All I want from Santa is to be safe…

Santa letter 4Dr. Michael J. O’Connell, New Hampshire commented that recently a 13 year old black kid from Chicago wrote Santa telling him that all he wanted for Christmas is “to be safe”. Not clear about the kid’s meaning.  Safe from whomSanta letter 8?  Other kids?  His parents?  Bullies?  Or, more likely, cops?  Obama was referred the question (ahem, right, ‘referred’) and he answered him with a well-publicized message that his safety was of ‘constant’ concern to him.  The answer a real leader, particularly a black presidential leader, should have given this kid is as follows:

“My son, first of all, what are you doing writing Santa at age 13?  A little old?  Are you sure my liberal colleagues did not put you up to this?

Second, I am not quite sure why you feel unsafe.  But given the fact that you reside in the inner city, are black like me, and various actions of the police have been called into question by the media lately, I will assume you mean safety from the police.  There is a fail-safe approach to the police that will guarantee your security when dealing with them, so listen to me carefully.

If any kid (white, black, brown, yellow or purple) wishes to remain safe when confronted by an officer, whether for J walking, selling black market cigarettes, smoking a cigar or a joint, or simply looking suspicious, show him respect by not being confrontational.  If an officer asks a question, answer it accurately, fully and politely.  Surliness is contraindicated.  Keep your hands away Santa letter 2from your pockets.  You live in a neighborhood where firearms are everywhere.  Do not approach this officer unless directed, do not turn and run.  If you have done something wrong, that’s pretty much your problem to fess up.  The police serve us all by ensuring that the public and public systems are safe.  Everyone needs to help the police in this vital and often overwhelming and dangerous task.”

Well yes, this response is wordy, but with all the President’s speech writers, I am sure it could be made pithier.  But doesn’t this answer drive to the essence of what this kid was getting at?  And wasn’t the kid implying police were out to harm him by their nature (prejudice, racism, etc.)?  Shouldn’t the President have taken this opportunity to defuse and disabuse this kid?  But, no, like his failed presidency, Obama chooses to fail his race.  Merry Christmas kid!

 

Big brother activities…

big brother 5 Big brotherDr. Michael J. O’Connell, New Hampshire agrees that it is somewhat unsettling that the NSA and CIA have access to so much, perhaps most, of our internet and telephonic activities.  All in the name of fighting terrorism and perhaps crime in general.  It is also unsettling that on practically every city street corner, there is camera surveillance.  Again, in the name of public protection.

Many ideologues, such as Slavoj Zizek believe that such Big Brother activities are not simply invasive, but nefarious.  Interesting that Zizek, a well-known castigator of ideologues, should himself delve into fanciful speculation of the use of information for fomenting evil.  A perfect definition of an ideologue HE is.  In his recent documentary, “The Pervert’s Guide to Ideology,” he presents a couple instances in which citizens in this country were arrested and detained for something they had written in an email or text.  This activity certainly gives one pause, but is that reason to believe there are widespread incarcerations of totally innocent people?  Where’s the evidence of that, aside from his several examples, all of whom were released after questioning?

Regardless of whether history will prove this huge information harvest to be an overall public benefit, an evil trap, or just a general but tolerable nuisance, it should send a wakeup call to all users of social media.  As an employer of over 200 people, I am amazed at the comments made available on Facebook by many of them.  Maybe it’s time to think before posting.big brother 6

 

Obama’s failure…

Dr. MichaeBarack 4l J. O’Connell, New Hampshire commented that every time Obama appears at press conferences or interviews, it becomes clearer that the presidency is not what he expected or was prepared for.  He started his first year in a very good strategic position, because the situation could hardly have been worse.  We were still in conflicts in both Afghanistan and Iraq, the economy was bordering on depression, and manufacturing jobs were fleeing overseas while our unemployment rate hovered at 10%.  Our relations with other developed nations was suffering from the ‘bravado approach’ of which Bush junior was accused.  Nothing could have been better for Obama, because only improvement on all fronts could be anticipated.

So what has Obama accomplished given this perfect set up for success?

  1. He has mandated a massive overhaul of healthcare that has disenfranchised many physicians and pushed many hospitals and healthcare systems to the brink of ruin. Patients are herded through provider offices like assembly line widgets, vocal interaction with the doctor is minimized, that frequently quoted “40 million Americans without insurance” has changed little, and those who are now covered have either catastrophic policies with huge deductibles they can’t afford, premiums that are out of sight, or they qualify for Medicaid that many providers will not accept due to dreadfully poor reimbursement for medical services.
  2. He has pulled troops out of Iraq and Afghanistan, with no deal with the existing government for maintaining air force bases in the desert, as had been an exit strategy by Bush. He must now rue that decision since our troops are slowly returning to Bagdad to “protect our interests” as ISIS extremists slowly bear down on the Iraqi capital, unraveling all that had been accomplished.
  3. Thanks to sloppy oversight, Edward Snowden has single handedly given our enemies and allies alike our blueprint for success in preventing further terrorism on our soil, in commerce and trade overseas, in competition with China, Europe et al. Our allies all now know that we spy on them, as they do on us, and more importantly, they now know how we do it.  Relations with our allies is arguably worse than at any time in the past two decades.
  4. Asleep at the wheel, and with our intelligence crippled by #3, Obama allows Russia to divide the Ukraine, and annex Crimea. A land grab.  Something no developed nation has done since WWII.  Again due to crippled intelligence, he has allowed moderate factions in Syria to whither, unaided and now disenfranchised.
  5. The economy limps along, gradual improvement in unemployment, some job creation…and it has taken nearly 7 years of Obama’s ‘laser beam’ concentration on this issue to accomplish a half-hearted recovery.
  6. Despite obvious need to trim back the government, return to fiscal responsibility, and stop stacking our massive debt on the backs of our youth, Obama continues to spend dollars we don’t have.
  7. Global warming, admirably part of the Democratic campaign platform, has been given lip service by this president

It must be shell shocking to the president that his famous campaign slogan of “yes we can” has clearly become “guess we can’t.”  His record is abysmal.  His extraordinary naiveté will be his legacy.  In some ways he seems to have learned few lessons from the oft criticized Bush administration.  In other ways he has fled so far from some of the controversies of that pervious president that he has run too far in the opposite direction, putting us in different but grievous risk.  “Change we can believe in”?  Unfortunately, I can believe it.

Ferguson unrest…

 

FergusonDr. Michael J. O’Connell, New Hampshire, commented that it is understandable that the Ferguson community should be profoundly angry at and upset by the shooting of an unarmed black youth by a white police officer.  This scenario is uncomfortably common in this country, shootings of blacks by white cops.  We are reminded all the time, explicitly and more often implicitly, by the media of the analogy to lynchings, performed largely by white southerners in the early half of the last century.  Despicable stuff.  Despicable times.

However, as what often happens in cases such as the Ferguson “lynching,” the truth slowly emerges and that exact analogy slowly breaks down.

  • First, we do not have an accounting of the perspective of the officer.
  • Second, we have no forensic exam results yet.
  • Third, we have only eye witnesses’ who were black passersby (and with inherent biases of their own).
  • Fourth, the victim is apparently not the ‘totally innocent kid’ who simply was minding his own business walking down the middle of a side street with a friend. Just a few minutes earlier he had stolen a high priced box of cigars from a convenience store, and shoved aside the store clerk on exiting the establishment.  The latter made a quick call to the police, and this information was reportedly broadcast to the police in the area within 2-3 minutes.
  • Fifth, within 10-12 minutes of the “cigar theft”, the young man was dead.
  • Sixth, within 24 hours of the incident, our black president, who had no business commenting on the event before ALL the facts were in (did Obama learn NOTHING from the Trayvon Martin shooting?), was publicly mumbling/grumbling about the shooting.
  • Seventh, this country is still largely white. This majority is represented in nearly all businesses both private and public (except of course the NFL and the NBA).

Ferguson 3Yes, this was a tragedy, for the victim, for the family, for the community, for all owners of the looted stores from the huge majority of black rioters–now five nights in a row.  I suspect we will see it as a huge tragedy for the police officer.  We will learn something more akin to the truth as this story unfolds.

 

Demise of healthcare as we have known it…

Demise of healthcare 6Dr. Michael J. O’Connell, New Hampshire stressed that there is a deadly struggle underway in medicine today.  This is not overly dramatic language used to make a point or attack a process.  Medicine as we know it is dying, and the agony will be experienced by all the stakeholders:  providers, patients and insurance companies.  Increasingly, providers are being employed.  Independent medical practices are now dwarfed in number by those practices that are owned by a hospital or hospital system.  The same is happening to specialty practices, though at a somewhat slower rate.  Due to the stressors of running a practice (keeping up with Obamacare regulations, complying with myriad insurance treatment policies and guidelines, and challenges of simply making a profit, many specialists are lining up for acquisition by both horizontal and vertical systems.

Those specialists resisting this transition are encountering intimidation by Medicare in the form of RAC audits and OIG investigations and listing in all the media of the infamous Medicare Pay List.  For the patient, this reorganization of health systems means confusion, industrialization of service delivery and briefer, more superficial and unsatisfying office evaluations, punctuated by ‘scientific’ sterile treatment protocols and loss of the personalized touch.  For both patient and provider, the art of medicine is fading.

For insurance companies, their fate is clear.  While trying hard to participate in this ‘new medicine,’ and be a meaningful ‘partner’ in the future, the end is in sight.Demise of healthcare 5  As insurances merge and larger companies are created, it will be easier, in another decade or so, for the government to overcome the few monopolizing entities that will still exist, and finally a single payor, managed care, federally administered system will evolve.

The process will be heralded by economists for its efficiency, and no health care will be provided without a basis in scientific “proof” – proof that many times doesn’t exist – proof that is true today, and wrong next year.  The transformation of complex, unique patients into so many homogenized widgets will be complete.

Thank you Mr. Obama!

Sacking of Mosul…

Afghanistan Mosul 6Dr. Michael J. O’Connell, New Hampshire, commented that the recent Al Qaeda sacking of Mosul, highlights once again the incredible shortsightedness and lack of geopolitical savvy of the Obama administration.  Just as in Afghanistan, Obama made the decision, after years of our armed forces blood, sweat and tears in Iraq, that the U.S. would pull out entirely with NOT ONE AIRBASE in the expansive and totally empty desert. NOT ONE.  The strategic stupidity of this man is amazing.

With a major easily protected base in the wasteland of both these countries, the Taliban, Al Qaeda and any other extreme right wing orgs would be stopped in their tracks by remote controlled drones, occasional targeted F-15 strikes, Blackhawk and JSOC operations.  Now there is no staging area for any of this.

Afghanistan Mosul

Even George Bush never thought that Iraq or Afghanistan could stand totally alone as a democracy in the sand, while surrounded by Sharia guided freak heads.  With proper planning of an Iraqi airbase, even the nuclear dance in Iran would be far simpler to monitor and control.  Poof.  Gone.  Yet ANOTHER hair brain decision by our President.

 

Afghanistan Mosul 7

 

 

 

 

 

 

The Birgdahl release…

Birgdahl 17Dr. Michael J. O’Connell, New Hampshire, commented that the recent Birgdahl release in exchange for the release of five ‘detainees’ from the Guantanomo facility has caused an uproar not only among Republicans (of course), but also a surprising number of Democrats, many of whom are quite influential such as Diane Fienstein voiced dissatisfaction.  Even Hillary Clinton’s pseudosupport of the exchange was and continues to be progressively more wobbly, as the questions circling Birgdahls unauthorized departure from his post seems deserving of military investigation and likely court marshal.  Regardless of Birgdahl’s motives, an important question is what will be the effect of negotiating with the Taliban, something we have avoided doing with the enemy for the entire Mideast conflict?  Will such action spur more captures of our troops and holding them in exchange for still more dangerous releases from Guantanomo?  Time will tell.

As much as the Liberal press reviles JSOC and the CIA, covert operations should be expanded in my opinion, not eliminated.  There is no good reason why Birgdahl and others could not have been Birgdahl10located and freed by special ops, without the necessity of what appears to be a disastrous exchange, or at least an exchange with potentially disastrous consequences.  A recent documentary, “Dirty Wars,” by Jeremy Scahill about JSOC should be viewed by everyone who is interested in how ‘reporting’ can distort the truth by simply presenting only one perspective.

I would like to see realism reinjected into our various conflicts.  Few Americans want war.  But past history suggests that war is a part of our world and very much in the future as well. Do we really want to wean off covert activities in exchange for soldiers lost on the battlefield?  Do we want to see more ill advised exchange deals?

Another Obama gaffe…

Obama gaff 5 There is yet another gaffe by this administration already plagued by scandal, inaction, and ineptitude.  How does one consider exchanging five hardened ideologues from Guantanomo Bay Detention, and not totally vet the soldier for whom they had released?

Obama was totally blind sided by the fact that the soldiers in BObama gaff6ergdahl’s unit were aware of highly suspect circumstances in which Bergdahl left his post that fateful night almost five years ago.  How could this information, true, false, half true, meaningful or meaningless…be ignored or never investigated or never sought, long before lethal terrorists were released.

The strange behavior of Bergdahl’s parents after their son’s retrieval from captivity (haven’t talked to him, haven’t flown to Germany to see him, let him “decompress,” he is having “trouble speaking English”???) suggested there was much more to the story.  Now we know.  The story contains yet another stupid chapter, in a stupid administration by a stupid president. And, we thought Bush junior was stupid.

–by Dr. Michael J. O’Connell, PainCare, New Hampshire

Brain drain…

Brain Drain

The Obama administration continues to quietly tweak the Affordable Care Act –anymore tweaks and it will be almost unrecognizable.  The latest changes are clearly huge patches in the attempt to plug holes and draw more young subscribers, into the now infamous “Abominocare.”

The far reaching, and I hope unintended, consequences of this massive heap of mangled legislation, will impact providers, hospitals and patients for decades to come.  Providers of age 55-60 or so are already retiring in droves, or are considering to soon.  This will create a devastating ‘brain drain,’ particularly from that portion of medicine that is known as the ‘art,’ something that ‘Abominocare’ does not even recognize.

The ‘Art of Medicine’ is not taught in medical schools because it requires something called “crystalline intelligence;” a young buck can’t learn it as it forms with age, experience and maturity.  Physicians in particular are reluctantly becoming more satisfied that their retirement nest egg will suffice and are leaving practice, and taking with them their delicate and invaluable understanding that the ‘Art of Medicine’ is vastly more important than the Science of Medicine.  As anyone on Fifth Avenue can tell you, it’s “how you make them feel,” not the specific medicine or surgery prescribed (God help us with our fixation on ‘curative’ surgery).  ‘Abominocare’ emphasizes evidence-based medicine (EBM).  Were it only that simple.  Any 65 year old GP still in practice can tell you all about EBM and how misguided it is.

Obama Presidency…

Obama presidencyThe desperation of the Obama presidency to salvage some sort of modestly respectable legacy has resulted in a most regrettable decision…to make a deal with Iran.  President Rouhani may have perfectly legitimate intentions (though I much doubt that), but he does not rule Iran.  He is a titular head, akin to John Kerry himself, a secretary.  The Supreme Ruler of Iran, Khamanei, is truly in control and must be having a good chuckle over the supreme naivete of John Kerry and Barack Obama.

In exchange for significant loosening of sanctions, sanctions that have taken a decade to cobble together among our allies and finally have an effect, Rouhani has agreed to allow inspections of several of the more ‘threatening’ nuclear sites in the country and will decommission the facility with the greatest capacity to enrich uranium to weapons grade.  According to this treacherous agreement, Iran can even further enrich at other facilities.

Did we not learn our lesson with Saddam?  These folks have a different sense of the word trust.  Just as Saddam deftly moved equipment from one storage facility to another, one step ahead of the inspectors, so will the Iranians, in a cat and mouse game.  Furthermore, why does Kerry so trust our esteemed intelligence department that so woefully bungled the imaginary weapons (WMD) of mass destructions in Iraq?  How does anyone know where Iran is truly hiding its ability to manufacture the most serious WMD possible?

This deal has not been fashioned to make the region more secure, it has been hastily cobbled together in hopes of giving Barack one positive element to his bleak legacy.  In all likelihood, it will add to one VERY sad presidency.