Heck of a rant on abortion: "If I ... shoot me"

After this I didn't need an afternoon nap. Thank you, Katha Pollitt, writing in the Nov. 30 issue of The Nation! Still, as a man, I'm concerned at the list of routine man things that she finds comparable to abortion. Well, it is a rant.

Reminds me of the lead essay by Jeffrey Toobin in the Nov. 23 New Yorker, which opens with news that when our Founding Fathers wrote the Constitution, why, abortion was "legal and commonplace." Take that, you originalists who want to go back to the early days of the Republic.

Too much

I made the mistake of clicking on the Flickr link to the White House photostream. Too much. On p. 2 we learn that the Oval Office has a deputy director of operations. He's shown holding the door open for the president. Too much.

Keep guns from terror suspects: A petition to sign

In the Issues Committee of our county Democratic Party we're proposing measures to keep assault weapons off our streets. I'm all for it. So I was pleased to see in my email inbox this petition drive on another aspect of the gun craziness that afflicts our country.

Check out the petition at http://www.closetheterrorgap.org/. I'd say it makes sense. The terrible slaughter at Fort Hood, as we're coming to see, was foretold repeatedly. And the suspect was a suspect before he got fully armed. How is this possible?

Further thoughts on this very disturbing event:

• I don't see the Fort Hood shooter as a deranged madman. He was entirely too rational -- but only in the sense that he was following the rationale of a rigid ideologue whose twisted theology demanded murder to avenge the deaths of his fellow Muslims.
• We need, in addition to strict gun laws, to ban hate speech. Yes, our beloved First Amendment needs to be brought up to date. Tell me the benefit we derive from letting anti-Semitic Nazis call for a new Holocaust. Tell me the benefit of letting Muslim preachers in our midst call for jihad against the World Trade Center. 
• I have lived in countries where that kind of speech or publication is strictly illegal. They are democracies with plenty of civil liberties. But they recognize danger to society as a whole in letting citizens call for murder of whole groups. This is true in Israel. It's true in Germany. It's true in other countries. They have judges and courts to make the close calls as to what's over the line.
• Spare me the inanity of that old chestnut that says: I hate what you're saying but I'll give my life for your right to say it. Not I! Free speech means something else to me. It stops well short of hate speech and incitement to murder.
  

Think about it. Meanwhile, check out that petition, which is also available at Mayors Against Illegal Guns. I believe I counted 35 Florida mayors as sponsors of that nationwide group including quite a few in Miami-Dade County and several members of our Democratic Executive Committee.

UPDATE: This also is featured above the banner on Daily Kos Wednesday morning. Let's roll with this!

Miami bloggers, some anonymously, get together

We weren't all there. One of the best of the Miami bloggers, South Florida Daily Blog, declared himself a family man with other obligations on Saturday afternoon, and was absent. Somehow his family obligations apparently included a tremendous amount of work putting up videos on Glenn Beck's crazy appearance in Central Florida. Well, that was up on Sunday. Anyway, otherwise it was a diverse, chatty, sometimes shy group that came together in a blogup that hadn't happened for a couple years.

Who was shy? One was Eye on Miami, who cherishes anonymity to keep doing a great job of investigating. Eye also was chatty. Nice to meet you, Eye. You won't see Eye, except for a name tag, in this exemplar of my usual crude videos:



Others in the video were the MiamiBeach411 couple, Gus and Michelle, Carlos Miller of fearless defense of the First Amendment, the very tall Michael Froomkin of discourse.net, Annette Peikert of SoulofMiami.org and lifeisartfest.org, our Twitter friend Maria de los Angeles of Sex and the Beach, and about 30 others whose cards I didn't get. If I get a list I'll certainly update with it.

UPDATE: Shame on me for leaving out Mustang Bobby, who's Bark Bark Woof Woof in the blogosphere, And we drive the same kinda car.

More to come, I'm sure.

FL-18 Ros-Lehtinen: Saving the Atlantic and its fisheries is “unacceptable”

Talk about short-sighted. And this is my member of Congress, Ileana Ros-Lehtinen, R-FL-18. As always, except for her very reluctant vote in favor of expanding children’s health insurance after numerous votes against it, she is on the wrong side of an issue. O woe, she bleats in the US House. If they impose these rules limiting fishing for grouper, her constituent in the Florida Keys will have to give up his charter fishing business. Exactly. Her constituent has been over-fishing since he was able to start an outboard motor, and it’s got to stop.

I don’t see that this foolishness has made it into the Miami Herald, so thanks to Keys newspapers  for bringing up Ros-Lehtinen’s willful neglect of the world we live in. She prefers the narrow interests of a few of her constituents to maintenance of the food chain we all inhabit. Check out the story linked above. She says it’s “unacceptable” for rules against over-fishing to drive commercial fishermen away from their boats. Well, that’s how she’s quoted, and it sounds like her.

Here’s a different analysis, from the Dec. 3 issue of the New York Review of Books, a review by John Terborgh, a Duke professor whose passion is preservation of the tropical world. Sorry to report that his trenchant article is available only to subscribers. He laments the failure of (no less than) modern democracy to protect natural resources.

“This is because both the regulators and the regulated are inextricably linked as each side pursues its self-interest. Fishers, many of whom are paying mortages on expensive boats and gear, fear a loss of income if limits are imposed. Staying afloat financially in the present takes priority over prospects of a more bountiful future. Thus, the industry reflexively resists any imposition of limits and makes sure the politicians understand this priority. In turn, the politicians fear losing their seats if their constituents rise up in wrath against them. The upshot is that the resource loses nearly every time.”

Did we all get that? “The upshot is that the resource loses nearly every time.”

The overall message of Terborg’s article is that the world is in overshoot in practically all areas. Too bad we don’t have wiser representatives in Washington than Ros-Lehtinen.

There are meetings soon of the South Atlantic Fishery Management Council to consider these rules on over-fishing. There still may be time for you to send in a public comment. Don't forget to send a note to Ros-Lehtinen.
 .

So fine this evening

A corner of Biscayne Bay where Miami Beach meets Surfside.

Daily Kos speculates on Crist turning Democrat

With tongue perhaps in cheek, the mighty Kos blogged yesterday that Charlie Crist might as well switch to the Democratic Party in his quest for a seat in the US Senate.

Almost more interesting to me was the Daily Kos polling on the opinions behind the Republicans who favor the outgoing governor Crist or the former Florida House speaker, Marco Rubio, to be nominee for Senate. Turns out – surprise! – a lot of Rubio’s backers don’t think Barack Obama is a US citizen. That has been a quiet front lately. But the birthers are still lurking around the corner from all our polling places, and Rubio bids to be the one to set them loose.  What a strange state we inhabit. We can be certain that the nation and the world will be watching Florida closely through the 2012 election. We started this in 2000.

ASIDE: My first shot at posting this news of the Kos poll didn’t quite come off. It may be nuts for a blogger to confess this, but I was not even to the state of blogging while wearing pajamas at my computer; I was flat in bed browsing news through Google Reader on my iPhone, and tried to post with an email to the magic Blogger address that makes it all happen. But NOW I’m blogging while wearing pajamas at my computer …

For the record, all that was posted on the first attempt was this URL which sort of takes one on a loop to Google Reader and not much further into knowledge of the wider world.

http://www.google.com/reader/i/#stream/user%2F14525197483831170873%2Fstate%2Fcom.google%2Freading-list

The better way to fix health care. Essay by Santiago Leon

The health bill may be revealed in the Senate later today, which is appropriate for your blogger, who had a minor health issue that kept him away from the keyboard for a week. Namely hernia repair surgery. Thanks, Dan, for offering to do it with swizzle stix. Rough enough with proper instruments.


To commemorate my return to action, I asked my personal expert on health insurance, Santiago Leon, for one of his best essays on health. Sandy is head of the Democratic Party’s issues committee in Miami-Dade, and his profession is selling health insurance plans. As a Democrat passionate about health reform, he’s working to put himself out of business. Remarkable!

The following may seem dated since it refers to a June publication. But as we get closer to the red zone, shall we still try to get the legislation right? Yes, and here’s what he has to say:

By Santiago Leon

On June 8, the New York Times published an article entitled "Health Care Spending Disparities Stir a Fight," by Robert Pear. In the article, the writer describes an epiphany experienced by President Obama and the controversy he has provoked by sharing this newfound insight and demanding that something be done about it. Here is the gist of the insight:

Dr. Elliott S. Fisher, one of the Dartmouth researchers, diagnosed the problem this way: “Medicare beneficiaries in higher spending regions are hospitalized more frequently, are referred to specialists more often and have a much smaller proportion of their visits to primary care physicians.”

In his blog last month, Mr. Orszag wrote, “The higher-cost areas and hospitals don’t generate better outcomes than the lower-cost ones.”

This insight is important because it may explain as much as 30% of America's inflated health care costs.
The Times article has special relevance for Miami, which, as the highest-cost area in the country for the Medicare program, plays a starring role in the story. Moreover, in Miami, the problem of over-treatment does not affect only the elderly. Miami is also one of the highest-cost areas in the nation for private health insurance.


To its credit, the Miami Herald has published various articles making reference to the Dartmouth findings -- most recently on the soaring local rate of Caesarean deliveries. Unfortunately, the response, if any, has been muted. Have local employers, who are paying for Miami's medical extravagance in their insurance premiums, blown the whistle on over-treatment? Have our two largest employers, Miami-Dade County and the School Board, reacted to the current revenue crisis by looking under the hood at what is driving their health care costs? Have the academic leaders of the local programs that train health care professionals shared the Dartmouth findings with their students and urged them to take action on them? It does not seem so -- but, when you think about it, that should not surprise us.

Health care looms large in the Miami economy, and generates vast wealth and much employment. Think of an institution that might focus concern about the excesses of the system, and then think of where its leadership or revenues come from. Hospitals, pharmaceutical companies and other suppliers to the industry, insurers, diagnostic facilities and their owners and executives, as well as physicians and other providers of health care, are major beneficiaries of the excesses of the system. In turn, they are major benefactors of political candidates, universities, the media, employer associations and civic and charitable organizations. In a sense, those who perpetuate the culture of medical excess are indeed local heroes: medical overtreatment, while we may suffer from it, is also a major profit center for our community, pulling billions of dollars into the local economy- probably more billions than even Medicare fraud. It appears that so much money runs through the local health care system that it anesthetizes the doubts of all who might question the way it accumulates.


According to the Times story, not everyone in Washington is buying in on the Dartmouth observations. John Kerry is doughtily defending the teaching hospitals of Massachusetts, and Bill Nelson is defending the Medicare mills of Florida. However, even if Washington is eventually able to agree on the problem, the solution will not be easy. The problem is deeply rooted in the incentive structure of American health care.


Today, most health care is provided under fee-for-service contracts. This is a problem. Piecework may work reasonably well for sewing shirts, but it definitely does not work well in a situation where the same person bills you for telling you what services you need and then bills you for providing them. The financial incentive for the provider is obviously to decide that you need a lot of services. Reducing the price of the services is not a solution- the provider will simply bill for more complicated services or increase the frequency with which they are provided. Having someone looking over the provider's shoulder is also not effective -- a health care provider worth his (her ) salt can always come up with a good reason why a patient should have a particular service. Clearly, then, the solution is to change the incentive system. For example, one way that has been tried is to pay the provider a certain amount, per assigned patient per month, whether the provider treats the patient or not. Problem: under such a system, the financial incentive is to provide as little treatment as possible.


Lest we all simply give up, it needs to be understood that there is an answer to this problem. Moreover, it is not a theoretical solution or a scheme that works in some other country but might never work here. Rather, we are talking about a home-grown, American system which has been used for decades by American institutions like the Kaiser Permanente health plan, the Veterans Health Administration, the Mayo Clinic and the Geisinger Health System -- all of which are recognized for providing high-quality, cost-effective care. How they achieve that result is no secret. Rather, the system that has been demonstrated to work in all these organizations is simply this: pull together, under one clinical and financial roof, as many as possible of the people and institutions that provide the health care services we need, including physicians, hospitals, clinical laboratories, diagnostic facilities, pharmacies and other providers of health care. In all the programs mentioned, the organization is non-profit or governmental. The individual health care providers are on salary and are working as part of a team which, as a team, is accountable for both quality and cost. The incentives to over-treat or to skimp on care are absent because there is no profit in doing so for the organization as a whole or for any individual in the system.


Simple and effective as the solution is, to create the kind of health care system we need, in order to improve quality and reduce cost, is politically challenging. As Americans, we tend to have a deep and abiding belief in the private market: a practically religious conviction that, whatever the actual results, competition at every level must lead to the optimum result: on the other hand, we also believe in teamwork, and there is no reason that there could not be more than one integrated health care system in any community of a certain size.

Implementation of a new health care system will require a major change in attitude among providers (many of whom are quite comfortable with the present entrepreneurial system) and also among consumers (who like the idea of being able to see the provider they want, when they want). However, if the incentives are properly set up, it should be possible over a period of time to move in the right direction.


My prediction is that health care in Miami will change, as it must; however, we may be among the last to board the train.

Miami Beach election time brings out blogger's doubts

We’re in the middle of an election on Miami Beach right now -- runoff time over two seats on the city commission.  In the first round, on general election day Nov. 3, Mayor Matti Bower was re-elected easily, as was Group 1 Commissioner Jerry Libbin. In runoffs are Group 2 candidates Jorge Exposito and Maria Mayer and Group 3 candidates Michael Gongora and Gabrielle Redfern. Runoff day will be Nov. 17.  Those, like me, who registered for absentee ballots should get them in the mail soon.

Your blogger’s only preference is in Group 3, where I know Gabrielle Redfern from Democratic Party meetings, and both of us are on the county Bicycle and Pedestrian Advisory Committee. She’s a smart and effective advocate for interests of the ordinary folk. This is a severely under-represented group that needs someone like Redfern, with her heart in the right place and wide-ranging experience in public affairs.

The point of this post, however, is more to ask why anyone wants this sort of work. I’m drawing on two fresh sources here, so I’m calling this a rounded look at city government on Miami Beach.

The sources, and their grim views of the Beach, are:

·         Gerald Posner’s new book “Miami Babylon,” a chronicle starting in 1980 into crime, drugs, corruption and elections mostly on Miami Beach, though the mainland is a big, bad player too.

·         Victor Diaz, now leaving office after a year as an appointed Miami Beach city commissioner for Group 3 until the current election decides a successor to Richard Steinberg, who was elected in 2008 to the state House of Representatives. Diaz spoke to the Tuesday Morning Breakfast Club on Oct. 27 and implied that money was too big a factor in how city commissioners vote. TaDA! Is that the definition of corruption, or what?

I have only my sketchy notes of Diaz’s talk, and he didn’t name names, so he leaves more of an impression than an indictment. Leave that to Posner’s book.

Before going further, some Miami Beach numbers. Population about 90,000. Registered voters 46,178, of whom only 7,374 voted on Nov. 3. That’s a pitiful turnout of 16%. Still, 16% is important. It’s the share of health care in our national economy, and we know what a big deal that is. Candidates don’t have to send their expensive brochures to every registered voter – only to the ones who always vote.

Last time we had municipal elections, in 2007, the candidates together spent $130.55 per vote cast. A shocking big number, it comes from $1,301,763 reported spent by the candidates, and 9,871 voters.

Our nonpartisan municipal elections are always held in the odd-numbered years so no national or state issues draw out large crowds of voters. Why’s that?

Diaz complained that the commission indulges in “prepackaged” discussion, and he suspected that too many votes were cast at the behest of a lobbyist who had been the commissioner’s campaign consultant.

In the Q-A after Diaz’s talk, I asked about the role of money. He agreed with my drift that money was a big part of our problem and suggested we need a citizens’ PAC for good government and a grass-roots movement to transform city government.

 One of the most pernicious impacts of political money came from the so-called electioneering campaign organizations that send objectionable accusations to voters, Diaz said. The organizations’ filings aren’t due until after the election, so interest vanishes by the time someone could dig out who was behind the vile charges. After last week’s voting, dismissed candidate Sherry Roberts sent out an email saying she couldn’t endorse either of the two who finished ahead of her in Group 2, Jorge Exposito and Maria Mayer, because of such mailers with dubious sourcing and allegations. I’m hereby nominating Sherry Roberts for a big role in that good-government PAC suggested by Diaz.

Diaz said candidates have to be pressed on who’s behind these groups, usually described as shadowy in the media.

Now to Posner’s book, “Miami Babylon,  Crime, Wealth, and Power – a Dispatch from the Beach.” People packed into the furniture store behind Books and Books on Lincoln Road for the author’s talk and signing. In the crowd were a lot of Beach politicians including Mayor Matti Bower and ex-convict former Mayor Alex Daoud – my notes say Posner called him “charismatic but corrupt.”  Daoud got a speaking role in the Q-and-A portion, declaring to Posner, “I don’t give a damn about the criticism. I’ll throw a party for you anytime.”

Some had promised to throw parties for Posner but backed out when they read the book. Posner didn’t seem to think the book was too tough, saying, “Nobody’s going to jail because of this book, and that’s all right.”

But, Posner said, Daoud’s book, “Sins of South Beach,” published in 2006 after he finished his jail time, should have resulted in more prosecutions, because Daoud fingered former Mayor Harold Rosen as having paid bribes to Daoud.

In Posner’s book he puts it this way: “The most surprising thing about Daoud’s disclosure is that it caused no fallout at all. Not a single television or radio news program mentioned it. The Miami Herald assigned a reporter and photographer to interview Daoud and then killed the story.”

The excuse could be that Daoud’s book gives off an aura of unreliability. He prints page after page of old conversations in direct quotes. I never was able to finish the book, though paging through it now I see I missed the hot spots where he gets graphic about the sexual aspect of corruption.

Here are links to two Miami Herald stories on Posner’s book, one before the author’s talk, and the other reporting on that talk.  Note that neither one mentions Posner’s explicit criticism of the city’s flagship newspaper and its role in condoning some corrupt behavior. It must be said on behalf of the Herald that it does some important investigative work exposing corruption, though most of that involves Miami. And Posner used the Herald as source for a lot of his material.

 Miami Beach, Posner speculated, may escape closer attention because its happenings are treated like “neighborhood” stories for the twice-weekly Neighbors section of the Herald. Strange, considering that much of the outside world thinks Miami Beach IS Miami.

One of the good guys of Posner’s book is Frank Del Vecchio, who retired to Miami Beach with wide experience in municipal affairs in Boston and Washington DC and then became the most prominent watchdog of Miami Beach government. Del  Veccio finds it to be part of a badly flawed system in Miami-Dade County. Posner quotes him saying “public/private partnerships in Miami Dade are totally crooked. It is the most corrupt government, at almost every planning and implementation stage, I ever encountered.”

That’s a powerful criticism. And it’s in the air we breathe, apparently. “In Miami, there is no agency tradition, no fear of oversight by another body, and no judicial system that has real peer review standards,” Posner quotes Del Vecchio saying. “Instead, the dominant political constituency, Cuban, is bound by loyalty, not ethics. Even the corrupt politicians up north knew they had to deliver to the communities they served, or they would be out of office. Here, the political interests are not to serve the public good. It’s just all short-term thinking to help themselves. In Miami, the ingrained politicians have more control than the old ward bosses of the Northeast because here they control the banks and own the land. There are no checks and balances.”

One can only wish the best to any honest person who dares run against this environment.

And let’s not forget we’re part of Florida, where Ponzi schemers like Scott Rothstein are big political donors.  Check out the Herald’s latest story on him, In which Gov. Charlie Crist is bold enough to joke that something is going to cost Rothstein “another $100,000.” Brazen is the word for it.

PS: For more on Posner's appearance at Books and Books, go to Youtube.com and search for Miami Babylon. Someone put up a three-part video on the event.

Here's my little video on it:

Super crowd for DJ le Spam

And familiar faces from VoteFest a cool year ago. Nice to see Dave and Dara!

Red Bull going down by the pickup load, people taking on fuel for the whole night.

That concert earlier at the Lincoln Theater was superb. The overall title was "New York State of Mind: Sounds of the Times." Especially powerful was "Gotham," a composition by Michael Gordon, and a film, mostly historical images of New York, by Bill Morrison. The combination was deeply moving without ever being obvious, and our vaunted "orchestral academy" was excellent.

These guys are great!

But I'm heading five blocks up Collins Ave to see DJ le Spam and the
All Stars. Midnight now and the crowds and traffic are heavy and happy.

Sleepless Night gets started on Lincoln Rd

Next for me is a concert by New World Symphony.

Haiti in Miami Beach -- party time at Tap Tap

The Haitian restaurant Tap Tap is a gem in South Beach, and a resource for Democratic campaigners -- not only during the Obama campaign but continuing. A good place to have a little meeting or bigger ones. And Friday night it was party time for the restaurant's 15th birthday, coinciding roughly with the big Haitian holidays of Brav Gede -- corresponding to All Souls Day and All Saints Day, if I got it right. If not, try me again anytime. Wow, was the music loud and good! For that we thank Manno Charlemagne and the band, and for the party thanks to Gary the boss.

Take the stairs!

My next car. Just decided.