Showing posts with label CDC. Show all posts
Showing posts with label CDC. Show all posts

Monday, January 19, 2015

Law Enforcement, Race and the Gun Culture - I

It is time to take a break from the discussion of Israel and to turn to other pressing issues. I intend to return to the subject of Israel, if for no other reason, to give Albert Nekimken an opportunity to complete his rebuttals. But now onto other issues!

There have been many unfortunate deaths in the United States lately.

“Each year, nearly 900,000 Americans die prematurely from the five leading causes of death – yet 20% to 40 % of the deaths from each cause could be prevented according to the CDC. Allow me to stress that these are pre-mature deaths, and at least 20% of those, or 20,000, and possibly as many as 40%, or 40,000, of those are preventable. More than 39,000 people died by suicide in the United States in 2011, more than twice as many who died as a result of homicide, (17,000). See here. How many die at the hands of police officers is difficult to determine.

As these figures show, homicide is far down on the scale among the causes of death. Yet our fear of homicide and our fascination with it is insatiable. Murder mysteries are a genre that has, always had, and continues to have endless fascination for us.

It apparently matters how and why we die.

The idea that we could be in danger from the police, the very people we depend on to protect us, is unacceptable and horrendous. Is it something we need to worry about? Do African Americans need to fear the police more than other races?

These questions have been forcefully brought into our consciousness by the police killings of Eric Garner in New York resulting from a chokehold, and of Michael Brown in Missouri, by the use of a gun that has led to demonstrations, which have become an increasing source of friction, and to some extent a political football.

Fox News ran a clip, widely viewed on YouTube, where the demonstrators appeared to chant: “we won't stop, we can't stop, so kill a cop", when they actually chanted: "we won't stop, we can't stop, 'til killer cops, are in cell blocks,"

This was quickly picked up by many in the press, particularly on the Right, and even a faux apology by Fox (See here) that it was all a mistake, when in fact the recording had been doctored, (See here) did not catch up even with the so-called liberal media. Thus Nicholas Kristof writing in the New York Times, after Fox had already disavowed the video, stated: “Some extremist protesters turned to the slogan ‘arms up, shoot back,’ or to chants of ‘What do we want? Dead cops.’ That was inexcusable”, showing how even well intentioned media get taken in.

But in all this heat has anybody checked the facts?

CNN had a very interesting analysis from which I quote:

Syndicated columnist Nicholas Kristof wrote this week that young black men are 21 times more likely to be shot and killed by police than young white men. Fox News Channel host Bill O'Reilly had a much different take on his show Monday night, offering that more whites are killed by police than blacks.

In 2012, 123 African-Americans were shot dead by police. There are currently more than 43 million blacks living in the U.S.A.," O'Reilly said on his program.

"Same year, 326 whites were killed by police bullets. Those are the latest stats available.

 Two dramatically different statistics -- and they could both be right. 

But CNN didn’t bother to do the arithmetic. I did!

I focused on the O’Reilly figures. He gives the number of “blacks” in the total population but doesn’t give us a figure for the number of “Whites” in the total population. According to the Census Bureau the figures are about 198 million “Whites” in the US to about 42 million “Blacks”. That is a ratio of about 4.74 or about 5 times as many “Whites” as “Blacks”.  The killed by police ratio according to O’Reilly is 2.65 as many Whites as Blacks, so that using O’Reilly’s own figures, Blacks are killed by police as a ratio of their presence in the population at a far higher rate than Whites.

Of course, O’Reilly could have argued that this is because Blacks are more crime prone, or more given to resisting arrest, but he didn’t. His own figures seem to show that police are much more likely to kill a Black person than a White person by far.

CNN goes into a lengthy discussion as to why Kristof and O’Reilly came up with such different figures, but they miss the point. O’Reilly’s own figures show a huge discrepancy between the rate at which police kill between the races.

Does that mean that the police like killing Blacks or that Blacks are more violent and more crime prone? That there is more crime in Black communities than in White ones, there can be no doubt.

But I think the problem may lie more in police perception, than in any reality.

The North Jersey media published an interesting article entitled "Something good coming out of Ferguson" from which I quote:

Several months ago, I was struck by another incident, this one in Columbia, S.C. A young black man was pulled over by a white officer. In complying, the young man pulled into a gas station and got out of his car. He learned he was stopped for a "possible seat belt infraction."

The officer asks for the driver’s license and car registration. The driver opens the car door and reaches in to get his wallet from the front seat. As he does that, the officer starts screaming at him to get out of the car, to put his hands up, to get down on the ground. And while yelling, in an almost hysterical tone, he starts shooting at the man.  
The young man was shocked. He yelled, "You told me to get my wallet. I was just getting my wallet. Why are you shooting at me?"

Then a touch of humanity entered the conversation. The officer said, quietly and with some concern, "Were you hit?" The young man said, also quietly, "Yes, I think I feel blood running down my leg," or something to that effect.

The officer kept his gun aimed at the man, but called for help.

It’s easy to brand this cop as a violent man, intent on creating a situation in which it would be reasonable to shoot a young black man.

However, what became clear to me in watching the video was that the cop was terrified. You could hear it in his voice. You could see it in the way he moved, the way he held the gun, the way he shouted at the man.

Returning to the CNN article, CNN reports

That reality, (unreliable statistics) in part a result of weak local reporting and national data gathering efforts on police homicides, has long frustrated researchers and analysts who say they need to know more about those shootings…

 The problem, experts say, is that the United States doesn't collect accurate statistics and verify nearly enough information to show definitive trends in police shootings.

 There isn't a mandatory reporting. It is a self-reporting. Almost on the honor system," Sunny Hostin, a CNN legal analyst, said on CNN's "The Situation Room" on Tuesday.

 Although the FBI does have some statistics, most people know that those statistics can't even be counted upon, because they are self-reported," Hostin said. "So my suggestion has been all along that we need mandatory reporting from our law enforcement agencies around the country and I think that the number of officer shootings involving young black males is actually much higher than is even self-reported. That's something that needs to be part of the conversation.

 "We've been trying for years, but nobody wanted to fund it and the (police) departments didn't want it. They were concerned with their image and liability. They don't want to bother with it.''

But it may be that we have become too obsessed by the race issue. It is real, and much of what is happening in this country is dictated by race, but there is an even more fundamental problem.

CNN has an interesting commentary on the broader aspect. Again allow me to quote from its web site.

The difference in the number of killings in the U.S. and the rest of the world is startling. While police in other major countries typically kill a few people every year, the numbers here are enormous….
 How many people are shot by police every year? Nobody seems to know the exact number (something that is itself disturbing -- no official government agency tracks the full data for the entire country)
 On average, at least one person is killed by a cop every day in the U.S. In contrast, not a single one was killed in Britain last year, where police fired their guns a grand total of three times, according to The Economist. In 2011, when the FBI reported 404 justifiable law enforcement homicides in the U.S., police killed six people in Australia, two in England, six in Germany.

Whether one is of white, black, brown, or of yellow complexion, these are very disturbing facts and figures.

I have long been disturbed by the behavior of some who wear the police uniform and a badge and carry a gun. I am of white or rather pink complexion, but I have had my own experiences.

I will always remember when as a teen, (or maybe it was in my early twenties) I was in the resort town of Greenwoodlake, NY, a summer vacation community straddling New York and NJ, but with the town itself in NY. I had gone into town to buy something and had parked my car legally. When I came back I found that my car was wedged between two cars so that there was very little maneuvering space for me to get out. Backing up to the maximum possible, I touched the bumper of the car behind me, and then started to move out of the space, when a police officer accosted me and accused me of trying to leave the scene of an accident. I tried to explain that I had barely touched the bumper of the car behind me and that there was no damage, where upon the officer, who appeared to also be in his early twenties, suggested that I should put up my fists, and we would duke it out. I declined, and the officer relented. But it left a lasting impression on me, that, particularly in small towns, the kids that get a uniform, a badge and a gun, may be no different from the local hoodlum, without one.

This was not the last time I discovered that police officers are not always paragons of virtue.

More next time!

Comments, questions, or corrections are welcome, and will be responded to and distributed with attribution, unless the writer requests that he/she not be identified. However, please give your full name and the town and state in which you reside or have an office. 

Wednesday, August 19, 2009

Health Insurance Reform - Lies and Damned Lies

In my last commentary, entitled: ”Health Insurance Reform," I addressed some misconceptions about our health care. I pointed out that it is far from the best system in the world. Depending on the criterion we use it ranks 24th, 72nd and 30th according to our own CDC. Lately the UK system has come in for some bashing but it comes in 14th on life expectancy, a lot better than the US, but it is severely under funded.

According the conservative British newspaper, The Guardian that has a cross-reference under the heading, Data: health spending around the world the per capita expenditure on health in the UK is $ 2,784. For the US it is $6,714 and when measured by total expenditure on health as a percentage of gross domestic product, we find that the UK spends 8.4% while the US spends 15.3%. We spend two to three times what Britain spends and get poorer result and then critics of US reform bash the British. Nobody is proposing adopting the British system but we could do worst. It is certainly better than the one we have.

The bashing of the British system got to be such a sport that Investor's Business Daily wrote an editorial saying, “People such as scientist Stephen Hawking wouldn't have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.” When Stephen Hawking, upon hearing of this, pointed out that he is British, and it is the British Health Service that has kept him alive, the paper pulled this nonsense from its pages and blog. But the right wing, Rupert Murdoch-owned NY Post, stuck to the lie by writing:

“One troubling provision of the House bill compels seniors to submit to a counseling session every five years (and more often if they become sick or go into a nursing home) about alternatives for end-of-life care (House bill, p. 425-430). The sessions cover highly sensitive matters such as whether to receive antibiotics and "the use of artificially administered nutrition and hydration."

Scary, and a boldface lie, despite the reference to page numbers in the bill. The section referred to according to the Associated Press was authored by Republican Reps. Charles Boustany of Louisiana, Geoff Davis of Kentucky and Patrick Tiberi of Ohio and would authorize Medicare to pay for counseling if desired in the preparation of Living Wills. The AP article goes on to point out that “just a year ago, Congress overwhelmingly approved legislation requiring doctors to discuss issues like living wills and advance directives with new Medicare enrollees. And the government already requires hospitals and nursing homes to help patients with those legal documents if they want support, under a 1992 law passed under Republican President George H.W. Bush.”

But just about any lie will do to stop reform because in the words Republican Senator Jim DeMint "If we are to stop Obama on this, (referring to Health Care Reform) it would be his Waterloo. It will break him."

What is good for the country doesn’t matter. What matters is “breaking Obama.” They wouldn’t debate on the merits. On the merits they lose. And we know they don’t have a case when they start putting out boldface outrageous lies. And so what used to be something they were for, now becomes something that is euthanasia. And they all jump on the bandwagon. It started with that sterling Republican leader Sarah Palin when she put on her Facebook page, “The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's "death panel" so his bureaucrats can decide, based on a subjective judgment of their "level of productivity in society," whether they are worthy of health care. Such a system is downright evil.” 

Such a system would be downright evil, but no such system is, was, or ever will be considered. What is evil is the lie. One might hope other Republicans would immediately repudiate it, but no, former House Speaker Newt Gingrich defended the bizarre claim by Palin.

Well, I don’t know if such outlandish lies will stop needed reform, but they have succeeded in killing the provision that would allow being reimbursed for the cost of getting advice from your physician on what provisions you want in a Living Will, that, by the way, can provide that you want to live no matter what the state of your health is. If you want to live in a vegetative state for decades you can provide for that in a Living Will. All it does is tell providers what your wishes are when you are not able to do so any more. It avoids the situation that occurred in the infamous Schiavo case.

But the outrageous get even worse, if that is possible. Glen Beck on Fox News actually went into detail on the Nazi extermination programs suggesting the Health reform mimics the Nazis and Rush Limbaugh proceeded to describe the ways Democrats are like Nazis -- a list that included their dedication to animal rights and their opposition to smoking and pollution. 

Jewish groups including the Israeli lobby, AIPAC were outraged, but nothing seems to be too low for people whose only allegiance is to the insurance companies and the drug companies and who will use any tactics to defeat what is not an option but a necessity.

I have questions about the cost of the bill and how it will be paid for. We all have questions of one kind or another. Some, particularly the very rich, the insurance companies and the drug companies, may be better off without reform and they are entitled to be against it. But when outrageous lies are used, we know that the opposition is bankrupt. An honest and civil debate is called for. Lies, smears, and scare tactics have no place in a discussion of such a crucial subject.

Tuesday, August 11, 2009

Health Insurance Reform

Health Insurance Reform appears to be in trouble, or at least that is what the media is telling us.

Should we care? Or is the present system fine for most of us?

These are questions that are legitimate and should be asked by all. After all we are told we have the best medical care in the world. For example Senator Shelby (R-Ala.) told Chris Wallace in June on "Fox News Sunday" that President Barack Obama's proposed health care plan is the "first step in destroying the best health care system the world has ever known" and Senator Mitch McConnell on July 19 said on Meet the Press: “They don't seem to grant that we have the finest health care in the world now. We need to focus on the two problems that we have, cost and access, not sort of scrap the entire healthcare system of the United States.”

These comments are very important because they set up certain premises that if true should give us all pause. Do we have the best health care system in the world? We all would like to think so. We like to think the U.S. is Number I in everything. That is something we should strive for, but in a sense we all come from Missouri, we ask is it true?

Well the World Health Organization has stopped doing these studies, so the latest figures we have date to 1999, but there is no reason to think that much has changed. On the basis of life expectancy the U.S. ranks #24. Japan Ranks #1, France #3, Sweden #4, Canada #12, UK #14. When the rankings are by eight relevant measures the U.S. comes in – hold your breath – comes in at #72.

But many Americans don’t trust the statistics of these “foreigners.” Well the American CDC (Center for Disease Control and Prevention) does a ranking on infant mortality rates. The latest one done as of 2005 shows the U.S. in 30th place.

So much for the claim that we have the best medical care in the world.

It is true, as some Republicans have contended, that the rich, the prominent often come to the U.S. for treatment - the Shah of Iran, with terminal cancer, came to the U.S., but all that shows is that if you have unlimited money excellent care is available in the US. Very few come from Germany or Italy or Canada, etc. Only a very few of us have unlimited money and whether people know it or not, even the insured don’t have unlimited coverage as so many are discovering.

We keep hearing about the uninsured and their lot is indeed serious. But the same goes for most of the insured who don’t know that when they need their insurance most they will discover that they forgot to read the small print. It doesn’t cover the most expensive procedures or they find the condition is a pre-existent one, even though they didn’t know that, and their insurance exempts pre-existent conditions. And then there are the co-pays. They can bankrupt you if you need an expensive procedure even if the procedure is covered by private insurance.

But let us remember what else McConnell said: he doesn’t want to “sort of scrap the entire healthcare system of the United States.” Well who does? What an outrageous setting up of a straw man. The discussion revolves around the insurance system, not the medical delivery system. The most controversial part of the reform is whether to have a government insurance system alongside private insurance and they treat that as though it were the most outrageous idea in the world. Well, Senator McConnell has government run health insurance along with every member of Congress. They all love it. Every American over 65 has a government run health insurance. Its called Medicare. All are very happy with it. Children who are not insured in a private health insurance plan have access to a government health insurance plan. Its called SCHIP. Parents whose children are covered by this plan are very happy to have it. The poor have a government health insurance plan, its called Medicaid. They are grateful to have it even though in many states it is under funded. As for veterans who are insured under the Veterans Administration program, a government program, they wouldn’t exchange it for private insurance.

None of these American Health insurance plans has turned us into a Socialist state and the insurance companies are still in business.

But now they tell us that Medicare may look good but it under-reimburses doctors. It is true that Medicare pays doctors less than they charge their un-insured patients*, but so does every private insurance company. According to Ethical Health Partnerships, “No matter how much we pay for private insurance, their payment to physicians is either slightly above Medicare rates (for better insurance companies) or BELOW Medicare rates. It is not uncommon for some insurance companies to pay 10-20% LESS than Medicare.”

It is no wonder that I have yet to find a notice posted in a doctor’s office that says we no longer take Medicare, though undoubtedly some don't. However, I do frequently find notices, “We don’t take United Health Care” or some other carrier, anymore. That means you lose your choice of doctor, and your choices of doctors are limited, with most private insurance companies having in-plan and non-plan doctors.

But one of the scare tactics used by the opponents of reform, and don’t be fooled by the claim that they want reform but “only the right kind,” is that you will lose your choice of doctor. They turn the facts on their head. Your choice of doctor is limited by the private insurance industry - it is not likely to be limited under any government program.

I realize that there are other issues that are troubling. Most important is cost. I will try to address all of them, or as many of them as I can, in future presentations.



* who are not only subject to the burden of having to pay all their medical expenses out of pocket, but are charged at a substantially higher rate then the insurance companies, so that they end up subsidizing the insured.