Borderline Personality

None of the doctors who have seen our son over the past two years want to say it. In fact they go out of their way to say they can't say it, because he's not 18 and you can't diagnose someone with borderline personality until he is 18. We got the message anyway, as they desired.

The wife and I ask each other why he does the things he does? Why he refuses to do other things. We assume he has the ability to choose. I get mad at him when he has a setback. I get disappointed, frustrated, distraught. And mad. Mad at him. Mad at me. Mad at the situation. Mad.


I don't get mad, or at least shouldn't get mad at someone who has a cold. I don't get mad at someone who is in a wheelchair and is blocking the aisle in a train, or delaying the plane taking off. They didn't choose to be sick. My son didn't choose to be sick.

I get mad at the decisions he makes. But is that fair? Is he making decisions? How much free will does he have? When I get mad at him for hurting himself; when I get mad at him for refusing treatment; How is that fair? When I become exasperated by the choices he makes it assumes he has the ability to make choices. How much choice does he really have?

He takes us on a roller-coaster ride. He's up; we are up. We are full of hope, optimism. He's down; we are down. No hope, despair, unending heart-ache. All the books, all the doctors warned us. Some suggest not letting him take you on that ride, as if that is even possible.

It seemed like two weeks ago there was progress. It seemed like the long-prayed for miracle. And we knew it could be a false sign, like we have seen before. We were so hopeful anyway. How can you not be hopeful? And then it was gone, in an instant, again. Back down, again. There doesn't seem to be a steady with him, only going up or going down.

We called today. Like we call every Sunday. He refused to speak to us.

Fly the Friendly Skies

I'm a bit disappointed. I was hoping for months and months of pain so a real "national conversation" could take place as to why the federal government runs air traffic control to begin with. But no. The Senate passed a bill to allow the FAA flexiblity to move money around so air traffic controllers would not be furloughed. It passed with unanimous consent. The House just passed the Bill: 361 yeas, 41 nays, 30 not voting. Who says bipartisanship is dead?

When Congress agrees on something they act, quickly. I'm guessing they wanted to avoid the inconvenience they would suffer as they travel to and from DC and maybe more importantly avoid being accosted in airports, and on airplanes by angry constituents wondering why the FAA couldn't cut something else, other than air traffic controllers.

The sequester, as a policy, in my opinion is not all bad. In fact, it's rather genius. Congress can't agree on spending priorities so it decides everything (excluding welfare for old people) has to be equally cut. Sounds fair to me. If you can't decide how to prioritize  why not cut everything equally? Well, here is something the overwhelming amount of Congress can agree on, so they fix it. Washington Works!

Like I said, I hoped for more pain so we could ask the tough questions. Maybe Obama vetoes the bill? Can we get that lucky?

Lawmakers, aides may get Obamacare exemption - John Bresnahan and Jake Sherman - POLITICO.com

Congress exempting itself from the laws it passes is nothing new, but always galling.

My favorite line: "Yet if Capitol Hill leaders move forward with the plan, they risk being dubbed hypocrites by their political rivals and the American public. By removing themselves from a key Obamacare component, lawmakers and aides would be held to a different standard than the people who put them in office." You think?

http://www.politico.com/story/2013/04/obamacare-exemption-lawmakers-aides-90610.html

Latest on POLITICO

Congressional leaders in both parties are engaged in high-level, confidential talks about exempting lawmakers and Capitol Hill aides from the insurance exchanges they are mandated to join as part of President Barack Obama's health care overhaul, sources in both parties said.

The talks — which involve Senate Majority Leader Harry Reid (D-Nev.), House Speaker John Boehner (R-Ohio), the Obama administration and other top lawmakers — are extraordinarily sensitive, with both sides acutely aware of the potential for political fallout from giving carve-outs from the hugely controversial law to 535 lawmakers and thousands of their aides. Discussions have stretched out for months, sources said.

A source close to the talks says: "Everyone has to hold hands on this and jump, or nothing is going to get done."

Yet if Capitol Hill leaders move forward with the plan, they risk being dubbed hypocrites by their political rivals and the American public. By removing themselves from a key Obamacare component, lawmakers and aides would be held to a different standard than the people who put them in office.

(Also on POLITICO: GOP pulls contentious Obamacare bill)

Democrats, in particular, would take a public hammering as the traditional boosters of Obamacare. Republicans would undoubtedly attempt to shred them over any attempt to escape coverage by it, unless Boehner and Senate Minority Leader Mitch McConnell (R-Ky.) give Democrats cover by backing it.

There is concern in some quarters that the provision requiring lawmakers and staffers to join the exchanges, if it isn't revised, could lead to a "brain drain" on Capitol Hill, as several sources close to the talks put it.

The problem stems from whether members and aides set to enter the exchanges would have their health insurance premiums subsidized by their employer — in this case, the federal government. If not, aides and lawmakers in both parties fear that staffers — especially low-paid junior aides — could be hit with thousands of dollars in new health care costs, prompting them to seek jobs elsewhere. Older, more senior staffers could also retire or jump to the private sector rather than face a big financial penalty.

(Also on POLITICO: Baucus will continue ACA push)

Plus, lawmakers — especially those with long careers in public service and smaller bank accounts — are also concerned about the hit to their own wallets.

House Minority Whip Steny Hoyer (D-Md.) is worried about the provision. The No. 2 House Democrat has personally raised the issue with Boehner and other party leaders, sources said.

"Mr. Hoyer is looking at this policy, like all other policies in the Affordable Care Act, to ensure they're being implemented in a way that's workable for everyone, including members and staff," said Katie Grant, Hoyer's communications director.

Several proposals have been submitted to the Office of Personnel Management, which will administer the benefits. One proposal exempts lawmakers and aides; the other exempts aides alone.

When asked about the high-level bipartisan talks, Michael Steel, a Boehner spokesman, said: "The speaker's objective is to spare the entire country from the ravages of the president's health care law. He is approached daily by American citizens, including members of Congress and staff, who want to be freed from its mandates. If the speaker has the opportunity to save anyone from Obamacare, he will."

Reid's office declined to comment about the bipartisan talks.

However, the idea of exempting lawmakers and aides from the exchanges has its detractors, including Rep. Henry Waxman (D-Calif.), a key Obamacare architect. Waxman thinks there is confusion about the content of the law. The Affordable Care Act, he said, mandates that the federal government will still subsidize and provide health plans obtained in the exchange. There will be no additional cost to lawmakers and Hill aides, he contends.

"I think the law is pretty clear," Waxman told POLITICO. "Members and their staffs should get their health insurance through the exchange; the federal government will offer them health insurance coverage that they obtained through the exchanges because we want to get the same health care coverage everybody else has available to them."

Waxman has been working on this issue with congressional colleagues and the Obama administration.

Continue Reading

Sen. Richard Burr (R-N.C.) said if OPM decides that the federal government doesn't pick up "the 75 percent that they have been, then put yourself in the position of a lot of entry-level staff people who make $25,000 a year, and all of a sudden, they have a $7,000 a year health care tab? That would be devastating."

Burr added: "And that makes up probably about 30 percent of the folks that work on the Senate side. Probably a larger portion on the House side. It would drastically change whether kids would have the ability to come up here out of college."

Yet Burr, a vocal Obamacare opponent, is also flat-out opposed to exempting Congress from the exchange provision.

"I have no problems with Congress being under the same guidelines," Burr said. "I think if this is going to be a disaster — which I think it's going to be — we ought to enjoy it together with our constituents."

The developing narrative is potentially brutal for congressional Democrats and the White House. The health care law, controversial since it was passed in 2010, has been a target of the right and, increasingly, the left. There are concerns about its cost, implementation and impact on small businesses. If the two sides agree on a fix, leadership is discussing attaching it to a must-pass bill, like the government-funding resolution or legislation to hike the nation's debt limit.

Republicans, though, haven't been able to coalesce around a legislative health care plan of their own, either. House Majority Leader Eric Cantor (R-Va.) pushed a bill this week that would shift funds from a health care prevention fund to create a high-risk pool for sick Americans. That bill couldn't even get a vote on the House floor as conservatives revolted, embarrassing Cantor and his leadership team. GOP leadership pulled the bill.

But the secret talks about exempting Capitol Hill hands from the exchanges has the potential to be even more politically risky. During the 2009-10 battle over what's now dubbed Obamacare, Republicans insisted that Capitol Hill hands must have the same health care as the rest of the American people. The measure was introduced by Sen. Chuck Grassley (R-Iowa), who spent months negotiating the details of the health care law but later became a major Obamacare critic.

The mandate on health exchanges doesn't cover everyone. Aides in lawmakers' personal offices must obtain health care through the exchanges but not committee staff. Lawmakers and aides older than 65 are covered by Medicare.

OPM also has to decide where the members and staffers would be covered. According to several people who have spoken with OPM officials, lawmakers would probably be in the exchange of the state they represent. But staffers would sign up in the state where they usually live — that means district office employees would join home state exchanges, and Capitol Hill staffers would mostly be in Washington, Virginia or Maryland.

Jennifer Haberkorn contributed to this report.

FAA Questions

I actually have some sympathy for Obama taking criticism over the effects of the sequester. The President is right, cuts means less services.

However, what I would like to know is: Why do we have air traffic controllers? Can't that all be computerized? Why does the government employ air traffic controllers? Why don't the airlines run the air traffic control network?

 

Posted with Blogsy

Ezra Klein's $1200 toenail

I saw a TV commercial the other night for the Kindle. It was a side by side comparison between the Kindle and iPad and the the key differentiator between the two, per this commercial, was price. The Kindle was much lower-priced than the iPad. Google "Kindle v iPad." The first link that appeared for me was from amazon.com labeled, appropriately enough, Kindle Fire vs. iPad.

In Apple's fiscal 2012 it generated $32.4 billion in revenue from iPad and related products and services. This was up from $20.4 billion in fiscal 2011 and $5.0 billion in fiscal 2010. Unit sales were 58.3 million, 32.4 million and 7.5 million respectively in fiscal year 2012, 2011 and 2010. Revenue divided by units yields average selling price, ASP of $556, $630 and $666 for fiscal 2012, 2011 and 2010 respectively. Quite a ride.

That kind of volume attracted competitors, like Kindle and Samsung and others. New products were introduced, prices came down, new features were offered. I would argue this is a market that works rather well. And by "work rather well" I mean consumers have many options, competition is intense and excess profits (in an economic sense) are temporary.

A few days ago I checked on airline prices from JFK to LAX. If I wanted to travel two days from the date I looked, and stay just one day, the fare was about $1,000. However, if I elected to fly on the exact same flight numbers, same time of day, but booked one month in advance and stayed over for one week the fare was about $200. Despite prices that are vastly different for the exact same service-flying to and from LAX, same day of week, same time of day-I would argue this market too, works rather well.

My daughter is graduating from college next month. When we were choosing colleges we knew there was a list price and the actual price we would pay. The actual price was the list price net of scholarships, work/study, possible loans, etc. I think this market, despite many distortions, works rather well also.

Which brings me to Steven Brill's "A Bitter Pill," the longest article Time Magazine ever published, and Ezra Klein's $1,200 toenail. Both complain the market for health care is flawed and point to many examples to prove their assertion that the market for health care is flawed. I agree completely, the market for health care is flawed. 

But think about the context when they complain about pricing in the ER and the $1,200 toenail. What are they implicitly comparing health care pricing to? I would say they are looking at functioning markets, like iPads, airline flights and even colleges and saying healthcare pricing isn't functioning properly because it doesn't look like pricing in any of those markets. Again, I agree.

That's when they take the leap I wouldn't take. Since the health care market isn't working like the markets for iPads, air fare, or colleges, the viable solution, they say, is a single-payer. For Brill that single payer is Medicare. But wait a minute. WHY is the market for health care not like the market for iPads and airfare and colleges? Has something happened to introduce the distortion that makes the health care market look and act differently? I think the answer is employer-sponsored insurance, government mandates of coverage and Medicare itself. 

I won't push that argument because I don't think it matters to Brill and Klein why the market for health care is different than the market for iPads and air fare and colleges. For them, any market in health care is immoral. That is, there shouldn't be a market at all in health care. For them, the government should determine what health care its citizenry should have and then set about delivering it. For them, ANY market would be objectionable because ANY market would be immoral.

Now that's not a position I take. But it is futile for me to try to argue to them the best way to make the health care marke work is to remove obstructions. I could point to the removal of obstructions in the air fare market as evidence this could work. Or I could point to the deregulation of natural gas. Or I could point to the deregulation of the US economy post WWII. I could point to a mountain of evidence this approach has worked in other markets time and again. But I would be wasting my breath, because the objection isn't the type of market, it's the market itself they object to.

Brill wrote the longest article in Time Magazine's history telling me what everyone already knows: the price incentives we see everyday in the market for iPads, air fare and colleges are highly distorted in the health care market. He does this, I presume, so he can then claim, "Market Failure. Government must step in." 

I think it would be much more honest for him to say, "Markets in health care are immoral." I don't agree with that either, but at least we would have a basis to interact. 

Guns and terrorism

Is it my imagination, or do many of those who supported gun control in the wake of Sandy Hook are complacent about the laws we have in place to combat terrorism while those who are complacent about gun control feel strongly more needs to be done to combat terrorism.

Both sides feel justified in restricting civil liberties to combat what they regard as an exigent requirement to protect the public and both sides seem to view their opponents as evil, foolish and in the thrall of some special interest.

Why does AFL-CIO care about entitlements?

Why does the AFL-CIO care so much about entitlements? I don't see the connection between union membership and social security, Medicare etc.

AFL-CIO President Richard Trumka assailed the proposed cuts to entitlement programs as “wrong and indefensible.”

“A president’s budget is more than just numbers. It is a profoundly moral document. We believe cutting Social Security benefits and shifting costs to Medicare beneficiaries — while exempting corporate America from shared sacrifice — is wrong and indefensible,” Trumka said.

Binders Full of Good Looking Women

Romney: Binders of women + Obama: The best looking attorney general = Binders full of good looking women.

Chaos

I was raised Catholic. Because both my parents were employed by the Church my siblings and I spent much or our childhood in Church. I think that proximity led to a certain amount of cynicism on my part, but I'm rather cynical to begin with. I'm guessing my rather large amount of sanctimony is a function of growing up as I did also.

I stopped going to Church around high school. It had stopped speaking to me.

I was called back over the past five years. I think it was a desire to let go of the hate and anger that was inside me, and damaging me and my family. On the tenth anniversary of 9/11 I tried to attend mass, walked half-way to the Church down the Street and turned back in tears. It would be impossible to explain all of the emotions that first lured me to Church and then stopped me half-way and reduced me to tears. Impossible to explain since I don't even know myself all that was bubbling within me.

I have been a regular attendee at the 7:30 AM Mass since February of 2012. That was when my wife and I realized we would have to send our son away from home to receive specialized care that would hopefully allow him to control his emotions and give us some confidence he would not be a danger to himself. He was shattered, broken. I was also. I have failed many times in my life but never felt like a failure, until then. Not just a failure, but a failure at the most fundamental, basic, important task any parent has which is to keep their children safe.

I have prayed for a miracle at every Mass, Today's First reading was Acts 5:12-16.

12 The apostles performed many signs and wonders among the people. And all the believers used to meet together in Solomon’s Colonnade. 13 No one else dared join them, even though they were highly regarded by the people. 14 Nevertheless, more and more men and women believed in the Lord and were added to their number. 15 As a result, people brought the sick into the streets and laid them on beds and mats so that at least Peter’s shadow might fall on some of them as he passed by. 16 Crowds gathered also from the towns around Jerusalem, bringing their sick and those tormented by impure spirits, and all of them were healed.

That's how I feel sometimes, bringing my son out on a mat so that at least a shadow might fall on him, and heal his torment. Mine also.

But the miracle is not why I went back. My life was in chaos and I needed order. I needed comfort and meaning. To some extent I have found that.

Our son has had many ups and downs. For a short period it seemed like the miracle we prayed for had been granted. Then it was taken away. Back up. Back down. In our most recent conversation he started by saying he wanted to let go of the hate, because he realized all it was doing was hurting himself. We've had too many ups and downs to celebrate all is better. We are celebrating he is better today.

Canada vs. Mexico

"The Proposal," is on TV tonight. I don't like it that much. Sandra Bullock plays a Canadian about to be deported, so she concocts a scheme to marry her American assistant Ryan Reynolds. Boy meets girls etc.

Every time I see this movie, yes, I've seen it more than once, I ask, "Why would the US deport a Canadian." When my eldest child saw the movie, she asked the same question. When my youngest child saw it this evening she asked the same thing. Why would the US want to deport a Canadian. The premise seems so unbelievable.

I dislike most counter-factual arguments. But would the premise be unbelievable if Bullock's role was instead played by Eva Mendes about a Cuban being deported? Or if the role was played by Sofia Vergara about a Columbian? Or if the role was played by Eva Longoria about a Mexican? Maybe the premise would be just as absurd. But I don't think so. If the lead role was a Cuban, or a Columbian or a Mexican, I think the premise would be more believable.

But why is that? Why has the US built a fence across the border with Mexico but not Canada? What do we fear about the Mexicans we don't fear about the Canadians? Or am I wrong and we would have an equal fear about the Canadians if Canadians were attempting to enter the US by the millions? Maybe. Maybe we would. Maybe then we would be building a fence to keep the Canadians out as well.

Maybe, but I just don't think so. I think there is something we fear about he Mexicans we don't fear about the Canadians. Language? Maybe. Wealth? That is we don't want a poorer population? Maybe. Religion? Doesn't seem to be mentioned much, but maybe. Drugs and violence? Probably. Racism? Maybe, but that's just speculation, and I'm not willing to tar everyone who disagrees with me about immigration as racist.

I think the country benefits from immigration. I suppose opponents could drag out studies that support the opposite, but the evidence is overwhelming the country benefits from immigration. Just like the country benefits from free trade. You can manufacturer a study that claims the opposite but the evidence is overwhelming and obvious the country benefits from free trade and easy and open immigration policies are part and parcel of free trade. If two mature parties should be allowed to engage in a relationship without the heavy hand of the State preventing them, why should the State prevent me from hiring a gardener from Mexico (excuse the stereotypes), a customer service rep from India and a cab driver from Pakistan?

The current debate on immigration depresses me. Neither side comes anywhere close to my position. Not even close. Legislation

could be introduced as soon as next week in light of a tentative deal on guest-worker programs struck by the U.S. Chamber of Commerce and the AFL-CIO. ... Under the tentative deal ... the U.S. would issue anywhere from 20,000 to 200,000 guest-worker visas annually. ... Labor and business groups also reached a tentative agreement on wage levels.

 200,000? That's it? Wage levels? Huh?

Let them in. Let them all in. People come to America for a better life for themselves and in the process they make all of us richer as well.

Diane Feinstein on the First and Second Amendments

Diane Feinstein was at the Commonwealth Club on April 3, 2013. You can find the show on iTunes.

Around 7:20 into the show she remarks on the Senate:

When I went to the Senate in 1992, there weren't clotures every week. The big issues of the day were expected to be debated on the floor of the Senate, to be passed out of committee, and people were expected to vote, not to hide, but to stand up and vote. Now, virtually everything takes sixty votes, just to have a vote on the floor. It's really very bad. 

What's happened is a fear has set in, that if they vote for the bill, they won't be re-elected. It's that plain, and it's that simple. My view is, then they shouldn't go to the Senate. 

Robert Caro, in "The Passage of Power," and in "Master of the Senate," spends a great deal of ink on the Senate, but his portrayal is much different than Feinstein's.

From "The Passage of Power,"

The inefficiency of Congress was nothing new, of course--the only period since the Civil War that the pattern had been broken in the Senate, the principal logjam, was the six years of Lyndon Johnson's leadership

In fact:

Some analysts were questioning the efficiency of the governmental framework of which Congress was so pivotal a part. In a book, The Deadlock of Democracy, published earlier in the year, the distinguished historian--and unabashed Kennedy admirer--James MacGregor Burns said that "we are at the critical stage of a somber and inexorable cycle that seems to have gripped the public affairs of the nation,...mired in governmental deadlock, as Congress blocks or kills not only" Kennedy's programs but Republican programs as well. Concluding that "We...underestimate the extent to which our system was designed for deadlock and inaction," he said that perhaps the system would have to be changed.

Caro writes

Walter Lippmann said: "This Congress was gone further than any other within memory to replace debate and decision by delay and stultification. This is one of those moments when there is reason to wonder whether the congressional system as it now operates is not a grave danger to the Republic."

Lippmann commented Congress replaced "debate and decision by delay and stultification," Life Magazine wrote of "the least productive Congress in memory," newspapers "thundered against filibuster, and public demand for cloture rose."

I wonder if Senator Feinstein knows the history of the Senate, knows, as Burns points out that the system was "designed for deadlock and inaction," or is counting on her audience not knowing.

Of course, her complaint is the Senate is blocking her attempt to restrict the Second Amendment. It's somewhat odd she is attributing the block to the filibuster since her legislations could at best, according to Majority Leader Reid, attract 40 votes. That's a landslide against her proposal.

I'm rather ambivalent regarding guns. I am not, however, ambivalent about restricting the rights enumerated in the Constitution and the Bill of Rights. I'm one of those people who think the Constitution has and continues to work rather well. I'm one of those people who thinks a system designed for deadlock and inaction is a feature, not a bug.

Senator Feinstein is not happy with just restricting the Second Amendment, she sees value in restricting the First Amendment as well. Around 12:30 into the program she is asked about  the connection between violent video games and violence in society:

I have been hopeful, and we'll wait and see what happens, that the video game industry itself, would respond. Because you get into First Amendment issues in the Congress if you legislate in this arena. I think there's enough evidence out there to show that these video games have a very negative role for these young people. And the industry ought to take note of that and the industry ought to respond by taking some of these very violent games off the market.

Has that ever happened, she's asked.

"No," she responds,  "this is meant to be a little shot across the bow."

Some wonder why restricting the Second Amendment brings up such passion. Some blame the NRA as if the NRA is some body operating independently of the voters. But Senator Feinstein knows that's not true. She mentions why her legislation can't get the votes. 

What's happened is a fear has set in, that if they vote for the bill, they won't be re-elected. It's that plain, and it's that simple.  

I heard the disappointment in her voice. The accusation that somehow this was a bad thing. And it puzzled me. Representatives responsive to their constituents is a bad thing? If the Senators vote for legislation their constituents do not support, they will lose their seat. Isn't that the way it is supposed to work?

Some wonder why restricting the Second Amendment brings up such passion. Listen to Senator Feinstein and you will hear why: People are afraid if they allow Congress to limit the Second Amendment, then the First Amendment, and then maybe the representative nature of our government. People are afraid of a "little shot across the bow," and what may follow.

Our system is designed for deadlock and inaction. Some, like myself, observe it has served us well. Others are frustrated it requires patience and persuasion to change. And that's why the gun debate stirs up such passion.