Sunday, August 12, 2007

Would you like to be President? We can help

C'mon, you know you could do a better job than the guy in the White House.

If only you could come up with the money. If only you could raise your name recognition to a national level. If only your boss would give you a couple of months off to campaign.

The coffee shops and bars and boardrooms of America are filled with people who think they could transform the Oval Office, if only they had the chance. Maybe you're one of those who stare in disbelief at their TV sets and crumple their newspapers at the breakfast table and mutter: "What are they thinking?"

So here's your chance to shine, in a very limited way. Just like God (in the person of Morgan Freeman) gave Jim Carrey the chance to be God of Buffalo in "Bruce Almighty," we at the News & Advance would like to make you President of the United States. Sort of.

Here's the deal. Between now and next January, when the primaries begin, we're offering you the opportunity to tell us how you would fix some of the things you think are wrong with this country. Or bolster what you think is right.

What would you do if you were the man or woman in charge? How would you get us out of Iraq? Or do you think we should stay there? How do you feel about the national debt? Global warming? The separation of church and state?

We'll find a panel of astute people to sort through all of your suggestions and narrow them down to five candidates. Then, we'll give each of those who make the cut the opportunity to deliver a short campaign speech that we'll post on video on our Website. We'll also publish your ideas in the newspaper. Then, we'll throw it open to a general vote of all our readers.

The finalists will not be chosen on the slant of their ideas -- we will hold no prejudice toward left, right or center suggestions. Indeed, it will be a much better election if we have an ideological range. The key will be whether your suggestions are clearly thought out and presented. Nor do you have to be an Ivy League graduate -- common sense will count just as much as an advanced degree.

So think about this, and take your time -- you've got several months. We'll also probably reward the person who's elected in some way, although that's still in the talking stages. You can e-mail us your ideas, or mail them.

If you'll notice the previous blog on this site, I've thrown out a few of the many issues you could discuss. I'm sure you have your own.

The only rules are these:

1. We want you to suggest a platform of your own, not simply criticize what's being done now. Pretend that there's a vacancy at the top, and you're starting from scratch.

2. We want you to be serious. Any suggestions like "Give everyone a million dollars" or "Legalize crime" will be chuckled at, then discarded.

3. Stick to national and international issues, not state and local.

So give it a shot. Who knows? Maybe you can even make it onto the national ballot from here.

Some issues politicans avoid at any cost

I think we can see where this is going. The 2008 presidential election is going to be all about Iraq (with maybe Iran and Afganistan thrown in), to the exclusion of almost everything else.

Of course, a lot can happen between now and then, but chances are the same vitally important domestic issues are going to be ignored yet again.

That's probably because they are difficult, prickly head-scratchers that don't lend themselves to TV soundbites. They may, however, lend themselves to solutions, if we'd just talk about it.

It seems to me that we often squander the true value of our elections. Besides deciding (in theory, at least) who is most fit for an office, they also open the floor for debate on the pressing questions of the day. Locally, it might be whether this section of a county should have sewer service or that section should be re-zoned. Nationally, the stakes are much higher.

All too often, though, debate is not what happens. The candidates either attack each other personally, or drone on about how they'll never raise your taxes. The things that really matter are blown away by the hurricane of hot air.

So what does really matter here in America, in 2007? That's a subjective question, and your list may well differ from mine. But here's a starting point:

1. Health care. Sure, the candidates will talk about health care, but most likely in an abstract, pie-in-the-sky way that doesn't take in the realities "on the ground," as the popular saying goes.

Here's what I always wonder about: Why should it be the responsibility of the your employer to take care of your health care?

Think about it. Doing the same job, I would get one salary from the Amherst New Era Progress, another from the News & Advance, another from the New York Times. Those salaries reflect the resources each newspaper has available. In terms of my medical coverage, however, it would cost all of them essentially the same.

Put simply, this concept that business should shoulder the burden of health care is killing small companies.

So if business don't do it, who should? Maybe a coalition of some sort between government and insurance companies, throwing out a net that ultimately covers everyone. But any decision that's made has to involve doctors, hospitals and pharmacuetical companies. Instead of simply lobbying the government, these groups need to interact with it.

Of course, any improvements in the health care mess will mean ....

2. Taxes. We have the war in Iraq. We have a crisis in health care. The infrastructure is sagging (the Minnesota bridge collapse, case in point). We have an endangered Social Security system.

If you're a couple sitting at the kitchen table with your bills strewn about you, and you see red ink seeping onto the tablecloth, you're going to say: "Hey, we've got to come up with some more money from somewhere." Or, you might say: "We really need to cut down on our spending."

Americans have been convinced that we don't need to do either. Just put it on the national credit card, and we'll deal with it later. We accept financial strategies from our governments that would appall us personally.

We don't resist taxes because we're stingy -- Americans are among the most generous people on earth. The problem is, no one ever seems to equate taxes to services in any sort of direct way. Moreover, those of us in the lower and middle class brackets see the more fortunate gleefully driving Brinks trucks through gaping loopholes in the tax code on their way to the bank.

I think if a tax system were truly fair, Americans would buy into it (if not necessarily with a smile).

3. Social Security. A lot of us have a system in which our checking and savings accounts are joined at the hip. If you overdraw your checking acocunt, money is automatically drawn from savings to cover the deficit. The federal government has that, too -- the checking account is called the budget, the fallback is Social Security. They just don't tell you about it.

4. Prison/drug law reform. Again, politicians have failed us miserablly here. Besides "I'll never raise your taxes," the most popular mantra is "I'm going to be tough on crime." Common sense goes out the window. The fact is, putting someone in jail for making a poor lifestyle decision (i.e., possesing drugs) makes about as much sense as busting an overweight person in the McDonald's line, or hauling a workaholic out of his cubicle.

Sure, certain drugs are bad for you, but filling our prisons with young people who then become a drain on society doesn't seem a very good way to deal with thhat.

This is, like most of the problems we ignore, very complicated. Why not make the emphasis on getting people off drugs, thereby drying up the demand? Otherwise, we have the problem of convincing a 17-year-old with no future that even though he's making $1,500 a week, there are better alternatives. Which leads to ...

5. Jobs. Our society used to offer "meat and potatoes" employment, the kind you could get with a high school diploma and make a decent living from. Most of them were in manufacturing of some sort, and you could make a good living from them. Here in Lynchburg, you could work at the Lynchburg foundry, the shoe factory, the textile mill. Now, the choices seem to be hi-tech or fast food. Government can't solve this problem, but it's certainly something that needs to be addressed.

6. An alienated minority. We can ignore the plight (and, yes, the attitude) of the disaffected youth culture in the inner cities only at our peril -- and theirs.

Sunday, August 5, 2007

Hot pursuits and bad endings

High speed police chases. Let's talk about this a minute.

It's certainly a timely subject, because hot pursuit has killed both a chaser and a chasee in Central Virginia so far this year -- a sheriff's deputy in Campbell County, a 21-year-old driving without a license in Bedford.

And the obvious question has to be: Were these pursuits that ultimately turned tragic really necessary in the first place?

For better or worse, vehicular pursuit has become embedded in our culture -- what would an action movie be without at least one car chase? Perhaps because of that, it's something many men (and, increasingly, women) fantasize about.

In real life, though, who are the people most likely to put the pedal to the metal and try to flee the cops?

1. They could be a dangerous criminal, someone on the FBI's Most Wanted List. A rapist, a terrorist, an armed robber. They could be, but it's highly unlikely -- this is a big country, and there aren't enough dangerous criminals on the lam to go around.

2. They could be fleeing from the scene of a crime, like a bank heist. Still unlikely.

3. They could be driving a stolen car. Now, we're getting more into the neighborhood of probability.

4. They could be driving on a suspended license, or unwilling to acquire the extra points that might get their license suspended.

5. They could be drunk.

The last category is the one I find most disturbing.

Let's consider this. You've got a person the police are trying to catch because they feel he is a danger to other motorists. So what sense does it make to then force this person -- whose depth perception, vision and judgement may already be impaired -- to drive at higher and higher speeds?

That's what happened when a drunk driver slammed head-on into a car containing the Barrick family on Waterlick Road a few months back.

My position on this is that I am a fellow traveler on the public highways (the Barrick accident happened on a road I drive every day). Sure, it makes me uncomfortable to think of wasted drivers sharing those highways with me, but the thought of a wasted driver going 100 miles an hour ups the ante considerably.

When you put the worst case scenarios side-by-side, it goes something like this:

If the police let the person go, the worst case scenario is that he or she will escape to drive drunk, or on a suspended license, another day.

If the police instigate a chase, the worst case scenario is that someone dies.

There are exceptions, naturally. The police are almost obligated to pursue a fleeing robber, or a criminal believed to be a public menace. But in the case of the ordinary citizen with a less-than-ordinary driving record, chances are the in-car camera has already snapped a photo of the license plate and videotaped the fleeing car. True, it's not as exciting to go by the person's home or place of work the next day to make the arrest, but it's probably a lot safer. And innocent people don't get hurt.

Based on events such as have happened in Central Virginia this year, localities all over the U.S. have decided that routinely embarking on these 90-mph thrill rides simply isn't worth the risk.
To me, that only makes sense.

Wednesday, August 1, 2007

ER's test the patience of patients

I used to work in a hospital emergency room, although it seems like 100 years ago.

It was back in the mid-70s, in Lexington County, SC, and I imagine the same challenges we faced there are still bedeviling ER personnel today.

This was, I always tell people, the perfect preparation for a later job in journalism. The hours were uncertain, the pay wasn't great, and I had to ask personal questions of people who didn't want to answer them.

Even with all that, though, the Lexington County General Hospital ER fulfilled my No. 1 requirement of any job, that every day at work be different.

We had shootings and stabbings and car wrecks. We had close encounters with chainsaws and fire ants and fish hooks and vicious dogs (as well as vicious husbands and boyfriends). At the same time, we also had a steady flow of patients who probably shouldn't have been there.

My favorite exchange between nurse and patient at that hospital was with a man who came in for treatment of what used to be called, in polite company, a "social disease." This was duly noted on the chart that I, as the primary conduit of information, filled out and placed in the window behind me.

With this individual, "patient" was a misnomer. He became increasingly agitated as later arrivals were treated ahead of him (never mind that they had suffered heart attacks and seizures), and finally he stalked over to the nurse's window and said: "Can I please be seen by someone? I'm a very busy man."

The nurse, an older woman who had seen it all, looked at his chart and replied dryly: "Yes. I can see that."

I thought about all this when I read Cynthia Pegram's story a couple of Sundays ago about long waits for emergency room patients. At Lynchburg General, one of the busiest ER's in the state, the median time before treatment was more than three hours.

The centerpiece of this article was a cautionary tale about a woman who was referred to the ER by her doctor with a possible urinary tract infection. She and her husband first walked through the doors at 1 p.m. on a Sunday and didn't leave until 13 hours later.

Some doctors can perform open-heart surgery in a lot less time than that. Put another way, that's 13 episodes of "ER," back-to-back. And in the end, the woman was told: "Just keep taking the medication you've been taking."

The couple made a point of telling Cynthia that they had no complaints about the quality of care, or the compassion with which they were treated. But 13 hours?

Here's the problem, I think. Running a hospital emergency room is like trying to operate a fast food place and a fine-dining restaurant in the same space.

Some people are there because they'd be dead otherwise. Some are there because their doctors told them to go there. And others, with more minor complaints, are there because they don't have any other place to go.

When you try to funnel all this diverse humanity through one portal, it can get crazy. The usual rule of "First come, first served" doesn't apply when you're waiting for three stitches in the end of your finger and ambulance attendants suddenly burst through the door bearing someone who has been struck by lightning. That's what happened to the woman in Cynthia's story -- she kept being trumped by worse-case scenarios.

It seems to me, however, that there must be some logical way to deal with this. How about reserving one area of the ER for the more routine cases, and let that operate indepedently of the trauma and cardiac areas?

Moreover, isn't there some way of determining how serious something might be before that person gets to the ER? Perhaps the problem is fear of lawsuits, but couldn't some of this be handled by a nurse practitioner, even over the telephone?

Emergency room visits are never pleasant, and they're not cheap. But maybe they could at least be shorter.