We all know that terrorists go to college

Because they turn into latte-drinking tree-hugging sandal-wearing liberal elitists who use fancy words and support education. That's what I've read, anyway...

WASHINGTON — A German graduate student in oceanography at M.I.T. applied to the Transportation Security Administration for a new ID card allowing him to work around ships and docks.

What the student, Wilken-Jon von Appen, received in return was a letter that not only turned him down but added an ominous warning from John M. Busch, a security administration official: “I have determined that you pose a security threat.”

Similar letters have gone to 5,000 applicants across the country who have at least initially been turned down for a Transportation Worker Identification Credential, an ID card meant to guard against acts of terrorism, agency officials said Monday.

The officials also said they were sorry about the language, which they may change in the future, but had no intention of withdrawing letters already sent.

“It’s an unfortunate choice of words in a bureaucratic letter,” said Ellen Howe, a security agency spokeswoman.

Ms. Howe and Maurine Fanguy, who oversees the new ID card program, said that most foreign students did not qualify for the identity cards, but that the letters were not intended to label the recipients as potential terrorists. (Some applicants are also turned down because of criminal records.)

So ... when will these officious bureaucratic little napoleons be reined in? Can we hire people with just a little common sense and social awareness? Anybody?

So watt?

Why should we care that China is working on an electrical plant in Iraq instead of the U.S.?: (my bold)

Recently, the US media reported what seems to be a not very important event: China is among the countries that has received contracts for building electric power plants in Iraq. Still, close scrutiny of the event revealed a lot about the nature of not so much China's but the US's foreign policy and political system, and the real state of the US economy.

The very fact that China was invited to build power stations in Iraq looks like a rather surprising development. The point is that this should be done by the Americans, who not only have the expertise but - and this should be quite an important consideration - have allocated literally billions of dollars of taxpayer money for Iraqi "reconstruction", ie, providing the country with essential services, without which, as the George W Bush administration rightly asserts, a stable government is not possible. Still, after several years of work and all the billions spent, as one Iraqi official acknowledged, little has been done to provide even such essentials as electricity.

[snip]

During the Cold War era, the nations of Eastern Europe publicly proclaimed their desire for liberty as the major reason for their attachment to the US. Still, liberty was not the major attraction: the desire was for the American way of life - as it was visualized - and it was the life of economic plenty, a life where everything ran smoothly and efficiently and the American dollar was the king of currencies.

Still, as the experience of those who encounter Americans in Iraq, Afghanistan and many other parts of the world reveal, these characteristics - efficiency and concern for results - have become more and more passe. American companies have behaved in extremely "non-American" ways; they immediately created several layers of highly paid but absolutely useless management, brought workers from abroad for exorbitant wages and spent on themselves all the "aid" money - presumably given to help the populace - and then departed with with little to show for their "expertise".

And this image of US management as wasteful, corrupt and inefficient, after years and billions of dollars spent, and unable not just to improve the life of ordinary people but even to return Iraq's basic services in many areas to a level existing even during Saddam Hussein's rule, has damaged the US's image much more than all the abuses of Abu Ghraib and Guantanamo. At the same time, however, the inefficiencies of the American economy are not just reflected in a change of the image of the US. The implication is much more serious.

It is true that the US continues to be one of the major economies of the world and has considerable financial resources. Still, as the dollar's value continues to fall against all major currencies (this in itself reflects the realities of America's economic health) and the US's debt continues to rise to astronomical levels, the ability of the US to maintain its imperial presence continues to erode.

It is not only that the weakening dollar makes maintaining the US global presence more and more burdensome but also that the US has fewer and fewer resources for providing substantial amounts of largess for its friends and satellites.

The US has started to lose its major weapon: the checkbook. And it is here that other nations who became "Americanized", ie, efficient and rich, have started to replace the US. And it is this that is indicated by what seems to be the trivial fact of replacing an American company by a Chinese one in building an electricity plant in Iraq.

When you run a bloated bureaucratic inefficient indifferent business.... people will actually notice and take their business elsewhere. Gee. How strange.

Guess they didn't cover that in Econ. 101 where you aren't supposed to cram your greedy cronies into government contract jobs and rip off the treasury, taking the money without doing the work, huh, Georgie?

Governed by those

Who hate government and want to prove that it doesn't work.

David Kurtz at Talking Points Memo prints a letter that discusses Bush's destruction of what used to be a functional system:

Your post . . . about the slowdown in cases in San Francisco got me thinking about the larger bureaucratic issue associated with more than half a dozen years under Bush.

This is a relatively trivial incident, but a while back I attempted to get my passport renewed and discovered the wait times had doubled (partly because of the new rule requiring travelers to Canada to have passports) -- trivial, yes, but it also highlights some of the more mundane effects of an administration run by people who have a fundamental antipathy toward government service and government programs.

This gets writ large in the case of incidents like Hurricane Katrina, the prosecution of the Iraq war and so on...but it also gets writ small in thousands of details of everyday bureaucratic life -- especially as the Bush influence trickles down through the bureaucracy from political appointees to career employees.

If the governing Bush/Cheney philosophy is that the public sector doesn't work, that it is inherently not just inefficient and corrupt, but antagonistic to citizens and individuals, this philosophy has a way of slithering its way into the workings of the system itself -- not just in the case of high profile corruption scandals, but also, again on a more mundane level, in the day-to-day operation of government bureaucracies.

And here's the weird thing, even though that sounds so unexciting, there's something almost stifling about imagining a bureaucracy that really is antagonistic to individuals -- one that not only slows down, but finds some vindication in throwing up road blocks, thwarting citizen requests, and, in the end, not serving the public. I have family members who lived in former communist countries -- and that's really how the bureaucracy was there, and life under those circumstances was made much more difficult, bureaucratic responsibilities increasingly cumbersome, much of the time the system just didn't work, and had to be gamed (or bribed).

Although I have large scale concerns about Bush's handling of the war, the economy, and so on, I also have some more micro scale concerns about what his philosophy of governance means for everyday life and our everyday interactions with the bureaucracy. Indeed, this scale, though more mundane, is also the one that in some ways affects the majority of the population more directly, even if much less dramatically. I've lived in places where the bureaucracy functions quite well, and where citizens take a certain pride in the fact that the government serves them.

The idea of living in a country where the administration's goal is to demonstrate just how bad government is/can be scares me at this very prosaic level -- I want my schools and courts and inspection agencies and passport agencies and so on to be run by people who really believe in government service and in the fact that the government can work effectively to serve the populace. Bush seems to be doing everything he can to dismantle such a world -- and he risks fueling a vicious circle in so doing.

Strange....

I know just how she feels...

Helena, MT (AHN) - A 36-year-old Idaho woman became frustrated and allegedly used pepper spray on hospital employees when they refused to discharge her.

Susan Kollars sprayed employees at St. Peter's Hospital on Sunday and then ran towards Interstate 15. According to AP reports, it is not clear why Kollars was denied discharge from the hospital or why she was admitted.

According to Police Chief Troy McGee, a man driving a pickup saw Kollars but she tried to spray him as well. She was then taken into custody and returned to the hospital. She now faces three counts of misdemeanor assault resulting from the incident.

Personal adventures in our US health care system: Part eight

Phone call from someone named Jenna.

'Yes?' I ask.

'This is physical therapy from the hospital. Concerning your MIL. Do you have her Medicare number?'

Personal adventures in our US health care system: Part seven

Day of surgery to remove bar:

Planning for the prosthetics clinic before the 1 pm surgery, I called days ahead and made the appointment. ‘8:30, 8:45, or an 11:00 is available,’ said the office paperwork lady that I remembered so well from last time. I thought… 8:30 is a wee bit early … ‘8:45 please’ I said. ‘I know that she will need a small splint, here are her measurements.’ ‘Oh, good to know,’ said office lady. ‘We will have to get a special one for her.’

Husband and BIL and I involved on this one. All three of us to the prosthetics clinic, then to the hospital. I would check in with all the paperwork and then leave. They would sit through the surgery and take her home.

MIL ready to go. (Thank god for the care-givers. They are worth their weight in gold.) Wheelchair, slope, car, clinic. Parking lot, wheelchair, MIL, office. Running a bit late but still about 8:40 when I dash in ahead of the others. ‘MIL here for her appointment.’

‘You’re a bit late,’ said office paperwork lady, flapping papers about on her desk. ‘Oh, no,’ I said, ‘We have the 8:45 appointment.’ ‘No, you have the 8:30, but we can still take you.’ ‘No, I’m sure…’I began to explain. ‘You will be beat,’ stated office lady emphatically. My mouth hung open in astonishment.

BIL and husband rolled in MIL. Gave office lady the co-pay. If I threw a tantrum right there in the office, ripping off wallpaper, jumping on the spindly furniture, and eating the potted plant, it would feel good temporarily, but hurt MIL’s prospects for this splint thingie she had to have. I sat down quietly.

A few minutes of hunting about my papers made me realize I was missing something. I drove quickly home so I missed the next part. My husband filled me in.

They sat in the waiting room until about 9:15, when my husband noticed the prosthetics doctor driving into the parking lot. The actual visitation lasted less than 5 minutes. The doctor didn’t even look at the broken arm, but measured the other arm. Then he didn’t have the right size. BIL and husband very unimpressed. Left with splint Velcro thingie in box.

MIL, BIL, husband and I to hospital. Admissions, paperwork, forms, upstairs, room. Changed MIL to gown, visited the smallest bathroom in the world. (Try that with someone who can’t move her arm nor stand up without assistance.) Blood pressure, temperature. Verified husband still had splint box. After settling MIL into bed, I kissed her, thanked BIL and husband and joyfully fled the hospital.

My husband came home hours later stunned into exhaustion. BIL and he had seen MIL into surgery. They had gone to the allotted guest room and settled in to wait. And waited. Sometime later Dr. R.S. showed up, declaring her out of surgery and fine. Husband offered him the splint box.

‘Oh, no. I couldn’t find you, so I used one of ours,’ Dr. R. S. said cheerfully.

Personal adventures in our US health care system: Part six

Finally the final check-up before surgery.

BIL and I went. (MIL, wheelchair, slope, car, doctor’s office.) X-rays downstairs. Up elevator, sign in, co-pay. Bones look straight (really amazing), Dr. R.S is pleased. Sets date for surgery (very fast, he said, hardly any time at all under). Back over to hospital for pre-admission. What is her Medicare number? Explained about the Multi-County Stupendous Coverage Card and the fact we had not yet found it amid her papers. MIL beams at woman. Woman spent 10 minutes hunting through computer files for number. Nothing. Typed in: not yet found.

Up a floor to another office to talk about steps needed before surgery. Did we need this step? Sadly yes. Blood taken at time of last surgery cannot be used and urine needs to be taken. Can’t we do it here? No, said the nurse. The offices used different urine sample cups.

Different urine sample cups?

My mouth must have been agape. Why didn’t they stock both then? … But I didn’t ask.

BIL, MIL, and I out door, parking lot, car, wheelchair, new building. This building was right across the street from the hospital too. We waited in the messy waiting room amid crowds of people. Into another room to give blood. The floor tiles were broken and buckled, the cotton balls were scattered about the floor. Boxes were stacked along the wall. The bathroom was filthy and trying to assist MIL for the urine sample was a nightmare. She then had to go into a special room for blood being unable to get onto the stool. Which meant we waited longer.

Finally, exhausted, MIL taken home. I offered to make the run to the prosthetics clinic where we had to get a splint for MIL for after surgery. Dr. R.S. had said it would be small or medium, so I measured MIL’s arm. To clinic, into office, spoke to woman through office glass window. ‘Here for MIL’s splint.’

‘Ah,’ said the office woman settling down comfortably behind her file-covered desk. ‘I have her paperwork right here. Is she here?’ ‘No, I have her measurements with me.’ ‘Oh, no, no, no. We cannot give it to you. Insurance. Liability. She must come in.’ ‘That is very difficult,’ I gasped out and left.

Yet another visit for MIL. The only time open for family members would be the day of the surgery.

Personal adventures in our US health care system: Part five

Post-operative visit to Dr. Real Surgeon.

BIL and I on this run. MIL ready, wheelchair down to car, over to Dr. R.S.’s office. Kept MIL downstairs while I ran up to sign in, verified that x-rays were needed, ran down with paperwork. X-rayed. Looked absolutely amazing. Straight…wow. Those bar thingies work!

Back up the elevator to Dr. R.S., co-pay, in office for exam. Should have had warning. Dr. showed up with several papers, mid-talk went out to retrieve another insurance form. Discussion about seeing a physical therapist at the hospital. We accepted this, worked it in for that day. (MIL, wheelchair, parking lot, car, wheelchair).

Over to hospital, waited for physical therapist. He checked her arm and hand. Showed her how to keep moving her fingers and shoulder. Waited about an hour for about five minutes’ worth of finger wiggling. Oh, well. A flyer would have been as helpful.

Now almost two months had gone by.

Home care by care-givers and family meant cleaning the bar with peroxide. Daily program to get MIL to wiggle hand and fingers, but all for naught. The splint and bar weighed too much, prevented movement, and her hand turned into a useless club. Well…when the stuff comes off, then we will work it hard.

Personal adventures in our US health care system: Part four

Day of surgery:

No eating after midnight, no pills, nothing. For an old woman weighing under 100 pounds, this is ... interesting. Gathered MIL from house, wheelchair, down to car, to hospital. (Getting good at this!) Admissions, advanced directive, paperwork, forms.

Into pre-surgery room, changed clothes, blood pressure, temperature, IV, etc etc. Waited in room for perhaps an hour. MIL wheeled off to surgery. Husband and I went to waiting room. And waited. And waited. Husband figured out what was happening and went to talk to doctor and nurse standing in hall. MIL showing some signs of dementia and was repeating herself. Nurse thought it was that she had yet to come out of anaesthetic properly.

Went from recovery room to regular room to wait. For discharge. Husband stood by door and commandeered nurses as they went by, asking when we could leave. An hour, two. Finally discharged.

MIL had a long bar running above her arm mounted into her flesh by two three-inch forked pins. This held the bone in position. An ace bandage over a small bendable splint on the lower part of her arm covered this contraption. She now had to live with this thing for two months.

Dr. Real Surgeon set up appointment for post-surgery check. We took her home.

Personal adventures in our US health care system: Part three

Day of meeting Dr. Real Surgeon.

BIL and I took MIL dressed and ready in her wheelchair down slope and into car. We showed up with x-rays from the hospital. Waited in very crowded waiting room. We had learned: we now carried file with all paperwork and proof of existence. Every time we walked into an office there was a co-pay involved, so small bills were good. X-rays from hospital not good enough, so down the elevator to another office for x-rays. Back up the elevator to Dr. Real Surgeon. Finally in to see Dr. Real Surgeon who looks at x-rays and tells us we have two options. Take care of it in the clinic or surgery. In clinic would mean arm would heal as it was, surgery would mean it would be straight and function better. Gee. Hospital and surgery it was. Dr. Real Surgeon gave her a splint and a wrap. Dr. Real Surgeon filled out several insurance forms and gave us surgery date.

Note to medical office: If you are an office that deals with the elderly and the broken-boned, do NOT let your elevator guy schedule a maintenance service during office hours. We were stuck on the second floor for about 45 minutes and the people we saw wheezing up the stairs and staggering into a seat made us think about heart attacks…

We had MIL in the car, so we went to the hospital to take care of pre-admission. (One of us shifted MIL from car while the other set up wheelchair, folded blankets, got pillow, then parked car.) 400 people holding numbers were packed into room as small as a walk-in closet, all waiting for five harried women at computers. We waited for at least an hour. Finally at the counter, we filled out forms. The hospital pre-admit woman asked for Medicare card. I explained MIL had been working with the Multi-County Stupendous Coverage Card all this time and we had not yet found the Medicare number in her paperwork. MIL beamed at woman with her endearing sweet old woman smile. Woman types in: Medicare number not available at the moment.

Wheeled MIL out of hospital, (got car from parking lot while one stayed with her, shifted MIL into car, undid wheelchair, folded blankets, pillow, put wheelchair in trunk) and took her home.

Update: forgot about the visit during the pre-admission to an office to check her heart, etc. for surgery. Waited a while in that place as well. Test was with the sensor pads and wires all over the body....

Personal adventures in our US health care system: Part two

Next day. Got call at 6:00 am in morning to come and take MIL home. I said no thanks, we agreed to keep her there until 10 or so to take her to Dr. Something Surgeon’s appointment. Mentioned lack of care-giver, large hill and stairs. Person on phone retreated in confusion.

Told that I need to personally get the x-rays that were taken when we go to see Dr. Something Surgeon, I took care of this pick-up in the morning. (Waited, of course.)

BIL and I came to discharge her at 10 am. Appointment was at 11 am. We had time. Forms, change of clothes, forms, waited for someone to activate discharge. Did I mention forms? At 10:45, we were finally wheeling out of the hospital and into the parking lot. MIL had new sling and wrapped arm. Stuffed MIL into car, drove frantically to office of Dr. Something Surgeon. Wrong street, address confusing. Arrived at offices at 10:58 am. Left BIL and MIL in car as I dashed into building to sign in and get wheelchair.

Office was closed. Sign said 11 to 12 lunch hour and no new patients accepted. I frantically knocked on door, as I could see light in through privacy glass. I finally bent down and looked through letter drop. The woman at the counter looked startled. I yelled that we had an appointment with Dr. Something Surgeon that the hospital arranged. The woman asked if we were returning patients, everyone was at lunch and anyway there was no appointment on the books for MIL. After pleading my case, counter woman came and opened door, even though office mate told her not to. Counter woman informed me the hospital was always doing this, making appointments with Dr. Something Surgeon that were not accepted. Besides Dr. Something Surgeon was leaving the country for several months. She shut the door.

BIL and MIL were waiting out in the parking lot. BIL heard news about no appointment. Cell phone call to regular doctor. Explained we were sitting in a parking lot with MIL with broken arm and a need to see surgeon. Now. Regular doctor made appointment for MIL to see Dr. New Surgeon in an hour. We drove to building (across from hospital) and got wheelchair. Waited in waiting room. Filled out forms. Saw Dr. New Surgeon who was one of those that treated MIL last night at hospital. Verified the arm was broken. Made appointment to see Dr. Real Surgeon.

Out to car with wheelchair, loaded MIL in car, took her home. By this time we realized we needed to keep personal wheelchair with us and not use office ones.

Personal adventures in our US health care system: Part one

Boy, do I have a story to tell you guys!

Names changed to protect the culpable.

My elderly MIL fell before Christmas while maneuvering her walker and hurt her arm. She felt little pain and could move her fingers, so we assumed she just badly bruised it. Two days later it began to change colors, swell, and do an S curve that arms shouldn’t be doing, so we took her to emergency. Thus began our wonderful adventure into the maze of United States Health Care.

First, bring something to do every time you even get near the door to a doctor’s office, hospital, or any waiting room. They’re serious about waiting. This lets things ferment properly.

My MIL lives on a hill. With a steep driveway. And lots of stairs. So to get her into a wheelchair takes two or three family members and/or care-givers. (Go backwards through doorways, btw.) Ok, so MIL, diapered and scrubbed, into wheelchair, blankets, pillows, wheeling her out the door and down the slope and into car equals about twenty minutes. Left wheelchair at house knowing hospital will have one.

Drove to local hospital about one in the afternoon with kindly caregiver in her car. Got MIL out of car into hospital wheelchair into ER admitting room.

My MIL has the Multi-County Stupendous Coverage Card. We brought this card and her Advanced Directive which allows the health care givers to figure out how hard they have to work to save her should she attempt to kick the bucket while under their care. They are very interested in the Advanced Directive and really don’t want to talk to you unless you have filled one out. (Available on the net.)

Anyway, we also had her Social Security number and her last driver’s license card even though she ceased driving many years ago. But no Medicare card. She’s been getting health care and regular doctor appointments all along on her Multi-County Stupendous Coverage Card. Multi-County Stupendous Coverage Company moved everyone into Medicare Program D months ago.

She’s admitted. Changed clothes to gown, trying not to move arm. X-rays in one room, blood and urine in another, then given a curtained spot in between a shrieking child vomiting on the half hour and an obese man with a large family. We sat or stood while she sat in wheelchair. And we waited. Forms came to fill out. People came and took temperature and blood pressure. More forms. Food came, sandwiches for all three of us. Questions about how she fell. They verified the arm was broken near the wrist. Very broken. Great, thanks. By the way, how did she break it? After several times, I realized they are checking for senior abuse. I didn’t discover it until later but I was giving the wrong date, not having been there when she fell. Luckily MIL was coherent and competent to answer most questions. Did her sweet old lady act extremely well. Finally they got someone to give us a doctor appointment for the morning.

Did I tell you it is now 10 pm?

They told me to take her home and see Dr. Something Surgeon in the morning. The care-giver who so graciously assisted me down the hill had to leave about 9pm, and I was alone. No one else was available to help. I must have shown my panic as I pleaded to leave her at the hospital overnight. I explained the lack of help, the lack of overnight care, and the house on the hill with stairs. They said they would talk to the floor manager supervisor person to see if there was a bed. We waited. Someone came by to dismiss her and I told them the story of the extremely large hill with hundreds of stairs again. We waited. They finally came to admit her to a supervised room. I arranged the time to pick her up for her 11 am appointment with Dr. Something Surgeon.

My husband came by to pick me up at 10:30 pm and we picked up my car at MIL’s house and I went home. We arranged for BIL to help me with the 11 am appointment as husband was working.

End of Part One... oh, yes! You betcha there is more!

Part Two

Part Three

Part Four

Part Five

Part Six

Part Seven

Part Eight