Men sure are having a hard time lately, aren't they?

Harvey Weinstein, famous Hollywood producer...

Mark Halperin, News producer, author and political commentator...

Kevin Spacey, actor in screen and stage productions...

Roy Moore, former Alabama Supreme Court Judge and politician...

Louis C. K., comedian, actor, writer, director, producer...

Al Franken, current Senator from Minnesota, former writer and actor on Saturday Night Live

Glen Thrush, political reporter for the New York Times...

Charlie Rose, television journalist and talk show host...

John Conyers, Congressman from Michigan

Donald J. Trump, Real Estate, businessman, reality TV show host and 45th President of the United States.

These are just a few of the well known names of men who have been accused of improper and sexually oriented conduct toward others that have hit the headlines in the last few weeks. You'll note the list doesn't include others who have been previously accused of similar inappropriate behavior like Bill Cosby, Roger Ailes or Bill O'Reilly.

If you Google this subject, there's no shortage of things that will come up.

It's a strange thing, this "sexual misconduct" thing. When you have grown men like Louis CK, for example, guys who can make or break a career, they certainly hold the power over younger female wannabees. By now we've all heard the "MO's" of guys like him.

Aspiring actress somehow meets famous/powerful male in some setting. It may be a professional one or it may be a social one or it may fall somewhere in both camps. One way or the other, the young lady is invited to come up to his room, or his house, office, etc. to discuss the business further. Once in that environment, it doesn't seem to take long before someone is making advances, speaking lewdly, pleasuring one's self or worse. The woman is in a helluva situation, with no easy way out sometimes and a genuine fear of "...shit, what will this mean for my career? I don't want to be a waitress all my life.

It's easy for any of us who haven't been in that situation to cast judgement. Or, if we have found ourselves in a similar circumstance, to ask why didn't she just "do what I did?" Which may mean anything from comply fully with the creeps advances and hope that somehow down the road it'll be somehow "worth it," to find a way to walk/run away as fast as you can. We're all wired differently and I suspect that while most women would choose to just get out of there intact, there are those who will - in an almost transactional way - go along.

It's a unthinkable choice to have to make, on the spot and one that 99% of men have no concept of whatsoever. I'm in no position to judge the choice any woman decides is the right one if she finds herself in such a terrible situation. (And neither are you.)

I'm 57, I've worked for over 40 years and I've never - not once - ever been pressured or harassed while working or at school by an employer or professor. I don't think I'm the exception to the rule.

Men have had an asinine outlook toward women for centuries. Religion hasn't exactly been an advocate for women right's either. The odds have been stacked against women for, well, for ever...

Obtaining a college degree, succeeding at a job or ascending through the ranks is already difficult enough for legitimate reasons. The work is usually difficult to some degree, there's competition for a particular position or promotion. Real life, family, kids, health issues, relationships, etc. also can present necessary distractions that make everything harder and stressful.

It's probably safe to safe to say that if you take a man and a woman, send them through the same college and career experience and they both attain the same basic position of leadership, that the female has had to put up with more bullshit along the way than the male did.

Everything from her figure to her clothes, her hair, her makeup, her perfume, etc... Men don't typically have to deal with that nonsense. And then on top of that, some fat, sweaty "fill in the blank with guy's name" wants to fool around a bit or he'll impede her career?

Seriously?

Men are pigs and we always will be, I suspect. Some of us behave better than others. I'd even say most of us know how to act around a woman and be professional. The ones who don't deserve everything that comes their way.

While not enough, most guys have been informed of basic rules of a workplace. It's not rocket science. Here are the basics:

Don't touch anybody except to shake hands.
Don't talk about anyone's physical appearance with others.
Meet with clients, associates, etc. in a mostly public place.
Keep the conversation and your language as professional as possible.
Find companionship, sex, etc. somewhere else than work.

It's not that hard...

A Year Has Passed Since Trump Became President. Some Thoughts...

 A year ago I sat in this seat, at this desk, in this office watching the 2016 General Election returns that announced that Donald J. Trump would be our next President.

 As comedian Lewis Black so often says, "You've got to be shitting me."

 No, this was of course as real as it gets.

Donald Trump won because of a few different reasons.

1) Trump resonated with the blue-collar, lower-income voters that felt left behind by the Democratic Party. Trump sang the songs those folks wanted to hear, he wasn't a fancy talker like President Obama was nor was he, uh, well, black. A white guy who had some level of perceived success in business and had the TV star name recognition that blew everyone else away. No matter his ideas were fragments of thoughts, not well-thought out actual polices mind you, but his pitch sounded good enough to the voters in all the rural and non-urban environs. The Dems never found a voice, although I suppose Bernie Sanders came the closest. Close wasn't remotely good enough.

2) Hillary Clinton was a terrible candidate. While likely a far better administrator, she isn't that likable, and when you factor in her self-inflicted gaff of all gaffs with the personal server and her lame handling of it, well - that was that. Some curious campaign strategy to skip various states as the campaign drew near its close and voila! Despite getting more votes, she got the "wrong votes" and you know who got the White House.

3) Not enough of us vote. Roughly six in ten of eligible voters bothered to vote, which adds up to a LOT of people not voting. Apathy is not a good strategy to advance the Country in any direction.

Other factors worth considering is the lack of outreach President Obama made in terms of developing the next generation of democratic politicians. The Democratic party's utter incompetence in terms of well, almost everything. Some will point to the 2016 general election campaign as a case-study on how to screw up an almost sure thing through a lack of vision, hubris and poor judgment.

None of this is new information and your mileage may vary as to what you think explains best the 2016 election.

I can't pin this all on the Trump effect and neither should you.

I am still unable to fully express my disappointment in how things have gone since President Obama took office, where my optimism was dashed within the first few months. For a good understanding of how quickly the Obama Administration became utterly fucked with no clue or willingness to counter punch the GOP, pick up a copy of Michael Grunwald's "The New New Deal" which chronicles the early days of the Obama first term.

As Obama said, “We've always known that lasting change wouldn't come quickly or easily. It never does.” 

The ugly business of getting the needed votes and the appalling horse-trading required for same quickly fouled the fresh air of what I hoped would be a new age in our politics and our Country. I didn't expect the loyal opposition to hand Obama everything he asked for, but my God, the obstructionism came so fast, so fiercely that even I was surprised.

So the eight years of the Obama Presidency was underwhelming and too much time was spent explaining, defending and explaining some more why his policies were generally good ones. The old saying goes "if you're explaining - you're losing" proved true and while he won re-election, he never came close to being the "change-agent" I'd hoped he would be. Obama made many mistakes and is guilty of his own elevated levels of hubris to be sure. It was foolish of him to declare - over and over again - that " if you like your health plan - you can keep your health plan".  Otherwise known as Politifact's 2013 Lie of the Year.

Our politics grew more coarse, the media beat its drum dronishly and the message went out to all the land. Politicians - no matter their party or promises - all sucked and sucked hard. Trust none of them.

Right-wing talk radio, Fox News evening lineup hosts and a handful of right-leaning websites fed into this narrative that all politicians were evil, untrustworthy and basically out to fuck us all.

So, come to the 2016 General Election and who do we see on the right?

Jeb Bush, Chris Christie, Lindsey Graham, Ben Carson, Mike Huckabee, Ted Cruz, Bobby Jindal, Rand Paul, Marco Rubio and John Kasich among others. What do they have in common?

They're all career politicians...

Who did we see on the left?

Hillary Clinton, Bernie Sanders, Martin O'Malley were likewise, career politicians in one form or another.

Bernie was a breath of fresh air to some but unelectable in my mind from the start in that election cycle. The United States of America wasn't and probably isn't ready to elect even a soft Socialist into the White House.

Then there was Trump. NOT a politician.

Hmmmm...

People didn't care he was an asshole.

People didn't care he stiffed any number of contractors and small business along the way.

People didn't care he boasted about his conquests with women.

People didn't care about his divorces.

People didn't care about his very un-presidential tone and demeanor on the campaign trail.

People didn't care about when he claimed John McCain wasn't a true war hero because he had been captured.

People didn't care when he criticized the Gold Star Mother.

People didn't care about his "some very fine people on both sides" comments after Charlottesville...

People didn't care after Trump resurrected the NFL players taking a knee matter, despite a Veteran suggesting to Colin Kaepernick he do so instead of sitting in protest.

They didn't care about anything...Trump's broken promises or failed plans don't matter to the group that adoringly voted him into office. As a resident of the slowly decaying Johnstown, PA area told Politico in a sobering article earlier this week, "Johnstown and the surrounding region are struggling in the same ways and for the same reasons. The drug problem is just as bad. “There’s nothing good in the area,” Schilling said the other day in her living room. “I don’t have anything good to say about anything in this area. It’s sad.” Even so, her backing for Trump is utterly undiminished: “I’m a supporter of him, 100 percent.”

It was all fake news, made up either by radical Democrats who hate the Country or by long-serving RINO's who should've been kicked out a long time ago.

The cake was baked. From President Reagan saying "government is the problem" back in the 1980's all the way up to election day, we've been on this path where we ridicule honorable Government servants, educated policy people who are trying to improve the lives of the people in the country to college professors and anybody else who ain't singing America, Red, White and Blue is #1 songs.

Ted Nugent, Roy Moore and Joe Arpaio are now "in" while thoughtful, creative public servants and dedicated policy wonks are out.

Welcome to the Dark Ages v.2.0...

Nepotism run amuck, inexplicable staffing choices, choosing to not staff key foreign policy and State Department positions. The bullshit claims that we'd have the BEST healthcare in the world. The excuses for why the infrastructure improvements haven't begun in earnest yet. The influx of Wall Street and other billionaires into his Administration.

His reckless and incessant Tweeting of petty, foolish and self-indulgent messages at all hours of the day and night.

His dangerous handling of North Korea.

His inept handling of China.

And of course, his inexplicable relationship with Vladamir Putin and Russia.

We get the government we deserve. This is what happens when enough people take the lazy way out and listen more to know-nothings like Sean Hannity, Rush Limbaugh, and Alex Jones than they do to serious, educated and qualified people of knowledge and science and facts.

This is what happens when, despite all the information we could want at our fingertips, we collectively decide its too hard to read about health policy or what tax cuts mean for our deficit or what the 14th Amendment actually was trying to say when it actually said "...deny to any person within its jurisdiction the equal protection of the laws."

This is going to get worse before it gets better.

We deserve Donald J. Trump as our President.

We must do better.

This is NOT to say in any way, shape or form that the Country is in this fix because "my guy/girl" didn't win. If a reasonably thoughtful person like John Kasich, for example, had been elected, I highly doubt I would feel the visceral level of distress I and others do on a daily basis.

Kasich is a Republican. I used to be a Republican. That doesn't mean he could never advocate for policies I might find acceptable.

We'll do better as soon as we begin to shun the extremes in our politics and find a new, meaningful appreciation of those thoughtful voices in the Center. Nobody will get all they want, but likewise, nobody should wind up with nothing they hoped for.

There's no acceptable honest explanation for why the individual mandate, supported by minds at the Heritage Foundation to derail Hillary Clinton's attempt at health care reform was somehow tyranny and un-American when President Obama weaved it into the Affordable Care Act. How it went from perfectly reasonable to dangerous and tyrannical overreach is intellectually dishonest.

As we start Trump's second year in office, I can only imagine where our politics will be a year from now.

Why Healthcare is a Right, and is Consistent with our Founding Principles...

Donald J. Trump has been our President since he was sworn in on January 20th . One of the biggest issues he'll have to deal with is the nation's approach to health care. He has been quite clear that he believes the Affordable Care Act to be a disaster and had promised to repeal it in first week or so in office.

Today, February 14, 2017 marks the twenty-sixth day of his Presidency. He is two days into his fourth full week. The Affordable Care Act has not yet been repealed.

There is no consensus what will happen to the 30 million or so people who have signed up for health insurance via the ACA. Some think a repeal and delay approach would be best where the ACA would carry on for a year or two while its replacement was negotiated, but still give the Trump White House and Congress the ability to look America mostly in the eye and say, "We repealed the Affordable Care Act. Obamacare is no more!"

A smaller number of Conservative voices feel there should be no repeal of the ACA until the "replacement" plan is ready to be transitioned to. Still others have suggested all those currently covered via the ACA could keep their coverage and eventually the "greatness" of the new polices available after "Trumpcare" is introduced will be so appealing, so superior that over time, people will eventually abandon the polices and/or coverage via the ACA marketplace exchanges or the medicaid expansion.

Talk of terminating the main funding streams for the ACA may sound good, but if those streams are ended, while those services are permitted to be still provided is rife with problems. Such an approach will grow the deficit and debt, which combined with Mr. Trump's other campaign promise of a massive infrastructure program that will cost a lot would start the next Administration off on an odd way given all the rhetoric we heard about shrinking government and reducing spending.

Delivering healthcare is a complicated endeavor under the best of circumstances, and we're not remotely delivering healthcare to anyone in the United States under the "best of circumstances." More on that point later on.

A question that often comes up in the debate about what role, if any, should the government play in the delivery of health care to Americans - maybe the fundamental question behind the acrimonious discussion on the matter - is this.

Is health care in the United States of America a right or a privilege?

IN the typical debate about this question, one thing that those who think its a privilege bring up is that the words "healthcare" appear nowhere in our Constitution. The "its a right" crowd usually counter by saying its covered by the general welfare clause. Not really. "General Welfare" really meant that the Government would be able to keep itself healthy and in tact and able to function.

Keep in mind, the Supreme Court ruled the ACA and its "individual mandate" that required most Americans to obtain health insurance to pay a fine, to be essentially a tax, which gave it a different status than many thought it should have.

I think the place to look is in the Declaration of Independence.

Here's the phrase:

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. 

You won't find the phrase "healthcare" here either...

However...

"Men are endowed by their creator with certain unalienable rights." This basically means God has given us certain rights (not privileges,) that no one can take away.

"Among these are life, liberty and the pursuit of happiness." So... God gives us the right to be alive, to have Liberty from birth and to be able to pursue happiness. Let's look at the first of these unalienable rights from God.

Life: We have a right to live. I know we still execute people across the United States for various crimes and we're told those people lost their rights because they broke the law. Those words don't appear in the Constitution either, so it appears there's some negotiable wiggle room. If death can be an exception, can't life? Further, if life is a God given right, and its unalienable - then it can't be taken away. (Yet it is...)

We know African Americans, for example, weren't considered people and were abused terribly. The text of the Constitution doesn't include Blacks or Negroes or anything else.

We know women were denied the right to vote until the 19th Amendment was added in 1920. The Constitution doesn't mention women in its text.

It doesn't say except for crooks or Blacks... it says "men." Not some men or certain men or special men or white men or men who can afford it. It just says "men."

If we want to say we should apply the Constitution literally, then it has to be a 2 way street.

If we're entitled to live, its also implied we're entitled to have access to the basic things one needs to be able to live. Not live like a King, but not expire due to lack of food, heat, water, and yes...health care. 

We decided over fifty years ago that Americans should be able to get help buying food if they met certain financial criteria. Generally speaking, these were the poor people of our society, and while we hear about abuses (which OF COURSE should be addressed) we know that a LOT of people get public assistance. There's also assistance available to qualified people for heat, water, etc.

Next in the usual course of a discussion is the following, "Everyone CAN get healthcare.. all they have to do is go to the emergency room and they can get treated..."

Yes and no...

If a person is in an "emergent condition" the hospital must treat them to the extent that they are stabilized. That may take minutes, hours, days or potentially weeks depending on the circumstances. Emergency room care here in the US is very good, but also very expensive. We lead the world in medical bankruptcies, and this is one of the reasons why. People with no insurance have to pay cash for their medical services and for many - its a catastrophic amount of debt that buries them forever.

The law that compels the hospitals to treat such acutely ill or injured people doesn't afford much protections to those not yet in a emergent condition. You can't walk into an ER and ask for nutritional advice. You can't ask them to review your medications. You can't stroll in to an ER and ask for a treadmill test because you think you need one. You can't pop in and ask for a cup of dialysis. You can't ask for anything really.

Folks in that situation were typically turned away, and they were welcome to return when they were in a bad way. Then and only then would the Emergency Room staff be happy to help them. Hopefully, things wouldn't be too hard to repair or fix and there would be a happy ending. Too often, it wasn't a happy ending.

Emergency room care isn't health care. Its emergency medicine. Its not the sort of preventative health care one would receive from their primary care doctor. It's not screenings. It's not education. It's not routine checkups, blood work, urine tests, etc. It's not contraception. It's not nutritional guidance. It's not learning how to walk again or write again or speak again after something took those skills away. It's not an discussion on the options for end of life care that's occurring while a patient is in the middle of a crisis that may end their life.

In other words, its not the kind of health care that could help a person stay healthy or address a small issue on their own under the guidance of a primary care physician before it becomes an emergent condition which may be life threatening. 

Maybe they were kidding about life being unalienable?

So, allowing people to not have access to affordable health care creates a perverted dynamic. We, the people of this fine country won't help you to access the cheaper but vital healthcare that might in fact, keep you out of the very, very, very expensive emergency room where the care is great but where people still die in every hour of every day.

This also makes financial sense...

To which the General Welfare clause makes a a return visit to this discussion. The Congress is compelled to secure the general well-being of our government's fiscal health. GDP issues due to health care costs pose a major threat....

A look at thirty four other industrialized countries healthcare spending as a percent of their GDP:

From the managed care of the 1980's to the Affordable Care Act of 2010, the United States pays a higher percent of our GDP than any other country on earth. That's bad...

Another thing to note. Those other countries on the chart have universal coverage. They are able to provide health insurance to all of its citizens, while spending less as a percent of their GDP.

Pick your poison in terms whether you prefer Conservative or Liberal, Republican or Democratic style plans and approaches to address health care delivery in the US. Its inefficient and consuming more of our dollars than any other country in the world.

The so-called "greatest healthcare system in the world" also has major issues with its delivery and outcomes when compared to other industrialized countries around the world who offer universal coverage.

Consider...

*The United States has fewer physicians per 1000 (2.6) than the median OECD Country in 2013 (3.2)...

*Data from this decade shows Americans see their doctor on average fewer times (4/yr. ) than the median OECD country (6.5 visits per year.) Canadians saw their doctor on average 7.7 times a year. In Japan, the average number of visits is 12.9 per year.

*The US also has fewer hospital beds per thousand people (2.5) compared to the average median OECD (2.9), Germany has twice the number of beds as we do and Japan has over three times the number of beds we do.

*In terms of outcomes...

US life expectancy - 78.8 years
OECD Median  - 81.2 years

US Infant Mortality - 6.1 deaths among 1000 live births (highest among 11 countries studied)
OECD Median IM - 3.5 deaths

Chronic disease prevelance in the US (2 or more chronic conditions) = 68% of adults >65 yrs. old
Other countries in study, figures range from 33% in the UK to 56% in Canada

Obesity in the US is the worst in OECD countries...  35.3% of the US population is considered obese. Higher than any other country in the study.

While we do well with treating cancers, we don't compare well to other countries in treating diabetes, amputations due to diabetes, ischemic heart disease...

See the entire study from the Commonwealth Group here...

So...

We cover fewer people, in many cases our outcomes are less than steller to say the least and we pay significantly more for this level of "...effectiveness."

Bottom line:

Our approach to health care delivery in the United States since the 1980's through today is expensive, inefficient, unavailable to many and consuming far more of our GDP than any other industrialized country in the world.

If you have money or a job that provides you the access to health insurance you still have to deal with the terribly flawed, segmented and inefficient US health care system. If you're poor or don't have a job that provides health insurance benefits, depeneding on where you live - you may be with out access to even Medicaid, the public safety net program for poor people. Medicaid is administered by the States, and many have refused to participate in the Medicaid Expansion within the ACA. Currently, 32 States and DC have adopted the expansion, while 19 have rejected it. 

Without access to affordable health care and health insurance, people have a impediment to life, liberty and a pursuit of happiness afforded them by our Declaration of Independence. This issue hurts both individuals as well as the welfare of the United States.

The above reasons are the foundation of my position as to why healthcare is a right and not a privilege.