Wednesday, May 29, 2024

In Memoriam

Four days ago, on Memorial Day, we heard from two presidential candidates. In separate statements, they addressed the significance of the day.

First, President Joe Biden, at Arlington Cemetery:

“Freedom has never been guaranteed – every generation has to earn it, fight for it, defend it in battle between autocracy and democracy, between the greed of a few and the rights of many. It matters, our democracy is more than just a system of government. It’s the very soul of America. 

 “We gather at this sacred place, at this solemn moment, to remember, to honor the sacrifice of the hundreds of thousands of women and men who have given their lives to this nation. Each one a link in the chain of honor stretching back to our founding days, each one bound by common commitment; not to a place, not to a person, not to a president, but to an idea unlike any idea in human history: the idea of the United States of America. Today, we bear witness to the price they paid...”

Then Trump, on “Truth Spectral”:

“Happy Memorial Day to All, including the Human Scum that is working so hard to destroy our Once Great Country, & to the Radical Left, Trump Hating Federal Judge in New York that presided over, get this, TWO separate trials, that awarded a woman, who I never met before (a quick handshake at a celebrity event, 25 years ago, doesn't count!), 91 MILLION DOLLARS for 'DEFAMATION. ... 

"... The Rape charge was dropped by a jury! Or Arthur Engoron, the N.Y. State Wacko Judge who fined me almost 500 Million Dollars (UNDER APPEAL) for DOING NOTHING WRONG, used a Statute that has never been used before, gave me NO JURY, Mar-a-Lago at $18,000,000 - Now for Merchan!"

Can you spot the differences? Subtle, right? Who’d be the better leader? Who’d have the best interests of our country in mind? Toss of a coin, really.

It still galls me, recalling when Trump, draft-dodger, said “I’ve always wanted a Purple Heart,” after a sadly Foxified veteran handed him his. Seriously, who “wants” a Purple Heart? Maybe he expected those fake bone spurs would have earned him one.

Well, as it happens, I have a Purple Heart, not gifted; presented to me by my hospital commander in Vietnam, for injuries received in a rocket attack. Were I to give my Purple Heart to someone, it wouldn’t be Trump. Nor anyone who thanked me for my service and voted for him, the least respectful of veterans of any president, ever, who calls them “suckers” and “losers.” Familiar with the psychological term “projection”? It comes to mind when a person like that refers to “human scum.” Especially on Memorial Day.

My feelings about Memorial Day and Veterans’ Day are mixed. I honor and respect all those who served, those who made it back home, and, especially, those who didn’t. Those who volunteered and those who, like me, were drafted. All deserve respect and, even more, proper care at home. But, other than the Revolutionary and Civil Wars, was our democracy ever truly at stake?

In active combat zones, troops on the front lines aren’t fighting for democracy, the Constitution, or even America. They may not even know why they’re there. In the line of fire, they’re fighting for their lives and those of their team. Too much do we equate patriotism with fighting wars.

In the larger view, the daily, ongoing defenders of our democracy are teachers. Which is not to ignore the indispensable role in society of all workers. But, specifically, democracy? There can be none without an electorate having at least a rudimentary ability to tell truth from lies, fact from fiction. We’re seeing that in real-time.

And parents, of course, though not the ones demanding banning of books and an end to teaching history. Nor the subset of home-schoolers determined to protect their kids from the horrors of empathy, open-mindedness, and separation of church and state.

And journalists. Except ones employed by Rupert Murdoch or his ilk.

It’s not by happenstance that attacks on public education, science, expertise, and legitimate news are intensifying as today’s Republican Party gives itself over to a demagogic liar, one whose disdain for democracy and lust for authoritarianism is undeniable. Trump’s reelection (he’s never won the popular vote) would culminate decades of effort to confuse, misinform, and deceive enough Americans into allowing the intentional end of the democracy our soldiers have fought for – or believed they were fighting for – since the founding.

If Memorial Day is for remembrance, it’s never been more so. We need to remember those things that, until now, actually made America great. The Constitution and acceptance of it. Truth, as in there was no election fraud. Peaceful transfer of power. Country over party. Remember those ideals, because if Trump gets to implement Project 2025, this year will be the last we see them.

Wednesday, May 22, 2024

They Don't Hide It


Trump and MAGA Republicans aren’t hiding who they are. The only mystery is how anyone finds it appealing. There follow examples that smack more gobs than normal people have at their disposal. If “normal” hadn’t, in the post-Gingrichian and current Trumpian eras, become so far below normal.

In Louisiana, Republican legislators have voted to end mandatory lunch breaks for child workers, because of course. This follows a trend within several red states to weaken other laws protecting children. (Republican child-protection ends at birth.) It makes sense: when Trump, as promised, deports millions of immigrants, shortages of workers will become so severe that, absent allowing (or forcing) children to work all day will be the only thing keeping the economy going. Forced birth might be part of the plan, too. 

Taking no back seat to Cajuns, North Carolina legislators are proposing to make wearing masks illegal. It’s on brand: being considerate to yourself and others is woke nonsense. Shopping at Walmart, packing ARs: that’s their kind of considerate. They might have to mandate diapers, though, for their breakless children. 

Who they are in Florida is Governor and VP won’ta-be Ron DeSantis banning mention of climate change in state documents. Florida: at risk for and already suffering from its effects more than most states. If no one mentions it, it’ll go away from there, like American history. Or would, if it weren’t just a wokes hokes. 

Elise Stefanik, R-NY, who once and rightly excoriated Trump as the horrible human he’s always been, unglued herself when reminded of that as she jockeys for veepnesshood. And let’s not forget totally glued MTG, pushing Trump's latest lie. 

Unironically and presumably unaware of how toolishly ridiculous they looked, decked out in matching cultish Trump costumery – identical dark blue suits and red ties – a cluster of confederates complicitly condemned the criminal court where Trump is called to account for crimes for which he was indicted by a grand jury that considered the evidence and voted to charge him.

Then there was Squeaker of the House, Mike Johnson, second in line to assume the presidency if God so chooses. Killing irony like MAGAs claim Democrats do newborns, he accused President Biden, who isn’t, of doing what Trump has ofttimes promised: using the DOJ (and FBI and IRS) as his personal vendetta apparatus.

That someone in that position lies so freely, defending such a manifestly dangerous person, ought to worry everyone: calling corrupt the system of justice that, imperfect though it may be, is being followed to the Constitutional letter. Besides which, the current trial is in a state court for state-defined felonies. Biden’s DOJ has nothing to do with it. Nor is he involved with pursuing Trump’s federal crimes. Foxotrumpic dishonest repetitions notwithstanding.

To repeat: adhering to the Constitution, crimes were asserted; evidence was presented to a grand jury; an indictment was issued; after myriad delays by Trump, the absence of which could have had it over with well before now, allowing him to lie his way through rallies at will, a trial began; prosecution and defense made their arguments; a jury will decide innocence or guilt. Those Trump-suited clowns’ repetition of “if they can do it to him they can do it to you” applies only if you commit crimes like his. In which case, you’d deserve it. That’s how it works. There’s nothing unfair about it.

If there’s judicial corruption, it’s the Supreme Court agreeing to review the lower court ruling which laid out exactly why Trump’s immunity claim is meritless. SCOTUS could have let it stand but chose to take it and delay ruling on it, leaving all pending Trump trials to fester till after the election. And Trump’s grateful Judge Cannon, foot-dragging ruling on the stolen documents case, to similar effect. The documents case is the most indisputable and second-most serious crime of them all. 

There’s nothing more SCOrrupt than Justices Thomas and Alito refusing to recuse from J6-related cases, when the former’s wife is so involved, and when Alito has flown his sympathies like an inverted flag. Thanks to their lifetime appointments, they don’t have to care; lucky for them, they don’t. Alito, it should also be said, is the most undisguisedly partisan Justice in modern times. 

Is anyone surprised that Trump, having announced his intent to testify at the current trial, won’t? It’s reminiscent of his taking the Fifth hundreds of times, after previously stating that only guilty people do so. Or, having warned that if Joe Biden became president we’d see a crash of stock markets like “no one has ever seen,” after record highs are surpassed weekly, that he’s now saying it’s because Wall Street thinks he’ll win. For three years?

Repeated lies, conspiracies, intentional division, false promises, and phony predictions are who Trump is. Predictably, he’s mouthing the same warning of economic disaster if Joe is reelected. And yet, millions of people still believe whatever he says. It’s not normal.

Wednesday, May 15, 2024

He's A Goner

It’s over. No thinking person will vote for Trump now. The catastrophe is out of the bagman. How?

At a gathering of oil executives at Mar-a-Lago last weekend, dropping any pretense of caring for anyone but himself, Trump promised that for a billion dollars in donations he’d give them anything they want. Pollute at will, unregulated. Drill everywhere. End support for windmills, solar power, electric vehicles. “You’ll get it on the first day,” Trump said, waving his corruption like a bloody flag. 

So much for “He loves America” and “He cares about us.” A billion. Trump’s price to sicken your children and contaminate the planet they’ll inherit. From the day his daddy handed him millions, it’s been about the bucks. Morality? Not even an afterthought. This episode makes it undeniable. Listen to his media buttosculators finally giving it the coverage it deserves, atoning for their servile, perfidious fealty.

Even before this oily solicitation, Geoff Duncan, former Lieutenant Governor of Georgia, announced he’d be voting for President Biden. “Unlike Trump,” he said, “I’ve belonged to the GOP my entire life. This November I am voting for a decent person I disagree with on policy over a criminal defendant with no moral compass.”

Then there was Charlie Spies, the Republican Party’s top lawyer, who resigned after Trump trashed him for acknowledging the 2020 election wasn’t stolen. The list of prominent not-for-Trump Republicans, which includes Trump cabinet members and current and former office-holders, is long. As Trump might say, “People are saying they’ve never seen anything like it.” 

Okay, not everyone. Not Trumpists who show up at his rallies, definitely not a cult, wearing diapers. Not those who didn’t think “wtf” when he praised “the late, great Hannibal Lecter.” Not Holy Mike Johnson, R-LA, Specious of the House, who spoke during a break in Trump’s election interference trial, to which he’d hied along with a bunch of Republicans hoping to become Trump’s VP, announcing plans to “rein in the abuses” of Special Counsel Jack Smith. Because stealing government documents to the having of which Trump had no right, hiding them, lying about them, reportedly sharing them, ignoring subpoenas about them, aren’t crimes about which a government of laws should care.

Mouthing words Trump evidently wrote for him, genuflecting to an adulterous dallier with porn stars, Mike, who, according to Mike, God likened to Moses, who told us his philosophy can be found in the Bible, most of whose commandments Trump has violated, disgraced himself and the office he holds.

On Meet The Press, Senator Tim Scott, R-SC, refused, six times, to say he’d accept election results if Trump loses. He’s another angling for the VP nod, which will go to the grovelliest of grovellers. He’ll need some up-grovelling, as Senator J.D. Vance, R-OH, Trump critic till he wasn’t, is throwing himself, hard, into the grovel pit.

Who else? Johnny McEntee, Trump’s former valet, now adviser to his democracy-destroying Project 2025, personifying the excreta inflowing if Trump is “elected” again, seen here gloating about his heartless cruelty, like Trumpism itself, toward the vulnerable. 

Senator Katie Britt (R-MS), spinner of that creepy “rebuttal” to President Biden’s State of the Union speech, proposing a national data bank for collecting data on and tracking pregnant women; intended, she smiles, to provide help at all stages of pregnancy, including funding for crisis pregnancy centers. Not, however, any that mentions abortion. Not creepy at all. Nothing to fear, ladies. To make it happen, vote for Trump. 

Among voters, creepy abounds. Seventeen percent blame Joe Biden for the end of Roe v. Wade. Not a huge number, but when reality insists on zero, it bespeaks brain worms. As does the fact that a higher percentage claim Trump would handle the economy better than President Biden. To which the proper response is: “Foxconn.” (“Fox” + “con.” No irony there.)

Remember? The Taiwanese company that suckered Wisconsin’s then-governor, Republican Scott Walker, into gargantuan tax breaks; touted by Trump as validation of his “America First” policy? That invested a fraction of the intended amount, created far fewer jobs than promised, then bailed? Under President Joe Biden, the abandoned buildings will be occupied by Microsoft, who’ll invest $3.5 billion for an AI training hub, creating hundreds of permanent local jobs and thousands of job-ready graduates.

Providing infrastructure funds his leadership created, Biden’s administration has dispersed $450 billion for 56,000 projects in 4,500 communities. It’s fixing 165,000 miles of roads, 9,400 bridges, 450 ports, and 300 airports. 1,400 drinking water and wastewater projects. 8,000 low- and zero-emissions buses. Cleaning up 95 neglected Superfund sites. 12,000 miles of high-speed internet infrastructure. At Biden’s direction, America is benefitting in even more ways than those. 

So, who deserves reelection? A democracy-degrading, billion-begging, pollution-promiser, or a results-producing maker of America greater?

Thursday, May 9, 2024

A Clinic Clinic

Herewith, a local example of a wider issue:

When I joined The Everett Clinic forty-two years ago, we were thirty-some physicians. The main campus consisted of what’s now called the Founders’ Building and a couple of parking lots. The building was industrial and off-putting, guiding patients to the various locations by way of colored stripes on the floor. TEC had just opened its first satellite office, in Marysville, and had negotiated an exclusive contract with a now-defunct health insurance provider.

The clinic’s manager, a legend among medical executives nationwide, had seen the future: to survive, we had to grow, build more satellites, and hire lots more primary care docs. Now there are around 600 care providers, and over 15 satellite locations.

Back then, because of that insurance contract and the Marysville opening, relations between non-clinic and clinic docs were prickly. Outside the clinic, my arrival wasn't greeted warmly. Those were unpleasant, tricky times.

Non-clinic docs eventually formed a “clinic without walls,” The Western Washington Medical Group,” which soon bedded down with the Sisters of Providence. That made it awkward for those of us who admitted patients there, an underwriter of the competition.

Happily, over time, it became apparent that there was room for both kinds of practices. No one put anyone out of business, nor had they intended to. Everyone gets along fine, now, mostly.

Once a month, we all met in the basement to conduct business. Early on, Clinic partners voted on all expenditures over ten thousand dollars (if memory serves). Then it became a hundred thousand. Eventually, a million. Subcontracting all lab and imaging services at the time, it was a tough sell even to approve purchasing blood testing equipment. Then X-ray machines. Scanners. The cost of building the adjacent Gunderson Building and multi-level parking garage blew minds.

Creating our outpatient surgical center, in the planning of which I partook heavily, caused apoplexy among non-surgeons, who saw it as a huge risk. It wasn’t. Patients loved it and still do. As insisted upon by some of us, its commitment to comfort for patients and families, by way of commodious and welcoming, non-industrial surroundings, changed the culture of the clinic at large. No more cold and bland warehousing.

The Clinic made news when, at another attempt by a large insurer to cut reimbursement, we refused to accept. Sent notices to affected patients, of which there were many thousands, that we’d arrange alternative coverage. Because we’d become large enough, and because our reputation for excellence was fact-based, faced with losing so many customers the insurer backed off. Nationwide, it was the first incident of its kind. That was then.

Offers to sell to investors weren’t rare. Believing we could survive as a doctor-owned, self-managed group as long as we provided excellent care and were large enough to hold the line, we always said no. Why sell out and lose control?

Why, indeed? When DaVita, which had recently paid millions in fines for Medicare fraud, made an offer, it wasn’t refused. Of the reasons given, the million-dollar windfall (so I’ve heard) to every partner might have played a role. By then, I was retired, not part of the decision, on which I’d have voted no. 

Although many retirees got in on the (alleged) spoils, those who’d bailed more than fifteen years prior, which included not only me (though I’d returned, at their request, for several more years as a contractor) but some who’d worked there much longer than I and had contributed immeasurably to the success of the clinic. It hurt. But that’s a story for another time.

It wasn’t long before DaVita sold the Clinic. For profit, one assumes, with no say from its members because they no longer had any. Optum is the new owner, and that’s now the official moniker. In name, at least, The Everett Clinic is no more.

In conversations, many docs regret selling out; particularly those there in the before times. Especially primary care docs. Under pressure for efficiency (profit) above all, there’s frustration, leading to turnover. And that’s the point: unless we get to universal coverage, the profit-first consolidation of American healthcare into a few giant corporations will likely make things worse. America’s largest health insurer, United Health Care owns Optum, which raises interesting questions. In any case, the ability of physicians to practice outside the corporate world is coming to an end. 

In my opinion, the more dedicated physicians are to excellence, the less happy they’ll be. I considered medicine a calling, an overarching commitment, not a business. Constantly squeezed to cut costs, limit care, and increase profits, will prospective docs still see it that way? Treat it as just a job? Not the optimum outcome.

2024 is the hundredth anniversary of its founding. My wife and I remain Everett Clinic patients. I’ll still call it that. The doctors we see and the care they provide are superlative. 

Four have recently left or are leaving soon.

Wednesday, May 1, 2024

Letter Rip

I reply to everyone who emails about my columns. I’ve had coffee with detractors. In one case, we became friends and got together often. More commonly, fizzle happens. Email conversations end when, after being called a liar or commie, I ask for examples.

Never addressing my specifics, captious letters to the editor are similar: boilerplate, counterfactually amusing, rarely original: “The Herald is a lefty rag; Schwab is blinded by Trump hate; subscription canceled.” But a recent one posed a reasonable question: Instead of recounting the dangers of reelecting Trump, why not provide reasons to vote FOR President Biden? Fair enough. It must be said, though, that wanting reasons to vote for Joe, as opposed to not voting for Trump, is like being in a burning building and demanding, “Don’t tell me why I have to leave; tell me why it’s safer outside.”

A self-described “moderate independent,” the writer must not yet have started paying attention. I can help.

Claiming to be “independent” or “I don’t watch Fox” or “I do my own research” is usually code for closeted Trumpophilia. The writer accuses me of “extreme hostility to half the country.” She refers to Biden’s “constant lies,” providing as examples, “The border is secure,” “Inflation is under control.” “I’m the president for all Americans,” “That people are better off today than when Trump was in office. That Biden never talked to his son about his business dealings.” Her independent moderation leaves her unbothered by Trump’s lies about electoral fraud, rampant immigrant crime, what liberals want, etc.

I confess hostility toward Trump’s crude hate-mongering, and I despair that millions (not half the country, yet) are fine with it. President Biden did once say the border is secure, and that was embarrassingly wrong. If he’s repeated it “constantly,” I haven’t heard. In fact, he was a driving force behind the Senate’s bipartisan border bill which acknowledged severe problems and provided significant remedies. As Trump demanded, it died in the House; for me-first, America-last reasons.

Never as high here as in other countries, inflation is now a third of what it was. No president will be, in the minds of every single American, “for them.” But President Biden has never said Republicans hate America; nor called them anything comparable to “communists, Marxists, fascists and radical-left thugs that live like vermin within our country;” never called the press “enemy of the people.” Better off? Seen any refrigerated morgue trucks outside hospitals lately? Anyone employed now, after, as did millions, becoming unemployed under Trump? Have any investments?

Accusations abound about our president and his son. Yet, after months of made-for-Fox “investigations,” no evidence has been presented. So, as Marco Rubio once put it, let’s “dispel with this fiction” that the writer is moderate and independent. Hers are textbook Foxotrumpian talking points.

Reasons to reelect Joe Biden depend, of course, on where one stands. If you believe climate change is real, dangerous, and that the US should work to mitigate it, President Biden is your choice. Trump, obviously, isn’t. If you believe that abortion should remain legal, at least within the restrictions of Roe v. Wade, President Biden is your choice. Trump, obviously, isn’t. When it mattered to him, personally, though, he was.

If, living in Washington State, you know that mail-in ballots are convenient and fraud-free, choose President Biden. If you think poll workers should be free of intimidation; if you think equal access to voting is good for democracy, and that extended days including weekends, convenient drop-boxes, and evenly-distributed polling places promote it, choose President Biden. Trump has called for one-day, in-person voting only.

If you consider record-breaking job creation while addressing our infrastructure needs desirable, it’s President Biden’s doing. In Trump’s term, more jobs were lost than created, and “infrastructure week” became a running joke. If you think environmental poisons need regulating, President Biden agrees, and is. Pleasing his pay-pals, Trump did the opposite.

If you consider Social Security, Medicare, Medicaid, and the ACA worth preserving, Joe Biden will. Trump won’t and has said so. If you value public education, science, and expertise, President Biden does, too. Not Trump.

If you prefer a president who’ll appoint competent, experienced people to address pressing needs of the American people, rather than sycophants who’ll facilitate a promise to use our government for punishing critics; if that troubles you, even if you think you’re marked safe; if you like democracy, vote for Joe Biden. He hasn’t promised vengeance if he wins, nor a “bloodbath” if he loses. Trump has made it clear that a “day one” dictatorship would be just the beginning

Here are additional reasons, from other writers, including actual conservatives.

Finally, and not insignificant, President Biden is empathetic and decent. Go back far as you want: Trump never has been. And if that's not enough, enter here, the burning building.

Coffee’s on me, Ms. L. I'm in the book.

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