Thursday, August 23, 2012

Once I was young and a Democrat

[from billlifka] It was a fine time and a good thing to be. I had many friends and relatives who were Democrats. In fact, most were. Now, most of them are dead but I have new friends and relatives who are Democrats, although not so many.

I was a Democrat longer than I was Independent and that longer than I was Republican. However, I wasn’t registered as a Democrat which may be like Bill Clinton’s having smoked pot but not inhaling. Barack Obama has inhaled with pleasure, which may explain a lot. The point is that my credentials as a past Democrat may be questioned but, I assure you, Democrats of my age would recognize me as a kindred spirit. I was born as a Democrat as I was born as an American and a Catholic, all being quite compatible at the time. I chose to be a paper boy and a Cub Scout at the age of nine. These were the first observable signs I had started to think on my own although there’d been covert outbreaks of latent Libertarianism from the age of three.

I never thought much about why I was a Democrat other than as a blessing of birth. When FDR ran for his second term as president, my mother explained that all should vote for Roosevelt because, “He was for the poor people, like us.” Being six years old, I always accepted what my mother told me so long as it didn’t interfere with my plans for that day. Even then, I thought it was a strange argument since I didn’t feel particularly poor. Starting with my being a paper boy, it seemed even stranger since all I needed to do to have money in my pocket was to do a little work and just doing the work made me feel good about myself, also. Then too, I found it hard to understand why FDR was great if he was for losers. At the time, I was for the Chicago Cubs but in those days the Cubs won two pennants so I didn’t think of them as losers until I got a little older. If my mother had said FDR was going to turn losers into winners I would have understood it was like hiring a new manager for the White Sox.


Despite my confusion at an early age, I did come to understand why people would vote for FDR even if they weren’t born as a Democrat. In fact, I think I would vote for him, if I were over twenty one at the time because he did talk a good story and engaged the federal government in a lot of activity, especially for a guy who needed to operate out of a wheelchair. Now I know that activity shouldn’t be mistaken for progress, but in those days it caused most people to feel better even though the depression just went on and on until the war. When it came to the war, FDR was one of the better presidents because of his ability to convince Americans all would turn out well in the end. It also helped that he picked an outstanding leader for the military forces and was convinced, mostly by his wife, to let businessmen lead industrial mobilization. Like his cousin, an earlier president, FDR was not comfortable with the private sector and distrusted all who were in it; they just wouldn’t kowtow to his economic ideas and lack of experience in their field.

By the time Harry Truman came along, I was learning things that caused doubts about FDR but, still a born Democrat, I would have voted for Harry if I were twenty one because Tom Dewey’s moustache made him look sneaky to my eyes. On the other hand, it seemed clear that Harry was straightforward and outspoken and I liked the sign on his desk, “The buck stops here!” He was a guy who took responsibility for his actions and had made tough decisions without flinching over what people might say about him. Even then, I knew those were important traits for a leader. He made some mistakes but if I were transported back in time with my present knowledge, I’m sure I would vote for him and not because I was born a Democrat.

My family never got anything from the Democratic Party, even though FDR was for poor people. Mostly, the Party functioned in the large cities, like Chicago, and they got people work. This was a good thing that people had to work for their money, like being a garbage man. It was true that higher ups might be building inspectors and depended on bribes for extra money but they had to support their families and come election time they had to work hard for no pay in “getting out the vote” which meant getting people out to vote. This is harder than it might seem, especially when some people lived in cemeteries. On a national level, FDR did find work for many in the CCC where they built forest preserve shelters and other public works. My relatives found work for each other like when my father introduced his brother and two brothers-in-law to his boss. That didn’t stop them from being good Democrats even if they made a living on their own

Even though I was a born Democrat, Ike seemed to be an obvious choice over Adlai Stevenson. Adlai was a very bright guy and witty speaker but had the real world depth of a driveway puddle. With Eisenhower, I drifted away from my Democrat birthright but only to that place in between called Independent. I don’t blame Independents for giving up on both Political Parties. Both have earned that treatment. On the other hand it’s sort of like the idea of Purgatory, a place neither heaven nor hell. I can understand why one might choose hell for all the fun that comes before or heaven for all the fun that comes later. Choosing the in-between is hard to fathom. Nevertheless, I felt comfortable there and then John Kennedy came along.

In retrospect, I should have suspected all wasn’t right about Kennedy. But he looked so good, had such an endearing family and talked so convincingly, it was easy to succumb to his charm. By that time, I had forgotten I was born a Democrat, but not that I was born a Catholic and was offended that the presidency had eluded Catholics and the previous one who had tried had been rejected primarily because of his religion. JFK was assassinated and, therefore, deserves to be an “American Saint.” If he had served a full two terms, he might well be remembered differently.

Ronald Reagan came upon the scene. Admittedly, he was running against a guy who had failed in his first term miserably. Nevertheless, he was dismissed as an actor, forgetting his success as Governor of California and as President of the Actor’s Guild, a working job. As an Independent, I had no problem voting for him and became converted to the Republican Party during his time in office while retaining the right of occasional dissent over peripheral items of dogma. I think I have learned how to judge an effective leader of my country based on his past performance in responsible jobs and his character traits as displayed in those positions. I listen to what he says he will do and strongly discount what others say he will do, especially those who have reason to lie about him. I give no thought whatever to whether we share a political party, religion, ethnicity or the many peripheral social preferences that exist in abundance.

Most importantly, I imagine how this blessed country of ours will fare under his leadership. I’ve been around for the great depression, being totally unprepared for WWII, engaged in five other major military adventures and countless minor ones and many social and economic crises. All has not yet been manifested, but we are in the midst of what I believe will be the greatest testing of America in its history. The foundations of our government, economic system and social structure are under siege without restraining influence of experienced leaders with the prudence and wisdom to chart and navigate safe passage through dangerous reefs for the ship of state.


My purpose in this writing is to convince those who choose the Democratic Party as theirs to vote for the opposition candidates, Mitt Romney and Paul Ryan and that, in their doing so, they will act to save their Democratic Party as well as their country. I write as one who once shared membership in their party, although in simpler times, and one who has voted for rational reasons and for not-so-rational reasons, for candidates of my party and for candidates of another party.

Like many Republicans, I disagree with some opinions of my fellow Republicans. I believe most Republicans respect members of the Democratic Party and accept that contention between the two major Parties is important to the well-being of America. I believe most Republicans accept that elected officials from the two parties must find a way to conduct the business of the country in a manner that addresses major needs of the country without violating reasonable and critical beliefs of either Party. It goes without explanation that many of the less important desires of both Parties may not be agreed upon but can be subjected to continuing debate. Such debate should be open and with courteous regard for opposing beliefs. I believe that Democrats in my youth displayed many traits that are consistent with my beliefs and exist today in many members of the Democratic Party. These include patriotism, importance of the U.S. Constitution, belief in open debate and legislative process, personal responsibility, the value of work, the opportunity for all to improve their status in life and that it’s wrong to set one group of people against another group of people in open warfare. If you share these beliefs, you should vote for Romney and Ryan and for legislators who have demonstrated the same beliefs, regardless of their party affiliation.


It’s dangerously foolish to assume Barack Obama, in a second term, will change his stubborn march to turn America into a second class nation subject to domination by world organizations. He will continue to violate the Constitution as necessary to further his totalitarian ambitions. His acolytes in Congress will continue to block open debate to provide the excuse for government by executive order and bureaucratic mandate. He will continue to pit one group of Americans against another and seek majority backing through mindless wealth transfers that drive the country ever faster into bankruptcy. It’s dangerously foolish to assume that a very large minority of the public will accept this without resisting in ways that will result in widespread violence. At least worst, the Democratic Party would lose it’s acceptability as a governing body. At the very worst, the country would be torn by violence that would rival that in the American Civil War.

On the other hand, there is Romney and Ryan. Romney has proven he can govern effectively in an overwhelmingly Democratic State and obtain support from egotistical foreign Olympic czars. Ryan has proven he can work across the aisle and prefers reasonable compromise to mindless contention. Both know the solution to America’s critical problems lies in economic actions of the type in which both are highly experienced. They are good people, just like most Democrats.
billlifka

Saturday, August 18, 2012

VP Candidate Paul Ryan talks Medicare at The Villages

Paul Ryan (center) with his mother and Lee Greenwood who introduced him with his famous "Proud to be an American" song this morning in The Villages, FL. Video available at http://www.realclearpolitics.com/video/2012/08/18/paul_ryan_addresses_the_villages_with_his_mother.html
It was my pleasure to cheer Congressman Paul Ryan as he addressed an enthusiastic audience at "Florida's Favorite Hometown", the retirement community of The Villages, in central Florida, where my wife and I have lived for the past nine years. The banner behind him and in front of the podium said "Protect and Strengthen Medicare" and a good part of Ryan's talk had to do with that topic.

He introduced his mother, a snowbird who lives in Ft. Lauderdale, Florida and he reminded us that the Romney/Ryan plan would not affect current recipients nor anyone 55 years of age or older, which, at a show of hands, included at least 80% of the crowd. He said that President Obama had taken $716 billion out of the Medicare trust fund and that could cause one in six hospitals and nursing homes to close. In contrast, he said, the Romney/Ryan plan would save the program for those at or near the eligibility age, and strenghten it for the next generations by offering choices based on competition between private plans and the government plan.

A video of his complete talk is available at: http://www.realclearpolitics.com/video/2012/08/18/paul_ryan_addresses_the_villages_with_his_mother.html

Just to be sure both sides of the Medicare issue were represented, a yellow airplane flew over and around the square pulling a sign that said: "PAUL RYAN: HANDS OFF OUR MEDICARE!"

Also see this ABC News report on Ryan's talk that includes a contrary view of the $716 billion dollar Medicare cuts:  http://abcnews.go.com/Politics/OTUS/paul-ryan-defends-medicare-plan-accuses-president-obama/story?id=17034339

As we say down here "It's a beautiful day in The Villages" and this day was no exception. My friend Jerry and I arrived via golf cart and passed through the airport-like security cordon without much delay into Lake Sumter Market Square where Lee Greenwood was entertaining the crowd. We found a good standing position on a raised wooden platform about 100 feet from the podium. We enjoyed several more songs and then we heard from some local politicos.

From where we were standing we had a good view of the building Ryan and his party would exit to get to the square. Security and coordination people walked between the square and that building and then we saw Ryan, in a dark blue shirt, standing at the ready with his mother, in bright yellow, and other dignitaries. Then we saw them cross the street to the square and out of our view.

I noticed "Campaign Carl" Cameron to the left of the podium broadcasting to his Fox News audience. Then Greenwood sang his famous and very moving "Proud to be an American" song and introduced Ryan and his mother to lots of good-natured cheers. (See the video at http://www.realclearpolitics.com/video/2012/08/18/paul_ryan_addresses_the_villages_with_his_mother.html)

I found Ryan's talk very well done, and even better than the talk I saw Mitt Romney give here in the same square back in 2008 during the GOP primaries that he lost to Sen. McCain. At that time, the crowds were smaller and security more relaxed and I had the priviledge of shaking hands with Romney after his talk. My wife and I also attended the talk given by VP candidate Sarah Palin in our square in 2008. Although we arrived hours early, over 40,000 other people showed up and we couldn't get into the specially secure area of the square that afforded a direct view and had to watch the proceedings on large "Jumbotron" TV displays set up around the square.

By contrast, we arrived for Ryan's appearance less than an hour before he gave it and were able to get into the standing room only part of the secure area. Thousands of others, who brought folding chairs which were not allowed in the secure area, chose to watch via "Jumbotron" on the streets around the square. Of course, the "Jumbotron" view is much clearer and better than the direct live view, and sitting is much better than standing for an hour, but, by some strange quirk of human psychology, a direct view is preferred.

At one point, near the beginning of his talk, Ryan noticed that someone had a medical emergency and he interrupted his talk to be sure the medics were on the way. Given the August heat, and the fact that residents of The Villages are beyond retirement age, medics are always at the ready. Later in Ryan's talk I saw a woman in a stretcher being whisked out of the secure area.

The crowds were very polite and supportive, with absolutely no pushing to get the best view. We did crowd together, and sometimes a standing supporter waving a sign did block the view, but it was all done in a festive spirit.

After the talk was over, a light rain began to fall. We sauntered out of the secure area, along with over a thousand others, which took some time given that we are mostly retirees and some of us have trouble walking. We remembered where we parked my golf cart and followed the traffic through happy people walking to their carts and cars in the light drizzle, and, with a minimum of delay, got back home in good humor.

All in all, a great way to spend part of a Saturday morning.

Ira Glickstein

Friday, August 3, 2012

Quality of Life and Health-Related Quality of Life

What is Quality of Life and how is it related to Standard of Living? How should Health-Related Quality of Life play into decisions by individuals, health insurance plans, and government subsidized health care decisions?

These are important questions that can have no definitive answers. However, they are well worth discussing in a collegial, rational, and fact-based way.

I presented this Topic to The Villages Philosophy Club today and had the nearly 50 people who attended, mostly retirees in their 60's, 70's and 80's, select what they judged to be the most important factors leading to high Quality of Life. They also used a questionaire called "EQ-5D" to estimate their individual Health-Related Quality of Life levels. We then discussed the results and the implications for making individual Health Care decisions.The results of our selections and evaluations are posted below.

You may view and download the PowerPoint slides here: https://sites.google.com/site/iraclass/my-forms/QualityOfLife3Aug2012.pptx?attredirects=0&d=1


WHAT IS QUALITY OF LIFE?

After researching this question on the Internet, and thinking about my own country, community, family, and life, I came to the conclusion that Standard of Living is only one contributor to a high Quality of Life. It is definitely possible to live at a moderate Standard of Living so long as you have other beneficial factors in your life. I came up with a list of some 21 beneficial factors, seven having to do with Personal aspects of our lives, seven with People in our lives, and seven with Things in our lives, as follows:
PERSONAL
⃝ Higher Education and Knowledge
⃝ Honest, Hard-Working Reputation
⃝ Satisfying, Rewarding Career
⃝ Travel, Hobbies, Recreation and Leisure Time
⃝ Robust Health and Long Life
⃝ Emotional Well-Being
⃝ Strong Religious Faith

PEOPLE
⃝ Loving Parents, Grandparents
⃝ Loving Spouse, Children, Grandchildren
⃝ Loving Siblings and Extended Family
Great Teachers, Clergy, Bosses, …
Loyal Friends and Good Neighbors
Cooperative, Competent Co-Workers
⃝ Competent and Friendly Service People

THINGS
⃝ Freedom and Human Rights
⃝ Stable and Secure Finances
⃝ Comfortable, Safe Home and Community
⃝ High-Tech Electronics and Entertainment
⃝ Fine Food, Fancy Furnishings, High Lifestyle
⃝ Excellent Healthcare
⃝ Golf, Swimming and other Sports Facilities

RESULTS OF THE SURVEY

During my presentation to The Villages Philosophy Club today, nearly 50 people participated in the survey. Each member was asked to vote for his or her top ten items and the scores are tallied and graphed below to determine the most important two in each category and the most important ten in the whole list.
The top "THINGS" items were:
-Freedom and Human Rights, and (tied for second place)
-Stable and Secure Finances, and
-Excellent Healthcare


The top "PERSONAL" items were:
-Robust Health and Long Life, and
-Emptional Well-Being




The top "PEOPLE" items were:
-Loving Spouse, Children, Grands, and
-Loyal Friends, Good Neighbors


The overall top ten items were the ones with their numbers highlighted in pink:

They are:
1-Robust Health and Long Life
2-Freedom and Human Rights
3-Stable and Secure Finances
4-Excellent Healthcare
5-Loving Spouse, CHildren, Grands
6-Comfortable/Safe Home/Community
7-Emotional Well-Being
8-Loyal Friends, Good Neighbors
9-Travel, Hobbies, Recreation, leisure
10-Loving Parents, Grandparents


OTHER MEASURES OF QUALITY OF LIFE

The Human Development Index (see
http://en.wikipedia.org/wiki/File:2011_UN_Human_Development_Report_Quartiles.svg) is a 2011 UN publication that considers life expectance, literacy, education, standards of living, and other aspects of Quality of Life to come up with a score for each country. Not surprisingly, the highest levels are found in the US, Canada, Western Europe, Japan, Australia, Chile, and Argentina. The lowest in Central Africa and parts of Asia.

The Quality of Life Index (see http://en.wikipedia.org/wiki/Quality-of-life_index) was put out in 2005 by the respected British magazine The Economist and they consider:
Healthiness: Life expectancy at birth
Family life: Divorce rate


Community life: High rate of church attendance or trade-union membership
Material well being: GDP per person
Political stability and security: Political stability and security
Climate and geography: Latitude (warmer and colder climates)
Job security: Unemployment rate
Political freedom: Political and civil liberties
Gender equality: Average male and female earnings

Again, the US, Canada, Western Europe, Japan, and Australia get high scores, but, surprisingly, the top country is Ireland. The US comes in 13th, just after Finland and ahead of Canada.

The Happy Planet Index (see http://en.wikipedia.org/wiki/File:Happy_Planet.PNG) is a 2006-2012 effort that "is not a measure of which are the happiest countries in the world: [but rather a]
Measure of the environmental efficiency of supporting well-being in a given country, and of the Subjective life satisfaction, life expectancy at birth, and ecological footprint per capita. 

The US comes in at a dismal  #114 in the 2009 rankings, and is in the worst category along with much of Central Africa and Russia. The best three countries in the 2012 ranking are Costa RIca, Vietnam, and Columbia which each have a "Happy Planet Index" that is twice that of the US.

WHAT IS HEALTH-RELATED QUALITY OF LIFE?

How should Quality of Life impact health care decisions? Government agencies, including the US Centers for Desease Control and Prevention (CDC) and the UK National Institute for Health and Clinical Excellence (NICE) have considered this question for decades, and their decisions are currrently affecting your health care availability, and will do so more and more in the future.

The US CDC website (see http://www.cdc.gov/hrqol/concept.htm) has links to many Health-Related Quality of Life pages, as does the UK NICE website (see http://www.nice.org.uk/).


Health-Related Quality of Life is measured by several different questionaires, inluding the SF-36 and EQ-5D. The SF-36 (see http://www.anapsid.org/cnd/files/sf36.pdf) consists of 36 multiple-choice questions. The EQ-5D (see
http://www.medicine.ox.ac.uk/bandolier/painres/download/whatis/QALY.pdf) has five multiple-choice quesitions. The result is a personal score that ranges from 1 (for perfect health) to 0 (for death). It is possible to score as low as -0.5 (worse than death).

The members of The Villages Philosophy Club took the EQ-5D survey and the average personal score was 0.88, indicating a pretty healthy group. Around 40% of us reported PERFECT HEALTH with a score of 1.0. About 30% reported NEAR-PERFECT HEALTH with a score of 0.88. About 22% (including me) reported the next level down with a score of 0.76. About 4% reported a score of 0.62, and about 2% each reported 0.47 and 0.33.

When a health care decision is to be made between alternative treatments, consideration is given to an estimate of the level of Health-Related Quality of Life that will most likely result from each treatment alternative, as well as an estimate of how long the patient is likely to live if given that treatment. The result of multiplying Health-Related Quality of Life by Years of Life is called the Quality Adjusted Life Years (QALY).

In the UK, if a given treatment alternative costs less than about 30,000 pounds per QALY, and if the doctor and patient want that alternative, it is approved and paid for by the National Health Service. If the desired alternative is more expensive than about 30,000 pounds per QALY, it is denied, and a lower cost (and more cost-effective) alternative is approved. 30,000 pounds is equivalent to about $47,000.


Ira Glickstein