Books, beers, boxing and elections

There are indications that there might be an upset in the making in the Philippine presidential election on Monday, May 10. My friend, Danny Gil, who has moved back to the Philippines for good after a lifetime as an engineer in the U.S., says the younger Filipinos are out in force for Gilbert Teodoro, the current fourth placer in most surveys.

Gibo Teodoro's last rally drew 130,000 people, mostly young idealistic Pinoys and Pinays, while Noynoy Aquino's could attract only 65,000 people. This, despite the fact that Noynoy's army had been deployed to haul in as many Filipinos as they could for the rally.

My friend also reports that there was not much energy in Villar's rally, which was attended by an estimated 30,000. In fact, former President Estrada's rally drew much more than Villar's. Never mind that Estrada was a convicted plunderer until pardoned by President Arroyo and is known world-wide as the tenth most corrupt political leader in the world. The poor and disenfranchised in the Philippines still want him to be their President.

There are rumors that Estrada has an agimat, or anting-anting, which allegedly has magical powers that have fixed people's fascination for this former B-movie actor for all time. I can't comment on the reliability of such reports, but I do know that if there is indeed an agimat or anting-anting it does not work on the educated and elite Filipinos. Most in the educated and elite Filipino community regard the 71-year-old former President as a clownish nuisance.

But, since a good slice of the Filipino electorate think elections are a joke and can be stolen by the rich and powerful, who knows who the people will actually vote for?

My friend Danny reminds me that former President Fidel Ramos consistently showed up in fourth place in surveys leading up to election day in 1992 but managed to pull off an upset victory.

Convicted plunderer Estrada, who is currently in second place in some surveys and fast closing in on Noynoy's lead, may win by a nose. To the consternation of the intellectuals, reformers, elitists, educators, religious leaders, and just about everyone who cares about the future of governance in the Philippines.

My friend's enthusiasm for Gilbert Teodoro is, unfortunately, unwarranted because Teodoro's appeal is with the educated elite and the idealistic youth. This appeal never translates to victory in the polls because the C, D and E classes (the poor and lower middle classes) comprise 70 to 80% of the electorate and those are not going to vote for Gibo Teodoro.

I personally would be delighted by a Teodoro victory because he is a nephew of one of the friends I grew up with in Manila. His mother used to have lunch with us guys at my friend's house, though I could never count her as my friend. She was not the overly friendly type, was apparently shy and reserved, and seemingly looked upon us friends of her brother's as a curious bunch. Nonetheless, a Teodoro victory would please me mainly because it would please my childhood friend, but I just don't think it is possible on Monday. 2016 perhaps?

The biggest surprise of the 2010 election is Senator Manny Villar, who went from number one at the start of the campaign season to his current third place in most of the pre-election surveys. This is a personal tragedy of Greek mythology proportions. A man who has never lost an election and who has built up a real estate empire from an initial shoe-string operation appears to have self-destructed in recent months.

Villar can't seem to burnish his image after a torrent of critical newspaper and Internet stories flooded Filipino consciousness. This proves that if a story is repeated over and over, pretty soon even the marginally literate and downright stupid will believe it.

Of course, since Villar appears to be the Arroyo administration's secret true ally, the voting machines could end up deciding the eventual winner of the election. Whoever controls the voting machines controls the outcome of the election. President Gloria Arroyo controls those voting machines, according to the cynics, and the result of the presidential election has already been pre-ordained.

The Filipino people, especially the so-called Yellow army of leading candidate Noynoy Aquino, are gearing up for an election night vigil and street rallies and protests. Stay tuned, the aftermath may be the most interesting.

I do not condone any kind of revolution, other than a "kick-the-bums-out" revolution in the ballot box, but I would completely understand if the Filipino people finally go out in the streets and enforce their will through bloody and noisy demonstrations, if not outright armed rebellion.

OK, snap out of it, Cesar. None of this will happen because if there are glitches in the voting machines, the Philippine Commission on Elections can still count the paper ballots that shall be cast and read by the machines. What? No paper ballots? But that's impossible. The Filipino people were promised paper ballots as back-up to the machine counts.

I don't have the Filipino channels in my DirecTV satellite subscription but I will call DirecTV this morning and subscribe to the Filipino channels. I think the days after Monday's election will test the will and character of the Filipino people and the patience of the military, which has been quietly watching recent trends and developments with eagle eyes.

I'd like to know whose side the Philippine army is on. But the army is no longer the monolithic army of bygone days. There are factions and fissures now. Which faction is more numerous and cohesive: the PMA class of 1978 who are reputed Gloria Arroyo allies, or the Magdalo faction, whose leader - Cesar Trillanes - is quietly pulling strings from behind the bars in his prison cell?

This is Philippine democracy in action. One front-row seat, please.

Too bad I can't drink beer or any kind of liquor anymore. Doctor's orders. So I'll just have to make do with the popcorn and the root beer.

I'm sure Obama's people are watching the Philippine elections, which will decide not only the next President but also half of its senators and all of its congress people. The country remains a showcase for American-style democracy. If the Philippines messes up big-time, it will be #@!%$-ing big, as Vice President Joe Biden might whisper into Obama's ear.

The IMF, the World Bank and other lenders are watching the unfolding zarzuela, ever-concerned that any kind of major political upheaval in the Philippines could damage the country's ability to service its sovereign debts. A Philippine default on its foreign loans is just what the world doesn't need, with the Greeks almost certainly eventually defaulting on their debts and the Spaniards hot on their trail.

But, should the world really worry about a Philippine default? The country owes $80 billion, but more than half of this is owed to Filipino creditors. A $40 billion default will not be seismic to a world economy that is 61.1 trillion U.S. dollars. That would put Philippine debt to the world at .00007, 7 thousandths of 1 percent.

Of course, the country could still surprise us, with the widely-expected winner - Noynoy Aquino - emerging as a clear victor. What are the odds of this happening? I'd say there's a 50-50 chance. In the Philippines, the candidate the plurality of Filipinos vote for is not always declared the winner. Not unless it is a landslide of historic proportions.

By late Tuesday or early Wednesday, the world may know who the next President of the Philippines shall be. I'm still counting on Noynoy Aquino to pull this off.

The Magdalos will just have to wait for a more opportune time to take over the reins of government in the Philippines.

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Speaking of odds, shortly after the Mayweather-Mosely fight, Vegas odds-makers installed Manny Pacquiao a -120 favorite to defeat Mayweather in what appears to be the inevitable Pacquiao-Mayweather fight late this year or early next year. I don't know what -120 favorite odds are, so someone who is familiar with betting odds will just have to educate us.

I was at a dance party last Saturday, May 1st, and wasn't interested in the Mayweather-Mosely fight. One of the guests at the party lives close by and had bought the fight's pay-per-view and invited all interested parties but I declined since I am contemptible of Mayweather, who intentionally scuttled the Pacquio fight by making impossible demands on Pacquiao.

Turns out to be a very instructive fight. Mayweather proved that he can take a punch. Mosely rocked Mayweather with a one-two combination in the second round, but the latter just shook it off and dominated the remaining rounds.

Mayweather will be a very tough fight for Pacquiao because the guy is hard to hit. He fights like a snake. He strikes, slithers away, strikes again, slithers away. This is the way Mayweather fights. Pacquiao can be frustrated by a fighter like him.

The odds-makers are right, though. It's impossible to hide from Manny. Sooner or later, Manny will tag Mayweather and then Manny's patented swarming, piranha-like feeding frenzy will take over and Mayweather will find himself sitting on the canvas.

I don't think Manny can knock Mayweather out because, let's face it, the guy is a great undefeated fighter who will find a way to survive Manny's ferocity. He will be able to run and clinch, run and clinch and throw enough rabbit punches to frustrate Manny.

Manny by decision, maybe even a split decision. The -120 odds in favor of Manny appears to be accurate, whatever that means.

I may even defy my doctors and pop open a San Miguel beer for that one.

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I always try to read David Brooks' columns in the New York Times. All NYT columnists are highly-educated and well-read, but Brooks stands half-a-head above them all. He has an amazing grasp of social issues and he can communicate his insights with crystalline clarity.

Nearly everyone in the academic circles of America knows that Asian Americans nearly always rise to the top. In fact, the joke among male high school seniors is that if they want to score high on SAT tests they have to date Asian chicks.

50% of all adult Asian Americans are college graduates, while only 31% of whites are, according to Brooks. The equivalent figures for blacks is 17% and for Hispanics it's 13%.

In terms of actual achievement, what this translates to are the following:

1. Asian Americans have a life expectancy of 87 years, compared with 79 years for whites and 73 for blacks. The more educated a person the better he takes care of himself, which is why there is some correlation between educational levels and healthy lifestyles.

2. In survey after survey, Asian Americans in the New York metropolitan region out-earn whites and all other minority classes. The correlation between educational levels and lifetime earnings is well documented, so it's not surprising that Asian Americans have risen to the top economically in the U.S. Caution: as a group, not as individuals. Whites still produce, far and away, the richest individuals in this country.

Asian Americans share the tradition of valuing education - especially college education - with the people in their home countries. They have made the judgment over the years that education transforms lives. This judgment has been proven correct in their home countries, in the U.S. and just about everywhere.

Which brings us back full circle to the Philippines. The country produces a bumper crop of engineers and other college graduates, but only in relation to available jobs. There are so few job openings for college graduates in the Philippines that even though only a small percentage of Filipinos earn college degrees, it feels like the country is producing too many.

We know, however, that globally education is the key to economic ascendancy. The Philippines must find a way to educate its masses adequately and encourage them to go for a college degree. If 50% of Filipinos eventually earn their college degree, they will not only live longer, they will become economically dominant. Just as the 50% of Asian Americans who have college degrees have become economically dominant.

College education is so cheap in the Philippines that if the government finds the will to provide a college education to a majority of college-age Filipinos it probably can be done.

My book, Out of the Misty Sea We Must (Blueprint for a New Philippines), is in the final stages of completion. Central in that book is the mandate for overhauling the public school system in the Philippines completely - turning it right side up - thereby elevating the skill levels of Filipino workers and raising the standards of all colleges and universities in the Philippines.

It should be out soon and available at amazon.com. I hope you'll buy it. You'll be surprised at the quality of the photography. Those who know the creative photographer, Carlos Esguerra, will of course not be surprised at all. But the majority in the Philippine-American community will be pleasantly surprised.

Oh, by the way, the editorial content is not too shabby and will be worth all of the $11.95 that the book will cost. $7 for orders originating in the Philippines.

My friend, Jobo Elizes, is the publisher.

The Silly Season

This must be the silly season. During the primaries in 2008, the then candidate Obama told the nation that the months leading up to the Democratic Presidential Convention – when it was clear to the world that Obama would win the nomination – were the campaign’s "silly season."

It was that time of the year when the losing candidate – Hillary Clinton – would make silly and unsubstantiated charges against Obama as a last and final try to derail the Obama campaign.

It must be the silly season now in this country because we are being subjected to – literally – the silliest arguments by our politicians.

Having been defeated in their attempts to short-circuit the health care reform legislation passed by a Democratic-controlled Congress, Republicans are hard at work trying to salvage scraps from their train wreck.

First, they finally came out with their own health reform plan. They said people should get tax cuts so they will be able to afford to pay for health insurance.

Let’s analyze this. A family of four with a combined income of $50,000 probably pays a total of $4000 in Federal income taxes. Give that family a tax cut of 10% and at the end of the year the family will have $400 more disposable income. Let’s see... this family would be lucky to find health insurance for less than $800 per month, or $9600 per year.

The tax cut gives them $400, so where will they get the shortfall of $9400 per year?

Another idea being pushed by Republicans is health savings accounts that accumulate tax free. Assume for the same four-member family an ability to set aside $100 per month in a health savings account. After six months Papa Bear gets sick and needs surgery done. The total cost is only $15000 because it’s minor surgery and requires only a two day stay in the hospital.

The health savings account was set up six months ago, so it only has $600 accumulated in it. Where will the $14400 shortfall come from?

Now we learn that an original-thinking, out-of-the-box Republican has a great idea. She says, forget about insurance, forget about tax cuts, forget about health savings accounts. Just go to your doctor and make arrangements to pay him in kind. Pay him in chickens, for crying out loud. That’s right, she says, pay him in chickens or offer to paint his house for him, or pay him in some other kind.

This Republican thinker is Sue Lowden, the leading Republican candidate for senator of Nevada and an odds-on favorite to unseat Harry Reid, the sitting Nevada Democrat who also happens to be the U.S. Senate Majority Leader.

Sue Lowden was interviewed after she made the statement about paying doctors with chickens and instead of backtracking, she elaborated on her health care plan. In the interim, she had received support from a doctor in Henderson, Nevada, who would accept payments in chickens if the patients can’t come up with the cash.

As of this writing, a few people in Nevada are offering their services to set up a barter system that will make it easier for people with no money to see their doctors and pay them with chickens or in kind.

The rest of Nevada can no longer hold back their laughter.

Let me see. Assume that a doctor charges $75 for an office visit. At an average of 3 pounds for every dressed chicken, that’s 25 chickens that the patient must give her doctor. The chickens have to be refrigerated to prevent spoilage. That means that the patient must rent a refrigerated truck to deliver the chickens. The doctor’s office must have a huge freezer to store all the chickens he expects to receive from his patients. And his nurses and office help will need to wash their hands each time they take in a bunch of dressed chickens.

So much for the chicken idea.

Let’s explore the other idea. The patient could pay the doctor “in kind.” The patient could paint the doctor’s house. But what if the doctor’s house has just been painted, or is brand new? Hmm, let’s see. What if the patient washes the doctor’s cars? But the doctor can have his cars washed for $5 at the school where kids on a football team are washing cars to raise funds. “OK,” the patient will likely say, “I’ll charge $5 a wash, so your three cars will get 5 washes each.”

“Fine,” the doctor says, “you’ve got a deal. Now where do you propose to do the wash?”

“I’ll do it in front of your garage,” the patient offers.

“But I live in a condo high-rise and there’s no space…”

“Fine, I’ll wash your cars in front of my house,” the patient offers.

“How are we going to get my cars to your house?” the doctor asks.

“Well, you could drive the cars over. While I’m washing your cars, you could be waiting in my kitchen and drinking coffee.”

“I’ll tell you what,” the doctor finally says, “you’re an attractive young woman. Why don’t you just invite me to your house and pay me in kind in any way you want.”

The patient, a pretty 26-year-old woman, flashes her snow-white teeth.

Is this the alternative health care plan that the Republicans said they would offer if the Democrats were only willing to scrap their health care reform legislation and started from scratch? The country almost fell for the Republican promise to restart the health care debate from scratch and put the country on the right track.

What the Republicans did not tell us was that starting from scratch meant starting with chicken scratch.

Why do politicians become silly when all they want to do is be original? It’s because we don’t have an intelligent electorate in this country. The silliest arguments are advanced because they can be made easily and in the form of sound bites. The shorter the message, the easier for people to remember.

God forbid a candidate should ask his voters to think. How dare him make me think. He is out of touch. He is an elitist. He is a liberal. He is asking me to think.
People worship at the feet of Sarah Palin because she talks their language: “It's good to be among you, the real Americans,” (translation: Obama is not, he is a Kenyan); “We will re-load," in obvious reference to the Tea Party’s predilection for carrying loaded weapons to political rallies.

“This is a gangster government!” Michelle Bachman screams.

“Obama is a racist!” cries Glenn Beck.

"They're setting up "death panels," warns Sarah Palin.

Ex-convicts who are sexual deviants must not be given Viagra through the new health care plan, one Republican senator offered by way of amendment to the health care reform law.

Down with European-style socialism, screams a banner being waved by an elderly man who probably is on Medicare and receiving Social Security payments.

The leaders know that if they do not stoop to the level of their audience they will be ignored, or dismissed as elitists. Or worse, the right-wing dogs will be let loose on them.

We test our school-age children to get a snap-shot of their academic progress each year. Is there some kind of test for adults?

America is mired in the longest-running silly season. Is this what happens when a country is on the decline?

A Wild and Crazy Guy

I announced in my last published post that I am writing a book. I’d like you to know that I am right smack in the middle of that project. With one hand I held on to the book project and with the other hand, I typed this post in this blog. It worked out well because I ended up with a chapter that I can use in my book – after some editing, of course.

One of the later chapters in my book will be a discussion of official corruption. I cannot in conscience omit such a discussion since I am offering a Blueprint for a New Philippines in my book. I cannot imagine a new and improved Philippines without tackling the issue of official corruption.

Chapter 16 – A Wild and Crazy Guy

In chapter two, The End-Around, I was in full agreement with Tom Friedman, whose thesis about India is that the New India that is centered in Bangalore developed side-by-side with Old India. The latter has been known to have a stifling bureaucracy, somewhat corrupt, inefficient, argumentative, deeply-religious and overly-reliant on the Hindu caste system. The New India sneaked up on the older guy and did everything according to advanced, recognizably western, un-corrupt, efficient rules of management and resource allocation.

Bangalore might have been a typical American suburb, complete with upscale Indian-Americans who had grown up on McDonald's.

Enter the Philippines. A focus on great improvements in the level of education in the Philippines and the successful development of areas outside Metro Manila will mimic the success of Bangalore. For that matter, Guangdong, Shanghai, Macau and Ireland.

What the End-Around means is that the country shall avoid the confrontation with the corrupt culture in the existing metropolitan areas and concentrate its energies and investments in the more promising and newer industrial estates and commercial bases.

The more efficient, less corrupt culture that is expected to develop in the new concentrations of economic development shall serve as the model for the Filipino people. That fact alone will put pressure on the rest of the Philippines to shape up. The old will be shown up by the new, just as the rest of the Philippines is being shown up by the Subic Bay authority. Change will be perceived as having landed, its inevitability shall cause the old to lay down their arms and surrender to an army whose time has come.

This of course is only in theory. The jueteng lords will probably ignore the culture in the new industrial and commercial areas, like it isn't happening. The 20-percenters in the highest echelons of power may just become more sophisticated in their ways to better hide their nefarious activities.

It is not a given that the un-corrupt culture in the new industrial and commercial areas shall influence the traditional politicians (“trapos” for short, meaning dirty, grimy rags).

The country has a long history of corruption. It is not ordinary corruption, it’s major league. The late dictator Marcos is, after all, in the Guinness Book of World Records as having stolen the most from his country’s Treasury. The Philippines ranks high in corruption index year after year. Tackling corruption in the Philippines will be tough, very tough.

Tom Friedman's Bangalore model may in fact be only partly correct. The economic development in the new areas will tend to accelerate development in the older areas. But the change in culture, such as the eradication or the radical excision of corrupt elements in official Philippines may not be achievable within the foreseeable future.

CORRUPTION-FIGHTING AS A DISCIPLINE

A paper written by Vinay Bhargasa of the World Bank titled “Combating Corruption in the Philippines” lists 9 critical steps that the Philippines must take to successfully wipe out or minimize official corruption:

1. Reduce opportunities for corruption through policy changes;

2. Reform campaign finance laws to reduce the temptation for sitting public officials to plunder the treasuries under their control;

3. Increase public oversight of government operations;

4. Reform budget procedures;

5. Improve meritocracy in the civil service system;

6. Target selected departments where corruption is known to be rampant;

7. Enhance sanctions against those who are caught with their hand in the till;

8. Develop partnerships with the private sector;

9. Support judicial reforms (translation: get rid of corrupt judges).

Over the years, many important studies have come out that created road maps for officials if they really intend to clean house. Not one President after Marcos made a serious attempt to eradicate official corruption. That is extremely discouraging since the memory of a tyrannical and egregiously corrupt dictator was still fresh in everybody’s mind in the decades after Marcos.

Cory Aquino certainly didn’t begin to tackle corruption. Perhaps she couldn’t because she was busy fighting off the many coup attempts against her. Fidel Ramos had a relatively clean reputation, but again, no major initiative against official corruption came from his office. Which was disappointing since Ramos appeared to have the loyalty of Congress, the courts and the military. If anyone could succeed in launching a zero-tolerance policy against corruption in government, it was Ramos.

We all remember Joseph Estrada, who was convicted of plunder and served time in prison and under house arrest. The current occupant, Gloria M. Arroyo, is up to her eyeballs in accusations of 20-percent commissions on all major national government contracts.

The accusations against Mrs. Arroyo are just that: accusations. They have never been proven in court. The courts have not looked into the accusations either because the Ombudsman has already decided that the charges lacked merit. She arrived at that conclusion without, to my knowledge, conducting an investigation.

IT WILL TAKE A WILD AND CRAZY GUY

I have thought about the corruption problem many times and have concluded that the ideal President is a wild and crazy guy who has cancer or serious heart disease or who has nothing to lose. Such a President will not be afraid to die because he or she is dying anyway or is living la vida loca. It is only a matter of time before the guy moves on to the great beyond or falls into a ravine.

It will take someone who is fearless in the face of death threats to get the job done. We know that the President who issues an Executive Order declaring a zero-tolerance for corruption in government is immediately in danger of being assassinated.

I would recommend to such a President that he or she organize an elite corps of palace guards, made up of ex-U.S. Marines, Army Rangers and Navy Seals and under the command of the toughest Philippine Army general whose loyalty to the President is beyond suspicion.

Anti-corruption crack battalions shall fan out to the provinces to arrest known drug lords who have corrupted the police, known jueteng (numbers racket) lords, corrupt mayors and governors. Everybody else shall be on notice that every allegation of corrupt activity shall be investigated and prosecuted to the full extent of the law.

Lifestyle investigations shall be conducted on all employees of the Bureau of Internal Revenue and Bureau of Customs to determine which employees are living beyond their means.

To give offending parties a chance to mend their ways, the President should erect a system that will encourage corrupt government officials to come forward and appeal for light sentences, provided that they promise to reform their ways and that they turn state witness.

To the extent that the government can afford to, the salaries of BIR, Customs, provincial and municipal treasury agents shall immediately be raised to a level that those employees can live on.

The President may also start a program that will reward agents who significantly increase their tax collections from one year to the next.

Bidding on government contracts is published in government websites, so there is supposedly transparency in procurement, a very important and the most corruption-susceptible area of government. Yet, bidding is still allegedly rigged so that contractors who have managed to infiltrate the backrooms where deals are made end up with the winning bids.

This is just an allegation, made internationally famous by Mr. Jun Lozada two years ago. It is important to note that the very high government officials that Mr. Lozada fingered as the culprits in the ZTE-Broadband mess have fought back and filed a libel and slander suit against him. Lozada's accusations are not being investigated by the Ombudsman, but he is being investigated for the alleged twin crimes of libel and slander.

This should strike fear in the hearts of Filipinos who may be thinking of spilling the beans on high government officials.

The President who issues the zero-tolerance Executive Order will likely receive the advice to make the computerized procurement system fool-proof so that the lowest bidders end up winning the contracts and not the ones who are the most skilled inside persons.

THE LIVING WAGE

Most government employees do not earn enough to feed their families. That is just a fact of life in the Philippines. Either the government increases salaries of government employees across the board or government offices should allow tipping in certain areas. Yes, tipping.

We tip doormen, parking attendants, car wash employees, the newspaper delivery guy, the landscaper, the waitress, the taxi driver, the bartender.

Why should we not tip government employees who facilitate the processing of our papers?

If we introduce tipping in government offices, we must insist that the tips are handed out after the service is rendered, not before. If the tip precedes the service, it is a bribe. If it’s after the service is rendered, it’s a tip.

A few years ago, I came across a newspaper article which reported that in Indonesia the government was experimenting with allowing government employees who provide service to the public directly to accept tips. We know that under most countries’ laws, tipping to government employees is illegal because it is presumed to be indistinguishable from a bribe.

I don’t know what the outcome of that Indonesian experiment was. There simply isn’t any follow-up news about it. I would not be surprised if it was scrapped because the devil is in the details.

The possibility that a system of tipping to government employees in the Philippines, however, is alluring. What if a system can be devised that will allow the public to tip government employees? Would the Philippine Congress legalize tipping?

I tossed this idea in my head and came up with the following guidelines:

1. The tip must be given after service is rendered, not before.

2. The tip must be dropped in a collection box and not given to the individual who provided the service. This assures that everybody in the government office benefits;

3. The method of sharing the tips must be equitable. Those who face and directly provide service to the public must get a larger share of the tips because it is logical to infer that the tips were caused by the good service provided by the front-line employees.

4. Management must maintain records of each day’s collections, but must be careful not to accept a share of the tips. The purpose of the tips is to supplement the income of the grossly underpaid government employees in the Philippines; management must not take a piece of the pie.

5. The program must be periodically evaluated to determine if the tips actually cause government employees to work faster, harder and more conscientiously. If letters are received from the public that positively comment on the help they’ve been provided, management must make a big deal of them.

We are all too quick to condemn government employees who are on the take, we forget that these are human beings with certain needs that are probably not being met because they are receiving coolie wages.

A MIXED BAG

The President who issues the zero-tolerance Executive Order also has the responsibility to figure out ways to increase the wage rates of government employees – especially those at the bottom of the scale. The zero-tolerance policy must be perceived as fair. The corrupt government officials will consider the President Public Enemy Number One in any conceivable scenario, but the lowliest of government clerical workers will respond positively if they sense that the President is at least trying to be fair.

A move to increase the salaries of BIR, Customs and municipal and provincial treasury agents will send the signal that the President is meeting the agents halfway.

This is not to suggest that all BIR, Customs and Treasury agents are corrupt, or that a majority of them are. I am going on the basis of perceptions and hearsay evidence. The perception of rampant corruption in the ranks of tax collectors dates back to the biblical times and is already etched in our subconscious.

THE UPCOMING PRESIDENTIAL ELECTION

Of all the candidates running for the Presidency of the Philippines in next month’s elections, the one who stands out as the ultimate corruption fighter is Benigno “Noynoy” Aquino, III. Noynoy promises to go after corrupt politicians, including the outgoing President and her entourage, if it can be shown that there is a case against any or all of them.

The people are delirious. If Noynoy follows through on his promise of accountability for the perpetrators of one of the biggest snow-jobs on the Filipino people - the Gloria Arroyo presidency - he will restore the people’s faith in their government. Filipinos want to passionately believe in their government, but they must be shown that their faith will not be misplaced.

People are quick to point out that Noynoy has not done much to deserve the Presidency of the Philippines. Nobody goes into the Presidency deserving it. Everybody goes in and learns on the job. Savvy advisers will help, but the new President must learn whom to trust and when to go with his instincts, ignoring the advice of sages.

There are many “correct” decisions one could make when faced with a conundrum. Presidents must choose the correct course of action that benefits the people most. This means that the candidate with a heart, an empathy and a love for the people is always the best choice.

Not the most successful, or the most experienced. People can be successful and experienced while doing the wrong things.

The biggest problem in governance is the endemic corruption at the highest levels. The candidate who has a reputation for a lifetime of un-corrupt and caring politics is what the country needs today.

There is no other intelligent choice in the upcoming presidential election. It’s Noynoy or bust!

I'm sure that Noynoy's administration will be an important first salvo against the corruption godzilla that lives in Metro Manila's rivers. For that, we will enshrine Noynoy a hero at the end of his term.

But it will still take a wild and crazy guy to get the job done. Perhaps the one who follows Noynoy in 2016?

Blueprint for a New Philippines

Following is the unedited first chapter of the book that I am writing with the aid of a friend who has extensive publishing experience. Tentatively titled "Blueprint for a New Philippines," the book will provide a directional map for 21st century nation-building.

Chapter I - Introduction

We are sea creatures. Out of the misty soup of ages we came. One wave of sea-bodies upon another. If indeed the first people on our planet were driven out of Paradise, our forebears found other island paradises in the open sea. We came on shore only to find hundreds, thousands, eventually millions of fruit-bearing trees that we knew we could just live on till our dying days. The fruits and the fish in the rivers and the ocean. We were made for life, for eons.

Just as we came by sea, others heard about our paradises and came. Some say they conquered us, but it never felt like that. It was more like we welcomed them to our shores and they stayed. They taught us how to count, how to study the stars, how to better enjoy our world. They taught us how to worship their God - their Allah - which appeared to be better than our gods who ruled the forests, the mountains and the seas.

The women among us were so beautiful, so redolent, so sensual every stranger who came wanted to marry them and establish families. We men did not mind that our women wanted strangers, there were plenty of beautiful, desirable, sensual women whose hair smelled like coconuts who would share our bed - for one night, for a long time, for a lifetime.

The strangers who came from a far away land, told us how we have souls and that if we followed the laws set by Allah, when it was time to pass on, our souls would be reunited with Allah in a Paradise in the heavens. We liked that, so we began to worship their god, their Allah, and we were certain that someday we would all be reunited in Paradise.

When the palefaces came, they too talked of Paradise beyond death. Their God seemed to be just like Allah. Perhaps it was the same God? The pale faces looked like warriors, handsome and strikingly heroic. Our women adored them.

The warriors among us did not like them. One of our local princes, Lapu-Lapu, wanted to drive them away. Lapu-Lapu had the memory of ages. A long time ago, Lapu-Lapu's forebears fought the pale faces' forebears in wars that lasted over many lifetimes. We were recruited by Lapu-Lapu and his men and we tricked the pale faces and their leader to meet with us on an island at low tide. There, far from the big ships and guns, and at low tide - which meant the ships had to be far from the island's shore - we ambushed the pale faces and slew their leader.

The pale faces turned their ships around and did not return. We would not see them again for many, many years.

Our women did not like to see them go. Years later, we would learn what the pale faces thought of our women. A certain Pigafeta, who was their chronicler, wrote that our women seemed to prefer the men who came on the pale faces' ships. Our women, according to that man, wanted the men on the ships better than us men who grew up on the islands with them.

We native men and macho warriors did not know it then, but our women would over the next four hundred years be attracted to the strong and tall pale faces who would visit our shores. Many of these pale faces stayed. Some liked our women and our paradises so much they established families and clans. Some of the pale faces wore habits that marked them as messengers of the one who died on the Cross.

We grudgingly liked what we saw out of those unions. The children who issued from those coital unions were light-skinned and narrow-nosed. They had finer hair, were taller and had the features of a godly race.

When the pale faces came back, they were well-armed, ready and dangerous. We knew that we simply would be no match for them. There was plenty of paradise to share, so we established compacts, authority-sharing arrangements. The pale faces quickly established neighborhoods where they openly mingled with our people. Many of our women were enticed by the glib tongues and quickly changed their beliefs to match those of the pale faces. They were attracted to the man-god who died on the Cross so that we human beings could reclaim the Paradise we had lost.

More pale faces came, wave after wave of them they came. Some stayed, others went to the other islands of the north. We later learned that they got as far as the land of the Taga-ilogs. They forged a compact with Rajah Soliman and the other rajahs in the land of the Taga-Ilogs and beyond. The Taga-ilogs did not know it yet, but they were soon to become subjects of a King in a far-away land. This King did not know them, nor cared about them. He only knew that from the island paradises that his soldiers and missionaries had appropriated for him, there would come riches that would shore up his kingdom.

The men who came and dominated us had superior technology. They were better prepared for battle, we were better prepared for making love and making nice. It would have been a no-contest, so we went along.

This was our first defeat. It was a defeat of the spirit. We did not resist. We did not know that we needed to resist. We were simply overwhelmed and awed by the strangers with pale faces who worshipped a far more superior God than our gods and goddesses of the forests. Far more superior even than Allah.

The Chinese traders who came with their gold trinkets and their silk robes may have warned us about the secret agenda of the Spaniards. We were not sure when we learned that the pale faces were Spaniards, but eventually we did learn. We also learned from them that the Spaniards were the most powerful people in the world.

The Spaniards taught us that the world was not flat, it was round. They related to us that the Spaniards who first came to our shores, who had been led by Ferdinand Magellan - the man our chieftain Lapu-Lapu had tricked and slain - continued in their voyage westward and eventually got back to Spain. This proved that the world was round.

EUROPEAN FEUDALISM

What followed the Spanish conquest and domination of the archipelago that would eventually be known throughout Europe as "Las Islas Filipinas" reignited the Spanish love for feudalism, a political-economic arrangement that was losing its grip on Europe. The natives learned that their hunting grounds and agricultural lands were no longer theirs. They were told that those lands now belonged to certain Spanish families that were favored by the Spanish crown. There was a land-grabbing rush.

Feudal Spain knew that power - economic and political - emanated from land ownership. Those favored by the Spanish crown were granted large tracts in Las Islas Filipinas and became the most powerful, most influential clans.

Those who must make their living by working the land quickly became beholden to the land barons and a culture of dependency that rewarded the land-owners with the undying loyalty and devotion of the peasants soon became the law of the land.

The natives of Las Islas Filipinas were divided by sea into islands - 7100 at low tide - and were unable to unite and resist. They knew there was something wrong with the way their lives had turned out after the Spaniards got done organizing their towns. They did not know the extent of the problem, and did not have a clue on how to gain redress. They were separated by seas. They spoke different languages. They were made up of separate nations. They might as well have been different countries.

In one sense, they were. They were really different countries with different cultures. They were fast becoming Christians, worshipping the man the Spaniards told them died on the Cross to save their souls. But there was little else they shared. They learned how to speak Spanish more quickly than they learned to speak each other's language. The Ilocanos sounded weird to the Tagalogs. The Cebuanos sounded even weirder.

For the next 300 years, the Spaniards would completely remake their societies and they would simply go along. The brave and smart did rebel, but the rebellions were localized. The Ilocano nation's Diego Silang over-ran a Spanish garrison, imprisoned the Spanish soldiers and some priests. He formed a government that briefly ruled the Ilocano nation, egged on by the British, which had captured Manila in 1762.

The British promised troops to Diego Silang to help defend the fledgling Ilocano government. Those troops never materialized and so Silang's days were numbered. After Silang was slain through the treachery of one of his men, his widow - Josefi Gabriella - bravely carried on the fight but was eventually captured and executed along with hundreds of her troops.

No major challenges to the Spanish throne would spring up until a century later, when the Katipunan was established by Andres Bonifacio and his fellow Masons.

The country's history was a study in exploitation by an abusive foreign power. It was an exploitation that was carried on at the temporal level all the way to the level of the spirit. The Spanish friars were instrumental in this exploitation, selling the bill of goods that suffering on earth would be rewarded by rapture and joy in heaven.

Filipinos were sold on the concept of self-denial, indeed self-flagellation, to purify their souls for eventual ascension to the true Paradise.

If one were to look for an explanation of why Filipinos tolerate so much from foreign invaders, their public officials, their parish priests, their role models, one credible explanation would be that their Christian upbringing over the centuries taught them that true rewards are not in this life but in the after-life.

A SOCIETY WITH FEW WARRIOR HEROES

I mentioned Diego Silang, Lapu-Lapu, Bonifacio. Add to that list Emilio Aguinaldo. Since the Spaniards first set foot on Cebuano soil, despite the friars' and Spanish military abuses, there were no successful major revolts against the Spanish crown. A reading of Philippine history reveals some minor rebellions that would rightly be classified more as mutinies than full-fledged open rebellions.

Lapu-Lapu drove Magellan's men away, but in exchange for Magellan's defeat, hordes of Spanish ships came and intimidated the paradise dwellers of the open seas. Bonifacio and Aguinaldo had brief victories, but they both eventually went down in defeat. Bonifacio was in fact hacked to death by Cavitenos who he thought were his allies.

Our national hero, Rizal, was a martyr. The modern-day Rizal, Benigno Aquino, Jr., was a martyr. We have had plenty of martyrs, but few victorious heroes.

The Vietnamese have Ho Chi Minh, who slew the American dragon and took the Vietnamese people to their current golden age. The Chinese have Mao Tse Tung, the Ming and Han dynasties. Chinese history over the millennia is full of military heroes. The Japanese have the Shogun warriors. The Thais have their Kings of Siam who repelled invaders. India had Akbar the Great and the Madjapahit emperors. Even Mongolia had Genghis Khan.

And the U.S., our modern-day patrons, has George Washington, Andrew Jackson, Abrahan Lincoln, General Eisenhower, General Patton, General Douglas McArthur. The U.S. has many victorious heroes. Americans are a nation of winners.

What we have in our historic consciousness is a revolving door for martyr-heroes. Rizal, Bonifacio, Gregorio del Pilar, Diego Silang, Fathers Gomez, Burgos and Zamora, Benigno Aquino, Jr. and many minor martyr-heroes that are in history's footnotes.

Our greatest hero, Jesus Christ, was crucified. Every year, on Good Friday, we recollect this crucifixion by self-flagellating. Some are willingly nailed to a cross.

This is how our mind works. We can tolerate so much abuse from our officials because our God has shown us the way. Our heroes have shown us the way. We are the martyrs of Asia.

WE MUST RE-FRAME OUR HEROES

One of my all-time favorite movies is Braveheart, which stars Mel Gibson. It is the story of William Wallace, the brave Scottish warrior who resisted the abusive British crown and was initially victorious. The story line ended with William Wallace finally going down in defeat at the hands of a much more superior army of English and Irish soldiers, but Wallace's eventual defeat was not the meat of the story. The focus was on Wallace's victories.

Napoleon finally met his Waterloo after blundering in Russia, but that is not what the French remember him for. He is revered as the great conqueror of much of the known world in his time. Julius Caesar was slain by his so-called friends in the Senate, but that is not the lesson of Caesar. It is his greatness as a military commander and his role in the emergence of Rome as the primary world power at the beginning of the first millennium.

We have to rewrite our history. We must show our heroes as winners, not as losers. Martyrs such as Rizal and Aquino must be de-emphasized. We must extol Lapu-Lapu, Diego Silang, hold up our noses and extol Aguinaldo's victories on the battlefield against the Spaniards. In sports, we must write about Manny Pacquiao and how he has united the many nations that exist side by side in what is known - incorrectly - as the Filipino Nation. We must tell our children about Flash Elorde, Ceferino Garcia and other great boxers. We must tell them about Caloy Loyzaga and his teammates who won third place in the world basketball competitions in the 1950s.

We must fight off our tendency to view life as an opportunity for self-denial and view death as deliverance and reward. That mindset has led to only to one conclusion. We have become a Talunan nation.

We are the losers in Asia. Fellow Asians mock us as the sick man in their midst. We tolerated the abuses of the friars, the murderous ways of the American conquerors, the brutality of the Japanese. We are tolerating the corruption and broken promises of our politicians. We tolerate the abusers, including and especially our sexually predatory masters.

There is a silver lining in all of this. We are great as nurses, as cooks and stewards in ocean vessels, as maids in Hongkong households, as farm hands in Hawaii. We endure, we persevere, we do not complain.

The Jews rejected Jesus as savior because the Jews were waiting for a savior who would lead them in battle. Jesus clearly did not fit the bill. The Jews are still waiting. Meanwhile, their reverence for winning has made them the most influential people in the world despite their minuscule numbers.

What we Filipinos need are stories of victory, not defeat. We are not warrior nations, but paradise dwellers, so we probably will never have the equivalent of a Ho Chi Minh who will unite the many nations that make up the Filipino whole. But we're in dire need of victorious role models. Let us cast away the Talunans - the losers - in our history. Let us embellish the exploits of our victorious heroes such as Lapu-Lapu, Diego Silang, Emilio Aguinaldo and Cory Aquino.

If we do this, by mid-century we may start seeing Filipinos who succeed spectacularly on the world stage. In sports, in business, in all organized life activities.

We can all help this along by making decisions that benefit the Filipino people. We have to restructure our society, our way of doing business, our educational system. We have to create a new religion within our formal religion. This religion will teach us that holiness, like cleanliness, is reaching the limits of our potential. We must think of wealth-making as a virtue. We must promote selfishness. In love, as in war, we must learn to be selfish.

I have crafted a plan, a Blueprint for a New Philippines, based on Filipino selfishness. It may not be the only way, but it sure as hell beats the usual Filipino way.

We are sea creatures. Only the sea will cleanse us. Now the sea is giving birth, not to new life forms, but to new ideas. From far away lands these ideas are coming, waves upon waves of them. The ideas come as echoes, insistent, plaintive echoes. Books such as "A Country of Our Own," as plaintive as South Africa's "Cry, My Beloved Country." Defiant Filipino voices from all over the world exhorting their countrymen not to assume that what goes on in the country needs to be the way of the future.

We are sea creatures, we are being baptized with the holy water of progressive ideas. We are being transformed by the religion of self interest. We need not accept as our lot what four hundred years of foreign rule and influence have wrought on our psyches.

We can reinvent ourselves, just as the sea creatures of eons ago emerged from the water to walk on soil and become creative forces that rule the known universe.

As the Chinese learned to be selfish, not in a personal way but in a collective way through their collective culture and will, the Chinese giant has awakened. Filipinos must learn to be selfish, in a collective way - not in a personal, corrupt way. We must chuck the culture of victimization that we have all been accustomed to. In certain very crucial instances, we must be the victimizers, not the victims.

I'm not just talking about the traditional politicians who victimize us. God knows what a complicated mess that is. I'm talking about the international business people who come to our shores to promise us all the great things in life, all we have to do is sign on the dotted line. We must become smarter and out-smart them all. Just as Lapu-Lapu outsmarted the worldly-wise Magellan.

We must emerge as a new nation, a new people, a new living ambition that is tailor-made for this new century and all centuries to come. Out of misty sea we must.

Ailing hospitals as patients

While doing my research on hospitals in the U.S., I felt like one of the cartoon characters in my son's video game. The character, Mario, runs - no, trots - all over the place, jumping across brooks, over brick fences, on tiled rooftops. Hop-scotching on cobblestone roads, all the while evading weird-looking monsters trying to stop Mario dead on his tracks.

He is able to take evasive action and drops dozens of monsters and even when he sustains a direct hit, he manages to rise again and take flight, focused on a mission that he alone knows about. I don't know why he purposefully runs, or what the prize is at the end of his journey.

Eventually he is face-to-face with a tall brick wall. He can't scale it. He hurls his body against the wall. It won't budge. He considers going back, but the monsters are close on his tail. I stop the action.

I call my 11-year-old son. He comes over and shows me the way out of Mario's dilemma. Mario is able to escape once again and he is off running, er, trotting.

Researching the hospitals in the U.S. is a long journey into discovery. But each discovery leads to more questions, not answers. So you continue to do further research, which leads to still further research. You feel like Mario running for his life while focused on his destination. You feel like you're running for your life because you fear that you will arrive at a wrong conclusion and you will come up with a useless product.

The hospitals are supposed to be part of the solution to the health care mess the U.S. is in. Instead, it cries for itself solutions and answers.

Hospitals across the U.S. are losing money. One study shows that about a third of the hospitals across the country are in danger of closing their doors.

The other two-thirds would clearly benefit if the unprofitable hospitals do close their doors. Except many in the two-thirds-profitable category own many of the hospitals in the one-third-unprofitable category.

This of course is the short term conundrum. What are the long-term prospects for hospitals in this country?

I struggled with this question because the learned people in the industry are all over the place on this issue.

Hospitals are in trouble because of long-term trends and structural problems. These trends are permanent and call into question the hospitals' continued viability.

1. People are generally in better health at all age levels in the U.S. than their parents or grandparents because of more and better medicines. As a result, a smaller percentage of people is ending up in hospitals.

2. Americans are also living longer, postponing the end-of-life sicknesses that finally land them for longer-than-normal stays in hospitals.

3. Insurance companies, worried about their own bottom lines, are insisting on shorter hospital stays for maternity patients and all sorts of patients.

4. America has discovered the much-cheaper alternative of highly-skilled nurses going to patients' homes. Visiting nurses businesses have sprung up all over the landscape. America actually likes this better than traditional hospitals.

5. Many surgeries can be done on an outpatient basis, delighting the insurance companies.

6. The growth of the below-cost Medicare and Medicaid businesses that hospitals must accept has put tremendous pressure on hospitals to increase their prices charged to insurance companies. Insurance companies react by denying long hospital stays for their insured, further limiting hospitals' revenues.

7. America has discovered medical tourism. A major surgery costing up to $150,000 in the U.S. costs about $15,000 in India, Thailand or Malaysia, and the bill includes a one-week stay in a first-class hotel.

8. Hospitals are forced to purchase expensive new equipment to remain competitive. Industry continues to turn out new and better equipment at a torrid pace and hospitals are going into major debt to afford them.

Because of modern drugs and equipment that aid in detection of diseases at an early stage, Americans are living longer and are much healthier today.

The evidence is everywhere. Women in their sixties look like they are in their forties. Journalists are telling us that 50 is the new 40. MSNBC's Chris Matthews remarked, upon seeing Speaker of the House Nancy Pelosi celebrate her 70th birthday recently, that "70 is the new 40."

On I-15 in Las Vegas, there is a billboard for a Dr. Life, who is 78 years old and has the body of an Arnold Schwarzenegger at age 40. Doctors allied with Dr. Life and new-age doctors all across the country are predicting that the practice of medicine will slowly evolve into keeping people healthy, which will cause a decrease in the demand for sickness-curing patient care. That's a death knell for hospitals.

A relatively new company called Cenegenics, LLC, based in Las Vegas, is one of the firms in the new field of age management. Dr. Life is one of the doctor-licensees of Cenegenics, whose licensees are scattered all over the U.S.

The sad news for traditional hospitals is that their problems are structural and permanent and nearly impossible to scale, like that wall that always stumps Mario in my son's video game. But, like in the video game, the key to getting past that wall is to find the end-around passage. Hospitals must adapt and reinvent themselves, if they are to survive.

One ally of the hospitals is the epidemic of obesity in this country which will certainly take its toll eventually and will cause a temporary bump in business for hospitals - down the road, down Mario's road. But that is temporary, the long term trend by all accounts is that Americans are getting healthier.

What can hospitals do immediately to weather the triple-whammy of decreasing demand, decreasing money paid by insurance companies and increasing Medicare and Medicaid businesses that pay hospitals at below-cost rates?

They have to cut back, as many of them are doing. In Las Vegas and across the country, hospitals are cutting their staffs in a manner that mimics what is happening to the newspaper industry. A lot of pink slips are flying around these days because traditional hospitals are becoming obsolete, just as newspapers are being slowly replaced by cable news and the Internet.

While the outlook for hospital workers in the short run is not particularly encouraging, there is a projected huge demand for nurses and others in the medical field, with predictions for serious shortages across the country by the end of this decade. Nurses will be in great demand, though a smaller percentage of them will be working in hospitals.

How do all of these hospital problems relate to the health care reform?

It is clear that the health care reform legislation, which draws more than 30 million Americans into the insured pool, will cause an increase in hospital business. People who are allergic to hospitals because they can't afford them and not because they are not sick will of course avail of the hospitals' services and cause a modest increase in hospitals' revenues.

The sad part is that many of the new insured will be in either Medicaid or low-cost insurance policies that will not necessarily add to the hospitals' bottom line.

There will be plenty of work for the hospitals for a while, until the currently uninsured catch up with the general population in terms of general healthiness.

I can always count on my son to show me how Mario could go around that tall unscaleable wall. I can't ask him how hospitals can do an end-around. It may be too late in the day for some hospitals. The patients - now a third of the hospitals are the patients - may be too far gone in their ailments. Many of them cannot be saved.

The surviving hospitals - to no one's surprise - will of course be stronger financially and will serve Americans well as the country adapts to the conversion of the practice of medicine from curing diseases to maintaining patients' good health, helping them age gracefully and disease-free.

Oh, by the way, since hospitals must recoup some of their losses from serving Medicare and Medicaid patients, they will continue to charge outrageous fees for their services supplied to patients who are covered by private insurance. Hospital costs will remain high and will increase further, causing insurance companies to react by shortening hospital stays further. This will accelerate the growth of the visiting nurses businesses.

Only a single-payer system will solve the problem of high hospitalization costs because the single-payer - the national government - does not have to make a profit. It can absorb the increased hospitalization costs and not have to raise premiums, which private insurance companies must do to stay in business.

(Disclosure: My wife works for Cenegenics and both my wife and I own member units in Cenegenics, LLC.)

Americans are being screwed - royally

I am passionately in agreement with some Republicans who warn us that the health care reform package recently passed by Congress does not go to the roots of the problems and will therefore not solve the health care crisis in America.

The Democrats' health care reform legislation is a very promising start, but the country's efforts to rein in the cost of its health care will not be successful if the root causes are not addressed.

We know that doctors are a major cause. The practice of medicine in this country is an exercise in capitalism. It is no longer considered as a public service, which it is in many countries ranging from the highly industrialized countries such as Canada, Australia, Great Britain, France and Germany all the way to third-world countries such as the Philippines and Cuba.

We know that lawyers drive up costs by going for doctor's jugulars every time doctors make mistakes. If there is no tort reform, costs will remain high.

We also know that drug companies' primary mission is to maximize returns for their stockholders. As public corporations, their ultimate responsibility is to their stockholders. Providing cures or alleviating symptoms is only a secondary mission. Once upon a time, drug companies started out with a mission to find cures for diseases. Not anymore, now Big Pharma's mission is to maximize returns for stockholders.

We know that the same drugs that are sold in the U.S. cost at least twice as much as those sold in Canada. If those drugs were invented by Americans and developed by Americans, how come American consumers pay much more for them than their Canadian counterparts?

There is only one way to explain this. U.S. drug manufacturers made the determination early on that the way to recoup their research and development expenses was to charge American consumers outrageous prices.

The American system is perfect for this. The insurance companies are the ones paying for the drugs, and as everyone knows the huge for-profit insurance companies can afford to pay. They can absorb the costs since they can merely pass them on to their insured by periodically raising insurance premiums. There is no limit to the number of times insurance companies can raise premiums.

The high-cost drugs are absorbed into the health care system in the U.S. because we have a pipeline mentality here. Whatever costs are incurred by the members of the system are merely passed on ultimately to consumers. The drugs go smoothly through the pipeline and as long as the howls and protests are few, drug prices just keep on flowing at prices that have no relation to production costs.

Only the sick notice, but sick people do not have the energy to demonstrate in Congress. They will pay any amount to get well or to keep the symptoms of their ailments under control.

The insurance companies profit from the atrociously high drug prices. Assuming that insurance companies are allowed an 8 percent return on their costs, the higher the cost of the medicines, the bigger the profits for the insurance companies.

We keep reading in the papers that American consumers subsidize the cost of drugs in other countries. To what extent? Below is a comparison of the prices of some life-sustaining and life-saving medicines sold in the U.S., Canada and Mexico.

Prescription Drug-----Dosage------Price in Maryland----Canadian Price--Mexican Price

Zocor--------------5 mg., 60 tab.-----$113.97-------------$46.17----------$67.65

Prilosec-----------20 mg., 30 cap.-----122.62--------------55.10-----------32.10

Procardia XL-------30 mg., 100 tab.----144.89--------------74.25-----------76.60

Zoloft-------------50 mg., 100 tab.----238.44-------------129.05----------219.35

Norvasc-------------5 mg., 90 tab.-----127.17--------------89.91-----------99.32

The average price differential, based on the above drug cocktail, is 98% for Maryland versus Canada and 95% for Maryland vs. Mexico. (Source: Minority Staff Report prepared for U.S. Congressman Elijah E. Cummings of the Committee on Government Reform and Oversight, U.S. House of Representatives - August 10, 1999.)

The prices charged for drugs in Australia are even lower than the prices in Canada, according to one source.

The drug industry apologists do not deny that American consumers are being raked by the drug companies for even their spare change. Every single apologist for the drug industry will tell you that drug companies must be allowed to recoup their huge investments in research and development through atrociously high prices charged American consumers.

Yes, folks, the drug companies have determined that U.S. consumers must underwrite the cost of R & D, ahead of everybody else. We Americans must pay through the nose so that others - Canadians, Mexicans, Australians, Europeans - can have the same drugs at a fraction of the prices charged Americans.

Is this right? Why must it be a disadvantage to be an American compared to being a Candaian, or an Australian? Shouldn't it be the other way around? Shouldn't we Americans pay less for prescription drugs since it is our American drug companies who are constantly coming up with these newer and better drugs with less and less side effects?

Is it because our higher standard of living allows us to afford more? Maybe so. But as we Americans know, and as the whole world now knows, the American standard of living is under attack. We Americans are becoming more and more like the Europeans. The Chinese are fast catching up with us. The Japanese have exceeded us. The Australians and Canadians are right on the trail of the Japanese.

So why do we Americans continue to subsidize the cost of medicines in other countries? Because we allow the drug manufacturers to price discriminate against us. That's the only explanation.

If we Americans stand on rooftops and scream enough is enough, we will no longer be forced to subsidize the world's consumption of life-saving and life-preserving drugs things will begin to change. And this is change that we can believe in.

The situation is urgent. Without a reform of the way drug companies price their products in the U.S., health care reform in America will remain just a dream.

We made a great start with the health care reform package passed by Congress and signed by President Obama. But, we must not stop there. Drug companies must charge consumers in other industrialized countries the same or nearly the same prices for their products as they charge American consumers.

It is not only fair, it is one essential way to reduce the cost of health care in America.

(Next week: the hospitals.)

Thank your lucky stars for Lawyers

FLASH! Sunday, March 21, 2010, 6:00 p.m. Las Vegas time:

PELOSI, REID AND OBAMA AND THE NATION TRIUMPH!

In 1936, Franklin Delano Roosevelt offered a new bill of rights that would supplement the list of rights embedded in the U.S. Constitution. Among the new rights that Roosevelt advocated was the right to health care. The U.S. Legislature did not pick up on Roosevelt's idea, and the new American "rights" died with Roosevelt in 1945. Not a single right on Roosevelt's list became law.

This historic weekend, the country enacted a law that makes health care a right (and a duty) in America. While still work in progress, the new health care reform act that creates the right to health care for every American national took a dramatic turn for the finish line when President Obama refused to be intimidated by the recent Democratic defeats in New Jersey, Virginia and Massachusetts.

Grown men and women openly wept when the first black President was elected on November 4, 2008. This time, everybody was all smiles. It was a giddy moment for the Democrats and the country. Everybody in this country will remember what they were doing the night health reform passed.

All of us, you and me, are witness to history. Never before in this country has health care been considered a right of every American. It has taken a black President to get it done. It has taken all of conscience-stricken America to prod him on, telling him he was on the second yard line, all he needed to do was to punch it into the end zone.

Yes, like "all" that was needed was to soften the muscles of the huge defensive linemen, the Republican misinformation machine. In one gigantic muscle coordination move and rocket-like leap, the President, Speaker Pelosi and Senate Majority Leader Harry Reid - all blocking for each other - punched the ball into the end zone.
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I may have made enemies last week, or at the very least I may have tried and tested some friendships, when I openly questioned the present system that rewards U.S. doctors as capitalists rather than reward them as public servants, which most of them are, and which is the way most doctors are treated in other countries - advanced, developing or underdeveloped.

A doctor in Las Vegas has surrendered his license because of the huge scandal
that resulted from the terrifying news that his clinic had reused needles and
that thousands of patients at the clinic had contracted hepatitis B. No HIV
cases had been found, or more appropriately been broadcast to the public, but
suspicions are rampant that there may have been such cases.

The doctor operated on the principle that he was a capitalist and that his first
obligation was to himself and his employees. His first obligation, in his mind,
was to maximize the profitability of his enterprise.

Doctors in most countries are franchised by governments to serve the public good and the systems in those countries afford doctors a comfortable lifestyle but not ordinarily an opportunity to create huge personal fortunes. The U.S. is one of a very few countries that consider the practice of medicine as a capitalist franchise.

Because of the magic of capitalism, huge fortunes are being made by doctors in the U.S. That is why lawyers and the public are holding doctors to heightened scrutiny and unusually high standards.

The nature of work, especially delicate and demanding professions such as doctoring, is that mistakes are inevitable. It is estimated in one study that 80,000 medical malpractices occur every year in the U.S. Of those 80,000, only 10,000 actually result in lawsuits. And out of those 10,000, 96% are settled out of court. Only 4% of the 10,000 - or 400 - actually go to trial by jury.

Insurance companies that issue malpractice insurance to doctors are therefore "saved" by the system. The 96% of the cases that are settled out of court cost the insurance companies an average of $125,000 while those that go to the jury average $235,000 in awards. My statistics do not reveal if the cost figures include the cost of insurance company lawyers. I apologize for not knowing.

The message is clear. Insurance companies are highly motivated to settle malpractice suits out of court because no matter how good their lawyers are, plaintiffs will nearly double their awards if the cases go to trial.

The lawyers know this, and short of encouraging frivolous lawsuits, lawyers tend to advice their clients to sue on the slightest provocation. They know they will collect regardless of merits, what more if there are compelling reasons to sue.

Assuming in all this, of course, is that it is not a frivolous lawsuit.

Chances are, it is not a frivolous lawsuit. People make mistakes, especially when they are on a steep learning curve. Doctors especially, when they are under stress and are making life-or-death decisions.

It is therefore unrealistic for the public to expect that doctors will not make mistakes. They will and they do. Every day. And they will continue to make mistakes. And they will continue to cover up those mistakes.

The public's defense is to know as much about their doctor as they possibly can. They must research their surgeon's credentials before they agree to lie on the operating table.

They look into the horse's mouth, don't they, before they buy the horse?

When I was starting out in college in the traditional world of business, there was the caveat emptor rule (Let the buyer beware). It was only recently that the world has been evened out for consumers through consumer protection laws.

For patients, however, it is always wise to assume that caveat emptor rules. Pretend that there are no consumer protection laws. Besides, the government cannot prevent, no matter how tough the laws, doctors from making mistakes. While the law will grant redress, doctor's major mistakes cannot be undone.

The patient is never the same, even after being showered with malpractice money awards.

And, though malpractice awards and settlements are for the most part modest, some awards have been huge, enough to slam the knees of insurance company executives:

Failure to timely diagnose, $10,200,000 settlement (Feb. 11, 2010).
Breast Cancer lawsuit, $17,500,000 settlement (Oct. 30, 2009).
DeKalb County birthing malpractice lawsuit, $15,350,000 settlement (May 23, 2008).
Medical malpractice lawsuit awarded by jury, $60,000,000 (February 18, 2010).

The Disability Insurance Resource Center website lists hundreds of awards and settlements, each one potentially if not actually ruining a doctor's career.

Do you see anything wrong with this picture? I do. We know that doctors will make mistakes. Experience tells us that these mistakes are often unavoidable, which is why malpractice insurance is a major source of revenue for insurance companies that offer them.

If you combine the universality of malpractice insurance policies with the certainty of mistakes occurring in the practice of medicine, you are looking at a gold mine for lawyers. Lawyers will get their 30% - after expenses - whether the plaintiffs settle or the case goes to the jury.

While awards are generally modest and reasonable, there have been very expensive cases to settle or litigate. Insurance companies must set their premium rates according to the possibility that any malpractice case will result in huge settlements or jury awards, tempered only by actuaries' estimates of what the likely breakdown will be between major news-making awards and usual and customary awards.

A recent study demonstrates that in the long-run, as the size of awards have gone up, the premiums charged by insurance companies have also gone up. In insurance underwriting, premiums are set on the basis of potential maximum losses, not on best-case scenarios. This is why malpractice insurance premiums have gone through the roof in this country.

The cost of malpractice insurance, especially in some professions such as obstetrics, gynecology, oncology and all kinds of surgery, has become so prohibitive that doctors have been known to take the early retirement route or branch out to other fields.

Doctors are being squeezed by insurance companies that are on a drive to tamp down the fees charged by doctors, and from below, by the cost of malpractice insurance.

This is the cruel present, but the promise of the future is worse. The doctors who bail out further exacerbate the shortage of doctors in many areas of the U.S..

Something must be done. The country cannot continue on this road to higher and higher malpractice insurance premiums because of higher and higher settlement and jury awards in malpractice cases.

Obama, Pelosi, Reid and others in the Democratic Party have done the heavy lifting in the struggle to provide health care to most Americans. They must now even the playing field for doctors and insurance companies.

The jury awards in malpractice cases must be capped. The Bush administration proposed capping jury awards to $250,000, with exceptions for egregious cases. Obama seems to be open to the suggestion, though the $250,000 figure is arbitrary and likely to change.

I advocate this change because I know that doctors do make mistakes, and it is the responsibility of everyone to select doctors that are least likely to make mistakes. How does one do this? By researching the doctor's qualifications. The Internet has so much information that one can use. Patients should beware of doctors about whom there is little information on the Internet.

Patients must also gather information by word of mouth, from other doctors, nurses or hospital administrators.

We do a thorough research before we buy a new car, it is only fitting that we ask a lot of questions before we agree to being treated by a doctor, or God forbid, being opened up by them.

When we make the final decision on the choice of our doctors, implicit in that decision is that we are partly responsible for what results from that choice. If our doctor makes a mistake we are partly to blame because we chose that doctor.

While this does not absolve the doctor of responsibility for loss of income or loss of job (economic losses), the more lucrative type of settlement or award (pain and suffering and punitive) would be removed from the equation. Should that happen, settlements and jury awards would tend to drop dramatically.

This makes a lot of sense. Let me restate my case in plainer terms. Assuming that we choose our doctors intelligently, what the doctors do to us is partly our fault. If we suffer pain and suffering, it is ultimately because we made the wrong choice. Punitive damages would be unavailable to us because we were a part of the decision making in the choice of our doctor.

Insurance companies are granted by states a certain profit margin based on their expenses. If their expenses are high, their margins are bigger and the total cost of malpractice insurance is high. If their expenses are low, their margins are smaller, resulting in the cost of malpractice insurance going down.

If the cost of malpractice insurance goes down, doctors' fees assuming a rational world would also tend to go down. As more doctors return to the practice of medicine because they are no longer intimidated by the cost of malpractice insurance, the doctor shortages occurring in many parts of the U.S. will be alleviated.

The increase in doctors practicing in their fields will tend to keep doctors' fees from spiraling ever upward, and in fact may result on doctors' fees going down. But don't hold your breath for that one.

Of course, we could short-circuit this whole process by eventually going to a single-payer health care system, a Medicare for all system where the Federal government covers all Americans and most doctors no longer make the huge fortunes that they build over their lifetimes. Doctors would be just like every body else in this country. They have to be truly outstanding in their professions in order to earn huge fortunes over their lifetimes.

The lawyers would just have to find others to sue for big bucks.


(Nest week: The pharmaceutical industry.)