Thursday, January 18, 2018

Appealing to the Base

Like it or not, Donald Trump’s base is deeply committed to this country, willing to work hard within their expectations and is built on a strong rural values of self-reliance and a belief in God. Most of these folks are decent, caring and law-abiding. They may have a vision of the United States that is out of step with modernity, but for most, their feelings are deep and their passion most legitimate. They are not comfortable with multi-ethnicity, with expressions of personal freedom that are at odds with their religious beliefs of their view of why America is so powerful, politically, militarily and economically. And to the extent they have been displaced, their economic promise slammed and their values challenged, they simply look at what has changed since they experienced comfort in their lives… and assess blame accordingly.

They were raised with the notion of an honest day’s wage for an honest day’s work. Since work was pretty much there – if nothing else, doing what your parents did – it did not matter what you did as long as you did it well. There was particular admiration for working with your hands, showing physical strength and/or agility, and the pride that goes with a job well done. That notion of post-WWII predictable sameness gave them comfort. The United States, pretty much unscathed by the ravages of WWII, was able to accomplish massive economic growth with virtually no competition from the rest of the world. Our wages were high, our work benefits generous and retirement predictably comfortable.

Then came global competition, and whether you can blame the economic inequality on trade agreements or simply the progression of mankind, those who had adjusted to a comfortable “permanence” were betrayed by reality. As automation crept forward, working with your hands was replaced with “brain” jobs, often requiring college degrees and beyond. Some folks just wanted to continue to work with their hands. While they might want their children to be better educated, there was an equally powerful and growing “anti-elitism” that challenged scientific methods and findings with “what we were raised with, what we know.”

Ethnic diversity, multi-culturalism were alien forces that just did not fit into any experience that a “meat and potatoes” lifetime could ever prepare them for. Questioning authority, the flag, the decisions of “wise” leaders, expressing “homosexuality” and alternative lifestyles – while experiencing layoffs, lower pay and uncertain futures – blended into one totally unacceptable mess that needed to be fixed. Threats to their companies – under the guise of environmental and financial regulation or coping with global warming despite the coldest winters they had every experience – were unfathomable, anti-religious and deeply unpatriotic. Change.

Higher education was challenged. Working with your hands re-glorified. Globalization was blamed for their ills. Regulation was taking their jobs away. Enter Donald Trump who promised them everything that they wanted, to bring back the America they knew… even though there wasn’t the slightest reality to his pledges. Despite his Ivy education, Donald spoke their language, expressed their anger and promised a future they wanted. He said what was on their minds, even if his words were not politically correct, even if they reflected a notion of white supremacy, which too many of his followers believed defined a successful United States.

To reach that base – most of whom do not have college degrees – Donald Trump became the master of communication to his core constituency. “President Donald Trump connects with the American people by using a language that even a fourth grader could understand, according to a recently published analysis by Factbase on the speech patterns of the last 15 U.S. presidents.

“The analysis looked at the first 30,000 words each president spoke in office and ranked each of the presidents' speech -- going back to Herbert Hoover -- using the Flesch-Kincaid grade level scale and several other tests that commonly analyze English-language difficulty levels.” AOL.com, January 9th.  

The above chart presents the grade-level of speech of each of our past 15 presidents. Speaking clearly in a way that most Americans can understand you is important… but Trump picked the fourth grade level? This may also explain why disdain for Donald Trump increases with educational levels. People with higher levels of expression feel talked down to, their education denigrated, which in turn makes those educated citizens feel singled out by Donald Trump as un-American.

It’s personal now, and unless you are scion of mega-rich business where you only care about your money, the more you are educated, the more you feel targeted by Trump and the worse you feel about him and his policies. So if it’s polarization you want, Trump does it not only in the policies he embraces, the racial preferences inherent in most everything he does, he also makes sure his words and speech patterns double down on his disdain for educated “elites.”

I’m Peter Dekom, and we have Trump-fired accelerating polarization, tearing this nation apart, at every level.

Wednesday, January 17, 2018

Was It Really a False Alarm?

On Saturday morning, January 13th, a Hawaii state cell phone alert texted a warning of an incoming ballistic missile across the entire state. It took the state 38 minutes to recall that notice as a false alarm. People had abandoned their cars, parents rushed to find their children, plans were cancelled and a mild panic ensued. It was a black eye for the governor, David Ige, oddly an engineer by training… and for the entire state. What that false alarm did do is remind us what we face in a very-much nuclearized North Korea that may well have nuclear warheads, no matter how much doubt Trump administration officials may cast, that are now capable of being delivered by existing-capacity ICBMs to virtually any part of the United States.

For those experts most familiar with North Korean politics in general, and Kim Jong-Un in particular, there is little doubt that absent force – which could trigger a nuclear war – the Democratic People’s Republic of Korea (DPRK – the official name for North Korea) will neither denuclearize nor stop its missile/nuclear weapons development program no matter the level of global sanctions imposed. As shown on CBS 60 Minutes on January 14th, the DPRK actually invited a high-ranking American scientist, Sig Hecker, the former director of Los Alamos National Laboratory (the birthplace of the American atomic bomb), on numerous occasions to visit their most sensitive nuclear weapons development sites to insure that the US was fully aware of their capabilities.

Even if millions of North Koreans starve to death, Kim Jong-Un has equated being torn from power by the United States if he were to abandon his nuclear program. Kim and his top generals passionately believe that stopping these weapon systems would be their death sentence, so if lots of people must die to keep them alive, they are more than prepared to let that happen. What’s even worse, because of the tight rein that the DPRK maintains over its people and what they are allowed to see and hear, the overwhelming population in the North believes it is already at war with the United States and is prepared to make the necessary sacrifice for their motherland… this, notwithstanding the widespread belief in the United States that the North can be brought to heel.

While people in South Korea and Japan, ostensible US allies, fear nuclear assault from the North, there is little doubt that the North’s main focus is the territory of the United States itself. And the Trump administration has been anything but subtle in their belief that hard American bully-tactics, replete with belittling name-calling for Kim Jong-Un, are the proper response to the DPRK’s nuclear weapons programs. And while Kim has hardly convinced the world he is a decent leader, he has managed to cast most of the blame for escalating tensions on an erratic and wildly unpredictable tweet-meister, Donald Trump.

“In perhaps the most incendiary exchange, in a September speech at the United Nations, Mr. Trump vowed to ‘totally destroy North Korea’ if it threatened the United States, and derided the rogue nation’s leader, Kim Jong-un, as ‘Rocket Man.’ In response, Mr. Kim said he would deploy the ‘highest level of hard-line countermeasure in history’ against the United States, and described Mr. Trump as a ‘mentally deranged U.S. dotard.’ New York Times, January 14th. Mr. Trump’s unrestrained need to tweet, to apply pejoratives and exaggerate play well to his base, but to the rest of the world, these habits are considered totally inappropriate and diplomatically destructive, baiting Kim Jong-Un to accelerate his weapons programs accordingly. That South Korea could open a dialog with the North over the Olympics only makes Trump’s provocations that much more inappropriate.

For the US military, however, this escalating war of words, followed by new testing by the North, is nothing more than a cautionary mandate to prepare for the worst: an all-out shooting war with the nuclear North. “Next month, at Army posts across the United States, more than 1,000 reserve soldiers will practice how to set up so-called mobilization centers that move military forces overseas in a hurry. And beginning next month with the Winter Olympics in the South Korean town of Pyeongchang, the Pentagon plans to send more Special Operations troops to the Korean Peninsula, an initial step toward what some officials said ultimately could be the formation of a Korea-based task force similar to the types that are fighting in Iraq and Syria. Others said the plan was strictly related to counterterrorism efforts.

“In the world of the American military, where contingency planning is a mantra drummed into the psyche of every officer, the moves are ostensibly part of standard Defense Department training and troop rotations. But the scope and timing of the exercises suggest a renewed focus on getting the country’s military prepared for what could be on the horizon with North Korea.

“Defense Secretary Jim Mattis and General Joseph F. Dunford Jr., the chairman of the Joint Chiefs of Staff, both argue forcefully for using diplomacy to address Pyongyang’s nuclear ambitions. A war with North Korea, Mr. Mattis said in August, would be ‘catastrophic.’ Still, about two dozen current and former Pentagon officials and senior commanders said in interviews that the exercises largely reflected the military’s response to orders from Mr. Mattis and service chiefs to be ready for any possible military action on the Korean Peninsula.” NY Times. The possibility of a Trump-ordered strike on the North is very real, probably more real than a preemptive strike by the North on US soil; Kim knows what the consequences of a Northern nuke against the US or her allies will produce.

For the record, and largely because of Chinese intervention, the United States and her UN allies did not fare so well in the Korean War (1950-53). The parties withdrew to their pre-war boundaries, there was no victor and while hostilities ceased, the only result was an armistice. Technically, a state of war still exists. The series of DPRK dictators who followed maintained a strong anti-US rhetoric over the years.

The United States has had similar Cold War confrontations when both the USSR (now focused on modern Russia) and the People’s Republic of China developed their own nuclear weapons/ICBM programs. Various treaties with these deeply anti-American enemies, combined with the concept of mutually assured destruction, created a modus vivendi with these nations and reduced the threat of a real nuclear war accordingly. Many other nations joined the nuclear family, from India and Pakistan to Israel, and the potential for a nuclear holocaust has so far been averted. We know that with each new nation having nukes, the risks increase, but do we actually want to begin a military confrontation to find out if we can successfully stop another nation that is well into a nuclear program… with rather rapidly moveable missile launching platforms?

I’m Peter Dekom, and I am particularly concerned for the possible missteps that a self-proclaimed “mentally stable genius” might provoke in a military confrontation with North Korea.

Tuesday, January 16, 2018

Racism, Mythology and Universal Condemnation

“We should have people from places like Norway.”  
Donald Trump at a Bipartisan Meeting on Immigration (1/11)

@realDonaldTrump, your mouth is the foulest shithole in the world. With what authority do you proclaim who’s welcome in America and who’s not. America’s greatness is built on diversity, or have you forgotten your immigrant background, Donald?  
Tweet from former Mexican President Vincente Fox reacting to Donald Trump’s purported putdown of El Salvadorans, Haitian and Africans in general

Though he admitted using some “tough language” in his January 11th  comment, it took Donald Trump until the next day to deny that he described the above as “shithole” countries, despite Congress people, standing right next to the President, who affirmed that he actually used that vulgar word in that context. While there might have been a legitimate issue to be discussed – whether US immigration policy should shift towards a skill-set bias in admitting foreigners to US residence and potential citizenship as many countries already do – given Mr. Trump’s clear pattern of unyielding deference to the most racist elements in his base, that most of his bans and exclusions are focused on “other than whites,” there is little doubt that he has solidified his status as the world’s most prominent racist in the eyes of most of the rest of the earth… including a whole lot of Americans, myself definitely included.

As Russia cozies up to Iran, building a barrier to US policies in the Middle East, and as China seems to follow American insults around the globe, stepping in to replace the United States as the main power broker in those countries, and as the President continues to withdraw from global commitments and embrace exceptionally unpopular global policies, the United States is losing influence and stature by the ton. The U.S. is the only country in the world to refuse to accept the Paris climate accord, one of only two nations currently recognizing multi-religious Jerusalem as the capital of the Jewish state of Israel, and the only Iran-nuclear accord signatory to condemn that UN-sponsored treaty, etc., etc. It is clear that the United States is (i) intentionally isolating itself in world where isolation has serious long-term economic and political consequences, and (ii) forcing the rest of the world to design rather inadequate “work-arounds” to enable commerce and political power to continue without the United States.

Considering that most of the world is not Caucasian, Trump’s white supremacist views and policies, while popular with his angry and frustrated under-educated base, have made him the effective “bully bad boy” to most of the world. His calls for other countries to work with the US on true global pariahs and threats are increasingly falling on deaf ears. As he has decimated the legions of experts in the State Department, he is increasingly forced to rely on military threats where diplomacy once sufficed, a very risky and profoundly expensive alternative. That South Korea could engage in conflict-reducing talks with North Korea, while the United States can only bluster for a de-nuclearization plan that the North will never accept, demonstrates the corner that Mr. Trump has painted us.

Global reaction to the plain meaning of Trump’s unambiguous putdown from the countries to which he directed his immigration comments poured in… in addition to the massively negative reactions here at home… except from his cheering base.

“President Salvador Sanchez Ceren of El Salvador also unleashed his displeasure on Twitter… ‘The declaration of the president of the United States strikes at the dignity of the Salvadoran public,’ he wrote in Spanish, adding in a second tweet that the country formally protests and energetically rejects such statements.

“On the eighth anniversary of Haiti’s devastating earthquake, Haitian Ambassador Paul Altidor said Trump’s comments were ‘misinformed’ and ‘misguided.’… ‘We’ve been a partner, we’ve been a strong neighbor, we’ve been a good friend of the people of the United States,” he said on National Public Radio. ‘And today Haitians are still here working hard contributing to the social and economic fabric of this country.’  

“As for Norway, Trump’s admiration wasn’t mutual — at least on Twitter, where users pointed out that Norwegians enjoy benefits such as universal healthcare, free higher education and paid parental leave that would not entice many to leave for the U.S… ‘As a Norwegian, the idea that anyone from Norway would consider moving to the USA strikes me as rather hare-brained,’ wrote Johannes Brodwall, a software developer in Oslo… ‘I’m a Norwegian who enjoyed studying & working in the US. The only thing that would attract me to emigrate to the US is your vibrant multicultural society. Don’t take that away @realDonaldTrump,’ wrote Jan Egeland, secretary general of the Norwegian Refugee Council.

“Africans felt especially aggrieved… At a bustling market in the Ghanaian capital, Accra, some saw Trump’s remarks as highly insulting. Others thought the comments would make the U.S. a less attractive destination for Ghanaians and help solve the country’s brain drain… In Kenya, where a young urban generation is technically savvy and active on social media, some posted pleas for understanding, while many tweeted their outrage.

“Political activist Boniface Mwangi from the Kenyan capital of Nairobi called on Trump to distinguish Africans from the country’s political leaders. ‘Please don’t confuse the #shithole leaders we Africans elect with our beautiful continent,’ he tweeted.

“Botswana’s government was the first on the continent to condemn Trump’s statements, referring to them as ‘highly irresponsible, reprehensible and racist.’… Botswana summoned the U.S. ambassador to express its displeasure over the remarks and to inquire as to whether Botswana was a ‘shithole country’: … ‘The government of Botswana is wondering why President Trump must use this descriptor and derogatory word when talking about countries with whom the U.S. has had cordial and mutually beneficial relations for so many years.’… Botswana called on the African Union and regional leadership bodies in Africa to condemn Trump over his comments.” Los Angeles Times, January 13th.

And here’s the big reveal: knee-jerk racism here in the United States on the part of too many of us makes the assumption that most of those African immigrées to the United States are unskilled, barely-literate dark-skinned travelers seeking to become leeches of American economic blood. Really? Sure we admit third world refugees escaping repression and extreme disasters, but the picture is vastly more complicated than that. Not to mention that on average, immigrées from sub-Saharan Africa are better educated that their average American counterparts.

The January 13th Los Angeles Times explains: “Lots of the news from sub-Saharan Africa is about war, famine, poverty or political upheaval. So it’s understandable if many Americans think most Africans who immigrate to the United States are poorly educated and desperate… That’s the impression that President Trump left with his comments to members of Congress opposing admission of immigrants from “shithole countries” in Africa and elsewhere.

“But research tells another story…While many are refugees, large numbers are beneficiaries of the ‘diversity visa program’ aimed at boosting immigration from underrepresented nations. And on average, African immigrants are better educated than people born in the U.S. or the immigrant population as a whole.

“‘It’s a population that’s very diverse in its educational, economic and English proficiency profile,’ said Jeanne Batalova, a senior policy analyst at the Migration Policy Institute think tank in Washington and coauthor of a report last year on sub-Saharan African immigrants in the U.S. ‘People came for a variety of reasons and at various times.’

“Overall, their numbers are small compared with other immigrant groups but have risen significantly in recent years. The U.S. immigrant population from sub-Saharan Africa (49 countries with a total population of more than 1.1 billion) grew from 723,000 to more than 1.7 million between 2010 and 2015, according to a new report by New American Economy , a Washington-based research and advocacy group. Still, they make up just half a percent of the U.S. population…

“The Refugee Act of 1980 made it easier for people fleeing war zones to resettle in the U.S., and today there are tens of thousand of refugees from Somalia, Sudan and Congo. About 22% of African immigrants are refugees, according to Andrew Lim, associate director of research at New American Economy.

“At the same time, the diversity visa program — also known as the visa lottery — has opened the door to immigrants from more peaceful places. Of the sub-Saharan immigrants who have become legal permanent residents, 17% came through the program, compared with 5% of the total U.S. immigrant population, according to Batalova.

“Applicants to the program must have completed the equivalent of a U.S. high school education or have at least two years of recent experience in any number of occupations, including accountant, computer support specialist, orthodontist and dancer.

“As a result, the influx includes many immigrants from sub-Saharan Africa who are highly skilled professionals… Batalova’s research found that of the 1.4 million who are 25 and older, 41% have a bachelor’s degree, compared with 30% of all immigrants and 32% of the U.S.-born population. Of the 19,000 U.S. immigrants from Norway — a country Trump reportedly told lawmakers is a good source of immigrants — 38% have a college education.

“The New American Economy study found that 1 in 3 of these undergraduate degrees were focused on science, technology, engineering and math — ‘training heavily in demand by today’s employers.’…That report also found that African immigrants were significantly more likely to have graduate degrees. A total of 16% had a master’s degree, medical degree, law degree or a doctorate, compared with 11% of the U.S.-born population, Lim said.

“African immigrants were more than twice as likely as the U.S. population overall to work in healthcare, Lim said. There are more than 32,500 nursing, psychiatric or home health aides, more than 46,000 registered nurses and more than 15,700 doctors and surgeons.

“‘Overwhelmingly the evidence shows that [African immigrants] make a significant, positive economic contribution to the U.S. economy,’ both at a national level and in districts where they are concentrated, Lim said. ‘They contribute more than $10.1 billion in federal taxes, $4.7 billion in state and local taxes, and most importantly, they have significant economic clout to the point of $40.3 billion in spending power.’… That $40.3 billion pays for housing, transportation, consumer goods and education for their children — ‘things that actually stimulate the economy around them,’ Lim said… The biggest beneficiary is Texas, where their spending power is $4.7 billion, followed by California, Maryland, New York and Georgia.” And people with those skills and training are the greatest job creators in this great nation.

Oh, did I mention that Haiti, occupied by the US (1915-34) and seriously taxed and exploited into near-insolvency by the United States, banned slavery in 1804. It took the United States nearly 60 more years to do the same thing.

I’m Peter Dekom, and so Mr. Trump, before you open your foul racist mouth and utter words that make the United States an unwelcomed global bully-pariah, would you ever consider researching the facts first… even though that has never been your style?

Monday, January 15, 2018

Could the United States Actually Have the Worst Healthcare System in the Developed World?

The United States faces a healthcare crisis because we have one huge disadvantage that the rest of the developed world simply escaped: we start from a platform of the highest prices for medical services, procedures and prescription drug prices in the world. Some will argue that we have massively better specialized equipment and better-trained physicians than any other country in the world. That may have been true a couple of decades ago, but that is neither the explanation nor the current state of medical technology and training in most of the developed world. Our “penalty” is historical.

As Europe and Asia were recovering from the decimation of World War II, U.S. territory was virtually untouched by the ravages of war. As the most of the developed world dealt with rebuilding (and remember that Canada was still a much more a part of the UK after WWII), the United States set about growing our economy. We did not have to rebuild cities; we built an American competitive advantage as we also funneled cash and expertise to rebuild our enemies and allies alike.

But that effort made the dollar strong, demand for skilled labor in the US exceptional and our pay levels tracked the demand accordingly. The GI bill was sending hundreds of thousands to college. People were building and buying homes like never before. Prosperity exploded. And relative to the rest of the world, our workers – unions were very strong – were paid multiples of what workers in the rest of the developed world were paid. We relied on our own internal growth, not globalized trade, to build the most powerful economy on the planet.

Meanwhile, doctors in Europe and Asia, living in a world of rebuilding from rubble, were not living in economies where high salaries were remotely possible. No one could afford that luxury. Those soon-to-return-to-developed status began to address social issues. The “communist” bugaboo, evidenced by the McCarthy witch hunt here in the US in the mid-1953s, did not impact Europe, where communist and socialist candidates routinely ran for office. Just mentioning “socialism” in the US would get a government official lambasted by the press and the public. Yet even though Republican conservative, Richard Nixon, first proposed universal healthcare for all Americans, it was an idea that could not find traction in a nation elevating “pure capitalism” over social safety nets.

That anti-socialism bias combined with exceptionally higher prices helped to make American healthcare far and away more expensive than any other country in the world. The world has long-since globalized. Medical research, equipment design and pharmaceutical development were no longer relegated to the United States. So as every single other developed country on earth established universal healthcare, the United States did not. Over the past decade, the percentage of our gross domestic product dedicated to healthcare has ranged from 17% to 20%, a figure that is often double the comparable figures in other developed nations.

So any American healthcare system is built on a very expensive base. We have to overcome prices that no other country has to face. And even if we could find a way to reduce healthcare costs even by a mere 10%, that reduction would effectively reduce our GDP by 1.7% to 2% as well. A 20% cost reduction would be more than our average GDP annual growth. Cutting medical costs is also cutting GDP, at least in the short run.

To get the Affordable Care Act through Congress, the Obama Administration had to deal with powerful lobbies from the pharmaceutical and insurance sectors. By simply having the ACA accept the drug prices as presented by the big purveyors of drugs (without negotiation), the US continued to have drug prices far above those of other developed countries. By eliminating the Medicare-equivalent possibility, a government insurance alternative, private healthcare providers allowed the bill to pass with their support.

Those two concession were flaws that critics pointed to, but clearly those disadvantages were intended to be phased out over time. It might take a decade or more to level off a system that could work the way universal healthcare programs function elsewhere. But a GOP Congress immediately wanted to repeal the entire bill. No fixes, just repeal. The new President and the GOP Congress have slowly chipped away at the ACA, rendering it pretty ineffective and threatening to throw millions of Americans off the rolls of the insured.

Under the guise of “tax reform,” Congress gutted the ACA’s “individual mandate” – an aspect of the 2010 legislation that provided the basic funding for a significant portion of the ACA. Unless alternative funding is authorized, millions of people who currently have healthcare under the ACA will be forced to lose that coverage. But it gets worse from there. Republicans in Congress are now mounting an effort to repeal legislation that makes mid-sized and larger companies offer healthcare at all: “Representatives Devin Nunes of California and Mike Kelly of Pennsylvania, both Republicans, recently introduced a bill, supported by party leaders, to suspend the mandate, canceling any penalties that would be imposed for any year from 2015 to 2018… ‘The employer mandate is a job-killer, a wage-killer and a business-killer,’ Mr. Kelly said.” New York Times, January 14th. But conservatives keep telling us how wonderful American medical care is.

If you think the United States provides the best healthcare on earth, then you really need to look at hard numbers that tell us otherwise. The medical canary in the coal mine – infant mortality – paints a pretty dismal record. The January 14th Los Angeles Times explains: “It’s no surprise that the United States ranks absolutely last in child mortality among the world’s wealthiest countries — that’s been true for years. A new study examines how this sad situation came to be.

“According to data from the World Health Organization and the global Human Mortality Database, the problems go all the way back to the 1960s. It was during that decade that the U.S. infant mortality rate (for babies younger than a year) and the U.S. childhood mortality rate (for those 1 to 19) began to exceed the combined rates for the other 19 richest nations.

“If the United States had performed as well as its peer countries from 1961 to 2010, more than 600,000 childhood deaths could have been avoided over those 50 years, the study authors concluded… The results were published Monday in the journal Health Affairs.

“‘The care of children is a basic moral responsibility of our society,’ wrote the study authors, led by Dr. Ashish Thakrar, a first-year resident in internal medicine at Johns Hopkins Hospital in Baltimore. ‘The U.S. outspends every other nation on health care per capita for children, yet outcomes remain poor.’

“And things could soon get even worse, the authors added: The Trump administration’s budget includes ‘substantial cuts to the Children’s Health Insurance Program, which covers seven million children, and to the Supplemental Nutrition Assistance Program , which directs three-quarters of its benefits to households with children.’

“But there’s plenty of evidence that things were bad already. Babies born in the United States have a lower life expectancy than their counterparts in other countries. In part, that’s because they face higher rates of obesity, injury, HIV infection and teen pregnancy, according to a 2013 report from the U.S. Institute of Medicine.” We are quite willing to incur a trillion plus dollar deficit to reduce taxes for the richest people in a white hot economy, but we are cutting the healthcare system that could reverse the above negative numbers.

There is no quick fix. There is no program that Congress could pass that would be an instant super-success. We cannot afford it… yet. It is going to take time. But we are going in the wrong direction. We need to build a system, over time, that makes the American healthcare system one that begins to deliver what the rest of the developed world has had for years… one that does not provide Cadillac healthcare only for the richest segments of our notion. And since we are starting with the most expensive system on earth, getting within manageable parameters is just going to take time… assume we actually get started.

I’m Peter Dekom, and it is time for Congress to pass legislation that benefits most of us and not a much rarified few of us.