influx and outflow of labor seasonally needed by US employers. Then the program was changed. Barred from working seasonally and denied access to work permits, many Mexicans and other Latinos took the easy road. Illegal yes, enforced no. That is until 9/11, when all hell broke loose. Never in the past 100 years had US citizens felt so vulnerable as after 9/11. Fearing for an influx of terrorists and watching unparalleled amounts of drugs crossing the border, we reacted to our fears by passing the Patriot Act, by beefing up Homeland Security, by building Border Walls, by making it a felony to repeatedly try to cross our borders, by greatly expanding the Border Patrol and by building large detention centers in the Southwest. My county Pinal is often referred to as “Penal County” and has numerous detention centers to house drug runners and detainees awaiting deportation. The number of anti-immigration bills started to proliferate state by state as the Federal government seemed impotent to deal with the crisis. Citizens armed themselves and formed border posses and watchdog groups to police our borders with Mexico. No one really seemed worried about those Canadians. I suppose ever since prohibition was rescinded, the Canadians have stopped smuggling whiskey across the border and are less of a threat to the US.  🙂

So let’s ask a simple question here?  Why do all of these illegals come to the USA? The answer is easy. Two reasons: Jobs and drugs. I wonder if the solution to the problem seems as evident to you now as it does to me. First, legalize drugs. Let the government tax them and let anyone sell them just like cigarettes, coffee and alcohol are sold. We have spent billions on a fruitless drug war and we have accomplished nothing. Furthermore, in light of all the drugs that Americans take, it is a hypocritical war to begin with. It is a war waged by idiots and morons who keep our prisons, courtrooms, and lawyers sucking our taxes and wages for no apparent gain. It is perhaps the most ludicrous endeavor that has ever been created.  It makes Alice in Wonderland look like a reality show.  We have become so blinded by the anti-drug rhetoric that we no longer have the ability to see reality. What did we learn from Prohibition?  “THOSE WHO FORGET THE PAST ARE CONDEMNED TO REPEAT IT!” Banning alcohol did not stop the use of liquor nor did it curtail organized crime. On the contrary, it gave organized crime the income and mandate to expand its power and territory and become even more powerful and dangerous. The same is true for the South American drugs, primarily pot and coke that we are trying to banish. The drug cartels have become so rich and powerful, they are immune to any efforts to abolish them.

The second reason illegals come over is to find work and to have a better standard of living.  To help others accomplish this, we need to create a new policy for temporary and migratory workers that represents the nature of work needed by immigrants and by employers in the USA. This policy needs to be fair and equitable but also realistic. The relationship we have with Mexico cannot be dictated by the relationships we have with Canada, Europe or any other countries. We need an equitable policy, but there is a difference between equity and equality. A fair and just policy must create a win-win both for our nation and for the immigrants we give visas or sanctuary to. There cannot be one size fits all for this policy. Part of this policy must be humanitarian. It is in our constitution and in our national charter to help others escape from tyranny, poverty and other calamities.  Part of our immigration policy must also be self-serving. We need to help our country become stronger and to better meet the needs of competing in a global economy. Realistically, we may have a cost attached to immigration.

Despite many arguments on the negative and positive costs of immigration, the best evidence to support a more liberal immigration policy is to look at our success as a nation over the last 250 years. Can anyone doubt that it was immigration that built and fueled the development of this great nation? We may need to balance short-term costs with long-term gains in a realistic immigration policy but to a good policy needs to be slanted towards tolerance for immigration and not intolerance. 

I have one final idea. Let’s take the development of an immigration policy away from the politicians and appoint a group of immigration experts from a wide range of viewpoints. Take twelve experts on this subject and put them in a room together. Give them four weeks to hammer out a new immigration policy. When they are satisfied that such a policy is realistic and equitable, let them distribute this policy to the newspapers and Internet websites for a review by American citizens. After four weeks of review, let there be a national referendum on the policy. A plurality of sixty percent should be needed to pass. If sixty percent can not be reached, the policy will be returned to the experts for further changes and amendments. Once a plurality of American voters has accepted this policy, it would be sent to the Senate and House for review and to become law. Woe to them if they could not finalize this policy.

Time for Questions:

There are many things you can find wrong with my suggestions. I can hear all the reasons why these ideas would not work. The question I have for you is this: “Can you find any better ideas.” The definition of craziness is to keep doing the same thing and expect different results. Maybe it is time we tried some new ideas; as Einstein said: “Problems cannot be solved by the same level of thinking that created them.” We need to discard our prejudices and biases and see things in a new light. What do you think needs to be done? When was the last time you wrote your representative to express your ideas? When was the last time you went to a party caucus or actively worked to help elect a representative? What could you do to help create a new and fair immigration policy for this country?

Life is just beginning.

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