Those Are The Rules

By Madeleine Kando

When I first came to America many many decades ago, I was appalled at the "live or let die" attitude of American society. I felt that free education and free health care were a citizen's birthrights. And I have always felt that America could learn from the Dutch approach to taking care of its' citizens' health.

I am again visiting my 96 year old mother in beautiful Holland. How clean and civilized it is here. Such a contrast with our dirty, pothole-studded streets in Boston. I am glad we 'parked' our mother here. Of all the places in the world this is paradise for the elderly. Or so I thought until my most recent experience with the Dutch Healthcare system.

I will not bore you with the details of my mother's medical condition other than to say that her eye specialist recommended a series of injections for her macular degeneration. Very encouraging news, I thought to myself. We caught the evil monster in time before it wreaks havock with my mom's vision. Don't wait too long, the doctor said. Next month at the latest.

So we go to the front desk to make an appointment. Yes, time is of the essence here. 'Oh, but you have to wait until the secretary is back from vacation to make an appointment' says one of the assistants. I am astounded. My mother is gradually turning blind and we have to wait for a secretary sitting somewhere on a beach getting a tan!? I hear my own voice escalate to a new level of irritation: 'Hold on here' I say in my rusty Dutch. 'We were just told by your boss not to wait too long with this treatment.' 'Miss Tan is the only one who sets up appointments of this kind, those are the rules. She will call you when she gets back.' 'When will that be, prey tell?' 'Next week.. sometime.'

I must have been a terrier in my previous life, because situations like this make me dig in my heels and really go for whatever I am after. Next day I call and ask to speak to the specialist. 'No, you cannot speak to him.' 'Why?' 'Those are the rules.' 'Can YOU ask him why we have to wait when he recommended not to wait.' 'No, I cannot do that.' 'Why?' 'Those are the rules.The tanning lady will call you back when she returns from her beach in Spain. But don't hope too much: there is a waiting list you know.'

A reality check with Dutch friends reveals that this is fairly customary here. Waiting lists are everywhere. I discover the hard way, that the words: 'don't wait too long' are meaningless. It is like the fuse of a dynamite stick. It fizzles out when it reaches the morass of the bureaucratic process.

In order not to commit murder and blow off some steam I go to the local swimming pool for a swim. I see a whole stack of swimming fins and ask the attendant if I can borrow a pair. 'No, we don't lend out swimming fins. Those are the rules.' I am tempted to ask her how many years hard labor she would get if she broke the rules, but resign myself to do without.

Refreshed I call the hospital for a third time and ask if my mom can go to another hospital where secretaries are not getting a tan while the patients are slowly turning blind. 'You can go anywhere you like, Miss.' Good! So I call another eye center. I go through my rusty, lengthy explanation and the lady on the phone is very patient. She explains to me that my mom has to be screened and has to come in for an initial evaluation. 'Why cannot the patient's records be faxed over from one hospital to another?' 'Oh no. We cannot do that. Those are the rules.'

There seems to be a general agreement amongst everyone that health care in this country is bare bones. That people are put on waiting lists, even when it is urgent. Unless it is life threatening people are left to deteriorate. Somehow the Dutch health care system is rated as one of the best in the world. But I don't think it applies to 96 year old women who suffer from multiple ailments. The 'egalitarian' mantra of the Dutch system has created more inequality than anything else. The old and the really sick are sent home packing and are told to live with it and not come back. Because those are the rules.leave comment here Read more...

How to Solve the California Budget Crisis - again.

By TomKando

By the time you read this, California may have a budget, and it may no longer be paying people with IOUs, but then again, you never know. So let me try to help the legislature and the governor once more:

1. The Budget deficit is $26 billion. There are 37 million people in California. If every Californian were to pay a one-time $700 surcharge, the deficit would be wiped out. Or if you prefer, there are 12 million households in California. To wipe out the deficit, each household would have to pay a one-time average (=mean) surcharge of $2,200.

2. Unfair, you say. Some could afford this, but for many it would be hard. Okay, so the surcharge could be progressive, like the income tax. The rich would be hit with a larger tax surcharge than the poor.

3. Also, using average(=mean) income is unfair. The median (half are under it, half over) is fairer. Median annual household income in California is $50,000. There are 6 million households making less than $50K a year, and 6 million who make more. To erase the $26 billion deficit would require that every household under 50K pay $1,100, and every household over 50K pay $3,300.

4. But wait, it’s not like we need to raise $26 billion: The legislature has already agreed about many cuts. Let’s say that only half the deficit still needs to be funded. This reduces the liability to a one-time $550 surcharge for every household that makes under $50K, and $1,650 for households earning more. This raises over $13 billion.

5. By the way, average household size is three, so for those making under $50K, the liability would be $183 per person, those making over that would pay $550 on average. People could pay installments:The poor would be hit with a $15 monthly bill for one year, and the rich with a $46 bill. And if you wanted, you could make the surcharge more progressive, and use more than two income categories.

6. If everyone else chipped in, I wouldn’t mind sending the Franchise Tax Board an extra $67 per month for a year (my half of my household’s liability. I am in the rich half of the population). That’s less than my fax bill, less than a dinner for two at Frank Fat’s. That way California would not collapse, and 37 million people would have a life.

7. ...Oh yes, what about future years? Well, first of all,don’t ever ask me to do this again. Furthermore, make sure you set aside a safety-net fund. Finally, index the state budget to population growth and inflation. The only problem is: This plan is far too simple and reasonable to have the remotest chance.leave comment here Read more...

Is America the Greatest Polluter?

Tom Kando

I wrote this a while back, when anti-Americanism was still more virulent that it is now, since Obama took over the presidency.

But it is still fashionable to blame America for being the world’s greatest polluter, for making a greater contribution to global warming than any other country, and for our weak environmental consciousness. Now, don’t misunderstand me: I am acutely aware of the environmental catastrophe which faces our planet. I just finished reading Jared Diamond’s Collapse, and I am afraid that he is right: the world is in deep ecological trouble. I am an environmentalist through and through, and I feel that the world must radically alter (= reduce) its consumption and reproduction patterns, or else we will soon experience the fate of the dinosaurs.

The only thing to which I object is the perennial tendency to single out the US as exceptionally guilty of destroying the planet.

For example, take our failure to ratify the 1997 Kyoto Treaty. We have been terribly vilified for this, and presumably our stance will soon change now that Obama has replaced Bush. Fine. But it is rarely noted that we were by no means alone in refusing to ratify Kyoto (Australia and several others did likewise), and that our refusal was based - some might say reasonably - on exemptions from Kyoto requirements granted to China and other “developing” economies - even though they already pollute and warm up the planet more than we do.

In an excellent article reprinted in McGraw-Hill’s 2007-2008 Sociology Annual Edition, Lester Brown points out that in ABSOLUTE AMOUNTS, China has in many ways overtaken the US, consuming more raw materials and energy than we do in many areas. Only in oil consumption are we still ahead. Otherwise, in coal, steel production, grain consumption, paper, and in most other respects China is now ahead of us - as it is in overall CO-2 emissions and in general pollution.

But the blame-America crowd then retorts that on a per capital basis we are still far “guiltier.” After all, China has four times our population, so they should be allowed to pollute more.

Besides, they add, what moral right does the affluent West have, to prevent China and other rising societies from achieving the same standard of living as we enjoy? Isn’t this a case of “do as I say, not as I did”? I don’t know about morality, but I am certain that if 1.3 billion Chinese (plus 1 billion Indians, plus Indonesia, Brazil and the rest of the “rising” world) reach the West’s per capita level of consumption, humanity will simply die.

But back to the US role: Much as anti-Americans would like to overlook this, our country does NOT have the highest per capital energy consumption either. Canada is ahead of us, and so are some of the very affluent small Middle Eastern States - I forget which, some Gulf States such as Qatar maybe, Kuwait perhaps. And some small and very rich European countries may be vying with us in this regard as well. Sweden or Norway perhaps. Of course, the reason for Canada, Scandinavia and some Gulf States’ very high energy consumption is their climate. The former need to warm themselves a lot for much of the year, and in the Middle East they need to cool themselves down year around.

But my point is this: The anti-Americans want to hold America responsible BOTH ways: 1) if they can’t blame America for being the world’s Number One polluter in absolute terms, they say, “Oh, well, on a per capital basis we are still the worst,” an 2) if some other countries have a higher per capita energy consumption than we do, then the America-blamers turn around and say, “oh well, don’t worry so much about Canada, it doesn’t have as many people as America does, so their collective contribution to pollution isn’t as bad.
So America gets it both ways, when in fact it is (1) neither the world’s largest polluter in absolute terms, (2) nor so on a per-capita basis.

Anyway, now that I got this off my chest, let’s all get back to saving the planet. This is a problem for which all countries are responsible and a responsibility from which no country should be exempt.leave comment here Read more...

Living in Limbo

By Madeleine Kando

I am not a very organized person, I am the first one to admit it. Probably because deep down I know that trying to create order in one’s life is futile and a total waste of time. There is such a thing as the law of entropy (if you haven’t heard of it yet, it means that if things are left to their own devices, they will always revert back to chaos). So there you have it: proof that organizing, dusting, cleaning and putting things away is a never ending task. If God had meant us to be organized he would not have created the law of entropy.

Cleaning up and putting things away reminds me too much of the story of Sisyphus, the Greek king who had to roll a huge boulder up a hill, only to watch it roll back down, and to repeat this throughout eternity.
I am comfortable with my messy nature. I have accepted the inevitability of having to spend a large portion of my day looking for things but I am pretty good at remembering where I misplace them (except my glasses - looking for some misplaced item without being able to see is a challenge). At times when a friend comes over, I can tell by their shocked expression that not all is as it should be in my house.

There is some reason to my madness though. I am messy because it allows me to pretend I am a butterfly. I like to flutter from one idea to another, from one mess pile to another. Leave a little bit of things unfinished and then go back to it so it’s fresh and messy. Once something is organized, it’s done, dead, finished. No more room for growth. I am secretly messy because I like the adventure of finding something undiscovered. A messy world is a world of discovery, change and surprise. An organized world is a static world, safe, boring.

I was living my little disorganized life, not being too bothered by my messy nature. The problem only started when I got married. I had the good fortune of marrying a man that appreciates me: my sense of humor, my intelligence, my beauty… my modesty. But my misfortune is that this wonderful man is also a very organized person and takes great pleasure in placing things where they belong. At first it was a welcome change in my life. He was like Cinderella’s little animal friends: the chipmunks do the sweeping, the mice to the dusting, the birds lift heavier items in unison to place them on shelves. I could hear the background music as I watched my new husband metamorphosize our house.

Now that I think back, I should have seen the warning signs of what happens when two people at opposite ends of the ‘orderly/messy’ spectrum get together. At first the symptoms were harmless: boxes containing old sunglasses quietly disappearing. Newspaper clippings of half-read articles vanishing overnight. But as more and more items started to disappear from where I had carelessly left them in my usual messy way, I began to think that I was suffering from early symptoms of alzheimer: ‘I swear I left my keys here yesterday’. One day, when my wallet was removed from it’s usual misplaced location I panicked: ‘Oh no! Somebody broke in and stole my wallet!’ When my car keys vanished from the spot where I had negligently tossed them, I almost had a heart attack. ‘Oh my God. I locked my keys in the car!’

So you see, living with an organized person is like living in limbo. The stress it causes to never be sure where things will be when you wake up in the morning requires a strong dose of valium. To hope that your glasses will be where you left them so you can make that first cup of coffee (hoping the cups have not mysteriously moved too). I have seriously considered going to couples therapy, not because I am ‘domestically challenged’ but in the hopes that my dear husband could be weaned off his well-intentioned but lethal desire to clean up.

If only all my possessions could be like my cell phone: equipped with a ringer. I would ‘call’ my keys, my glasses, my wallet, and presto, no more wasted hours looking for things. But for now I am resigning myself to the inevitable. Searching has become my middle name.leave comment here Read more...