Boreal B[l]og

For more than 10 years, I cleaned a two mile (3 km) stretch of Highway 83 north of Sonoita, Arizona, alone, in the high grasslands.  I hauled out a huge bag of garbage for every 0.4 mile (0.6 km), on one side, counting over 100 cigarette butts in that distance, too.  Considering the fire danger there, small wonder “government” made it illegal to throw cigarette butts.  We could have just made it voluntary, but even with regulation, every week thousands of people threw cigarette butts out the window along that 25 mile (40 km) road.

People don’t regulate themselves when it comes to littering.  That is a fact, and I saw it in the Boundary Waters in the 400 campsites I cleaned, too.  I don’t think we have laws against throwing soda bottles at those who pick up litter, so I guess it was acceptable to be hit while trying to “keep America beautiful.”  It was hot, dirty work, with rattlesnakes, fast cars nearby, and sharp sticking plants that had plastic bags impaled on them.

By cleaning those two miles, I saved having the government doing it and therefore made government smaller.  All government had to do was haul away the trash every week.

A while back, This American Life had a show called “What Kind of a Country Do We Want?”  The discussion was about size of government, using Colorado Springs as an example.

TAL is a good show.  They interviewed people on both sides of the issue, and even had an interview with Grover Norquist, who runs Americans for Tax Reform, and has been quoted as wanting government so small it can be drowned in a bathtub.  In his New Yorker article and later, he said, “We’re winning.”  I think he’s right.

And that scares me.  The other thing at the end of the show that scared me was a guy who said he was anti-taxes, even when it cost him more money to turn on the street lights, because “people should take care of themselves.”  Wow.  That’s a great idea.  Until your life caves in.  You lose your job, and you’re are my age.  Good luck in finding another.  You get deathly ill, and each CT scan rings up a few thousand dollars you don’t have.  Or you are a woman who gets breast cancer, and have to have chemotherapy and miss work.  Oh yes, you are a single mother, too.  I haven’t mentioned things that don’t always kill, like meningitis, M. aviae complex (MAC disease), but cost a great deal of money.  Nor did I mention a woman I know, who does vigorous outdoor work for a living, who needed surgery for spondylolisthesis, which gave her disabling back pain.  Without the surgery, covered by insurance, she’d be bedridden and her family destitute.

Sierra Vista, AZ, would have burned down last year, had it not been for the National Interagency Fire Center, a wonderful melding of 8 governmental agencies, to save duplication, that prioritizes fires and sends trained people to put them out.  No, I didn’t hear anybody in Cochise County complain about big government as government workers put their lives on the line to save the town.

Nor did I hear Iron Range residents in Minnesota, who threw out one of the best Congressman in the House, easily the most bicycle friendly one, because they wanted an anti-government person representing them.  When the Pagami Creek Fire jumped the lines and ran 12 miles in one day in the Boundary Waters Canoe Area, I heard not one voice speak out against the firefighters, who held the fire to 92,000 acres and kept it from running 60 miles further to Lake Superior.

An acquaintance of mine, who hates big government, is on government assisted medical care, and is not old enough for Medicare, a government program, although 40% of its and SSI recipients aren’t aware of that. I never called him out on how he can hate big government and yet take health saving benefits from the government.  I thought such a question rude.  I am usually called out on my contradictions immediately.  I haven’t asked this man if he gets Social Security.   “Keep the government out of my Medicare” was a remarkable line during the insurance reform debate.

Government is big, it is expensive, it has some inane rules, and at best it is often the butt of jokes.  How big should government be?  And that is an important national discussion we need to have.

For me, the answer is big enough to do those things for people that they just cannot do for themselves, like defend the country, take care of those who have catastrophic needs, ensure safety in public places–highways, the sky, put out huge wildfires–and in short, be the arbiter when two individuals or groups claim right of way, and something has to give.

In other words, we need government, because we cannot regulate ourselves properly, because it is impossible, or we choose not to do it.  Some examples:

1. Airline security.  That was run by the airlines until… 9/11.  Now it is run by the government, and it was a Republican government who created the cabinet position.
2. If you watch “Coast Guard Alaska,” there are a lot of independent folks up in “The Great Land” who have been saved by the Coast Guard.  For them, that part of big government works, although as a group, Alaskans probably don’t think much of big government….until water pours into the engine room of a fishing boat on a windy night 100 miles off the coast in 40 degree (4 C.) weather.  That’s OK.  It’s a contradiction, but that is the basic problem.  We all want things, but we don’t want to pay for them.  Congress is just people, who want everything, and want to cut the national debt.  It can’t happen, any more than you can lose weight by eating more and not exercising.
3. JCAHO, which has accredited hospitals.  As a neurologist, medical director of a hospital, and former member of the executive committees of both my county and state medical associations, I can assure you that doctors don’t regulate until they are forced to do so.  Then the regulations are a real pain, like lab safety (CLIA), JCAHO itself, and patient privacy protection (HIPAA).
4. The Interstate Highway system, begun under a Republican administration.  This was a federally funded system that revolutionized transportation in the US.
5. The Federal Aviation Administration, which has rules as to who takes off and flies what route and when.  I can’t imagine a free for all in the skies.  I sure wouldn’t fly.  Read on to see what happened when there was a free for all.
6. The National Park Service, which keeps areas like the Grand Canyon available to the public.  Sure, we could allow building and development all along the Rim, and down in, but at what cost?  It was the 26th president, a Republican named Roosevelt, who said “you cannot improve upon it.”  The NPS didn’t regulate flights over the Grand Canyon, which created a lot of unsavory noise, until a helicopter and a fixed wing collided on 18 June 1986, killing about 20 Dutch tourists and a few others near Tuna Creek, probably burned to death before they hit the ground.  Yes.  That happened.  Now, flights go elsewhere, and the Canyon is safer….and a lot more quiet.
7. Lack of regulation of Medivac helicopter flights, which led to two helicopters colliding near a Flagstaff, AZ hospital, killing 7, all of whom, including those being transported, would have survived without flying.  I think we need regulation of Medivac helicopter flights, because in many instances they are not urgent and life-saving.  Two people from the hospital I worked at died in the Pinaleño Mountains near Safford, AZ in 1992, when a helicopter collided with a mountain at night.  The person they came for could have been transported by ground and indeed was.
8. The Department of Defense, because somehow a bunch of 40 year-old men in Idaho aren’t going to be able to build and operate aircraft carriers and B-1 bombers.
9. The funding that allows every doctor to go to medical school, and allows others to graduate from college.  The funding that allows research to be done and put in the public domain, where others can view it, a critical distinction from private research.

Do I really need to go on?

I don’t know where government should stop.  As soon as people self-regulate and do things that might not be in their economic interest, then we might not need government to do it.  Had the medical community adopted my voluntary reporting of medical errors to a neutral body, we wouldn’t need to look at federal regulation.  I contacted more than 5 dozen heads of medical groups and got zero support.  We don’t know how many such errors occur every year, because we don’t count them, something else I offered to do for free in Arizona, but got no support.  This is a fact.  Indeed, more House members backed my measures in Arizona than doctors.  The Hospital Association killed the legislation.

Nor do we have regulation as to how much radiation people should get for medical procedures.  Approximately one-third of ED patients get a high radiation imaging procedure, and 1/3 of all children get one.  We are performing an uncontrolled experiment on the people in this country when it comes to radiation.  There is no excuse for whole body scans, when a good physical examination can guide the imaging procedure.  It is costly, dangerous, and unnecessary.  Having been sued, which is usually the excuse given for doing these procedures, I will still say many are unnecessary, and I will predict an increase in certain cancers and in birth defects beginning around 2020.  I really hope I am wrong.  But my strong statements need some way to prove or disprove them.

But I come back to “we just have to take care of ourselves.”  I remember Katrina, when we saw the homeless outside the Superdome, because we had decimated FEMA.  Every city has tens or hundreds of thousands of those who cannot pay for a major illness, cannot insure themselves against a host of things, cannot afford to retire, but can no longer work.  It’s a great idea to let people take care of themselves, until they just can’t.  Then what?

Do we privatize things?  I don’t know.  In theory, it is a good idea.  Private companies have to compete, and they will provide better quality for less money.  Maybe.  Private companies also have to make a profit, and the experience with privatization in Iraq wasn’t great, with shoddy workmanship, which led to electrocutions in showers, and substandard body and vehicle armor.  Can privatization work?  Yes.  I’d like to see my wireless bill drop and my successful calls increase, instead of the reverse.  How big?  How much?  I don’t know.

What kind of country do we want?  Ideally, one that works and doesn’t cost a lot.   We have to have a government run court system to adjudicate matters.  That is clear.  We have to have a group to pass laws, because we need laws to govern a society.  That is also clear.  And we need an executive body to set the tone of the country and to negotiate with other world leaders.

Like many things in the world, there are no easy answers.  Both Republicans and Democrats have increased the national debt.  Both have raised taxes.  Both have started unfunded wars.  It is not really a partisan issue.  Before we offer solutions, let’s ask good questions:

1. What is America about?
2. What should the government do and not do?
3. What should people do and not do?
4. At what point does a person’s freedom to do something (like not wear a helmet or get obese) conflict with another person’s freedom not to have to be taxed to pay for it?

There are other questions we probably need to ask, too.  Let’s ask all the right questions and then start working on figuring out what the best answers are.  Those answers won’t be right, but they will be a start.  I know one thing for sure:  sound bites are no solution.  This is a huge gray area, and we are doing too much arguing from the black and white sides.

It’s time to take a hard look at where the country should go.

This was written before the big fires that hit Colorado, including Colorado Springs.  One of the requests for President Obama was to be for “cash”.  It is ironic, although not surprising, that Colorado Springs, where a man said, “People should take care of themselves,”  must depend upon the resources of the federal government in order to survive.   Most of the time, we should want to be able to take care of ourselves.  Sometimes, however, we just can’t.  And that’s where we need the government.  Life just isn’t as simple as we’d like it to be.  My taxes should go to help the National Interagency Fire Center help Colorado Springs, even if I never plan to visit that city again.  I should be taxed for this.  Voting against one’s economic self-interest is something I should do.  

Tags: Philosophy

This entry was posted on June 14, 2012 at 15:50 and is filed under GENERAL STUFF. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.