Oriental Town Meeting October 4, 2011: Rainy Day?

Bizarre town meeting tonight. Only four commissioners present (Commissioner Styron was absent).

After an interminable discussion of minutes, the board considered a request by the town manager to amend the budget. Purpose: to appropriate funds to pay bills incurred and projected for hurricane clean up and remediation, including mosquito control. When two commissioners pointed out that there are still unexpended funds in the budget, the manager explained that he has no authority to expend those funds for any purpose other than the authorized line items. Except for hurricane expenditures, the approved budget is being implemented with no problems. He further explained that hurricane expenditures will be reimbursed 75% by FEMA and 25% by the State of North Carolina. The purpose of the amendment is to allow the town to pay its bills before FEMA and state reimbursements are received.

"Well what if they don't reimburse us?" Commissioner Johnson asked. "I'm worried that the Oriental taxpayers will be stuck with the bill."

After reiterating that he has negotiated the details both with FEMA and the state and explaining that he is carefully establishing a project number for each job, following FEMA guidelines, the manager posed a key question. Suppose there were no FEMA and no funds from the state. Is there anything the town is doing (debris pickup, mosquito control, etc.) that the board wouldn't want the town to do anyway. He received no answer.

The board rejected the motion to approve the budget amendment.

Commissioner Johnson then introduced a new motion to approve a smaller amount than requested for hurricane debris pickup and for mosquito control.

A similar series of actions first rejected a requested amendment to the water fund, and then approved a lower amount than requested.

"Oh, we don't want to dip into the reserve fund," Commissioners Johnson, Roe and Bohmert explained.

In many states, the reserve fund is known as the "rainy day fund."

We just had a very rainy day (Irene) and the health and welfare of the residents of Oriental are seriously threatened. And our commissioners want to dither about whether to pay for contracted services for which we will be reimbursed.

Looks like tonight was another rainy day at the meeting.

Death Panels?

My sister would have become eligible for Medicare three and a half months from now. She didn't make it.

I don't blame anyone in particular for her early death. She had health insurance. She received excellent care. But she might have lived a longer and still productive life except for two failures of our health care system. Both were caused by our reliance on market mechanisms to provide solutions to health problems.

There are seemingly endless choices of pharmaceutical products for chemotherapy. Sharon's oncologist, based on extensive diagnostic tests, chose one particular treatment. It worked well. Her cancer seemed under control.

As time passed, the manufacturer and medical practitioners learned that, though the drug was effective for my sister, it wasn't effective for many others. The manufacturer withdrew it from the market.

My sister's condition worsened.

The oncologist searched the pharmacopeia and found another treatment that he thought might be effective, though not as effective as his (no longer available) first choice.

As he expected, the second choice was not quite as effective, but seemed to be working.

Then a few weeks ago when another round of chemotherapy was scheduled, the hospital informed my sister that they were unable to find any of the necessary medication. A few days later, on August 19th, I read in the New York Times that government officials, the drug industry and doctor's groups were "rushing to find remedies for critical shortages of drugs to treat a number of life-threatening illnesses, including bacterial infection and several forms of cancer."

By mid August of this year, 189 drugs crucial to treatment of childhood leukemia, breast cancer, colon cancer and certain infections were in short supply. The drug for treating my sister's cancer was among them.

Weakened from lack of treatment and related complications, my sister passed away September 2d.

There were many factors affecting her death, some out of our control. But the final straw was the failure of the drug market reliably to supply life saving medications. Does the drug industry have death panels?

In any case, when the drug companies withdrew one medically necessary, safe and effective drug from the market and drastically reduced the availability of another, not for medical reasons but for marketing reasons, they had no regard for my sister's life.

"Do not ask for whom the bell tolls -
It tolls for thee."

-John Donne

Interruptions In The Natural Order

We just returned from laying my sister Sharon to rest in McAdams, Mississippi. Hers was a good life, well lived. But  it ended too soon.

I can only feel that Sharon's death interrupted the natural order of things. I remember when she was born during a snow storm in Oklahoma City. Her life was interesting, but anything but stormy. Still, in the natural order of things, she should have eventually joined our other two siblings at my funeral. I'm the eldest, so that would be the fair and orderly way.

A little over a week before her passing, our other sister visited her in the hospital and mentioned how much Sharon looks like our grandmother, especially her blue eyes. Sharon replied with a weak smile, "no, I don't look like Grandma. I look like death peeking out from behind a headstone."

She might have been weak and frail, but still able to share a bit of humor.


We will miss her.

Coburn: Destroy to Save

In a 1968 report by AP correspondent Peter Arnett concerning the fate of Ben Tre, a provincial capital of Viet Nam, an unnamed major observed that "to save the town it became necessary to destroy it."

This sort of logic happens in war. Senator Coburn of Oklahoma, in concert with Joe Lieberman of Connecticut, has brought the concept to Medicare.

Last month the two senators joined in an effort to reduce medicare benefits in an effort to "save" the program. Once they get through "saving" it, though, it will not be possible to see the existing program through the rubble.

I remember last summer during a series of town meetings, one Republican critic of health care reform shouted: "keep the government's hands off my Medicare." I join in that sentiment.

Where Are The Milk Jugs?

Remember a couple of years ago when local organizers in Oriental mailed empty milk jugs to Washington in opposition to President Obama's health care reform? Many of them were afraid the health care reform would harm their medicare. They were apparently influenced by "mediscare" reports.

I'm waiting for them to start up their protest again, mailing the jugs to Republican members of Congress. Turns out Republicans really want to reduce or abolish medicare, and are using the national debt limit to extort agreement.

Milk Jug Protests

Remember the local protests against President Obama's health care reform proposal at the Oriental post office last year? The protesters, mostly Republicans, said they didn't want any government interference in health care, though most of them were users of Medicare, VA and other US Government health care programs. Some seemed to fear that health care reform would take these away.

We now know that it is the Republicans who want to replace Medicare with a voucher system, thus turning it into something entirely different from the present system. But they get upset if anyone points out that Congressman Ryan's plan is a voucher system (which it is) and will end Medicare as it now exists (which it will).

Paul Krugman points out quite clearly in his blog why Medicare is sustainable in its present form, but is susceptible to improvement. If you are interested in his explanations, look here. For even more information, once on his blog, keep clicking on the "previous post" button. Eventually, you will come to an explanation of liquidity preference and an informative graph.

Personally, I think a better health reform would have been to adopt a system like VA. For various reasons, in any event, doctors are increasingly withdrawing from their own private practices and going on salary. This brings many benefits to them as well as to their patients. I, for one, would be more comfortable knowing that the physician isn't recommending a procedure because it improves his own personal income.

Where Do All These Bills Come From?

The newly elected North Carolina legislature has pursued a frantic pace of new legislation.

Some observers have charged that the new legislators have no idea what the effect of their proposed legislation will be. That may be true.

Normally, anyone taking a new job spends a little time getting to know the ropes. Not these legislators.

So where are all the bills coming from? Did you ever hear of ALEC? That is, the American Legislative Exchange Council. You thought you elected your local candidate to the state House of Representatives and the state Senate? Actually, you elected ALEC.

How do I know? I have been following the bills introduced in the legislature, and I have looked at the ALEC web site. Here is a link to ALEC's model legislation. Just read ALEC's models and compare them to the bills introduced by the new legislators. Most of them are ALEC bills.

So who is ALEC? The nationwide voice of corporate interests seeking to get their way through uniform acts by all of the state legislatures. Their aims have nothing to do with North Carolina. Do they have the public interest at heart? Not Likely.

Here is a good backgrounder.

Physical Changes

I saw my doctor last week for my annual physical. Everything was great. Only one piece of bad news: I'm an inch and a half shorter than I was when I was 21.

That's unfair.

The problem isn't that I want to tower over other people - it is that now I have to lose more weight. The weight charts are calibrated by height. As long as I thought I was taller, my weight didn't look that bad.

When you think about it, using overall height as the benchmark discriminates in another way. My legs are short. They should be a couple of inches longer. That wouldn't add much weight, but would make a difference on the weight chart.

Guess I just have to start eating less and exercising more.

On Legislating

Legislating is hard work. The easiest thing for elected representatives to do is nothing. You make fewer enemies that way. It is also easier if you don't do anything new. Maybe pass a few proclamations recognizing the Sweet Potato Festival or Vietnam Veterans or such like.

Even in a small setting like the Oriental Town Board of Commissioners, it is hard to cobble together a majority of three votes out of the five commissioners in favor of anything new, especially if there is controversy. Think how much work it is to obtain a majority out of more than five hundred members of Congress.

Last night's vote in the House of Representatives on health care reform was an awesome accomplishment. We will all be better off as a result, as will our children and grandchildren.

Pamlico - a Wilderness County

Attendees at tonight's (Monday, March 15) meeting of the Pamlico County Commissioners learned a startling fact: the State of North Carolina does not categorize Pamlico County as a "rural county," but as a "wilderness county."

This revelation was provided by Mr. Jim Gray, who spoke in favor of adoption of the proposed Emergency Medical Services (EMS) Strategic Plan. During the ensuing discussion, Commissioner Ann Holton reluctantly admitted the category might be accurate. Just the previous day she had to kick her golf cart up to top speed to get away from a bear. Mr. Gray emphasized the contribution that improved EMS services would make to moving the county out of the wilderness into the rural county category. He noted in particular the importance of enhanced EMS to economic development by encouraging population growth, especially among retirees.

Mr. Gray was one of three attendees who spoke up strongly in favor of the strategic plan during the public hearing. County commissioners voted unanimously to adopt the plan.

The plan is good news for Oriental and nearby locations. The first phase of the plan, covering the next three years, calls for establishing a satellite EMS location in the county's southeast region. This is expected to be at the Oriental Fire Station.

The second phase, over the next five years, will involve upgrading EMS to the Paramedic level. Pamlico County is one of fewer than ten counties in North Carolina to lack a Paramedic or higher level certification.

The plan is only a beginning. It will need funding to complete, but to all appearances, the county is now committed to making it happen.

Health Care

I was born in an Osteopathic hospital in 1937. At the time, it was the least expensive option available; an important consideration for working class parents during the Great Depression.

During more than seven decades since then, I have received medical care through most of the possible program structures:
a: No insurance - just pay the doctor;
b: Provided directly by the government - in my case, at military treatment facilities;
c: Provided by employer through private health insurance;
d: Single payer government paid health insurance - CHAMPUS, TRICARE, MEDICARE.

The only possible program I have never participated in is private purchase of private health insurance. One of our sons has done that.

It is great that both houses of Congress have passed health care reform bills. May they be quickly reconciled. We owe it to ourselves and our posterity to provide universal health care benefits. We are the only advanced country that doesn't.

Universal health care systems in other countries all result in better health outcomes at lower cost to society. I would have preferred either a straight system of government health care like that in Great Britain and the United States Veteran's Administration or a single-payer system like Medicare. But something is better than nothing. Once we get a system in place, we can make it better.

Next we need a real public option.