Friday, December 27, 2013

Year End Top Films 2013

Below find a short list of foreign films that will rival any to be found on the usual year-end “ten best” lists.

Most of the films on the list are personal favorites of mine. I must confess that I have a preference for “feel good” films. For example, I understand the greatness of Italian neo-realist films but find them almost unbearable to watch. Also, I avoid films where the emphasis is on violence and eroticism.

Although I am a great fan of American films, I believe that foreign films provide an opportunity to see and understand other cultures. In addition to being great stories with great characters, they can open up a window to other worlds. For example, the Iranian film “a Separation” offers a window into contemporary Iran that we will never find in our own media.
“Bon Voyage”: a combination love story and chase adventure set in France amidst the chaos of the German invasion at the outset of WW II. It stars Isabelle Adjani, and Gregoire Derangere with famed French actor Gerard Depardieu in a supporting role.

“Too Bad She’s Bad”: A 1958 Italian comedy that stars a young Sophia Loren, an unknown Marcello Mastroianni, and famed movie star and director Vittorio de Sica. “She” is the Italian ‘anatomic bomb’ Loren, stealing hearts as a lusciously larcenous petty thief. Mastroianni is the na├»ve young cabbie who tries to set her straight, while de Sica, as Loren’s smooth con man papa makes sure his not so little girl stays on the crooked and narrow.

“A Separation”: a film from Iran that won the 2012 Golden Globe Award for best foreign film. The story of an Iranian husband and wife who split up over his decision to stay and care for his aging father instead of leaving the country with his family. But his fateful choice to hire a stranger to do most of the care taking breeds unexpected consequences.

“The Way” : a powerful and inspirational story about family, friends, and the challenges faced while navigating through life. Martin Sheen plays an American doctor who travels to France after receiving the news of the death of his estranged son. Rather than return home, he decides to embark on the historical pilgrimage route to Spain’s Santiago da Campostella to honor his son’s desire to finish the journey. The film was directed by Sheen’s son, Emilio Estevez.

“Le Doulos": a French crime thriller by famed director Jean-Pierre Melville, stars stone faced young Jean-Paul Belmondo as enigmatic gangster Silien who may or may not be responsible for squealing on his gangster friend Faugel, played by Serge Reggiani. Shot and edited with Melville’s trademark cool and featuring masterfully stylized dialogue and performances, Le Doulos is one of the filmmaker’s most gripping crime dramas.

"Divorce, Italian Style": stars Marcello Mastroianni as Sicilian aristocrat Baron Ferdinando Cefalu who longs to marry his nubile young cousin Angela. One obstacle stands in his way: his fatuous and fawning wife, Rosalia. His solution? Since divorce is illegal, he hatches a plot to lure his spouse into the arms of another and then murder her in a justifiable effort to save his honor.

“Run Lola Run”: the story of two star-crossed lovers who have only minutes to change the course of their lives. After receiving a frantic phone call from her boyfriend, Lola has only twenty minutes to save his life. Franka Potente plays Lola in this film from Germany.

"Joyeux Noel": the story of a spontaneous Christmas Eve truce declared by Scottish, French and German troops in the trenches of World War I. Enemies leave their weapons behind for one night as they band together in brotherhood and forget about the brutalities of war.

Happy viewing in the New Year!


Saturday, December 21, 2013

The Christmas Tree

The following discussion of the origins and significance of the Christmas Tree is taken from a wonderful study of fairy tales and children's literature by G. Ronald Murphy, a Jesuit scholar. 

                                                The Christmas Tree

In a northern world in which every cold and snowy winter could be seen as a dangerous and prophetic vision of the end of the  world, it is not surprising that trees which could remain perceptibly alive and green, all through the cold of winter would be regarded as sacraments, visibly containing the real presence and life force of the unseeable Tree of Life. One tree, down to our own day, has retained in its very name in English the sacramental reverence that the Germanic people of England, Germany and Scandinavia had for it: the holly. "Holly" is, of course, "holy," and thus it was known as the "holy tree," since its holiness enabled it to keep itself alive--green--all through the time of winter cold. All the evergreens in the forest, including the more lowly ivy and laurel, must have been regarded with the same reverence.

 The evergreen tree has found its most lasting and most emotional place in our culture, without a doubt, in the Christmas tree, an amalgam of Germanic legend and the Cross. In December of every year the tree comes into the house. A tree inside the home after all the centuries that have passed is quite miracle enough. To glorify and celebrate its ancient, compassionate magic power, it is decorated with lights (with burning candles in Germany!) and with tinsel, to make sure it looks radiantly stolid and happy despite the cold and ice. Then a star is placed at its peak, since Wise Men must surely find their way to this tree. Below the tree, as if he had just emerged from its trunk, the true source of the warmth of the Tree of the Universe and its power to renew life, encouragement, and protection against all the kinds of cold, is lying in a manger: the newborn child. *

                         O Tannenbaum, O Tannenbaum,
                        how faithful are your leaves.
                        you are ever green, not only during the summer,
                        but even during the winter when the snow falls.
                        O Tannenbaum, O tannenbaum,
                        how faithful are your leaves.

Here is a link to a lovely version of O Tannenbaum, or just click below,

Merry Christmas to all.

*From "The Owl, the Raven, and the Dove," by G. Ronald Murphy, S.J.

Monday, December 16, 2013

True Greed


Recent reports from Rome indicate that the Pope is calling out the nations of the world to deal with the great problem of global economic inequality. I will reserve comment on the Pope’s views until I can find out more about what he actually said. Today, I would just like to focus on the way in which fragmentary news reports have argued that the Pope had launched a full scale attack on Capitalism.

It would appear that the Pope has been critical of a brand of Capitalism, the so-called “trickle down” variety.  According to the trickle down theory, as the rich get richer many of the crumbs from their tables will trickle down to the poor below. They will need servants, hairdressers, gardeners, gamekeepers etc. American commentators have praised the Pope because his words appear to be an attack on “greed”; the only one of the seven deadly sins that liberals still believe exists.

Trickle down economics is kind of a parody of real Capitalism. It is the way anti-business critics like to denigrate the American system. These critics were brought up to visualize anyone working for profit as Mr. Monopoly, or as Thurston Howell, the millionaire on Gilligan’s Island, the popular but incredibly ignorant comedy of a generation ago. But even if you look at today’s sophisticated TV fare you will see that the villains are all successful white businessmen. Young black men make up 70% of America’s prison population, but on the popular TV show “Law and Order” 90% of the criminals turn out to be successful white businessmen. 

Although more and more American college students study business administration today, profit-making enterprises are still regarded as somehow tainted in our popular culture. Working to turn a profit seems somehow ignoble. It smacks of greed. Many college graduates would much prefer to work for government or for so-called non-profits. Non-profits are “good” and supposedly serve the public interest, but profit making smacks of greed and selfishness. This attitude is seen everywhere in popular communications media.  Journalists, movies, TV shows, and music lyrics never tire of hanging the greed label on bankers, CEOs, and Wall St. brokers.
But recent news articles indicate that darlings of the media and anti-business left wing politicians are not immune to greed. Popular liberal movie stars like George Clooney and Matt Damon each make over 20 million per film. Is that greed? I would guess that they make more than twelve times what their stand-ins or stunt men make on their pictures.

Recently New York Yankee star baseball player Robinson Cano left the Yankees to sign a ten-year contract with the rival Seattle Mariners worth $24 million per year. Did anyone in New York, one of the most liberal blue states in the country, complain that Cano was making too much money? On the contrary, the Yankees were blamed for not offering Cano more to stay in New York. Certainly, no one suggested or argued that all baseball players should be paid equally. Neither did anyone blame Cano’s agent, the wealthy rap star JayZ, who will receive approximately 15% of Cano’s salary for the next 10 years. Why isn’t JayZ considered greedy for making $3.6 million dollars a year from Cano’s labors?

Actually Cano won’t be able to keep all the money. After deducting for JayZ’s share he will probably pay about 40% of his annual pay in the form of income taxes to Federal, State and local governments. Some have suggested that New York’s high state and city income taxes might have contributed to Cano’s move. Didn’t popular basketball star LeBron James take advantage of Florida’s lack of a state income tax when he moved from Cleveland to Miami a few years ago?

Pop stars and athletes are only the tip of the iceberg, Why are today’s wealthy labor unions and their leaders, especially the so-called public service unions, always exempt from the greed label? They are no longer the downtrodden workers of yesteryear. Today, their jobs are virtually guaranteed, their compensation exceeds that of the majority of taxpayers who pay them, and their benefits and pensions are without equal in the country. Why aren’t they considered greedy when rather than take a cut in their pay or pensions, they would rather see newer members of their own unions laid off?

One story in the news this past week illustrates the free pass given to popular figures when it comes to the greed label. The recent death of Nelson Mandela has sparked a wave of adulation all over the world. Mandela was the face of the movement that brought an end to the system of apartheid in South Africa. In a column over the weekend in the Wall St. Journal Holman Jenkins Jr. revealed that Mandela was a member of the Communist party in South Africa. Although he and his allies denied the fact all of his life, only after his death did the deputy general secretary of the Party reveal that “Mandela’s membership had been kept a closely guarded secret for ‘political’ reasons.”

I’m not bringing up Mandela’s communism because I believe he helped to create a communist society in South Africa. Apparently, it was almost the opposite. In his article Jenkins noted that Mandala’s official party, the African National Congress (ANC), became under his leadership “a party of revolutionaries turned business owners and financiers.”

Jenkins cited a 2012 book, “Who Rules South Africa?” by two respected journalists that provided some remarkable statistics. Three quarters of the ruling Cabinet members have outside business interests, as do 60% of the regime’s 400 members of parliament. In the impoverished Eastern Cape, Mandela’s ancestral home, three quarters of government contracts went to companies owned by state officials and their families. Cyril Ramaphosa, a former militant leader and the country’s likely next president, is worth 65 Million, three times the net worth of Mitt Romney. Jenkins concluded,
One indisputable ANC success has been creating a new black business elite with a stake in preserving South Africa’s advanced capitalist economy.
George Orwell’s little classic, “Animal Farm” ought to be required reading in all American high school classrooms. It is less well known than his futuristic “1984” but much more relevant today. In “Animal Farm” the animals revolt against and drive out the oppressive farmer in the hope of establishing an egalitarian utopia. In short order the wily Pigs turn the revolution to their own benefit and change its motto from “all animals are equal” to “all animals are equal but some are more equal than others.” In the chilling end, the once again oppressed animals stare into the farmhouse window to behold the wealthy Pigs dealing with the Farmer.

The funeral service for Mandala with the fake sign language interpretation was revealing in more ways than one. This video shows not only the fat cats but also that their words and speeches are never to be taken at face value.


Thursday, November 28, 2013

Thanksgiving Memory


To say I was born and raised in New York City would be a little misleading because in my memories of New York in the 40s and 50s, the city was a collection of small towns or villages. I was born in Woodside, a section of the borough of Queens, and the skyscrapers and streets of Manhattan were as remote to me as China would be to my grandchildren today.

Because of our insularity I can’t be sure if a Thanksgiving custom we had back then was unique to Woodside or whether it could have been found elsewhere throughout the great metropolis. Anyone else I’ve mentioned it to had never heard of it including my wife who was born a little bit north of the City in White Plains, the hub of Westchester county.

Anyway, on Thanksgiving morning the children in our neighborhood would dress up as bums or hobos. It didn’t take much since we would usually wear our clothes until they literally fell apart. We would take our most worn and tattered clothing and rip and tear them a little more. Then, we would blacken a cork over a candle and smear it over our faces to simulate dirt. I remember my grandmother giving me a little pouch with a drawstring, or was it a pillowcase, that we hobos could sling over our shoulders.

Then, we were ready to make the rounds of our neighbors to ask, “anything for thanksgiving.” Inevitably, they would answer our plea with some of the bounty from the meal they were preparing. Usually it would be apples, or walnuts, or sometimes a few pennies. Don’t laugh. Twenty pennies were enough to buy a Spalding (Spaldeen), the elite of bouncing rubber balls used by us in so many street games.

I don’t know where the “anything for thanksgiving” custom came from. We lived in a small neighborhood that seemed to have been mainly Irish with a mixture of Italians. In my nearby Catholic school the majority of the kids seemed to have Irish names. There were Ryans, Regans, Dunphys, Moylans, and Healys. However, A few blocks down busy 69th Street were the Napolitanos who ran the grocery store. In the other direction lived the dreaded Gallos whose kids were the toughest in the school.

But I’m not sure that “anything for thanksgiving”  was an ethnic custom. We were a predominately Catholic neighborhood and the idea of thanksgiving was part of our religious heritage even though none of us knew that the word “Eucharist” meant “Thanksgiving.” On the other hand, it could have been a peculiarly American response to the end of the Great Depression and the Second World War. Nothing had marked the depression so much as homeless men on bread lines or riding the rails. These were the hobos that we children imitated. Even though most of us could be considered poor, at least we and our neighbors would be able to sit down that afternoon in our homes to the best meal of the year. 

We did have a lot to be thankful for. The Depression was over, the men had returned from the terrible war, and the NY Yankees were on the verge of recovering their past glory.

Just one footnote. Halloween was practically nothing to us in Woodside, Queens. We did not trick or treat or dress ourselves up in costumes. For us it was All Hallows eve, or the eve of All Saints Day one of the great Holy Days of obligation. My only Halloween memory is filling stockings with baking or talcum powder and hitting each other with them.

Tuesday, November 26, 2013

Washington Insiders

St. Croix Review

In last week’s post on the Tea Party I mentioned a review of a recent book about Washington insiders entitled “This Town, Two Parties and a Funeral—plus plenty of valet parking!” by Mark Leibovich, a veteran Washington journalist. The review appeared in the Oct. 2013 issue of the St. Croix Review, a small but highly readable journal of opinion edited by Barry MacDonald.

I would just like to quote a few examples from MacDonald’s review that illustrate how Washington insiders, whether Republican and Democrat, often work together to achieve their own self-interested goals. In his summary MacDonald wrote,
Americans on the left should see that the many programs designed to uplift the poor have worked precisely as designed: the redistributors of money are uplifted, the poor remain poor.
Terry McAuliffe, a longtime Democrat fundraiser recently won a narrow Senatorial election from Virginia with the help of his Clinton patrons. McAuliffe had been a major fundraiser for the Clinton administration who later became chairman of the Democrat party. Many have probably seen him debating on TV with Ed Gillespie, the former head of the Republican party. In Macdonald’s review of the Leibovich book  we learn,

Ed and Terry are “outstanding friends.” They “forged a green room marriage” ( the green room is the place where people wait before appearing on a political talk show). Ed and Terry would tangle on air, each slinging their respective talking points as chairman of the opposing parties.
After leaving their positions they became partners on the paid speaker’s circuit: “top dog” Democrat and Republican putting on a show ($50000 a pop) disagreeing without being disagreeable.
Ed Gillespie and Democrat Jack Quinn are also “dear” friends and former business partners.
They formed a partnership: Quinn Gillespie and Associates, believed to be one of the first bipartisan “one-stop-shopping firms” lobbying successful members of both parties.
According to MacDonald, “50 percent of Senators and 42 percent of Congressmen become lobbyists. Also, “tens of thousands” of congressional staff move into lobbying jobs.

Here are some other examples:

John Breaux, a former Democrat Congressman and Senator, remarked that his vote could not be bought but “could be rented.” …After leaving the Senate John started his own lobbying firm just down the road from the White House.
Democrat Senator Byron Dorgan was “quick to get all contemptuously righteous about people on the Hill cashing in their public service.” After retiring he joined Arent Fox. Former Senators aren’t allowed to lobby for two years, so Byron doesn’t, but he “oversees a staff of lobbyists.”
The top prize for hypocrisy might go to Dick Gephardt, a former Democrat Speaker of the House, who prided himself for being a champion of organized labor.

Upon retirement Dick joined the Washington office of DLA Piper, and then started his own lobbying outfit, Gephardt Government Affairs. His corporate clients included Goldman Sachs, Boeing Company, Visa Inc., and Spirit AeroSystems, where he directed a “tough anti-union campaign.”
While a Congressman, Dick supported a House resolution condemning the Armenian genocide of 1915. While a lobbyist working for the Turkish government (being paid $70000 a month) he opposed the resolution condemning the Armenian genocide…
In conclusion, I would just like to mention Representative James Himes from Connecticut. Himes is a relatively new arrival on the political scene but he easily won re-election from Connecticut’s wealthy Fourth Congressional district. Just the other day a recent newspaper article indicated that he spends his spare time heading up the powerful Democrat Congressional Fundraising operation. In other words, he is in charge of getting Democrat Congressmen and women to cough up funds from their own war chests to support the re-election efforts of their fellow Democrats. Who is Himes really working for? He is supposed to represent his constituents. Why is he spending his time working for the re-election of people in Nevada or Louisiana?

Our Constitution begins with the phrase, “We the People.” Maybe it should be changed to “We the Pigeons.”


Monday, November 18, 2013

Tea Party Debacle?


The shut down of the Federal Government a few weeks ago seems to have been almost completely forgotten.  Fears of a global economic meltdown have subsided, and most Americans have readily accepted the media mantra that the Tea Party was to blame and that it and the Republican Party have been badly damaged by the debacle. But was the Tea Party to blame?

First, let’s dismiss the attempt to make Senator Ted Cruz of Texas the arch-villain of the shutdown. Cruz is a Republican Senator and while he might be somewhat outspoken, he has no actual power in the Democrat controlled Senate. Moreover, the Senate leadership refused to allow any votes on the various budget proposals sent to it by the House of Representatives. In fact, Senate Majority leader, Harry Reid, would not even allow discussion.

The House of Representatives actually sent two budget bills up to the Senate but they were dead in the water. So the shutdown was the result of a conflict between the Republican controlled House of Representatives and President Obama. In the House the Speaker of the House, John Boehner, had to walk a tightrope since many conservative members resisted any compromise with the intransigent President. 

 Boehner, who obviously could not count on any support from Democrat members, had difficulty controlling members of his own party. In particular, the difficulty was with the 50 to 60 Republican members who were identified with the “Tea Party” although the media liked to call them right wing radicals. During the controversy it struck me as odd that such a small minority, most of whom were elected recently, could have such influence.

Nevertheless, the finger pointing, especially by the media, was all directed at the Tea Party. Why?

I know that most members of Congress are elected over and over again for almost as long as they want to serve. Incumbents of either party are re-elected over 95% of the time. But still the House of Representatives, more than any other part of our government, is supposed to represent the people of this country. The so-called Tea Party members did not get their positions by a kind of coup. They were all elected by constituents in the home states and often by wide majorities. To attack them is to attack the people who elected them.

Moreover, most of them were elected in the past two or four years. They must reflect something that is really going on in the country. There are many other issues that bother Americans but no one can deny that the Affordable Care Act (Obamacare) is the main issue.

From the first, Obamacare was suspect. The way it was pushed through Congress was suspect. At that time both Houses of Congress were controlled by Democrats but even then Democrat leadership had to resort to foul play to get it passed. Some Senators got special treatment for their states. Also, remember that the Senate version was different from the House version but that instead of going through a reconciliation process, the House of Representatives was “deemed” to have agreed with the Senate version.

Then, the Supreme Court very kindly saved the proposal by an equal bit of political evasion. The President had always insisted that the “mandate” for every American to purchase coverage was not a tax. While Chief Justice Roberts argued that such a mandate was unconstitutional, he allowed the law to continue by calling the mandate a tax!

Finally, the Administration gave itself four years to get this new system up and rolling. In that period the Tea Party came into existence even before it became clear that the implementation of the overhaul of the Nation’s health care system would be a fiasco.

I know it’s ridiculous to talk about our Constitution anymore. But as I said above the House of Representatives was supposed to be the voice of the people. Originally, the President was elected by an Electoral College chosen by the various states. His term of office was four years. Senators were not elected by popular vote but nominated by state legislatures. They were elected for six years. But Representatives were elected by a direct vote of the people and their terms were limited to two years in order that they would be more responsive to their constituents.

In my opinion the Tea Party has been stigmatized by the ruling class in America, a class made up of politicians, lobbyists, union leaders, and government employees centered in and around Washington D. C. In the October 2013 issue of the St. Croix Review, my favorite journal of opinion, editor Barry MacDonald reviewed a new book, “This Town, Two Parties and a Funeral,,,” about life inside the D.C. beltway. It is a frightening story about how the political elites join together to achieve their own personal goals.

Here is MacDonald’s summation.

Intelligent, observant, caring and involved Americans, on both sides of the political spectrum are bamboozled. We misunderstand when we focus on ideology, because the hearts of the Washington players aren’t invested in ideology—ideology is a tool. The hearts of the players are in self-advancement and in the preservation of the system of self-advancement.
Americans on the left should see that the many programs designed to uplift the poor have worked precisely as designed: the redistributors of money are uplifted, the poor remain poor.
This governing class is not only out of touch with the American people, but it also doesn’t want to be in touch. The public uproar over the President’s proposed military action in Syria forced the President to back down. Fortunately, he was bailed out by Russia’s Vladimir Putin. That uproar now seems minor compared to the furor over the botched opening of the ACA and the loss of medical coverage by millions of Americans. Already, the ruling class is backing down. Who will they blame?


Tuesday, November 12, 2013

President Obama's Promise


In a recent op-ed in the Wall St. Journal Alan Blinder supported the President’s attempt to weasel out of his health care promise by calling the health plans that millions of Americans are losing “sub-par”. I believe the President calls these plans sub-standard. But in his long op-ed defending the Affordable Care Act Mr. Blinder, like the President, never bothered to detail just what was so sub-par about those plans.

Recently, other op-eds as well as letters in the Journal have shown that some of these below standard plans have actually paid substantial benefits to claimants, as well as providing good service to policyholders. One woman even received over 1.2 million in benefits and obviously loved her plan.

So what is so sub-par about these plans? As far as I can tell, they lack a provision for free health club membership. They also fail to provide free contraceptives. I also suspect that they fail to include dental and vision care. I’m sure that in the minds of the President and Mr. Blinder there are other deficiencies but I’m also sure that most people chose coverage that met their needs, especially for large ticket items. Most health care consumers liked their plans because they had chosen the deductible and co-insurance provisions that suited their needs.

Now, despite the President’s promise, millions will lose their coverage and be forced into one size fits all plans that will contain benefits that they neither want nor need.


Monday, November 4, 2013

Health Care in the U.K.

A good friend in England provided a balanced and well thought out response to my recent post (10/22/13) on American health care. Below he describes the system in Great Britain as a mixture of public and private options.

" I’ve been meaning to comment on your blog item on healthcare – not necessarily to contradict, but perhaps offer a different (U.K.) perspective. I was chewing this over with a retired health worker on holiday recently, then I read your blog.

  You’ll remember the rather crazy opening ceremony to the Olympics with the paean of praise to the National Health Service. Well, that was silly and over the top, and the NHS isn’t always wonderful by any means – we’ve had a series of scandals relating to appallingly poor care of the elderly recently. But that’s certainly balanced by some wonderful care over the years shown to my family and friends.

 Last year my youngest son suddenly had two detached retinas – he came very close to losing his sight. The very speedy care he received at our local eye hospital was wonderful – he’s now had a series of operations, and treatment will continue until they are satisfied that everything is as good as possible.

  Some years ago my grandson was born prematurely – it had been a difficult pregnancy. He needed to remain in the maternity unit for a week – a small apartment was provided so both of his parents could be with him for those first few days – at no cost.
  A few years ago my wife found a lump in one of those places that women fear most. Within a week she was at the hospital having a biopsy, and all, thankfully, turned out benign. The following week it was removed.

A good friend foolishly ignored symptoms he shouldn’t have done. One day he collapsed and was rushed into hospital with advanced bowel cancer. There followed two months in hospital, and two major operations. It may not be the end of it yet – but the treatment couldn’t have been better.

  What’s good is that, even for the poorest, visiting a GP or getting children vaccinated is free, and all necessary treatment is covered. My GP is good – not as good, though, as my last one, now retired, who told me once that my liver function was far too good for a man of my age and I clearly wasn’t drinking enough alcohol! (He was an Irishman with a great sense of humour.)

  It’s often assumed that there is an either/or situation in medicine – either state funded, or private medical insurance. This isn’t so in the UK. As it happened, my son was covered by private medical insurance provided by his employer. When he weighed it up, it made more sense not to claim – there was a (relatively small) excess to pay if he did so, and the free care was excellent anyway. A while back I took a different route – I needed eye surgery to correct a squint (strabismus) that has always bugged me, and for which I’d been operated on by the NHS previously. It had got worse again. It wasn’t urgent, and, yes, there would have been a waiting list, so I simply paid for it at the local private hospital so I could have it done when it suited me.

  You may quite reasonably say that taking out private medical insurance in the UK means you are paying twice. Well, yes, you are – the National Insurance Contribution (which I’m not now paying as I’m over 65!) and the insurance premium. But comparing costs, the total of both these is quite a bit less than Medical Insurance costs in the US. So you can opt out of the NHS and it’s still cheaper. Even if it wasn’t, I think paying a little extra to help out others who cannot afford treatment is an ethical thing to do.

    I’m aware that compulsory enrolment in a healthcare scheme goes against the grain in the U.S. – the advantage of it, though, is its simplicity and efficiency. The Brits like it – which demonstrates, I suppose, one of those cultural differences between the U.S. and Europe.

   Folk from the U.S. we have spoken to of our age (mainly my wife's chums on Facebook!) have told us how difficult it is to get insurance once you are over 60,  and how there are limits on what can be claimed per treatment – a problem for those with chronic conditions. The treatment itself, though, is first rate - my (insured) mother had a stroke when in Florida and the treatment was superb - it saved her life.  Of course, not all is wonderful with the system here. In particular, problems are looming because of the aging population - those free blood pressure pills are keeping us all alive long after we should have been conveniently buried! I guess this problem exists everywhere. When my wife's mother had a stroke (at a similar age to my mother) our feeling was that, although the treatment was O.K., we felt the attitude was 'she's too old to make it worthwhile', the opposite of my mother in the U.S. who was told she was too young to give up.

I do agree with your remarks on life expectancy. That’s mainly to do with lifestyle. Traditionally, the Mediterranean diet is the one to go for, though even there there are problems – the traditional diet, high in olive oil, was fine when most people did hard manual work. Now people sit at computers but still eat the same diet, which is why heart problems have increased hugely around the Mediterranean!

   From what I’ve read of the Obamacare proposals I tend to agree with you that it all looks expensive and inefficient. All I’d say is – there are better ways of doing it."

The mixture of public and private options in the U.K. that he describes above would appear to be the norm throughout Europe. Sadly, I do not believe it will be possible in the U.S. under the Affordable Care Act (Obamacare). Each day in the U.S. it becomes increasingly clear that individuals will lose their individual and even group insurance plans and be forced into the one-size fits all government sponsored plan. President Obama's assertion, "If you like your insurance plan, you can keep it," has turned out to be one of the biggest  deceptions in the annals of the U.S. Presidency. It will go down in history along with "Read my new taxes;" and "I did not have sex with that woman."

I turns out that President Obama really meant was that "you could keep your policy if he liked it." He insists on calling these policies substandard even when most of them were doing a really good job. He doesn't define what he means by substandard, but it would seem that they lacked low cost benefits like health club memberships and contraceptives. For hospital bills and high cost procedures it would seem that they were doing a more than standard job.


Monday, October 28, 2013

Hasan Niyazi R.I.P.


I just heard that Hasan Niyazi, my friend and fellow Art history blogger, died suddenly over the weekend.  Hasan was from Australia and in the past three years, his blog, Three Pipe Problem (3PP), had become one of the most popular Art history blogs in the world. He was the son of Turkish Cypriots who had migrated to Australia when Hasan was a young boy. Like Raphael, his favorite painter, Hasan died tragically in the prime of life.

His passion was the art of the Italian Renaissance. He claimed that his interest in Art began at the age of nine when he found a copy of a book by famed art historian Erwin Panofsky. I wonder if it began on the island of Cyprus under the eyes of the goddess Aphrodite, the beloved deity of the island.

I first encountered Hasan when I commented on a blog post he had written for 3PP in July of 2010 on Giorgione’s “Tempest.” We had a spirited back and forth that showed that Hasan was willing to engage in debate but that he was also open to new ideas if they could be backed up with hard evidence. Even though he loved the art of the Renaissance, he had trained and worked in the sciences and believed that Art history should be subject to the same rules that governed the sciences.

Our first encounter led to many more. He helped me immeasurably not only with his research into favorite painters like Raphael but also with the technical aspects of blogging. He was a wizard of design and had a great flair for using images in his work. He willingly shared his knowledge with me, a web newcomer.

Eventually, he allowed me to publish some of my discoveries and reviews on his site. His site was growing by leaps and bounds and he gave me the opportunity to reach a much larger audience. It was not easy because he was a stern taskmaster and editor. We had many arguments and disagreements but I believe we both gained by the exchanges. When I sent him my interpretation of Titian’s  “Sacred and Profane Love,” he chided me for not discussing all the previous interpretations, and eventually decided to do that on his own. It was a great example of web-based cooperation.

Speaking of the Web, Hasan ended his last post with these words.

The future of art history and the internet is a very exciting prospect. This goes beyond the fact that more art historians and institutions are engaging online, but also expands to include an increased public participation and interest in learning about art and history outside of an institutional and pedagogical content. The web allows quality knowledge, and fascinating images and video to be accessible everywhere, and by everyone—hence the potential for art history online is essentially limitless.

As a small token, I would like to dedicate my most recent discovery to the memory of Hasan. One of his favorite paintings was Titian’s “Pastoral Concert.” Earlier this year I sent him an advance copy before I posted it on my own website and blog. He read it and very kindly spread the word among his friends and followers. I interpreted the painting as Titian’s homage to his friend Giorgione on his sudden and tragic death at the age of 33.

Goodbye, young friend. 


Tuesday, October 22, 2013

U.S. Health Care System

Despite the fact that the United States spends more money per capita on health care than any other country in the world, many critics argue that health care in this country is inferior to what can be found in many other developed countries, especially those with National health systems. These critics are also proponents of a sweeping conversion of health care in this country to a single-payer or national system.

Critics of the U.S. health care system point to statistics compiled by the World Health Organization (WHO) that rank the United States thirtieth in the world in life expectancy. The accompanying chart shows that in 2007 the average life expectancy in the United States was 78.06 years. Actually, that was not too far behind #1 France with an average life expectancy of 80.59. (click on the chart to enlarge)

I recently came across an excellent article* that attempted to put this statistic in perspective. The article was based on a book by Scott W. Atlas, entitled “In Excellent Health, Setting the Record Straight on America’s Health Care”, that argued that the U.S. health care system before Obamacare was “ the best system in the world.”

How could this be given the mortality statistics? Atlas argued that the WHO statistics were skewed by a number of factors, and that they should be taken with the proverbial grain of salt. The most important element in the low ranking of the U.S. mortality rate would appear to have no connection with health care at all. It is the extraordinarily high rate of murder and automobile accidents in the U. S.
“Murder and accidents account for the majority of deaths among young adults in the United States, and deaths at young ages substantially impact life expectancies.”
If murders and auto fatalities alone were factored out of the statistics, the U.S. would have the highest life expectancy in the world. Murders and automobile fatalities are serious but they are not a health care problem.

Other factors are almost as important in lowering life expectancy. The United States has a much higher rate of obesity than other developed countries and obesity reduces life spans by up to eight or ten years. Also, while smoking has dramatically decreased in the U. S., the residual effects of a long history of smoking in this country will continue to impact mortality statistics for years to come.

Finally, differences in record keeping also impact mortality statistics. Scott Atlas noted the more stringent reporting requirements in the U.S. compared to Europe in the matter of infant mortality figures.
“considering that roughly half of all U.S. infant mortality occurs in the first twenty four hours, the single criterion of omitting deaths within the first twenty four hours by many European nations generates their falsely superior infant mortality rates.”
Rather than blaming the U.S. for higher infant mortality rates, Atlas argued that,
“The United States health care system should be applauded for its efforts to save premature babies rather than write them off as stillborn, as many other countries do.”

A proper evaluation of the health care system in the U.S. should be based not on flawed mortality statistics but on actual medical care, especially the diagnosis and treatment of important diseases. Here are some facts that Atlas unearthed.

1. Prolonged wait times are commonly found in health systems with government controlled nationalized health insurance. Numerous countries with single payer systems had to create policies to address prolonged wait times, including Canada, England, Italy, Sweden, and Spain.

[I saw this myself  when I visited my cousins in Italy a few years ago. They had purchased individual insurance policies to pay for things or procedures not covered by the national system. For example, government doctors would routinely say that you could wait four months for a procedure, or visit them in their private office for the procedure in the next day or two if they would pay on their own, The above chart indicates that over 90% of people in Italy have purchased private insurance policies.]

2. In the United States, referring doctors book CT and MRI appointments within days. In other countries people wait. In 2010, the average wait time for a CT scan was 4 weeks and for an MRI 10 weeks. A 2011 study in the United Kingdom indicated thousands of people waited over six weeks for an MRI scan. With respect to breast cancer biopsies, another survey indicated that only 1% of U.S. patients waited three weeks or more while 44% of Canadian and 20% of U.K. patients waited that long.

3. No elective cardiac bypass patients in the United States were known to have waited more than three months, while 47% in Canada and 89% in the United Kingdom waited that long.

4. The United States tends to have the highest percentage of screenings for breast, cervical, prostate and colon cancer.

In conclusion, the availability of state of the art medical technology, timely access to specialists, the most effective screening, the shortest wait times for life changing surgeries, the newest, most effective drugs for more accurate, safer diagnosis and for the most advanced treatment are all superior in the United States.

In 2008 one study showed that up to 85000 patients sought in-patient treatment outside their home country, and 87% of them traveled to the United States.


*The article was written by Charles P. McQuaid, President and Chief Executive Officer of Columbia Wanger Asset Management. and appeared in the 2013 semiannual report of the Wanger International Fund. It was based on the book by Scott Adams mentioned above, as well as a book by Robert Ohsfeldt and John Schneider, "The Business of Health."

Monday, October 14, 2013

Affordable Care Act

One of the first things I learned when I went into the insurance business almost 40 years ago was that insurance was simply the prepayment of claims. It is paying in advance to cover some future bill or expense. It does not matter if it is life insurance, automobile insurance, or medical insurance. The same basic principle must apply. A policyholder pays monthly or annual premiums and these premiums are pooled with others to pay eventual claims. 

Medical insurance is no different. It only had its origins in the 1930s during the Great Depression. At that time hospitals and physicians were finding it increasingly difficult to collect from their patients, many of whom were out of work. As a result we had the birth of the “Blues.” Both Blue Cross and Blue Shield were products of the Depression. In short, people would enroll in these plans and pay a monthly or quarterly premium that over time would build up enough of a reserve to cover their future claims. This idea seemed to benefit everyone. Doctors and other health care providers would no longer have to go after their patients like collection agencies; and the patients would not have to come up with a large amount of cash to handle large, unexpected medical bills.

However, to avoid excessive or frivolous claims that raise the cost for everyone, most medical insurance policies included deductibles or co-insurance to reduce or eliminate small claims. This was right out of Insurance 101 since actuaries were well aware that the most cost effective strategy was to make the patient bear part of the cost out of pocket.

However, the use of medical insurance to cover future health care costs only took off after World War II. The war had finally taken the country out of the Depression and the economy was booming. In a major change the Federal Government allowed corporations to purchase group medical insurance plans for their employees. Employers were not required to provide health insurance but the government altered the tax code to provide a great incentive.

Unlike other forms of compensation the cost of the medical insurance would not be considered taxable income to the employee. This was important especially to high salaried employees at a time when the highest tax rate was 70%. In other words, employees covered under such a group insurance plan could now have most of their medical expenses paid with tax-free income. It was a no-brainer. Instead of giving all employees a $1000 taxable salary increase, the employer could give them a $1000 tax-free benefit that would cover future health related costs.

The employer sponsored plans were incredibly attractive to all concerned and sparked a veritable revolution in health care in this country. Employers could deduct the cost of their plans as an ordinary business expense while employees could rely on their pre-tax medical insurance plan to cover major medical expenses. Since these were group insurance plans all employees had to be covered even if they had pre-existing medical conditions. Increasingly these group insurance plans came to dominate the market.
Nevertheless, the basic principle of insurance still governed these group plans. They all involved a pre-payment of claims most often through automatic payroll deductions.

This system of corporate sponsored insurance worked remarkably well for the great majority of Americans for many years. There were obvious problems, however, that needed to be fixed. People would lose their coverage when they lost or changed their jobs. Self-employed people did not ordinarily have access to these plans. Unemployed workers would eventually lose their coverage. People with pre-existing medical problems would find it almost impossible to get coverage on their own.

Attempts had been made to deal with these problems but critics of the system still insisted that over 30 million people were without medical insurance. Even if that number was accurate it would be wrong to say that all those people lacked access to medical care. One of the problems with the system was that so many people refused to purchase medical insurance and just went to local hospital ER for even ordinary care.

Instead of trying to fix the problems in the old system, proponents of the Affordable Care Act (Obamacare) sought to overhaul the entire health care system in this country. Now instead of getting a tax break for providing employees with medical insurance, employers would be forced to provide such insurance or pay a penalty. Even though the Obama administration has arbitrarily extended the corporate mandate for a year, some employers have already chosen to drop their plans.

More importantly, it is clear that almost half the country will qualify for a partial or full subsidy from the government in order to purchase their medical insurance. Not only is this incredibly complex and difficult to administer, but it is also open to fraud. Nevertheless, under the ACA a very large percentage of Americans will not have to pay premiums for their medical insurance. No matter what you call it, this is no longer insurance but welfare.

How is the government that is already over 17 Trillion dollars in debt going to pay insurance premiums for almost half the people in this country? Will it just print more money, or will it have to raise the taxes on the other half. Despite these subsidies it would appear that most of the un-insured will not be able to navigate the red tape necessary to enroll, or even be willing to enroll. 

In the next year it would not surprise me if more people lose medical insurance than sign up for Obamacare.