Strong suggestion for Democrats

I have a strong suggestion for Democrats who are not happy with the Roe v Wade verdict, watered down gun governance and restrictions on civil rights and are fearful of climate change inaction, environmental degradation and health care attacks, they need to vote. Know the rules that have been altered to keep you from voting and get out and vote. You could throw a few million people marches to get their attention as well.

There is a canary in the coal mine that is saying more voters are switching to the GOP (I read 1+ million), including the suburban educated women voters. To me, this tells me that people are listening to messaging coming out of more conservative channels that rakes Dems over the coals. I am not saying that messaging is correct, but people are listening to it.

Dems better crystalize key talking points that will appeal to all Americans and hammer them home. If they appeal to only progressive Dems, they will need to look up what happened to George McGovern in 1972. Watergate was in part related to Nixon wanting to run against McGovern and not Edmund Muskie. He knew he could beat McGovern but knew Muskie would be a tougher challenge. He ran against McGovern and won 49 states to 1.

Note, I am not saying progressive ideas are not good, but they need to be ideas that are saleable to all Americans and not offensive because of poor word choice. For example, “Defund the police” may have not meant exactly what it said, but the term was a gift to Republicans. My old party is bereft of good ideas in my view which is one reason conservative pundit Michael Gerson says the GOP is in “decay.” But, the GOP spin doctors do a better job, aided and abetted by Fox News, QAnon, and Infowars, et al, to focus on over-exaggerated issues where a label can be slapped on it and a bumper sticker created.

And, Dems please note, they are winning at this and expect to take the House and Senate majority. I have said before we need a viable Republican party, but this is not it. The best way to rid the country of this extreme party is not to vote for them.

It is better we found out now

A friend told me that regardless of the seditious actions and Big Lie of the former president, that even his better educated relatives and friends who voted for Donald J. Trump will do so again. As unbelievable as this sounds, too many think this way. Here was a note I forwarded to him that he could feel free to share.

As an independent and former Republican and Democrat, I understood why some voted for Trump in 2016, as his opponent, although very experienced and skilled, rubbed too many the wrong way. She was one of the most capable candidates that has ever run, yet Trump’s success was getting people not to vote at all or for one of the other three candidates due to her past.

After watching him for four years, I cannot believe people voted for him again as what I saw was overt deceitful and bullying actions and as a conservative pundit David Brooks said a White House that was “equal parts chaos and incompetence.” His bungling of the pandemic response lingered after he left office and endangered too many. Yet, his fans just ignored all the bad press as biased and voted for him again. Yet, seeing the Big Lie and instigation of the insurrection on a branch of government is seditious action and he and his allies should be held to account. It is traitorous behavior. Full stop.

The question is not could Donald Trump win again – he could as we are not a very informed nation on the whole. The question is he should not be allowed to run again because he betrayed his country, as president. We are more divided as a nation because a person with a shallow ego is not man (or adult) enough to admit he lost the election. He can spin this all he wants, but he has lost all but one out of 65 or so court cases and every recount, audit and review. He cannot lose any more than he has. His niece said he will burn it all down to avoid losing the election – it is our democracy he is burning down.

Presidential historians have ranked him the 5th worst president in the US primarily due to his botching the pandemic and the insurrection and Big Lie. Yet, what little success he had is overstated as he inherited an economy that was in its 91st consecutive month of economic growth, with a more than doubled stock market and six straight years of  2+ million per annum job growth. Saying Trump did great with the economy is also saying Barack Obama did as well, which Republicans are loathe to do. Yet, Trump left us with a recession and Obama inherited a recession from his predecessor.

Sorry for the soapbox. Please feel free to route this as you see fit.

Try building your cars in the US said a former president in 2017 (a reprise)

The following is a reprise of an earlier post. Too often, when we focus on the last previous president, we focus on his modus operandi of lying, bullying, and denigrating others. Some followers even discount these saying “he is just rough around the edges.” These personality traits mask that he is not the best of representatives of the United States as he chooses not to know things and is not the best of managers of those who do. This true story is a good example of such.

During his visit to Japan, the US President came upon a sudden revelation. Trump said “try building your cars in the United States instead of shipping them over.” What a great idea! The nice part is Japan automakers are already building cars in Tennessee (Nissan), Ohio (Honda) and Kentucky (Toyota). Last time I checked, those three states are part of the US.

What sometimes gets lost in his bluster, demonization and excessive tweeting is a man who is not steeped in history, geography or current events. Nor, as folks who work with him have said, does he shows much interest in learning or doing homework to make himself more aware. So, we must live with John Belushi’s less-studious character in the movie “Animal House,” when he spoke of the “Germans bombing Pearl Harbor,” as our President.

How should Japan Prime Minister Shinzo Abe react to such an uninformed statement by our President? I wonder if he looked at an adviser and nonverbally conveyed “really?” Does the US President know BMWs are made in South Carolina, Volkswagens are made in Tennessee and Mercedes and Hyundais are made in Alabama, e.g.?

When we talk about global trade and jobs, we cannot overlook what these foreign companies and many others are doing here. They are employing American workers. The focus tends to look only at jobs lost and not jobs gained by global trade. That inappropriately simplifies the issue and leads to wrong conclusions.

Global trade increases the economic pie, especially when the global needs are nurtured. That is a key premise of the Nash Equilibrium which won a Nobel Prize for its creator John Nash. Yes, we need to be mindful of jobs lost and provide restorative action. This could range from retraining to recruiting new businesses or looking for trade-offs. The same strategy holds true with the more significant culprit in job loss, technology advances.

Initially, I thought the now President was over-simplifying things to sell his messiah-like message. Only I can solve your problems, believe me, he has said in numbers of ways. As award winning author Thomas Friedman said about the President, “He has no second paragraph.” The sad truth is the President has no second paragraph because he may not know what comes next.

A President does not need to know everything – no person could possibly fulfill that mission. But, we must have one that knows more things than this one does and who does not lie or bluff when he does not. And, if he does not know, he need not be afraid of learning.

It is an uphill climb

The following summary comes from a man in his seventies who has leaned Democrat most of his life. He is a retired, successful businessman who lives in a metropolitan region of North Carolina called the Piedmont Triad. He is lamenting the kinds of conversations he has with old friends who lean to the conservative side.

“Unfortunately, I banter almost daily with three guys (separately ) who are very conservative, watch Fox News primarily ( including Tucker ) , read EPOCH Times , NY Post , you get the idea . Their ages are 65-88 and two are UNC grads while the other was UGA . All voted for Trump twice and would again because they agree with his principles ( ??? ) though might not like his ‘style’. I’m trying my damndest to understand them and budge them from some of their positions.

I believe each of these gentlemen, successful in business and with strong church and family ties, believes America’s Left’s infatuation with Socialism, PC , CRT , diversity , reverse discrimination, softness on crime, disregard for the Second Amendment, gay marriages , secularism, trans-genders, open boarders ( that’s usually how they spell it ) and voting rights for illegals is all undermining the basis of our Republic. They believe all that from the vote of their being . And they send ‘intellectual ‘ videos from Hillsdale and Prager and elsewhere to defend their position . While excusing Jan. 6’s actions ( what insurrection ? ) and Trump’s role and glee while his minions scared the crap out of Congress people , Left AND Right .

In addition, they believe 2020 was RIGGED, swear by 2000 Mules , put up with Gaetz and Greene by declaring the greater threat to our democracy is from the Left . They say the Rightist militias like Proud Boys are a non-factor .

One of these guys, a long-time acquaintance, owner of 65 McDonald’s at one time, is fond of telling me that we are ‘wired differently,’ that all liberals are wired differently meaning wired wrong . No doubt on his mind ‘we are losing our country’ and it’s due to the Socialist liberals. They all three love to point to Cuba and Venezuela as examples of failed Socialistic governmental policies. As if such comparisons make any sense .

These folks are committed and are seemingly in a strong position to make big gains mid-terms. Plus they have a stable of ‘good’ candidates for President if Trump will allow it.”

I sent the following return email (the quoted piece below) and told him he could forward it on if he liked. As an independent and former member of both parties, mostly Republican, I thought it might carry more weight. Probably not, but it is worth a try.

“A place to start is posing a few questions:

– do they know our economy is a blend of fettered capitalism (bankruptcy protection, insider trading laws, interlocking boards, etc.) and socialism (Social Security, Medicare, Unemployment, Medicaid, Workers Comp)? The key is what is the right balance?

– do they know that the economy, stock market, GDP growth and job increases have done much better under Democrat White House’s?

– do they know Trump was handed the reins on an economy that was in its 91st consecutive month of growth, a more than doubled stock market and six straight years of 2 million plus job increases?

– do they know Trump planned to contest the election by hiring 1,000 attorneys up to two months before the election and still lost all but one of about 65 court cases and every recount, review and audit?

These are questions posed by an independent and former Republican and Democrat voter. They may want to answer why Michael Gerson, one of my favorite conservative pundits has said the “Republican party is in decay.” We need a viable GOP, but vilifying the truth tellers and glorifying the liars is not the path forward.

These are just a few thoughts. By the way, most Democrats are not socialists. They just want people to have a fair deal.” 

It is an uphill climb. But, if we don’t get people to listen and discuss their points of view, then convincing them their positions are not well-founded will be difficult. It should be noted, neither party has all of the good ideas and both parties have some bad ones. The key problem is I get argue policies with more progressive people than me, while I must argue the truth with the current version of Republicans. We need a viable conservative voice in this country, but the current GOP is not it. That speaks volumes.

Chile water crisis should serve as a warning

In an article called “‘Consequences will be dire’: Chile’s water crisis is reaching breaking point” by John Bartlett as reported in The Guardian, a long-lasting drought and water misuse have led to an alarming problem. The sad truth is the water crisis in Chile is not an isolated event. The following select paragraphs tell an important story. The full article can be linked to below.

Unprecedented drought makes water a national security issue as more than half of Chile’s 19 million population lived in area with ‘severe water scarcity’ by end of 2021.

From the Atacama Desert to Patagonia, a 13-year megadrought is straining Chile’s freshwater resources to breaking point.

By the end of 2021, the fourth driest year on record, more than half of Chile’s 19 million population lived in an area suffering from ‘severe water scarcity’, and in April an unprecedented water rationing plan was announced for the capital, Santiago.

In hundreds of rural communities in the centre and north of the country, Chileans are forced to rely on emergency tankers to deliver drinking water.

Ecuadorian natives clash with the police 30km from Quito in 2010 in protest of a proposed water privatisation measure.

‘Water has become a national security issue – it’s that serious,’ said Pablo García-Chevesich, a Chilean hydrologist working at the University of Arizona. ‘It’s the biggest problem facing the country economically, socially and environmentally. If we don’t solve this, then water will be the cause of the next uprising.’……

‘I used to supply all of the markets and communities in the area,’ said Alfonso Ortíz, 73, a farmer who once employed several workers to grow watermelons, pumpkins, corn and oranges using water from the lagoon.

‘Agriculture here is dead. There’s nothing left,’ he said.

Chile’s economy, South America’s largest by per-capita GDP, is built on water-intensive, extractivist industries principally mining, forestry and agriculture.

But its growth has come at a price.

Supported by the private rights system, about 59% of the country’s water resources are dedicated to forestry, despite it making up just 3% of Chile’s GDP.

Another 37% is destined for the agricultural sector, meaning only 2% of Chile’s water is set aside for human consumption.”

Re-read that last sentence. “2% of Chile’s water is set for human consumption.” While this is an extreme example it is not isolated. Going on for several years now, the number one long term crisis facing us as surveyed by the World Economic Forum is the global water crisis. Climate change impact was second as it actually makes the first problem worse.

For those that think it cannot happen here, farmers in the plains of the US are worried about water. There is a great book called “Rancher, Farmer, Fisherman” by Miriam Horn that shares these concerns. There is one town in Texas that is now dry because of fracking and drought. Other water supplies are getting more dear and fights over river and reservoir access have been going on. The Biscayne aquifer that provides water to Miami is being encroached on by rising sea levels coming through the porous limestone. And, that is before the issue of lead pipes comes into the equation.

What troubles me greatly is the lack of public debate over this concern. Cape Town, South Africa was so bad off it had a countdown to no water. It survived, but just barely. Yet, not a peep was discussed here. We are to busy talking about contrived and exaggerated issues to deal with real crises. One would think not having water to drink or irrigate crops would be a concern. One would think that climate change causing water reservoirs to dry up faster and cause longer droughts and forest fires would be a concern.

Let me leave you with this thought. I heard a spokesperson from one of the largest US utilities speak on climate change impact. This utility had a long-range report that said two very disturbing things. First, they have increased their model for expected evaporation of reservoir water due to climate change by 11%. If the water level is too low, it cannot be converted into steam to turn the turbines to create power. So, they cut the water flow to people to make up for it, as they manage the river.

Second, these long-range projections noted the river will not be able to support the water needs of the metropolitan population in about fifty years unless something is done. This troubling projection has gotten very little coverage in our newspapers or TV news. This is more concerning to me than BS like critical race theory or replacement theory which are the contrived and exaggerated issues of the day.

Steven Solomon, author of “Water” created a term that has been used by at least one utility executive. “Water is the new oil.” If that does not scare you, note oil rich Saudi Arabia said it was OK to pray with sand rather than water. Why? They said Allah gave them a lot of oil, but little water.

https://www.theguardian.com/world/2022/jun/01/chiles-water-crisis-megadrought-reaching-breaking-point

Workers within industries that prop up fossil fuels said they could no longer ignore the climate crisis and they quit

In an article written by Anna First-Arai in The Guardian called “They once worked for big oil’s enablers. Now they refuse to be complicit,” fossil-fuel related workers are now voting with their feet. Here are the first few paragraphs with a link to the article below.

“More than a century ago, fossil fuel firms hardly needed help maintaining their image. Coal-powered trains, oil-burning power plants and gas-heated houses were likened to patriotism and social progress. But over time, especially as industry scientists began uncovering the direct link between the burning of fossil fuels and the climate crisis, America’s petroleum giants turned to the public relations industry they had helped create to persuade consumers to remain loyal.

PR campaigns that frame oil and gas as essential to solving the climate crisis have become the industry survival strategy. But over the past decade, the spinmasters behind these campaigns and the executives in industries that prop up fossil fuels have woken up to the role their work plays in contributing to climate breakdown.

Waves of employees have co-signed letters and quit en masse in response to their firms’ complicity in obfuscating climate crimes and rolling out aggressive greenwashing schemes. And the resignations are picking up pace. Just this week in a bombshell public resignation, Caroline Dennett, a consultant for Shell, parted ways with the company, citing its “double talk on climate”. She urged others to do the same.” 

This is article is worth the read. Maybe these kinds of resignations will get the attention of fossil fuel management. Shareholders have been more active voting to require management to be forthcoming on climate change plans and actions, but this will give them more ammunition to demand such action. A good question at a future shareholder meeting is “Help me understand why your employees are leaving en masse over your failure to address climate change?”

I have shared numerous articles about the positive movements forward on renewable energy and the need for more action. But, when a company’s own employees start walking out the door, that speaks volumes. I hope management is listening.

https://www.theguardian.com/environment/2022/may/27/big-oil-public-relations-defectors-climate-crisis

The real replacement practices

This concept of replacement theory where white workers are subject to a planned replacement by black and brown workers has been around for decades. In fact, the fascists in England were using this replacement theory in the early 1960s, of course, blaming Jews for its orchestration. In essence, the theory says white workers’ jobs are being systematically replaced by immigrants and those other people who don’t belong here. Sound familiar? Yet, this replacement theory well preceded the 1960s.

It is all subterfuge to create fear and blame others for your problems. Fear has been used to sell ideas and manipulate people for a long time. Overstating an inflammable cause is one way to do that. The fear of the other overlooks the deeper problems for loss of jobs and disenfranchisement. The key reasons for disenfranchisement are the actual replacement practices that we need to address. These are not some theory, but deployed routinely and recurringly in practice.

There are two key reasons, which impact all workers of all colors:

– technology improvements which reduce the number of workers needed, and

– CEOs chasing cheaper labor to lower the cost of production

The latter cause manifests itself in offshoring, outsourcing, or migration of factories. For example, the textile industry has left a trail of closed plants as the industry moved from England to the United States first in New England and then to southern states. Then in the 1980s, the heavy migration occurred to China and Mexico and eventually to Vietnam and Bangladesh searching for cheaper labor. One company that comes to mind went from 86,000 US employees in 1980 to about 4,000 today, with the rest abroad. That is not an isolated example and it is not just manufacturing work. It is call center, IT, analysis, etc. The US based insurance industry has been shipping claim forms for review to Ireland as the Irish were, on average, more literate than Americans, even before technology made it easier to get the Irish to review them.

The former cause has been occurring routinely as well, but has accelerated once again with the advancement in Artificial Intelligence (AI). Yet, a robot need not look like a humanoid to be effective. Computer driven machines and robotic appendages have evolved over time. I watched a “60 Minutes” episode about ten years ago, which demonstrated a programmable robotic machine that went for the price of a car to be used by small businesses. The tasks need not be complex to improve efficiency, so these cheaper machines could replace a half-dozen workers.

So, when you hear immigration is a problem, that does not address the main issues. Of course, the immigration system could be improved and opportunities to do so were not voted on after some agreement even by some of the most vocal critics. But, there are some industries and municipalities that need more workers. Those workers need to be trained or trainable, so some may come from abroad and some from here.

Where we need to focus our attention is working with new and old industries in transition and community colleges to train new workers. The coal industry has been on the demise for a dozen years, but some politicians have been clinging on to its protection. I have said several times, whether or not you like Senator Bernie Sanders, he was the only presidential candidate in 2016 to stand up in front of coal miners and tell them the truth – your jobs are going away, but here is what I plan to do about it.

In this vein, some towns are dilapidated by closed factories that moved. The forward thinking towns invested in bringing new workers from whereever they could. They developed initiatives to reinvest in the area using the brainpower of the new and old blood mixed together. They developed incentives to draw younger adults to their towns. And, it worked.

The issue of workers needing more opportunity and investment is where we need to focus our attention. This is a good example of a group of PR people coming up with an issue, blowing it way out of proportion as the problem, and putting it on a bumper sticker. “Build a wall” some might say as the panacea. Ironically, when the major proponent of that comment accepted a deal to get $25 billion for this wall in exchange for making DACA law, he was talked out of it. This was his number one issue, but he said no after saying yes. Why? He knew it would not solve the problems and his bluff had been called.

Our problems are complex and have multiple factors. One of the tenets of the book “Built to Last” by Thomas Friedman and Michael Mandelbaum is most of America’s major problems over time were solved in concert between some combination of government (federal, state and/ or local), venture capital, and private industry or philanthropy investment. We won’t solve our problems unless we identify them and their many causes. We won’t solve them by listening to opinion hosts and candidates who are trying to scare, who really don’t want to solve anything other than getting someone elected.

We will solve them by looking at the facts, coming up with a plan, getting buy-in and funding and making it happen. That is hard to put on a bumper sticker or define in a two-minute sound byte by an opinion host.

Offshore wind energy in North Carolina is taking shape

In an article by Adam Wagner of the Raleigh News and Observer called “Duke Energy among companies with winning bids for NC offshore wind energy,” North Carolina’s efforts to take advantage of its windy coast is taking shape. Per Wagner, “The Bureau of Ocean Energy Management’s 18 round auction netted $315 million for the wind energy areas, which are roughly 20 miles off the coast.”

The bids were won by two sets of companies, Duke Energy based in Charlotte and TotalEnergies Renewables USA. “‘Investments from two developers means an increased supply chain investment and recruitment, workforce development and thousands of good paying jobs and infrastructure development that will support other North Carolina industries,’ Katharine Kollins, president of the Southeastern Wind Coalition, said in a statement.”

The Duke Energy $155 million investment will help power 375,000 homes and help Duke meet its renewable energy goals. Most of its wind investments have previously been in Texas. TotalEnergies will produce electricity for roughly the same number of homes, as its investment was a little more than Duke’s. TotalEnergies has also won a bid for a lease just off the coast of New York and New Jersey.

The US has seen most of its wind energy on land in the plain states, with Texas leading the way and other states like Iowa, Minnesota, and Oklahoma following suit. The last statistic I checked said Iowa gets 43% of its electricity from wind. Texas is around 20%, but is a much larger state. I have referenced before deceased oil tycoon T. Boone Picken’s comment on “60 Minutes” about ten years ago when he said the future of energy in the US is in wind energy. Solar energy has taken off as well, but Pickens noted how windy the plain states and coast are.

Seeing this expansion off the coast of the US is exciting. Much of the offshore wind energy development has been in the North Sea off the shores of the Scandinavian countries and Great Britain. It is good to see this occurring in areas where it can help so many. NC has roughly 10 million people, so seeing investments that could power roughly 750,000 homes (doublnig the Duke share cited), reveals the size of the impact. Adding that NC is in the top five states in solar energy and our renewable energy future is even more promising.

Friday foibles and follies

On yet another Friday the 13th, be safe and be smart. And, watch out for black cats crossing in front of you. In the spirit of the day, let me offer a few foibles and follies for your contemplation.

Per our friend Scottie’s post, it always makes sense do your homework and be prepared for whatever comes your way. Please take about two minutes to watch the video of White House secretary’s Jen Psaki’s response to a reporter question on the claim of GOP support for Senator Rick Scott’s economic plan. Trust me, it is worth the watch. See below for the link to Scottie’s post.

I apologize for a little bit of morbid humor, but it is Friday the 13th. I once read the true story of man who is about my age now being diagnosed with prostate cancer. Being married for many years, he objected to the doctor’s insistent recommendation of a more invasive surgery that would leave him impotent. He said making love with his wife was the greatest joy in his life and he pursued other procedures. After being cured for twelve years and enjoying his love life, he read the doctor passed away. The man saw the obit and smiled that he had outlived his doctor, noting to his bride, the doctor makes whoopie no more.

There is another true story I read about an older New Jersey woman who refused to sell her coastal property to a famous developer who would later become a notorious former US president. The developer wanted her property as it was next the casino he wanted to build. To his chagrin, she denied every advance to buy her property, even the threat of lawsuit and he exhibited his famous temper. A few years later, as the casino went bankrupt, her property was still standing. And, she smiled that she had outlasted the investment.

In a news report following the housing crisis in 2007-08, one of the investment banks that went under was Bear Stearns. About a year before this occurred, a financial analyst got a meeting with the CFO of the organization as he wanted to forewarn them. The analyst saw the banks and finance companies selling mortgages to people who could “fog a mirror” as their only review. These mortgages were packaged together (called Collateralized Debt Obligations) and stamped as good risk and sold to investors by folks like Bear Stearns. The analyst told the CFO he had a model which showed Bear Stearns would go under as a result. The CFO thanked him and asked him to leave. The first fallacy was the CDOs being stamped as good risk as a lot of bad risk together does not make it good. The second fallacy is the Bear Stearns folks assumed the market would always go up, which is not a realistic assumption.

These stories may seem unrelated, but at the heart of them is to two underlying themes

– do your homework and be prepared

-if you know what you want and know the options, stand firm in your mission.

The Bear Stearns story is not an outlier as several entities either went under or had to merge during the Housing crisis. The movie called “The Big Short” based on Michael Lewis’ book and starring Christian Bale, Ryan Gosling, Brad Pitt, Steve Carell, et al, defines what happens when supposedly smart people don’t know what they are investing in. See link below to a summary of the movie.

https://en.wikipedia.org/wiki/The_Big_Short_(film)

Are US hospitals in trouble?

Many hospitals, especially more rural ones, have been in trouble for some time. More on the rural hospitals later.

“More than 33% of all hospitals are operating on negative margins, according to the American Hospital Association,” per Michael Popke of Benefits Pro in a piece called “America’s hospitals facing ‘massive growth in expenses’.” Here are two select paragraphs from the piece that tell the gist of the story.

“Hospital employment is down approximately 100,000 from pre-pandemic levels, while hospital labor expenses per patient through 2021 were more than 19% higher than pre-pandemic levels. A new report from the American Hospital Association highlights the financial and operational toll the pandemic and inflation has taken on hospitals — concluding that more than one-third are operating on negative margins.

‘Hospitals and health systems have been nimble in responding to surges in COVID-19 cases throughout the pandemic by expanding treatment capacity, hiring staff to meet demand, acquiring and maintaining adequate supplies and personal protective equipment to protect patients and staff, and ensuring that critical services and programs remain available to the patients and communities they serve,’ notes the nine-page report released this month. ‘However, these and other factors have led to billions of dollars in losses over the last two years for hospitals.’”

Per an article called “The South’s health care system is crumbling under Covid-19. Enter Tennessee” by Daniel Payne of Politico, the demise of heath care in more rural areas has been exacerbated by COVID-19.

“Rural hospital closures have been accelerating, with 181 since 2005 — and over half of those happening since 2015, according to data from the University of North Carolina. But that may be just the beginning. Over 450 rural hospitals are at risk of closure, according to an analysis by the Chartis Group, one of the nation’s largest independent health care advisory firms.”

The rural hospital concerns predate the advent of the Affordable Care Act. Too many hospitals had high percentages of indigent health care costs, meaning people without insurance. If they were not funded by a county, the hospital was at severe risk of closing. Since fourteen states have still not expanded Medicaid under the ACA, the opportunity for getting paid did not increase and many have closed. And, the patients, employees and communities suffer.

Yet, a major part of this cost dilemma existed before COVID-19. The US has the most expensive health care system in the world, but we rank around 38th in health care quality. That is a pretty poor rate of return on one’s spend. Hospitals spent too much on technologies that need to be used. There exists a correlation between the ownership of a technology and its higher frequency of use. Yet, with COVID-19 and its aftermath, fewer elective procedures and tests were done in hospitals.

These issues need to be evaluated outside of the political lens and with data. Yet, that is not bound to happen. It would at least be helpful to see more people covered with full Medicaid expansion, but that has been politicized for zero-sum game reasons, not to actually help people. It would be helpful to see Medicare expanded, at least down to age 62 from 65. As Medicare works reasonably well, I would like to see it go lower, but whatever we do, it should be evaluated on its results, not a politician’s beliefs.

If people think I am unfairly picking on politicians, it would not be a stretch to say most politicians do not know a whole lot about health care. We saw this with the atrocious “throw stuff against the wall” repeal and replace discussion in 2017 by the thirteen Republicans, which came within one vote from passing the Senate. That would have screwed about 20 million Americans. Senator John McCain gave it a thumbs down vote for its lack of veracity and its poor protocols on evaluation.

And, we saw it with the discussions and passing of the ACA, which Republicans refused to vote for which is strange since it has several Republican ideas in it from Romneycare in Massachusetts, when Mitt Romney was governor there. The ACA is not perfect, but at least we should fully implement it and shore up its deficiencies. It is only people’s lives.