Tuesday, December 28, 2010

New Year, Peace Corps Budget, No Snow in DC, Zelaya, Chavez, Latin Violence, Arizona Medicaid, Wiki-Leaks/Cuba

To each and every one, a very Happy New Year! It’s always good to make a fresh start with brand new year, even though we may not live up to all our resolutions or realize many of our hopes and dreams. Still, it’s a good time to take stock, make plans, reevaluate—have that tough conversation, cut up the credit card, really start on that diet, quit smoking or drinking, tell those you cherish that you love them.

On Christmas Eve, about 35 members of Communitas, all ages, races, and nationalities, celebrated Mass. Communitas is the small Catholic group mentioned in my book that meets at the Dignity Center, a gathering place for gay Catholics, though few of us in Communitas are actually gay. We begin the Lord’s Prayer “Our father and mother” and the line between priests and laity is blurred. On Christmas Eve, the sermon was given by a lay member, Chris, a man from Nigeria, who said, corroborated by my own experience as well, that Christmas is celebrated all over the world, even by non-Christians. He cited examples in his own country of Christians and Muslims laying down their arms at this time of year. However, even as he was speaking, Muslims in Nigeria were attacking Christians, which we were unaware of at the time. His 8-year-old son did the Gospel reading in a strong, clear voice. We sang a number of Christmas carols, including “Silent Night,” which brought back childhood memories. Afterward, we held a potluck supper with champagne.

Amazingly enough, while snowstorms battered and inundated the East Coast from Atlanta to Maine, here in Washington, DC, we had only a light dusting on Sunday evening. By the next morning, it was nearly all melted. I went to work in a Md. Suburb without delay.

Much unfinished business will pass over to the new year from the old. Because the federal budget was not approved before this Congress adjourned, there is a real danger that the increases the president included for the Peace Corps will be cut—or even that funding will be reduced below current levels by the new Congress in the name of deficit reduction. This, after all the efforts of former PCVs to get a budget increase. We’ll have to start all over with the new members. I’m not sure that Tea Party folks will be receptive to a Peace Corps message. Peace Corps in a very small part of the federal budget, but all those small pieces do add up. Those reading this who have congressional representation, unlike those of us here in DC, please make a pitch to your representatives about the importance of keeping Peace Corps funding at the levels included in the current Obama budget.

I’ve noticed that ads popping up on my Yahoo account are often in Spanish, sometimes even in spoken aloud in Spanish. How does Yahoo know that I know Spanish? It’s kind of scary.

WikiLeaks cables from the 2008 ambassador to Honduras, Charles Ford, reveal his misgivings about Honduran President Manuel Zelaya well before Zelaya’s mid-2009 ouster. He cites Zelaya’s suspected ties with organized crime and his manipulation of events to make it look like he was a champion of the common man and the poor. Of course, Honduran presidents, even before Zelaya, have been no strangers to corruption and graft. Perhaps what was different about Zelaya was his open alliance with Cuba and Venezuela.

Along with the sweeping emergency powers that his legislature approved, Hugo Chavez has asked for and received power to regulate telecommunications, including the internet, amid protests from media outlets and spokespeople.

In other news from Latin America reported in the local Spanish-language press, a survey of the region shows 61% of respondents supporting democracy, up from previous surveys. Quite disturbing is the finding, no surprise to me, that Latin America with only 9% of world population, has 27% of violent deaths. The only countries in the region exempt from the wave of violence are Argentina, Chile, Costa Rica, Cuba, Peru, and Uruguay. Again, that is not a surprise. Cuba, while it has a high suicide rate, does not allow ordinary citizens to have firearms and has lots of police who take their job seriously.

Meanwhile, some 50 migrants, including women and children, from Guatemala, Honduras, and El Salvador have apparently been kidnapped by armed men off a Mexican freight train halted with rocks and tree trunks on the track. Some of the US-based families of those kidnapped have apparently received ransom calls.

Arizona is sparking a national debate by cutting off transplants for working-age adults under its Medicaid program. In this recession, the whole question of how far to go with health-care expenditures has come to the fore. Indeed, I would argue, skyrocketing health-care costs are one of the reasons for the recession. Twenty-five years ago, when writing books, book chapters, and articles for my employer’s publications (the American Occupational Therapy Association), I tried to raise questions--ever-so-theoretically--about how far as a society were we willing to go and how much money were we willing to spend on what was already becoming a potentially infinite effort to preserve and extend life? Every time I dared speculate on the topic in print, even obliquely, it was immediately edited out, since our association was trying to increase employment opportunities and reimbursement for our members, as other health professions were also doing, so such cost questions could not be raised. Yet if the task of health care is to keep people alive and, if possible, enhance their quality of life, then the possible interventions are limitless, especially if “health care” is broadly defined to include things like toenail trimming (under Medicare Part B, I believe), Viagra, and hearing aids. Not that such provisions are undesirable; the examples are meant only to demonstrate the elasticity of what is defined as health or medical care. In bygone times, the definition was much narrower.

Additionally, the range of interventions is now much broader than previously and growing every day. Which brings us back to the transplant question. First of all, everyone single one of us will die sooner or later. We will probably die later and perhaps enjoy a better quality of life if we undergo cataract surgery, joint replacement, bypass surgery, and even organ transplant. Can we afford to do that for everyone? In a debate heard on NPR, an administrator for the Arizona Medicaid program argued that state residents have refused to pay higher taxes (no income tax there, only sales and property taxes), so there is insufficient money to fund organ transplants for people ages 21-65. She pointed out that an organ transplant costs about $250,000, is unsuccessful in more than half of cases, and entails life-time expenditures if the patient survives. In comparison, interventions like childhood immunizations are much more effective and cost-effective. “We don’t have the money to do it all; we have to cut somewhere,” she said.

An Arizona resident calling into the program said tearfully that her brother, only in his 40s, will die without a heart transplant. He was on the Arizona Medicaid transplant waiting list until the transplant program was recently eliminated. “You are killing my brother,” she told the Medicaid administrator, “How can you measure the worth of a human life in dollars?” Of course, it’s tragic that her brother had been given hope by being put on the waiting list to begin with, then was shocked when that hope was taken away. But I wondered if she would be willing to sell her house, if she has one, to gamble that her brother might be saved by a heart transplant when the success rate is less than 50% (for Arizona Medicaid recipients, it’s only about 25%, as I recall)? I suspect the answer would be “no,” but she expects the rest of Arizonans to take that gamble and bear that cost.

I’m not saying that Arizona has made the right choice—that’s up to Arizonans to decide—but there are limits, whether it’s heart transplants or something else. (And, of course, someone has to die before a heart is even available for transplant.) Another option would be to cut reimbursements and payments for medical personnel, equipment, and medications, but powerful interests resist that.

Finally, if there could be an expansion of Medicare to all age groups, which would help, but, of course, that would mean less profit for medical providers and more government intervention. All the hue and cry about “death panels” and “Obamacare” are probably designed to head off that possibility—put the onus on the government, whether the US or state government, or on insurance companies. The truth is that “death panels” and health care rationing already exist, but in covert form, otherwise health-care costs would be even higher than they are already. If the family of a very ill patient doesn’t authorize a feeding tube or issues a “do-not-resuscitate” order, as often happens, then the patient will probably die fairly soon. If the intervention had gone forward, the patient would have lived longer, but the cost would be considerable and their quality of life greatly diminished. In the case of patients with severe cognitive deficits and unable to decide independently, letting them go may be best for all concerned, including themselves. The medical-care cost debate is unavoidable—Arizona is only the canary in the coal mine. And Sarah Palin, staunch defender of Arizona and opponent of “death panels,” is strangely silent on the matter in this instance.

Speaking of cognitive deficits, I’ve begun having them myself. As my readers know, I’m an on-call Spanish interpreter, going everywhere by public transportation. Usually my travel to assignments require changing from one metro line to another and taking a bus at the end. And every destination is a different configuration. Sometimes I change trains going in one direction from a particular station, sometimes in another. The other morning, before daylight (maybe I was still a little groggy?), I automatically got on a train going in the same direction as the previous morning, but it was the wrong direction for that particular day. I was engrossed in reading the free abbreviated copy of the Washington Post given out at metro stops when I looked up and suddenly realized my mistake. So I had to get off at the next stop and reverse course, after having lost precious minutes in the process. As a consequence, I missed the bus I was supposed to take at the other end and had to wait for another. So, I barely arrived on time to the hospital where I was to report, whereas I like to arrive early. As it turned out, the scheduled patient never showed up himself and no one answered his phone, so I turned around and went home again, getting on the train going in the right direction this time. However, I must definitely pay more attention and can only hope this was not the beginning of a long downward mental slide. So far, no brain transplants!

Regarding my previous comments on tax breaks for the super-rich, one reader says: The only way progressives can get shitloads of money from "the rich" is to do what Vladimir Putin did: single out a guy like Khodorkovsky, pack his ass off to Siberia, and take his billions. That works just fine, and it also throws a scare into other rich thieves who might have thought about criticizing the government. What it doesn't really do is help the proletariat; but that doesn't matter because in Russia no one is naive enough to expect "fairness." What happened in Russia is just what's been happening in this country. Goldman is still ahead, and the rich thieves the government needs to support its bond market and all like that continue to thrive.

President Obama, no doubt about it, is a smart guy, very insightful, very quick on his feet, a refreshing change after an obviously handicapped poor guy like GW Bush, for whom you would almost feel sorry if he hadn’t been president and capable of inflicting so much harm. I just hope Obama knows what he's doing, but he's not God and cannot know, anticipate, and remedy every problem single-handedly.

Cuba Jeopordizes [sic] Normalization, Publishes Wiki LeaksAuthor: Tim Paynter Published: December 27, 2010
Read more: http://technorati.com/politics/article/cuba-jeopordizes-normalization-publishes-wiki-leaks/#ixzz19Q7at03t

[Anna] Ardin, one of the Assange's alleged victims, works in Sweden's Uppsala University and is known in some Cuban exile and dissident circles. She visited Cuba about four times between 2002 and 2006 as a representative of Swedish social democrats, said Manuel Cuesta Morua, head of Cuba's Arco Progresista, a social-democratic dissident group.

Two left-of-center websites also alleged that she was close to Cuban exile author Carlos Alberto Montaner and the Ladies in White, female relatives of Cuban political prisoners.
The websites portrayed Ardin's links to Cuba as evidence of a U.S.-backed plot to smear and jail Assange. One site said Montaner had links to the CIA.

Montaner told journalists that he did not recall ever meeting Ardin and dismissed the CIA allegation as Cuban propaganda. Ladies in White spokeswomen Berta Soler and Laura Pollán said they did not know Ardin.

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