Friday, December 11, 2009

Is the public option dead? Say it ain't so...

It seems as if the US Congress has been debating healthcare reform for an eternity. Remember last summer when President Obama was hopeful that Congress would get 'er done before the August break? Ha! We'll be lucky if they finish before the Christmas break.

The latest wrangling in the Senate sounds like a good idea, but in the long run, it's probably not. The latest Congressional shell game to avoid a "robust" public option and still make it look as if they are reforming the healthcare non-system is to lower the Medicare eligibility age to 55 and all younger folks who are not covered by insurance to buy into the federal system.

A little disclosure here, I am over 55 and buying into Medicare is attractive to me, but in the long term, this move benefits insurance companies more than anyone else. People use more health insurance as they age. By pushing the Baby Boomers-- who are getting older and fatter everyday-- off on the government, insurance companies are left with the "cream of the crop"-- younger, healthier Americans who are less likely to make a claim.

Shifting the cost to care for the people most likely to make a claim to the government will surely break the Medicare bank-- already scheduled to go bankrupt in 2012 (or 2017 depending upon how you crunch the numbers but in any case that's not too far away).

In a recent blog post, former US Labor Secretary Robert Reich says that this latest development will give insurance companies even more control over the current non-system, will do nothing to curb obscene profits, and will do nothing to control costs. It also guarantees that healthcare reform will be revisited in the coming years.

Again, this debate proves that we have the best Congress money can buy.

Tuesday, December 1, 2009

Unemployed in Arizona: State suffers largest job losses

The US economy has lost hundreds of thousands of jobs in the past year. Businesses of all sizes have closed their doors. In Tucson, signs of the recession are everywhere; empty auto dealership lots, vacant storefronts, and going-out-of-business signs abound.

One of the most telling signs of Arizona's weak economy is reflected in the job loss statistics. According to statistics released by the Economic Policy Institute, Arizona has lost the highest proportion of jobs in the US. Other states have lost more jobs, but their losses constitute a smaller percentage of their state's total economy.

As reported in the East Valley Tribune, Arizona has lost 9.9% of its jobs or 265,000. Most of the job loss has been in construction, which is down by 45%. These figures clearly reflect Arizona's dependence upon boom and bust cycles in the housing industry.

The statistics also reflect shortsightedness on the part of Arizona's political leaders--especially in state government. Rather than invest in education, job creation, and home-grown industries-- like solar power-- during boom times, the Republican-controlled state legislature offers tax cuts to businesses. In bust times, what do they do? They cut education (making Arizona less competitive in the long term). Cut social services. Cut financial support to cities. And cut anything else they can think of in order to avoid raising revenue. The thought of increasing revenue by relinquishing previous tax cuts is not even on their radar.

Last week, a Phoenix legislator was interviewed by John C. Scott, a Tucson radio talk show host. When asked about the state's financial crisis, including the job losses. His only suggestion was to offer further tax cuts to business--particularly homebuilders and developers to incentivize them to build more homes, which will create some construction jobs-- at least temporarily. (Scott should have asked who was going to buy these houses with so many Arizonans out of work.)

The myopia in the state legislature is frightening. The Republican ideologues continue to cling to Reaganomics. The trickle down theory-- giving tax cuts to the wealthy and thus incentivizing them to invest and create jobs-- has proven to be a failed economic policy. George Bush the First was right when he called it "voodoo economics." When will the Arizona legislature wake up?

Tuesday, November 24, 2009

What is our shared vision for downtown Tucson?

This month marks the end of an era in downtown Tucson-- an era of art, innovation, diversity, and creative energy.

Three galleries on East Congress Street will be closing this week--Dinnerware Artspace, Central Arts Gallery, and Rocket Gallery. A funky coffee shop and a fourth gallery have already closed. Five local businesses -- plus two others-- have been evicted to make way for a sports mega-bar.

These businesses paid rent, hung on through construction and the summertime, and looked forward to the revitalization of downtown. They were the pioneers of revival; they were downtown before anyone else wanted to be.

The galleries and shops in the 200 block of East Congress Street filled once-vacant storefronts and breathed life into downtown by bringing art, fashion, music, and community to a forgotten part of town. They complemented the existing bars, restaurants, movie theaters, and music venues. They will be replaced by yet another large bar-restaurant.

What is our shared vision for downtown Tucson? Do we want a downtown filled with bars, student housing, and parking structures? If we allow the developers to rule downtown, they will chase the quick cash and invest in mini-dorms and bars. People who once came downtown for the art scene will be greeted with restaurants decorated with generic sports bar kitsch.

The artists are not leaving downtown altogether, but they are being pushed to the fringes. Once again they will be moving to a part of Tucson that everyone else has forgotten--the warehouse district. Initially, Dinnerware and others will move to the Citizen's Storage building on East 6th Street. Eventually, artists will occupy the warehouse at 1 East Toole Ave.

In the meantime, Tucsonans who care about downtown must remain vigilant. We must not let the developers and politicians chase the quick fix while short-changing for our culture and our future.

Tucson's vibrant art and music scenes set this city apart from others. Cheap housing and generic sports bars are everywhere.

This article originally appeared in my Progressive Examiner column. To view the accompanying slide show, check out this link.

UPDATE: For an update on this story check out An Congress-- Not?

Tuesday, October 27, 2009

Prop 200 forum: Fear mongering and guilt vs fiscal responsibility

Monday night's Proposition 200 forum was a rousing-- and a bit contentious-- political debate.

Three local news media celebrities--Bill Buckmaster from KUAT, Ann Brown from the Arizona Daily Star, and Jim Nintzel from the Tucson Weekly--asked questions of four Proposition 200 supporters and opponents. Brain Delfs of the Tucson Firefighters Association and Jon Justice, a local right-wing radio host, spoke in favor of Prop 200. Brandon Patrick, organizer of Don't Hand Cuff Tucson, and Jeff Rogers, Pima Democratic Party chair, spoke against Prop 200.

For the most part, the players stuck to their media messages with Patrick and Rogers beating the unfunded mandate drum, while Delfs and Justice ducked the funding issue and tugged at audience heart strings with crime stories.

Currently, public safety is the largest part of the city's budget, with 64% of the funding. Prop 200 calls for a change in the city's charter which would mandate automatic funding of police and fire at a rate proportional to the population. According to Rogers, the only city in the country to enact such a charter change is Aurora, Colorado, and they are now bankrupt. Patrick and Rogers contend that this would be Tucson's fate if Prop 200 were adopted. They made it clear that they support funding for police and fire departments but take issue with the mechanism of funding, particularly when the city and the country are in a recession.

Delfs refused to address the funding issue, saying that "with growth, the funds will be there." Justice rattled off a list of city expenditures that he would cut completely or reduce--including Access Tucson, funding for the arts, children's programs, and the zoo-- in the name of public safety.

Justice also called Prop 200 opponents hypocrites because the Democratic Party supports the school funding propositions on the ballot but not Prop 200. Opponents in the audience chuckled when Delfs said that the school initiatives were not needed because "the state legislature has taken care of education." (Ironically, recreational programs, after-school activities, and education have been shown to reduce crime, anti-social youth behavior, and future incarcerations, but neither side mentioned these initiatives as a long-term prevention strategies.)

Justice made the most inflammatory statements of the evening. He repeatedly said that the Tucson City Council's priorities were "screwed up" and that Prop 200 was a way to hold them accountable. Specific funding of public safety via a charter change forces the City Council's hand, but I don't see how it "holds them accountable." He also tried to paint the Prop 200 opposition as a partisan battle. These statements appeared to be primarily hyperbole. The only specific example he gave of "screwed up priorities" was giving away city buildings to arts organizations for little or no rent (as if viable businesses would occupy some of these rundown dumps the artists now occupy). Judging from his website, Justice is using Prop 200 and Tucson City Coucil bashing to boost his popularity among right-wing radio listeners.

Patrick and Rogers said that the cuts outlined by Justice would be like "chipping away at an iceberg with a pick" because they would account for only $1-2 million.

After an hour, the forum ended abruptly with several audience members still waiting in line to ask questions. Nothing was resolved by the debate, but it was a worthwhile forum to discuss specifics and hammer out details. Thanks to Arizona Public Media and Cox Communications for their sponsorship.

This article originally appeared in my Progressive Examiner column. To view the accompanying slide show, check out this link.

Friday, October 16, 2009

John McCain, Your Constituents Want the Public Option

Wednesday afternoon Move On organized a healthcare reform rally in front of Senator John McCain's office in downtown Tucson.

Fifty or so people waived signs and chanted as commuters headed out of downtown in evening traffic. The protesters were looking for their senator and wondering what happened to that "maverick" and his straight talk express. You know-- that guy who talked about campaign finance reform years ago? What happened to him? He seems to have forgotten his constituency and dissolved into the mainstream, ultra-conservative Republican Party (along with his partner in crime, Senator Jon Kyl).

A few speakers told their personal horror stories about health insurance problems, and State Representative Phil Lopes urged everyone to keep fighting for the simplest public option solution-- extension of Medicare to all. (After all, Medicare is working well for US seniors, why can't the rest of us have that as an option?)

After the chanting, sign-waving, and speeches, the group went to the door of McCain's office to present him with a $3.4 million dollar check-- representing the amount of money he has received from the healthcare insurance industry over the years. You see, John McCain has received more campaign contributions from the healthcare industry in his career than anyone else in the US Senate.

Protesters politely knocked on McCain's office door, but no one answered. McCain's constituents were locked out--again-- a symbolic gesture given the differences between his stance on reform and the opinions of many in Southern Arizona.

There will be more rallies. McCain and Kyl, we're not giving up.

Tuesday, October 13, 2009

Feel Our Pain: Uninsure Congress

The US Congress is moving at its usual glacial speed on health care reform. Proponents of reform are working hard-- organizing, rallying, phone-banking, and canvasing-- to ensure grassroots support for a meaningful resolution to the debate. Unfortunately, lobbyists are working just as hard to keep the status quo, and they have millions of dollars behind them.

Given the overwhelming data, it's hard to believe that the US Senate seems to be frozen in time. Here are a few facts:
- The US pays more for health insurance coverage than any other country in the world.
- And yet millions of Americans are uninsured or underinsured.
- The cost for health insurance coverage continues to rise exponentially.
- Most bankruptcies in the US are caused by astronomical medical bills.
- Most citizens-- including most physicians-- support healthcare reform (1, 2) that includes a public option or a single payer system.

So, why don't we have healthcare reform legislation yet? Follow the money.
- Top insurers are spending millions of dollars to keep the status quo.
- Big Pharma is also spending millions to fight lower cost drugs.
- Who's the beneficiary of all of this monetary largesse? You guessed it-- our Congress-- including Chuck Grassley and Max Baucus, two influential members of the powerful Senate Finance Committee. Here are just a few links regarding campaign contributions 1, 2, 3, 4.

Robert Reich summed up the insurance industry's position up nicely in a recent blog post entitled The Audacity of Greed.

So, to sum up: we know there is a need for reform, we know the status quo stakeholders are spending millions to keep the current system, and we know our weak-kneed Congress has been receiving millions of dollars in campaign contributions. Given these conditions, how can we impress Congress with the need for reform?

Nicholas Kristof of the New York Times had a great idea in his opinion piece entitled Let Congress Go without Insurance. Kristof postulates that to truly understand the problems that uninsured and underinsured Americans are facing Congress should be divested of their Cadillac insurance at a rate proportional to the national rates of insurance. He suggests that if they fail to pass meaningful reform, 15% of them should lose their healthcare insurance entirely and another 8% should receive inadequate insurance.

Sounds like a plan to me. Direct experience is a wonderful tutor.

Originally published on Muse Views, October 13, 2009

Sunday, September 27, 2009

Is sex becoming too expensive?

Two pills have revolutionized sexuality—The Pill and The Little Blue Pill.

Just as Food and Drug Administration (FDA) approval of the first birth control pill in 1960 sparked the Sexual Revolution, FDA approval of Viagra in 1998 sparked a second wave of the Sexual Revolution for Baby Boomers.

Enovid (FDA approval in 1960) and Ortho Novum (FDA approval in 1962) liberated early Baby Boomer women from the threat of unwanted pregnancy (since abortion was not yet legal in the US).

Viagra (sildenafil citrate) liberated Baby Boomer men from the threat of erectile dysfunction (ED).

With all of this freedom, you’d think that all would be well in bedrooms across America. Well, guess again.

A recent article in the New York Times suggests that sex may be too expensive for men who use Viagra regularly. The astute Times reporters calculated that at $15 per pill, Viagra-aided sex twice a week would cost $1500 per year.

What’s a guy to do? Medical researchers have come to the rescue with natural ways to guard against ED. Their advice: Have sex more often and exercise!

Reporting in The American Journal of Medicine, Koskimaki and colleagues suggest a use-it-or-lose-it strategy to prevent ED. They found that “regular sexuality activity preserves potency.” In their study, men who had sex less than once a week were twice as likely to have ED as men who reported having sex once a week. Furthermore, they reported that the more sex a man has, the less likely he is to develop ED.

Since ED is often a symptom of other health problems—particularly diabetes or poor cardiovascular health—medical researchers also suggest exercise as a natural way to improve erectile function, as well as overall health.

Reporting in the same journal, Selvin and colleagues studied the relationship between five cardiovascular risk factors—diabetes, smoking, hypertension, high cholesterol, and obesity— physical activity, and ED.

They found that the prevalence of ED among men with diabetes was over 50%. (This is a particularly scary statistic since diabetes is on the rise in the US.) Furthermore, this research team reported a strong association between lack of physical activity and ED.

So, if you have a middle-aged spread, your sex life isn’t what it used to be, and you can’t afford to use the little blue pill regularly, get off the couch and exercise.

Friday, September 25, 2009

Gloves and hankies: Lessons from the 1918 flu pandemic

If it hadn’t been for the flu pandemic of 1918, I wouldn’t be here.

You see both of my grandparents lost their first spouses to the flu or complications from the flu. Grandma had two sons, and Grandpa had one. After they married in the early 1920s, they had two daughters, my aunt and my Mom. They built an early yours-mine-and-ours family and a 50+ year marriage on the tragedies of the largest pandemic in US history.

According to my Mom, Grandma was relieved that her first husband Charlie didn't have to go to World War I but was devastated when he died from the flu just a few years later. Lessons from the flu stayed with my Grandma her entire life.

For months now we have been hearing scare stories about the coming of the H1N1 flu, also known as the swine flu, and now it’s here. Will 2009 be a repeat of 1918 with an estimated 50 million deaths worldwide?

Wash your hands thoroughly and often appears to be the primary message from the US government, but are there other things you can do?

I believe my Grandma would have some suggestions. Grandma never left home without the gloves on her hands, a hat or scarf on her head, and an embroidered hankie tucked into the waistband of her dress. I always thought this was just her personal style, but when you think about her experiences with the 1918 flu, it’s apparent that her accessories had a purpose.

Gloves. Of course, in the winter, people wear gloves for warmth, but my Grandma wore gloves whenever she went out. She wore them to church and to the store—everywhere she would be meeting people, shaking hands, or touching objects that had been touched by others—faucets, door handles, railings, produce, you name it. Gloves can be both fashionable and functional. Will they be the new fashion statement for 2009? I hope so.

Hats and scarves. Growing up in the 1950s, everyone’s grandma had a collection of little hats for church or fancy occasions. My Grandma was religious about covering her head—hats for church and babushkas (scarves) for everyday wear. When it’s cold out, you lose a lot of body heat through your head. Throw away your vain worries about hat head and wear a hat or a scarf this winter.

Hankies. Grandma had a whole drawer of embroidered hankies to match her cotton gloves of every color. Obviously, hankies can be used to blow your nose, but Grandma also used them every time she coughed or sneezed. The advice these days is to cough into your elbow rather than cough into your hand. Whatever you do, don’t cough or sneeze into the air or into your hand (unless you wash your hands immediately afterward.)

Sharing. Grandma was decidedly not into sharing: don’t drink out of someone else’s glass, use their plate or eating utensil, taste their food, eat or drink out of a container, or even use another family member’s bath towel, hairbrush, or toothbrush. These are especially important for families with small children. Children who are attending school or pre-school are little germ magnets, and they bring these germs home. Protect your family by making it a practice to wash your hands when you come home.

Take a few lessons from Grandma and prevent disease by intervening with potential disease vectors. Wash your hands, wear gloves, cover your head, cover your mouth, and don’t share. And, of course, if you are able, get a flu shot.

Monday, September 14, 2009

You know you're a Baby Boomer when...

20. You remember dial telephones, five-digit telephone numbers, and party lines—telephone party lines, not political party lines.

19. You remember watching The Lone Ranger, Howdy Doody, the original Mickey Mouse Club, Johnny Carson, and Steve Allen on a black and white television—although you were probably too young to understand the jokes Carson and Allen were telling.

18. You remember when almost everyone’s mom was a homemaker and dad was the breadwinner.

17. You remember the excitement of the Sears Catalog—especially the Christmas edition.

16. You remember when people paid cash for everything and to pay for Christmas presents in December people opened Christmas Club accounts the January before.

15. You remember when the only television stations you could get were the three local affiliates for NBC, ABC, and CBS. That, of course was long ago, when there was news, investigative reporting, and locally-produced programming on television.

14. You remember the British “invaded” the US—musically, that is—and all music was on vinyl.

13. You remember the draft and the prime time ritual of pulling military draft numbers from a rotating bin, as if it were a macabre, life-and-death lottery (which it was).

12. You remember the days that President John F. Kennedy, Robert Kennedy, Martin Luther King Jr., and the Kent State students were shot.

11. You remember watching the Senate Watergate hearings live on television and watching President Nixon leave the White House after his resignation.

10. You or someone close to you served in Vietnam, protested against the Vietnam War, or moved to Canada to avoid the draft.

9. You have at least dabbled in Eastern religions, meditation, yoga, tai chi, alternative medicine, vegetarianism, controlled substances, and/or composting.

8. You own a copy of the Tao te Ch’ing, The Tibetan Book of the Dead, Diet for a Small Planet, or anything by Carlos Casteneda.

7. You remember when everyone smoked cigarettes everywhere, and LSD was legal.

6. You learned to type on a manual typewriter.

5. You remember AM transistor radios were a miracle of technology, computers filled entire rooms, and data entry was done on key-punch machines.

4. You remember when abortion was illegal, and the birth control pill had not been invented.

3. You remember the sexual revolution before AIDS, HIV, and herpes.

2. You own something tie-dyed and wore it to a Woodstock 40th anniversary party.

1. Regardless of your gender, you have an old photo of yourself with shoulder-length hair, a beaded necklace, hairy armpits, and no bra.

We’ve come a long way, baby…

Friday, May 8, 2009

Drug Wars: Follow the Money

Immigration, violence, drug policy, and world may seem odd to lump these four issues together, but I believe they all are connected.

In order to regulate drug use, US law defines what is a drug and outlines legal vs. illegal drugs and over-the-counter vs. prescription drugs.

Legal drugs happen to be those that are manufactured in first world countries—like the US and Europe. These include alcohol, cigarettes, and prescription drugs. Except for a few US pot farmers and designer drugs like methamphetamines and crack which are manufactured locally, most illegal drugs are manufactured in third world countries. These include marijuana, cocaine, and heroin. Interesting observation, huh?

If you look at the issue of legal vs. illegal drugs, the designations have nothing to do with public health or death rates. Smoking cigarettes kills more people worldwide than anything else—period—yet cigarettes are legal, freely available, and pretty much uncontrolled. Efforts by public health advocates and the Food and Drug Administration under the Clinton Administration to classify tobacco as a drug were thwarted by the Republican Congress. Although all of the drugs listed above are addictive, the nicotine in cigarettes is one of the most highly addictive substances.

Since the legal vs. illegal designation is not related to health or addiction, what is it related to? My theory is that economics and geo-politics play a role. Pharmaceutical companies and illegal drug manufacturers are in direct competition for the hearts, minds, and wallets of the addicted.

A year ago or so, National Public Radio reported increase heroin use in small towns in America-- areas that had never seen this in the past. How did this big city vice get a toe-hold in the heartland? The answer is capitalism + addiction. Heroin had become a cheap alternative for rural folks who were addicted to Oxycontin, a prescription pain-killer. Capitalistic, illegal drug dealers were undercutting the pharmaceutical companies' prices. Both heroin and Oxycontin are analgesics. Oxycontin addicts-- particularly those who had lost there health insurance-- were turning to heroin to feed their habits and alleviate chronic pain. There are multiple other examples of legal and illegal drugs competing for market share. Medical marijuana competes with prescription drugs that also help cancer patients handle pain. Recreational marijuana competes with alcohol and some prescription drugs for users who just want to mellow out and competes with tobacco for users who enjoy the act of smoking.

From a public health standpoint, what would happen if marijuana—and perhaps other currently illegal drugs—were legalized and taxed in the US? Would the death rates from drug use increase? Probably not -- if we get cigarette smoking and obesity under control at the same time. Would marijuana use increase? Maybe but usage most likely would be as price-sensitive as cigarette usage is now. Would medicinal use of marijuana increase? Probably because it would be available to patients and other uses would be discovered. Would drug violence in the US and Mexico decrease? Hopefully-- if we can also control the flow of guns back and forth across the border.

What would happen economically if marijuana were legalized for medical and recreational use and taxed, as alcohol and tobacco are now? First of all, tax revenues would increase. Drug dealers would lose a major income stream. Mexico, other 3rd world countries, and some areas of the US would gain a major cash crop. Legalization of marijuana won’t eliminate illegal immigration and drug-related violence in the US, but I predict it would have an impact. Mexicans are coming to the US for jobs because their economic system is broken. A big cash crop that has a ready market in the US and worldwide would be a boon to Mexico and many other poor countries and will make living in these countries economically viable.

OK, so, I know that marijuana legalization won’t eliminate the immigration "problem" completely in the US, but to what extent do we really want to eliminate it? Remember those aging Baby Boomers? As they-- we-- retire and eventually die, the US will need workers to replace them. We will have a labor shortage in the future without immigrants and their children.

Now that the dark days of the Bush Administration are over, I'm glad that people in the government are looking at drug policy. I'm also heartened by the efforts of Law Enforcement Against Prohibition. The war on drugs has not worked-- just as Prohibition didn't work in the 1930s. Illegal drug use and drug-related violence have increased since Nixon declared the war. The drug war is a failed experiment and has been allowed to continue for too long.

Originally published on Muse Views, May 8, 2009.