Sam Uretsky's Open Salon Blog

Proof of Identity -- a true, dull story

Sun, 3 Jun 2012 14:06:55 -0400

This is a true story – not a very good story, but true all the same, and maybe it will make a point, although it probably won’t change anybody’s mind. I’m not even bothering to change the names. My late wife and I were a couple out of an old Norman Rockwell print. We lived in a tract house that had been built in 1950, and raised two children, and for a few years had a Basset Hound who liked to be chained in the front yard where he could see the little children, and they would stop and play with him. We burned charcoal in the grill every summer, and wood in the fireplace every winter. Nancy was active in the PTA and I was active in the synagogue. Both of our children grew up, graduated college, and each of them has two children. There’s more, but it’s all the same sort of thing. We voted in every election and maintained the lawn. As I said, it’s not much of a story.

Except that if it happened today, we couldn’t have voted in every election, because Nancy wouldn’t have been able to register to vote – at least not in the red states that are concerned about voter fraud. The other day, for no particular reason, I decided to order a copy of my birth certificate. It’s done over the Internet now, and you answer some questions, provide a credit card number, and it arrives. The questions were pretty much a matter of public record, not completely unreasonable – mostly.

Except that when Nancy’s father died, we went though his papers and found Nancy’s birth certificate. It recorded a birth, Bronx County New York, parents’ names, but the infant had been named Naomi Esther. All her life, Nancy had been Nancy Ellen, and suddenly she was confronted by the fact that her legal name, at least with the Department of Health of the State of New York, was something totally different. If Nancy had needed a birth certificate in order to get an identification card in order to register to vote, she would never have known what name to ask for. I presume that Nancy’s Mother, whom I never knew, wanted her daughter to have a modern name., something less ethnic or Biblical than the name of record, and so Naomi became Nancy and never knew herself as anybody else.

There’s a bit more, but not much. I am changing the names on this one though. I knew a writer who used a pen name, and somehow the two got confused on the public records, so that the IRS or some other agency insisted she was Ingrid when her real name was Emily, and of course there was no birth certificate listing for Ingrid. Also, one of the questions I was asked in order to fill out the request form was whether my parents were married at the time of my birth. It struck me that this is the sort of detail that parents might not care to discuss with their children. Scott Brown. running for the senate in Massachusetts, seems to have done well by claiming that his opponent, Elizabeth Warren, made a false statement by saying she had a Native American ancestor. Ms. Warren’s response is that this is what she was told by her Mother, which sounds completely credible.

There’s not much evidence of voter fraud in spite of efforts to find some in order to justify tossing minority and low income voters off the rolls. There’s lots of evidence of families touching up their ancestry just for the sound of it. When Florida is expunging over 100,000 people off the voting rolls, it’s fair to question the motivation.

Just a thought.

Thoughts on the Personhood Pledge

Sun, 8 Jan 2012 09:01:53 -0500

Michele Bachmann, Newt Gingrich, Rick Perry and Rick Santorum have all signed a pledge to support the Personhood amendment. This is a proposed change to state constitutions which would protect the rights of the pre-born by declaring that every fertilized ovum is a “person” under law. The amendment, as presented to the voters of Mississippi read:

“Be it Enacted by the People of the State of Mississippi: SECTION 1. Article III of the constitution of the state of Mississippi is hereby amended BY THE ADDITION OF A NEW SECTION TO READ: Section 33. Person defined. As used in this Article III of the state constitution, "The term 'person' or 'persons' shall include every human being from the moment of fertilization, cloning or the functional equivalent thereof." This initiative shall not require any additional revenue for implementation.”

The voters ibn Mississippi, as conservative as any in the country, rejected the bill with over 55% of the vote, and the margin would probably be higher if the implications were more fully understood. Personhood goes beyond a ban on abortion, but would also ban any form of birth control that impedes implantation of the fertilized egg in the uterus. This includes all the most popular forms of birth control. Any woman who has a miscarriage might be subject to investigation for a possible felony. Governor Perry has said that he would not consider exceptions to the anti-abortion provisions in cases of rape or incest. At a forum in Iowa, Governor Perry Governor Perry described how he had undergone a “transformation” after a conversation with Personhood USA spokeswoman Rebecca Kiessling whose conception was the result of rape. “Looking in her eyes, he said, “I couldn’t come up with an answer to defend the exceptions for rape and incest,” . Governor Perry doesn’t seem to have looked in anyone else’ eyes.

There is a group of genetic conditions known as lysosomal storage diseases – inborn disorders of metabolism in which certain proteins cannot be fully metabolized. Over time, the waste products of faulty metabolism accumulate and damage the nervous system, leading to reduced function, pain and death. Modern methods of prenatal screening have made it possible to detect some (not all) of the lysosomal storage diseases prior to birth. The diseases are relatively rare, and have varying prognosis. Genetic screening of prospective parents can prevent these diseases; for example, Tay-Sachs Disease, formerly seen among Eastern European Jews, has been almost completely eradicated by testing of prospective parents. Tragically, while the gene that causes Tay-Sachs Disease has been almost totally eliminated from the high risk gene pool in Israel and the United States, infants are still born with this tragic condition because either the parents seemed to be at low risk, or did not have the full resources of genetic counseling. This would be most common among low income families who do not have medical coverage or access to prenetal care.

While testing the prospective parents has been the most effective screening method, and can prevent the conception of a fetus, others, an increasing number, can be suspected as a result of ultrasound and confirmed by testing of cells from the fetus. Depending on the diagnoses, some cases can be treated, although the range of treatments is usually quite costly and not always fully effective. A paper in OJIN, tghe online hournal of issues in nursing, discusses the cost issue:The majority of patients receive some benefit from ERT (enzyme replacement therapy), however the drug response is somewhat dependent on disease burden, previous damage that occurred prior to the start of ERT, and the patient’s individual disease complications. On average the drug cost per year for ERT is $200,000-$300,000 in the United States, depending on the individual’s weight, prescribed dose, and the average wholesale price of the drug .... This does not include markup on the drug from hospitals, private offices, or infusion centers. It does not include supplies, infusion charges, or other medications and therapies needed to treat the condition. In general patients are not denied drug coverage by their third party payers in the United States, but often times must be concerned about lifetime maximums which could be reached in 2-5 years, thereby increasing premium costs, and pharmacy plans with an annual maximum of $25,000-$50,000 on a subset of drugs....” The incidence of the lysosomal storage diseases is relatively low. but as more drug therapies are developed, more patients will require these treatments and will have to be factored into health costs estimates.

Still, there are diseases among this group that have no treatments, and for which the prognosis is slow but certain, painful death. The infant, no longer a fetus but a living child, will be born , and over time, in some cases as long as 8 to 10 years, will lose physical abilitites and cognitive function, but suffer constant pain. The Right to Life Groups have presented evidence that fetuses appear to experience pain – these is even greater evidence that infants feel pain. In other nations there are ethical debates about providing both abortions for untreatable conditions and treatments which put a severe strains on the families, patients, and all members of a poor society.

The Republican contenders have no such questions. They are in favor of repealing the Affoerdable Healthcare Act which would assure that these conditions could be covered by insurance, but are [ledged to let infants be born to as tragic a fate as can be imagined. Jennifer Mason, spokesperson for Personhood USA. has said “There are no exceptions in Personhood USA’s presidential pledge because there are no situations where it becomes necessary to dismember a baby.” There are, however, circumstances in which a baby may suffer a prolonged and incredibly painful deterioration and death. In Arizona, patients have died because the state refused to ;pay for solid organ transplants. This seems predictive of how the states will respond to requests for the enzyme therapies needed to treat the lysocomal storage disorders..

The people behind Personhood USA and the presidential aspirants who have signed the pledge have no questions and no doubts. Human rights begin at the moment of fertilization and end at the moment of birth.

The Cost of Cutting Costs

Wed, 14 Dec 2011 08:12:05 -0500

The United States Centers for Communicable Disease Control has reported an increase in the number of cases of type 2 diabetes among people under the age of 20. Type 2 used to be called Maturity Onset Diabetes, and is marked by resistance to insulin. In Type 1, which used to be called Juvenile Diabetes, the body doesn’t produce enough insulin to meet its needs; in type 2, the insulin is present, but it doesn’t function as well as it should. Type 2 diabetes has been linked to obesity, which is a growing problem in the United States and most of the developed world.

The American Diabetes Association estimates that 215,000, or 0.26% of all people under the age of 20 have diabetes, although this figure may be low because there is no general screening program, and the condition is more common among low income people who are less likely to see a physician than those in more affluent groups. Estimates of the costs of diabetes care are all over the lot and shouldn’t be relied on, but one of the more impressive studies puts the cost of control of uncomplicated diabetes, where the only expense is monitoring blood sugar and basic drug therapy at $11,000 per person per year. Once complications set in, which can include heartg attack, stroke, blindness and nervous system problems, the costs jump to $44,000/year – but complications are rarely seen in the under-20 population. Even so, the direct medical costs for type 2 diabetes among children comes to $236,500,000, most of which is probably paid by State Children's Health Insurance Program (SCHIP).

Most of these expenses could be eliminated by reducing the incidence of childhood obesity, by improving childrens’ diets and increasing the amount of exercise they get, but on Novermber 12, Congress, responding to lobbying from major food marketers, blocked proposed Department of Agriculture rules that were intended to reduce the calories and sodium levels in school lunches by increasing the amounts of fruits and vegetables served. Under the proposed rules, a slice of pizza would only count as a vegetable if it contained at least a quarter cup of tomato paste. The lobbyists protested, probably accurately, that this would result in soggy pizza. Wjo knew that school lunches had gourmet aspirations?

Another diet related problem, this one associated with maternal diet during pregnancy, is spina bifida, a condition in which portions of the vertebra do not close fully. While in its mildest form spina bifida patients may be asymptomatic, in more sever cases affected babies have some degree of leg paralysis and bladder- and bowel-control problems. The exact causes of spina bifida are unknown, and there may be a genetic component, but risk factors include maternal obesity and maternal diabetes. Fortification of some foods with folic acid has reduced the rate of spina bifida, but even then, monitoring is called for and additional supplementation may be needed. For most poor women, the most accessible source of prenatal care has been Planned Parenthood, which provides a fulol range of gynecologic services including prenatal care, including prenatal vitamins. Congress has defunded Planned Parenthood because the organization also provides abortion services. Since no other organization has the resources to replace Planned Parenthood, and the anti-abortion activists have made no effort to staff their centers with qualfied clinicians who can provide gynecologic services, there may be more infants born with neural tube defects. According to the Spina Bifida Association “The economic and social costs associated with Spina Bifida - for both the affected individuals and their families - can be significant. The average total lifetime cost to society for each infant born with Spina Bifida is approximately $532,000 per child. This estimate is only an average and for many children the total cost may be well above $1 million. Estimated total annual medical care and surgical costs for persons with Spina Bifida in the United States exceed $200 million. Currently available statistics on the cost of Spina Bifida are estimates based on the average dollar in the mid-1980s. Therefore, due to inflationary increases over the past two decades, these cost statistics likely are higher..” Many cases of spina bifida could be prevented with proper prenatal care, but Congress chose to cut off funds to the one organization that was providing affordable care to the uninsured. The bills will turn up, but they’ll be charged on a different line of the ledger.

Finally, one of the factors in prematurity is maternal diet. The full list of risk factors for premature delivery include maternal overweight and underweight. Prenatal care can reduce the number of premature infants. Modern medicine can save the lives of preemies, but the financial costs are dramatic. A 2008 report in Bloomberg Business said “A 2006 report by the National Academy of Sciences found that the 550,000 preemies born each year in the U.S. run up about $26 billion in annual costs, mostly related to care in NICUs. That represents about half of all the money hospitals spend on newborns. But the number, large as it is, may understate the bill. Norman J. Waitzman, a professor of economics at the University of Utah who worked on the National Academy report, says the study considered just the first five years of the preemies' lives. Factor in the cost of treating all of the possible lifelong disabilities and the years of lost productivity for the caregivers, and the real tab may top $50 billion, Waitzman says.”

With the exception of a single payer healthcare system, the best way tio hold down healthcare costs would be to assure a proper diet for everyone, or at least a bottle of multi-vitamins for those who are at greatest risk. Instead of paying the price of a decent meal, we're paying the price of rectitude, and it's more than we can afford.

Why You Should Move Your Money -- and Can't (long)

Wed, 14 Dec 2011 08:12:56 -0500

Move Your Money Day was November 5, 2011. It never had chance. The idea was a good one - the 99% should withdraw their money from the Too Big to Fail banks and open accounts with small local banks and credit unions. If enough money moved, there would be a number of benefits. Small banks and credit unions offer loans in their own communities, helping local merchants expand. – big banks may accept deposits on one area, but use the money to support businesses in other neighborhoods, or other nations.

Big banks are greedy. They got used to huge profits during the Bush years, and when Diodd-Frank tried to regulate some of these activities and control the fees the banks extracted from their customers, the banks went looking for ways to make money that weren’t covered by the bill. Banks that, not that many years ago, wanted to charge customers a fee for dealing with a teller, tried to impose a fee for using a debit card. Big banks pay lower interest rates than small banks, and while their size may make them more efficient, with the benefits of economies of scale, the benefits of this efficiency benefit the bank and its officers, with little advantage to depositors. The fact that the big banks are too big to fail means that there is always the risk of another TARP bail-out, while the banks that nearly destroyed the world economy have outsized influence with congress in preventing the sort of regulations that would prevent a repeat of the present mess.

The people behind Move York Money Day had the right idea – but it couldn’t work. The banks, actually all banks large and small, have gotten their root systems into our lives so that the idea of moving money in one day is almost laughable. The image, of course, is a run on the bank, visions of 1930, people lined up in front of the teller’s window to get cash. Assuming you kept your check register up to date, you were home free – or at least you were if you were near the front of the line.

The Federal Deposit Insurance Corporation, in their winter 2010/2011 newsletter, recommended that more people use electronic banking, including direct deposit and automatic withdrawal. These things are simple to start but difficult to change.

Kiplinger thoughtfully published a check-list of the steps needed to move your money – starting with finding a new bank and opening an account. They don’t mention that this step may not be practical for some people. It means keeping two accounts open at the same time, and some people can’t even afford to maintain minimum balances. The millions of people who are living one paycheck from disaster may go through all their income by the end of the month, and would subject themselves to overdraft fees that would just make things worse.

After that it’s a matter of waiting for all checks to clear, and shifting all automatic deposits and withdrawals. If you’ve authorized the electric company or the telephone company to go straight to your bank account, they have to be switched to the new bank – and there has to be enough money in the new bank to cover the bill. If your old bank offered free checking as long as you had direct deposit, then moving the direct deposits will probably lead to more fees before you can leave. You can’t close the old account until you’ve seen that all the automatic transactions go smoothly. The process may take a month, two months, may even run into a third. Representative Brad Miller (D-NC) has introduced HR-3077, "To amend the Federal Deposit Insurance Act to ensure that customers have the right to immediately close any account at any insured depository institutions on demand, without cost to the consumer, that consumers receive any balance in their account immediately, and for other purposes.” It’s not a complete answer – not for people who have authorized automatic withdrawals, but it shows some understanding of the problem. The bill has a long list of co-sponsors:

Donna Christensen [D-VI]

Eleanor Norton [D-DC]

Earl Blumenauer [D-OR3]

Michael Capuano [D-MA8]

Judy Chu [D-CA32]

David Cicilline [D-RI1]

John Conyers [D-MI14]

Susan Davis [D-CA53]

Peter DeFazio [D-OR4]

Keith Ellison [D-MN5]

Bob Filner [D-CA51]

Raul Grijalva [D-AZ7]

Luis Gutiérrez [D-IL4]

Maurice Hinchey [D-NY22]

Michael Honda [D-CA15]

Jesse Jackson [D-IL2]

Sheila Jackson-Lee [D-TX18]

Barbara Lee [D-CA9]

Zoe Lofgren [D-CA16]

Ben Luján [D-NM3]

James McDermott [D-WA7]

James Moran [D-VA8]

Donald Payne [D-NJ10]

Chellie Pingree [D-ME1]

David Price [D-NC4]

Steven Rothman [D-NJ9]

Janice Schakowsky [D-IL9]

Louise Slaughter [D-NY28]

John Tierney [D-MA6]

Peter Visclosky [D-IN1]

Maxine Waters [D-CA35]

Lynn Woolsey [D-CA6]

It doesn’t take much to see why this bill doesn’t stand a chance of passage in the House. Move Your Money Day never stood a chance

Mr. Romney and the Veterans

Sun, 13 Nov 2011 11:11:48 -0500

I’ve been ripped off several times in my life, but only once by a professional. That was a long time ago, when I was a slicksleeve in the Army. That’s a private, a rank that doesn’t have any rank insignia at all. What I did have was a posting to a base in the United States, and enough job security to buy a very used car. There were a few cars around the post that were traded every 6 months or so – usually VW bugs, since at the time there wasn’t much that could go wrong with them. A low ranking enlisted man could buy one, use it for a few months until he got shipped overseas, and then sell it for just what he had paid. I bought one, and then went to buy insurance. There was an insurance agent about 100 feet from the post, who was glad to sell me a policy. I was in a hurry and paid for 6 months coverage. Shortly after, I learned that the premium was about 3 times as high as that of the well-known national companies.

Military personnel are targets, just as the elderly are, with a particular focus on the lower ranks who may have less experience and less education than their elders. Besides overpriced insurance, soldiers have been sold overpriced jewelry, and investments that paid the salesman a 50% commission in the first year. Being victimized isn’t confined to the young and the old, there have been reports of financial advisors who took a fee from their clients, then placed the clients’ money in questionable funds that paid a commission to the advisor . The practice of placing a client’s money in investments that profit the company, not the client, has been tied to some of the biggest names in the industry, and represents a substantial portion of the corporate income. It seems likely that every occupation has some technique for maximizing profit, and at least some of them would qualify as cheats.

The National Association of Consumer Advocates has this to say:” United States military personnel are a set of consumers often targeted for consumer scams. Service member’s unique characteristics - a guaranteed paycheck, income that can be easily ascertained by rank, their more transient lifestyle due to multiple deployments and base relocations, and their directive to comply with authority – make service members more susceptible to predatory lending and fraud.”

On November 11th, Veteran’s Day, Mitt Romney spent some time in South Carolina, talking to veterans. According to the New York Times, when some of the men complained about getting Veteran’s Administration benefits, Mr. Romney said: “When you work in the private sector and you have a competitor, you know if you don’t treat this customer right, they’re going to leave me and go somewhere else, so I’d better treat them right,” ... “Whereas if you’re the government, they know there’s nowhere else you guys can go. You’re stuck.”

He added, “Sometimes you wonder if there would be some way to introduce some kind of private sector competition, somebody else who could come in and say, you know, each soldier gets X thousands of dollars attributed to them, and then they can choose whether they want to go with the government’s system or a private system.”

Mr. Romney would like to replace the VA with a payment voucher, the same sort of system that his party has endorsed in the Paul Ryan budget, replacing Medicare with vouchers. He is preparing to turn these veterans, who have served our country loyally, to the tender mercies of a corporate system that competes for short term profits, that has learned the secrets of hidden fees and fine print. Government is big, and bureaucrats may be impersonal, but they’re not motivated by greed. It’s only in the private sector that we have personal indifference and organizational avarice.