Best Post of the Week of April 2, 2017

The Best Post of the Week of April 2, 2017:

The Thorny Issue of Health Care in the United States

 Working in the ice cream cone bakery.

On being sick. . . a century (or half century) ago

The Sunday State Leader for April 8, 1917: Join the Guard, but not the Navy?

The shape of a national Army was beginning to take place in the first days of the wary.  The US would conscript, although there was opposition to it, and the Army was going to be huge.

Americans were joining the National Guard, lining up, as they had in prior wars, to go with their state units rather than the Federal Army.  With conscription that would soon change, but here we see the evolution of the Army.  Joining state units had long been the wartime norm.  It still was, but that was going to change in short order, although conscription had been a feature of the Civil War as well.

Men (and of course now women as well) weren't joining the Navy in the same numbers.  But, as it'd turn out, the role of the U.S. Navy would not be as vast as some had thought.

And Ft. D. A. Russell was going to be busy.

Easton, Pennsylvania. April 7, 1917

The City of Easton Pennsylvania.  Copyright, April 7, 1917.

Cuba Declares War on Germany, April 7, 1917

Cuba, on this day, declared war on Germany.

Article I
Resolved, that from today a state of war is formally declared between the Republic of Cuba and the Imperial Government of Germany, and the President of the Republic is authorized and directed by this resolution to employ all the forces of the nation and the resources of our Government to make war against the Imperial German Government with the object of maintaining our rights, guarding our territory and providing for our security, prevent any acts which may be attempted against us, and defend the navigation of the seas, the liberty of commerce, and the rights of neutrals and international justice.

Article II
The President of the Republic is hereby authorized to use all the land and naval forces in the form he may deem necessary, using existing forces, reorganizing them or creating new ones, and to dispose of the economic forces of the nation in any way he may deem necessary.

Article III
The President will give account to Congress of the measures adopted in fulfillment of this law, which will be in operation from the moment of its publication in the Official Gazette.

Canadian Pacific hospital car, April 7, 1917.

Canadian Pacific hospital car, April 7, 1917.

The Casper Daily Tribune for April 7, 1917. No panic here.

The Casper Daily Tribune is almost a shock compared to other papers in the state this week.  It didn't seem that worked up about the war.

It was starting off with the bold declaration that Casper, in the midst of the World War One oil boom, was "the city wonderful".  It predicated a population of 15,000 in the next few years, which may or may not have been a pleasant thought to long term residents, but as things would play out, it's prediction was in fact lower than that which the city would rise up to in the near future.  The refinery depicted in the photo on the bottom of the front page was much of the reason why.  Already, as the paper noted, residents who were returning to the town after an absence were shocked to see how much it had changed.

Major Ormsby, that was his name, not his rank, was interviewed in the paper about radios.  Ormsby was a local rancher who is remembered today for a road north of Casper that takes people to a rural subdivision, although it might be more recalled by some as it goes past the oldest of Casper's two strip joints (shades of what 1917 would bring in there).  At the time, however, that was all rural land and apparently Ormsby had a radio set there.  He was interviewed due to a rumor that his radio was going to be taken over by the Navy, although the article notes he'd heard no such rumor.  He also hadn't listed to his radio for a long time, apparently.  The paper noted that the nearest commercial station was in Denver, which was true, that being the very early predecessor to KOA, which is still in business.

The Cheyenne State Leader for April 7, 1917: Wyoming can furnish finest cavalry horses obtainable anywhere

As the US plunged into war, the Leader was proclaiming that Wyoming could furnish the finest cavalry horses obtainable anywhere.

Actually, it already was.

Wyoming, in addition to experiencing a petroleum boom, was also experiencing a horse boom as horse ranchers, quite a few of them with English connections, had been been supplying the British, as well as the French, with horses for the war for years.  Starting with the Punitive Expedition, it'd started doing the same for the United States.  Not all of these horses were "finished" by any means, indeed most of them were not, something that came as a shock to their European users who were surprised by how green these horses were.

Added to his, of course, Wyoming had a major Remount station in Sheridan Wyoming, right in the heart of Wyoming's horse country, which would continue on through World War Two.

In that other boom, the oil boom, that had become so significant that the Leader was quoting the prices from the Casper exchange now on a daily basis.

Update

Just a couple of days ago my Iphone updated.

It took it a really long time to do it.

After that, the battery on the Iphone 6, which I've only had for a couple of months, started running down in a day.  It had really lasted a long time before that.  I was actually thinking that I wondered if they'd update it again soon, to fix whatever they'd done.

Well, today it updated again.

I don't know that they're related.

I do know that I really wish Apple would be more content to just let these things exist in a steady state without monkeying with them all the time.

The United State Declares War on Germany, 1917

The United States declared war on this day against Germany. War commenced at 1:18 pm.

WHEREAS, The Imperial German Government has committed repeated acts of war against the Government and the people of the United States of America; therefore, be it
Resolved, by the Senate and House of Representatives of the United States of America in Congress assembled, That the state of war between the United States and the Imperial German Government, which has thus been thrust upon the United States, is hereby formally declared; and
That the President be, and he is hereby, authorized and directed to employ the entire naval and military forces of the United States and the resources of the Government to carry on war against the Imperial German Government; and to bring the conflict to a successful termination all the resources of the country are hereby pledged by the Congress of the United States.

California Naval Militia Mobilized

On this date, in 1917, the California Naval Militia was mobilized.  Sailors of the California Naval Militia were assigned to the USS Oregon, USS San Diego and the USS Huntington.  While moblized, they were not actually Federalized until May 3, 1917, reflecting some of the practices and legal oddities of the time.

More BC News

Yesterday we ran this historical item:

Lex Anteinternet: Women become eligible to vote in Provincial electi...: On this date the results of a referendum held in September, 1916, came into effect and women in British Columbia became legally able to vot...

Here's a current one, from the CBC.  Mixed good and bad news at best:

Allergy sufferers in B.C. will need to brace themselves for tree pollens like oak, birch and pine to start peaking in the next week, according to a Canadian laboratory that tracks airborne allergens by the day.

The province's unusually cold winter and spring have delayed the start of allergy season by more than six weeks, but it is coming. It stands in stark contrast to 2016, when the mild winter led to the allergy season beginning a month early.

The Cheyenne State Leader for April 6, 1917: Duels of Nations and Duels of Indiviuals

The news was all about duels.

The United States had entered the duel with Germany.

Villa was moving in his duel with Carranza.

And a farmer died in a duel with a cowboy near Sheridan.

And the Wyoming National Guard's Second Battalion had been called fully back into service.

The Laramie Boomerang for April 6, 1917: Wilson Signs Measure

Evidence that maybe somebody at your local paper isn't too familiar with some aspects of history . . .

Hmmm. . . . if that photo is right Sgt. Bellamy was in the Wehrmacht during World War Two. . . .

Uber comes to Wyoming. . . . and I don't like it.

I started this post a couple of weeks ago.  True to form, it's taken me awhile to get back around to it.  Today the same story hit the cover of the Casper Star Tribune. That story made me all the more miffed about Uber, frankly.

 Cab driver, New York, 1942.

I don't like Uber.

The concept that is.  I have no personal experience with it myself at all.

Uber drivers are, to my way of thinking, up until recently, Gypsy Cabs.

Now, gypsy cabs aren't cabs driven by gypsies, they were illegally operated cabs.

Uber bills itself as a ride facilitating outfit and by and large the concept has been accepted.  It's nonsense.  It's a cab company in which the cabs are owned by the cabbies, who are independent contractors.

Being a cab driver is one of the worst, and most dangerous, jobs in the US. At least at one time being a cab driver in Washington D.C., for example, was the most dangerous job in the United States . . . more dangerous than being an Alaskan commercial fisherman. .. and that's dangerous.

And no wonder.  You pick up people you don't know and take them to a place you didn't know you were going just a few minutes prior.

Think Uber drivers must all be safe dudes and dudettes?  Google the topic "Uber driver murdered" or something like that, and you'll pull up some scary stories.  You'll also pull up at least one website simply listing crimes and accidents of Uber drivers.  And you'll find the tragic stories of Uber drivers who are murdered.

Cab drivers commit crimes and have crimes committed against them as well.  But cabs came to be regulated and controlled everywhere for a reason.  Ride sharing is bunk.  Ubers are simply unregulated cabs.

But, in the "the market must be free" and "technology is always good" atmosphere we live in, Uber and like services are going to keep on keeping on.  To the detriment of cabbies.

And that should give us pause at that.

In some places cab drivers are members of unions. . . and for good reasons. Everywhere they are employees subject to their states workers compensation laws.  In other words, they have benefits in addition to their pay, which isn't large, for their dangerous work.

Uber drivers have their own cars and that's about it, in so far as I'm aware.

Well over a century of progress in labor reversed.

No wonder the blue collar workers in this country feel left out.

But at least its regulated. The drivers have to be licensed as cabbies, the companies have to complay with the law for operating cabs. There are some protections, for the cabbies and the customers.

Now, I suppose with Uber the price may be controlled, as set by Uber, but otherwise it's really a loose sort of deal.  

Well, I'll look forward to the cry "Uber drivers of the world unite. . . you have nothing to loose, not even your tire chains".

Award Authorization Date for the Purple Heart

April 15, 1917 is the first date for which a serviceman can be awarded the Purple Heart for "Being wounded or killed in any action against an enemy of the United States or as a result of an act of any such enemy or opposing armed forces".

An earlier award of a similar name, and which inspired this medal, was designed and authorized by Washington during the Revolution as the Badge of Military Merit.  It passed into disuse following the Revolution.  Following World War One, however, the medal was revived in 1932, after several years of consideration, and awardable to men who had received the Meritorious Service Citation Certificate, Army Wound Ribbon, or were authorized to wear Wound Chevrons subsequent to April 5, 1917, thereby catching every serviceman who qualified who had served in World War One but sadly omitting men who had been wounded during the Punitive Expedition that had immediately proceeded it.  320,518 medals were awarded for service during World War One.

Douglas MacArthur was the first U.S. serviceman to receive the modern award.

Wyoming's most prolific inventor

This is a semi automatic rifle designed by John Pedersen, Wyoming's most prolific inventor.  This rifle competed with others early on for the replacement for the M1903 Springfield. That ultimately went to John Garand's design.

More patents are held by Pedersen than any other Wyomingite.  Born in Grand Island Nebraska, the family moved to Jackson Hole when he was a child and he designed most of his designs from there.  Pedersen continued to use the family ranch as his home base for most of his life, although he traveled extensively and did live in other localities from time to time.  At the time of his death he was living in Massachusetts, near Springfield Armory, and perhaps because he was working for the United States government.

His most famous design, although not his most successful one by any means in terms of manufacture and use, was the Pedersen Device, a device which allowed for the 1903 Springfield to host what was basically a semi automatic action.  Manufactured in numbers during World War One, they were never actually issued and were discarded after the war.  His design for a pump action shotgun, however, lives on today ironically as the Browning BPS.  His Model 51 pistol was manufactured commercially by Remington and was recommended for purchase by the Navy prior to World War One, although it was not officially adopted.  The cartridge design he created following World War One for military trials, the .276 Pedersen, turned out to be far ahead of its time, although the wise intervention of Douglas MacArthur, given budget constrains during the Depression, kept it from being adopted.

While a very successful arms designer, with many important patents to his name, a great deal of his personal story is lost.  He was married and had two children, one of whom was a Marine Corps lieutenant during the Korean War who purchased the famous racehorse Reckless for use in hauling ammunition.  His wife was a published author who wrote on widely varying topics.  The divorced at some point, but it is not known when.  He later remarried late in life to a woman 32 year his junior.

Pedersen would be famous today but for the fact that he was a contemporary of John Browning, the most famous of all American firearms designers.  Browning, for his part, called Pedersen the "greatest firearms designer in the world."

Women become eligible to vote in Provincial elections in British Columbia

 Little Yoho Valley near Field, British Columbia, 1902.  Yes, this photograph has nothing to do with this story, other than that its in British Columbia in the early 20th Century.

On this date the results of a referendum held in September, 1916, came into effect and women in British Columbia became legally able to vote in provincial elections.

In this British Columbia followed the Canadian prairie provinces, Manitoba, Saskatchewan and Alberta all of which had already extended the franchise to women the prior year.  It was the fourth Canadian province to take this step.

The extension of voting rights did not extend to all.  First Nations men and women remained ineligible to vote. This mirrored the situation in the United States to some degree, where some Native Americans could vote and others could not, depending upon whether they were regarded as citizens or not. Full citizenship was not extended to all American Indians until 1924.  The full franchise came to First Nations members mid 20th Century.

Suffragettes parading, April 5, 1917

The Douglas Budget for April 5, 1917: Company F In Active Service

The United States was on the eve of war with Germany and Company F was back in Federal service.

The Wyoming Tribune for April 5, 1917: War By Way Mexico

Even this late the impact of the Zimmerman Note was sufficient to create a concern that the Germans could have enticed Mexico into war with the US.

Blog Mirror: Brookings Institute: The History of the Filibuster

Interesting reading:

Testimony

The History of the Filibuster

Chairman Schumer, Ranking Member Bennett, and members of the Committee. My name is Sarah Binder. I am a senior fellow at the Brookings Institution and a professor of political science at George Washington University. I appreciate the opportunity to testify today about the history of the filibuster.

I want to offer three arguments today about that history.

It goes on from there.

On being sick. . . a century (or half century) ago

 

The progress of the 1918 Influenza in chart form.

As those who stop in here know, I've been cross posting some of the daily entries on the 100 Years Ago Today Subreddit.  Because of that some of those entries have a much wider audience than most entries here do and that's been interesting when they generated comments.  Likewise, as starting with the 1916 raid on Columbus New Mexico I've been tracking daily events quite a bit (which is about to end, with the onset of World War One for the US), I've run across items that have sparked ideas for topics, a few of which, in the context of this blog, are actually topical.

Here's one.  What was it like to be sick?

It was serious.

The introduction of penicillin during World War Two, followed by later drugs like amoxicillin, have nearly completely changed our experience of being sick.  This really came home to me in two ways here recently, one being the entry on Loretta Perfectus Walsh and the other being the Cheyenne newspapers on closing public places.

Lets start with Chief Yeoman Walsh.

I noted in my entry on her the following:

The 20 year old Walsh served throughout the war but was one of the millions of people around the world who fell victim to the 1918 flu epidemic.  Like many of those individuals, including a great aunt of mine, she was amongst those who survived the flu itself but who was left with such impaired health as a result that she ultimately died as a result of it several years later.  In her case, she died in 1925 at the age of 29.  Her service in the Navy technically ran until 1921, on a four year enlistment, but the female yeoman had been released from active service after the conclusion of World War One.

A Reddit poster asked, if she died in 1925 of tuberculosis how could she have been a victim of the 1918 Influenza Epidemic.

The state of medicine provides the explanation, and this wasn't uncommon.  Indeed, the same is true for an aunt of my mothers after whom she was named.  She died several years after having the 1918 flu.

Now, if you have the flu, in can be serious.  But a century ago, it was serious.  And this was true for darned near any virus, let alone a virulent one.  There were no antibiotics that were available.  Indeed, there was really no treatment at all.  You simply stayed home in bed while some designated member of the family tried to ease your suffering.  If things were bad enough, you might end up in a hospital, but they had to be very bad indeed, and the treatment you'd receive there would differ but little.

 Sick bay, Camp Funston.  1918.

For illnesses, at that time, nearly all treatment was limited to simply trying to lessen your discomfort.  What treatments there were often related to this, or were sometimes helpful and sometimes dangerous folk remedies.  Starving a cold and feeding a fever, for example (or is it the other way around) is nonsense.

Suffering through colds surely isn't uncommon now, some readers might be noting. That's true, but suffering through things that stand a good chance of killing you.  And if they didn't kill you, and usually of course they did not, they often put a strain on your body that set you up for some other sickness later.

Canadian victims of the flu being buried, 1918.

 

This was very well known at the time, but it seems almost incredible now.  How could having the flu, or rheumatic fever, kill you from some other ailment, or cause a heart attack a few years later, or the like?

 

Well, it can. And for thousands before World War Two recovery from a serious virus often meant living in a permanently weakened state. And that weakened state, for some, meant an early death.

 

And for some who didn't die young, there were other long lasting impacts in some cases.  High fevers in adults sometimes resulted in permanent mental impairment.  Small Pox meant lifelong scars.  Indeed, to such an extent that you can often view photos of people from a century ago or more and the captions will debate if their face had small pox scars or not, or whether pot marked skin was  their natural complexion.  Noting a condition that was common at that time was apparently just not done, leaving us to wonder.  Measles in adult men sometimes caused sterility.

 

Now, also keep in mind that there were no vaccines for these diseases either.  For minor viruses, like the chicken pox, the approach often taken by parents was to expose children to another child who had it while they were young. Getting it over with was the approach.  For others serious diseases the approach was to desperately try to save the public from exposure.

Scarlet Fever, an extremely serious virus, took the front page along with the onset of World War One in this issue of the Laramie Boomerang.

Its for this reason that we see the extraordinary stories of Mayors closing public places; schools, theaters, and even churches, to avoid spreading serious diseases.  I can't recall this ever occurring in the US during my lifetime and I suspect if a mayor tried that now there'd be serious questions about his authority. But it was very routine at the time.  People reading the early 1917 newspapers that have been posted here can find numerous examples of this occurring in Cheyenne and Laramie, as mayors tried to battle scarlet fever.

And of course then were were social diseases.

 

Ragtime great Scott Joplin who died at age 49, after first being committed due to insanity of syphilis. Insanity and death was the natural, and inevitable, course of the disease.

 

We just read of the tragic example of Scott Joplin.  His is certainly not an isolated example.  Social diseases prior to penicillin were very dangerous.  Not everyone died, but a lot did, and the progression of the diseases was grim in the extreme.  Indeed, for women who fell into prostitution the chances of dying in this grim way were better than not.

In modern times there's likely only disease that fits the pre World War Two pattern, and that disease is AIDS.  A social disease itself, there's been enormous progress in combating it, even though it cannot be, as of yet, cured.  For those old enough to remember when it hit the news some decades ago it was a shocking thing to read of.  In a lot of ways, however, as horrific as it was, it sort of fit a pattern that many diseases prior to World War Two fit into. We don't think of it that way as those prior generations were so acclimated to death by disease.  Being sick before mid 20th Century was, to say the least, a completely different thing that it is now.

Nebraska Senator George W. Norris's speech to the Senate, April 4, 1917.

There are a great many American citizens who feel that we owe it as a duty to humanity to take part in this war. Many instances of cruelty and inhumanity can be found on both sides. Men are often biased in their judgment on account of their sympathy and their interests. To my mind, what we ought to have maintained from the beginning was the strictest neutrality. If we had done this I do not believe we would have been on the verge of war at the present time. We had a right as a nation, if we desired, to cease at any time to be neutral. We had a technical right to respect the English war zone and to disregard the German war zone, but we could not do that and be neutral. I have no quarrel to find with the man who does not desire our country to remain neutral. While many such people are moved by selfish motives and hopes of gain, I have no doubt but that in a great many instances, through what I believe to be a misunderstanding of the real condition, there are many honest, patriotic citizens who think we ought to engage in this war and who are behind the President in his demand that we should declare war against Germany. I think such people err in judgment and to a great extent have been misled as to the real history and the true facts by the almost unanimous demand of the great combination of wealth that has a direct financial interest in our participation in the war. We have loaned many hundreds of millions of dollars to the allies in this controversy. While such action was legal and countenanced by international law, there is no doubt in my mind but the enormous amount of money loaned to the allies in this country has been instrumental in bringing about a public sentiment in favor of our country taking a course that would make every bond worth a hundred cents on the dollar and making the payment of every debt certain and sure. Through this instrumentality and also through the instrumentality of others who have not only made millions out of the war in the manufacture of munitions, etc., and who would expect to make millions more if our country can be drawn into the catastrophe, a large number of the great newspapers and news agencies of the country have been controlled and enlisted in the greatest propaganda that the world has ever known, to manufacture sentiment in favor of war. It is now demanded that the American citizens shall be used as insurance policies to guarantee the safe delivery of munitions of war to belligerent nations. The enormous profits of munition manufacturers, stockbrokers, and bond dealers must be still further increased by our entrance into the war. This has brought us to the present moment, when Congress, urged by the President and backed by the artificial sentiment, is about to declare war and engulf our country in the greatest holocaust that the world has ever known… 

To whom does the war bring prosperity? Not to the soldier who for the munificent compensation of $16 per month shoulders his musket and goes into the trench, there to shed his blood and to die if necessary; not to the broken-hearted widow who waits for the return of the mangled body of her husband; not to the mother who weeps at the death of her brave boy; not to the little children who shiver with cold; not to the babe who suffers from hunger; nor to the millions of mothers and daughters who carry broken hearts to their graves. War brings no prosperity to the great mass of common and patriotic citizens. It increases the cost of living of those who toil and those who already must strain every effort to keep soul and body together. War brings prosperity to the stock gambler on Wall street—to those who are already in possession of more wealth than can be realized or enjoyed. [A Wall Street broker] says if we can not get war, “it is nevertheless good opinion that the preparedness program will compensate in good measure for the loss of the stimulus of actual war.” That is, if we can not get war, let us go as far in that direction as possible. If we can not get war, let us cry for additional ships, additional guns, additional munitions, and everything else that will have a tendency to bring us as near as possible to the verge of war. And if war comes do such men as these shoulder the musket and go into the trenches? 

Their object in having war and in preparing for war is to make money. Human suffering and the sacrifice of human life are necessary, but Wall Street considers only the dollars and cents. The men who do the fighting, the people who make the sacrifices, are the ones who will not be counted in the measure of this great prosperity he depicts. The stock brokers would not, of course, go to war, because the very object they have in bringing on the war is profit, and therefore they must remain in their Wall Street offices in order to share in that great prosperity which they say war will bring. The volunteer officer, even the drafting officer, will not find them. They will be concealed in their palatial offices on Wall Street, sitting behind mahogany desks, covered up with clipped coupons—coupons soiled with the sweat of honest toil, coupons stained with mothers' tears, coupons dyed in the lifeblood of their fellow men. 

We are taking a step today that is fraught with untold danger. We are going into war upon the command of gold. We are going to run the risk of sacrificing millions of our countrymen's lives in order that other countrymen may coin their lifeblood into money. And even if we do not cross the Atlantic and go into the trenches, we are going to pile up a debt that the toiling masses that shall come many generations after us will have to pay. Unborn millions will bend their backs in toil in order to pay for the terrible step we are now about to take. We are about to do the bidding of wealth's terrible mandate. By our act we will make millions of our countrymen suffer, and the consequences of it may well be that millions of our brethren must shed their lifeblood, millions of broken-hearted women must weep, millions of children must suffer with cold, and millions of babes must die from hunger, and all because we want to preserve the commercial right of American citizens to deliver munitions of war to belligerent nations.

Warren G. Harding's April 4, 1917 speech to the Senate.

 Ohio Senator Warren G. Harding's speech to the Senate.

My countrymen, the surpassing war of all times has involved us, and found us utterly unprepared in either a mental or military sense. The Republic must awaken. The people must understand. Our safety lies in full realization the fate of the nation and the safety of the world will be decided on the western battlefront of Europe.

Primarily the American Republic has entered the war in defense of its national rights. If we did not defend we could not hope to endure. Other big issues are involved but the maintained rights and defended honor of a righteous nation includes them all. Cherishing the national rights the fathers fought to establish, and loving freedom and civilization, we should have violated every tradition and sacrificed every inheritance if we had longer held aloof from the armed conflict which is to make the world safe for civilization. More, we are committed to sacrifice in battle in order to make America safe for Americans and establish their security on every lawful mission on the high seas or under the shining sun.

We are testing popular government's capacity for self-defense. We are resolved to liberate the soul of American life and prove ourselves an American people in fact, spirit, and purpose, and consecrate ourselves anew and everlastingly to human freedom and humanity's justice. Realizing our new relationship with the world, we want to make it fit to live in, and with might and fright and ruthlessness and barbarity crushed by the conscience of a real civilization. Ours is a small concern about the kind of government any people may choose, but we do mean to outlaw the nation which violates the sacred compacts of international relationships.

The decision is to be final. If the Russian failure should become the tragic impotency of nations--if Italy should yield to the pressure of military might--if heroic France should be martyred on her flaming altars of liberty and justice and only the soul of heroism remain--if England should starve and her sacrifices and resolute warfare should prove in vain--if all these improbable disasters should attend, even then we should fight on and on, making the world's cause our cause.
A republic worth living in is worth fighting for, and sacrificing for, and dying for. In the fires of this conflict we shall wipe out the disloyalty of those who wear American garb without the faith, and establish a new concord of citizenship and a new devotion, so that we should have made a safe America the home and hope of a people who are truly American in heart and soul.

U.S. Capitol at night, April 4, 1917

The Cheyenne State Leader for April 4, 1917: Conscription

By the 4th, still prior to the declaration of war, news of conscription was hitting.  An army numbering 500,000 men in strength still seemed to be the one that was contemplated, and which Wilson had indicated as anticipated in his speech.  It'd turn out to be much larger than that.

1st Battalion of the Wyoming National Guard was also being called up, it appeared.

Right away anti sedition measures were being contemplated, something that would occur and which is shocking to read about now.  We're used to thinking of the terrible example of Japanese internment during World War Two, but we've forgotten the anti sedition efforts, and even the enemy alien internment, of World War One.

The Laramie Boomerang for April 4, 1917: Troops might go overseas

War hadn't been declared yet but it began to dawn on people that war with Germany meant sending troops to Europe, something that President Wilson had indicated in his request for a declaration of war.  The news had been so full of the war being naval, and problems with Mexico, that this hadn't been obvious at first, even though it should have been.

Wilson's speech, however, grossly underestimated the number of men that World War One would require in that role.

In an act that would be shocking today, students at the Laramie High School who were 17 were being encouraged to enlist in the Navy.

And scarlet fever was back.

The long slow death of the filibuster

The filibuster became ill in March. . .

1917.

March 8, 1917, to be exact.

That's the day that the Senate adopted the cloture rule.

Prior to the cloture rule the Senate allowed for unlimited debate.  So, in a classic filibuster, a Senator could take the floor and yap as long as he could hold out, keeping a vote from occuring.

During the Wilson Administration, however, filibusters started to prevent the Senate from doing its work. The final straw came when the Senate couldn't vote on a bill to arm merchantmen.  After that, the Senate changed the rules so that debate could be cut off by a 2/3s vote of the Senate.

And that worked for a long time, but it started breaking down in recent years.  Hence the 2013 Democratic change in the rules, and the probable 2017 elimination of it in regard to Supreme Court nominations.

Well, if the Democrats didn't want this result, .they shouldn't have brought it about, either now or in 2013.

And they don't have to.

But if they don't, they might get something they really don't want.  A Supreme Court nominee who is reserved, which means more questions would be reserved to the legislative bodies . . .which liberals don't trust.

And hence, by taking this act, they'll eliminate the anti democratic filibuster, at least in part, in the name of being anti democratic.  A move they'll likely regret, assuming that Trump can get his act together with the GOP, or rather the other way around, and there's another Supreme Court nominee during the next two years.  On that occasion, a restrained nominee, and Gorsuch is hardly immoderate, won't be necessary.

And for those counting on voter outrage. . .suggesting that there are questions that should go to the voters is hardly a position that will hurt the GOP.  And this assumes that the average voter cares about cloture at all, which is doubtful.

A switch in time. . .

Sources close to Senate Majority Leader Mitch McConnell (R-Ky.) say there’s virtually no chance he will go along with abolishing the filibuster, something he has strongly criticized in the past.

Washington Post, July 1, 2015.

What comes around. . . .

Senate Democrats took the dramatic step Thursday of eliminating filibusters for most nominations by presidents, a power play they said was necessary to fix a broken system but one that Republicans said will only rupture it further.

Washington Post, November 21, 2013

The Thorny Issue of Health Care in the United States

 Mitsubishi A6M "Zero on the Akagi getting ready to commit an act that changed health care in the United States.

It's one of our long stated Rules of History that:

Holscher's Fourth Law of History.  War changes everything

This is something that somehow is repeatedly forgotten by those who advocate wars.  I'm not a pacifist by any means, but it should be remembered that wars change absolutely everything, about everything.  No nation goes into a war and comes back out the same nation.  People's views about various things change radically due to war, entire economies are dramatically changed, and of course the people who fight the war are permanently changed.

We've discussed this here from time to time in regards to specific topics, but this law is so overarching that the impact of it can hardly be exaggerated.  Every time a nation enters a war, it proposes, in essence, to permanently alter everything about itself.

And so too of health care.

Huh?

We have been in the throws of a debate about national health care in the United States. But how did we even get here?

Let's start off with a common erroneous assumption. And let's go back before the Affordable Health Care Act  We do not have a health care system based on the private market.

Gasp!

No, we don't.

By that, I mean this.  There's a common perception that before the AHCA good old free enterprise governed the relationship between patient and doctor, not a bunch of government regulations.

Well, maybe there weren't a lot of government regulations, although there were certainly plenty, but free enterprise and health care went out the window for the United States with Japanese torpedoes at Pearl Harbor in 1941.

Okay, that's an exaggeration, but not much of one.

There seems to be a notion that prior to President' Obama's successfully getting the Affordable Health Care Act through Congress that the government wasn't in the role of providing health care.  Not hardly.  Let's take a look at the history of it.

The History of Health Care in the United States

The government has actually been in health care at least since 1798, when it crated what became the Public Health Service.  The original act actually addressed "sick and disabled seamen" and created hospitals for them,  but that's really significant in that it was a type of Federal nautical welfare, or perhaps we might consider it Federal workman's compensation.   Anyway you look at it, that very early Congress determined not to leave seamen to the whims of fate or the free market,if they became sick or disabled.

Seal of the Public Health Service, which recalls its origins.

Of course, most people weren't seaman at that time in the country's history, and if we go back far enough, say some point in the mid 19th Century, we'd find what people seem to imagine, kind of.  That is, assuming that they weren't in military service or seamen.  Or perhaps if they weren't veterans either, as public assistance of various kinds came to veterans very early on as well. Anyhow, the that most people had was one in which the patient paid the doctor directly and that's what the doctor took.  And indeed, as fable would have it, what the doctor took was sometimes a sack of potatoes or a chicken.  That means, of course, that being a physician was not as lucrative as people imagine it is now, but we also have to keep in mind that there was little the doctor could actually do for a lot of illnesses.  Indeed, for a lot of them nobody ever saw a doctor..  And even if they did, as we'll explore in a post about a century ago, often all that could be done was to make the patient somewhat comfortable.

The first type of health insurance that most Americans were exposed to of any kind came through their employments, if they were industrial workers.  Large industrial concerns and mines began to employ doctors in the late 19th Century and it became fairly common by the early 20th Century.  Sometimes seeing the doctor was a benefit of employment or sometimes a minor amount could be paid to the company for a right to see the doctor when sick. This extended, it's worth noting, to everyone employed by the company.

That was industries way of trying to keep its employees well so they could work.  I don't mean for that to sound as mercenary as it no doubt does, as that benefited employee and employer both, but that is why it was done.

About the same time some hazardous employments, like firemen, began to pool funds for true health insurance.  This was more in the nature of the employees taking care of themselves and more closely resembles something that we have now, modern health insurance.  By the early 20th Century something else we have now, Workers Compensation, entered the picture in various forms in various states.  Workers Compensation is really a type of health insurance as well, although for some reason people commonly do not think of it that way.

And while this was occurring, medicine was improving.

By the eve of World War Two all the elements of the current system were there.  Workers Compensation for industrial workers and health insurance for private individuals who were not so employed. Still, a lot of Americans would not have any kind of coverage at all and they simply paid the doctor if they saw him.

Of course, and still worth noting, medicine at that point is not what it is now.

And then came World War Two.

During World War Two Congress regulated wages. The reason was simple.  There was a legitimate fear that the employment shortage created by the war would spur inflationary wages and inflation itself.  Having just gone from disastrous deflation during the Great Depression  there was a real desire to avoid disastrous inflation during the war.  So wages were regulated.

But benefits were not.

For most people the benefit for being employed had been your job.  The thought of additional benefits was ill defined But during the war, they came into sharp focus.  Employers quickly caught on that they may not be able to offer employees of another company higher wages, but they could offer them better benefits.

And health care as a benefit of employment was born.

An insurance based system, what's wrong with that (if anything)?

Today, 55% of Americans are covered by health insurance provided through their employer.  That means nearly half are not, but by the same token that fails to take into account people who are covered through their spouses plans in one way or another.

So, what's wrong with that?

Well, maybe nothing, but there are things that this system, created by accident during World War Two, has a hard time doing.

And one of those things is controlling costs. 

Cost of medical care have been dramatically increasing in recent years and have massively increased since World War Two.  Before anyone gets blamed for that, its important to note that other things have also dramatically increased in costs.  Technology is often the reason.  Today's medicine is so much more advanced than it was in 1945 that the change, hardly appreciated, can barely be grasped.

All sorts of conditions that were lethal (even routine diseases, a post on that is coming up) are not even regarded as particularly serious now.  Heart attacks and strokes simply killed prior to the 1970s, they very often do not now.  The list could go on and on.

And, when this occurs, at some point the advancement, no matter how expensive, becomes the accepted standard of care.

So, again taking us back to 1945, a lot of people would just have endured, or even died, of a condition that would be treated successfully, and expensively, now.

In order for a system based on insurance to handle that, it's going to have high premiums.  No doubt about it.  Paying if you get a bad cold or broken arm is one thing.  Major surgery is quite another.

And hence the problem.

Over time, it's been absolutely necessary for insurance premiums to to increase, just as insurance itself has pretty much replaced the private payer.  Almost nobody goes in for major medical treatment and pays for it out of their pocket as almost nobody could afford to do it.

So we do not have a free enterprise system in health care at all, we have an insurance based one, and we did before the Affordable Health Care Act.  The cost of treatment is largely based on what health care providers can justify to insurance companies and the deals those companies can strike, or force, with the physicians.  

Where the free enterprise system almost enters the picture is at the consumer end. That is, where employers (mostly) and individuals purchase health care insurance.

That's restrained, however, by the fact that it has long been the case that each state controls who can write in their states. Therefore, health care insurance companies, which insure on the basis of "pools" of insured (all insurance does that) is limited by the size of their state's pool, and their state's demographics.  States with large populations have carriers that can spread the risk, but they may also have larger groups of people with specific expensive conditions.

The Affordable Health Care Act enters the picture

So, enter the Affordable Health Care Act.

Now, its long been the case that there are a lot of Americans who simply have no health insurance at all and therefore have much reduced access to health care.  The Federal government has long picked up quite a few of these folks, however, at the treatment end as ultimately the Federal Government is the carrier of last resort in emergencies. As untreated conditions can become emergencies the Federal Government picks up quite a bit of coverage on this end, but in bad circumstances. Anyone who doubts this should pay a visit to a city emergency room.  You'll find them full, quite often, with people who are there with bad colds and the like. The uninsured receiving emergency care.  And I don't say that lightly.  Those can indeed be emergencies.

The sense, anyhow, is that this insurance based system isn't working.  And that has been the sense for quite some time.  

Now, it should also be noted that other industrialized nations have been through this evolution, and it often is.  The United States is the only industrialized nation, and more accurately the only first world nation, that doesn't have some sort of nationalized health care system.  Different countries arrived at that point at different times, and I don't know the history for most of them.  I'll only note that the famous example of the British National Health Care system came right after World War Two.  But I'd also note that the British Labour Party, which brought it in, has always been far to the left of the American Democratic Party.

Anyhow, that doesn't automatically mean  that we should to that.

Well, anyhow, what have we done.

Well, we did the Affordable Health Care Act, which has received the popular moniker "Obamacare". The GOP has been promising to repeal it since it was enacted, and President Trump promised to "repeal and replace" Obamacare with something.  Notably, those two things aren't the same. If you simply repeal it you go back to the status quo ante, with a period of pretty dramatic disruption (maybe).  If you replace it, you basically accept that President Obama got it right, but didn't get it all right.  

Hence, I suppose, why the Republican run at repealing and replacing it just failed. The Democrats feel that the Affordable Health Care Act is basically fine.  The hard right in the Republican Party feels its a Socialist abomination (its not Socialist, however).  The rest of the GOP has been stuck with this as a right wing rallying cry and doesn't really quite know what to do.

So, indeed, what to do?

So where were we?

Well, before we look at that, we probably ought to look at where we were first. Was the system before the Affordable Health Care Act working?

Maybe, but not really all that well.  Lots of people weren't covered by anything. See the ER comment above.

Okay, before we move on, on that, let's first concede that American health care isn't and wasn't bad.  Part of the debate, quite frankly, is like the "free college" debate that Bernie Sanders sponsored in the last general election.  The United States, we noted at the time, actually sends more of its population to university than almost any nation on earth including those who have high public sponsorship of education. And the system, which is based on a four legged stool (chair?) of public assistance, student investment via debt, student investment via parental support, and student investment through work, has the advantage of having student investment in their future.  Investment by the subject isn't a bad thing.

And the European models also have the background that the labor/employer struggle in Europe was much more radical than that in the US.

So is this just a lot of complaining?

No, it isn't.  And a lot of the reason is health care costs.

Health care costs have climbed about 110% since 1990.  Health insurance premiums have necessarily climb with that cost increase.  So, carriers are caught in a bind in which they must increase premiums to keep up with costs.  People quit buying insurance when they can no longer afford it, even if they appreciate it, as at some point other things are more immediate.  All insurance, after all, is a species of gambling.  The carriers are betting the odds you won't get sick, and you are betting the odds you will.

So, on this system, if we go back to it, what can we do to address that?

I suppose before we go there, we should ask the question that normally isn't, should we even bother?

At one time the answer to that would have been mostly no, although it's clear that there's almost never been a time in American history when the government didn't worry about this some.  Starting in 1798 it worried about in regards to seamen. It worried about it in regards to veterans, and there have been other groups over time.  Something is at work  here, a least a little bit. And while a person can cast it in economic terms, what it basically amounts to is that the government, and the people, have always felt that if people couldn't take care of themselves, medically, well maybe we ought to do it for them.  It is, basically, a Christian incentive.  Its the same one, notably, that caused massive welfare efforts in Scandinavia or massive education efforts in Ireland. We basically feel that there are areas where we ought to step in and help. And that's basically a Christian motivation, although not everyone involved in Christian by any means nor is it the case that everyone even recognizes the roots of this impulse.

Anyhow, back to the old, pre AHCA system and trying to tweak it.

You can try to do something on the cost end, and indeed carriers already do.

It may come to a shock to many but very rarely on anything actually expensive to carriers pay the full bill. Rather, much more often, they negotiate a lower fee. This is the absolute rule, by the way, with workers compensation. Workers compensation never pays the full bill on anything significant but instead reduces it down.

This is frustrating to physicians, but it also means that the real cost of anything significant is often not really known very well. This is well known to attorneys, however, as defense lawyers have argued for years that the proper measure of damages for injuries resulting in medical care should be the amount paid, while plaintiffs lawyers have always argued its the amount billed.  Right now, the billed argument is the one that has been prevailing.  The lesson is that prices can and are lower under certain circumstances.

Which doesn't mean they are low.

And which does mean that there's a bit of a struggle over every bill, with the carrier doing their part to lower them. That hasn't kept premiums from climbing, however.  It may mean, however, that they haven't climbed as much as they could have.

This brings up the topic of price controls, but Americans are not going to go for that, at least not unless its part of a different package entirely. So I'll leave that there.

Indeed, we have to admit that part of the pricing situation is insurance created, but  under the law of unintended consequences. Carriers do, by and large, have the money to pay.  Regular people wouldn't.  That means that prices can be up there, just not much more up there than they already are. At least for right now.  And of course the price of things for doctors is likewise expensive.

Well, if nothing much more can be done there, what about on the insurance end.

There's definitely something that can be done on that end, and it has been suggested.  Let insurance carriers in this area compete across state lines.

It may come as a surprise to many people but health insurance carriers do not compete across state lines.  Indeed, very few types of insurance compete across state lines. Rather, carriers are individual licensed for different types of coverage in individual states. 

That means that some states have very small insurance pools.  A state like Wyoming or Alaska, for example, doesn't really have an adequate population base to guaranty much competition in health insurance.  If you let carriers cross state lines, it would create a completely different situation and it would almost certainly lower rates.

Would it lower them enough?  That's hard to say.  Anything I said on it would be a guess.  But, guessing, I'd guess it might lower premiums by 1/3d.

But 1/3d might not be enough to really fix the problem.

Well, what other things can be done around the margins, then, with the current system?  Or, as we didn't have the system that I'm speaking about any longer, what else could be done if we went back to the old system we had prior to the AHCA? 

Not much.  I could think of a few things to experiment with, but they'd be experiments, and the results would be doubtful.  About the only one I can think of that might have much of an impact, although it might also be very much subject to the law of unintended consequences, would be to expand coverage by public institutions and programs where there is a relationship with the insured. For example, every college and university in the US has a "student health" department already.  Perhaps that could be expanded in some fashion for students enrolled in any one institution, with a provision that if they ceased to be enrolled they could re-enroll in their parents plan.  The military service has a program called "Tri Care" that covered teh families of military personnel, and perhaps that sort of thing could be expanded, where it hasn't been already, to the families of public employees.  Maybe these are good ideas, and maybe they aren't, but its something that could be looked at. But that's about it.

Would it make much of a difference.  Maybe, but maybe not. And maybe only temporarily.

So if that's not going to do the trick, what else?

The AHCA

Well, we've tried the AHCA. Maybe the GOP grousing is just that, complaining, and its really all fine?

Is it success?  It doesn't particularly appear to be.  Indeed, most Democrats don't even seem to really take that position.

Premiums continue to rise and while it has expanded coverage, coverage isn't universal. 

The AHCA, just like the attempt at "repealing and replacing it" are basically private carrier based systems with the Federal government being the carrier of last resort.  So, it doesn't address the problems that caused the premium rise, which is, after all, the thing we're really trying to address.

It does, however, create some brand new problems, and that's why it likely ought to be heavily modified.  Maybe the system would work better if that was done.

One thing it did was to totally unrealistically, but kindly, legislate "you can't look at my preexisting condition" as an item for enrolling in insurance. That's kind, but massively stupid.

Insurance is completely based on risk.  And as noted, it's a type of gambling.  Writing into an insurance law that a preexisting condition can't be considered, ad a basis for rejection for private insurance, is like writing a life insurance policy law that would say you can't consider a person's terminal diagnosis at the time they buy a policy.

This is, necessarily, going to have to be considered by carriers one way or another.  It actually rewards some who have ignored their health at the expensive of everyone else and it pretends that the entire problems in costs outlined above do not exist.

Another thing the AHCA did is adopt the liberal insanity that human beings must have sex and can't control that any more than they can control breathing.

The entire history of human beings up until the last couple decades is evidence of the opposite. While liberals in our society believe that the only thing that prevents premature births in anyone over 13 years of age is chemical temporary sterilization or abortion, it wasn't up until those two things became common that loose behavior became epidemic.  While there have always been accidental pregnancies the overwhelming majority of births up until fairly recently were within marriages.  Overwhelming.

This is another topic but it gets both into the law of unintended consequences and human behavior.  The cheap availability of contraceptives has actually boosted the number of children out of wedlock as the connection between sex and pregnancy became disassociated in the public's mind.  Indeed, in the entertainment industry they have no relationship at all, and its very rare for that industry to concede that sex can result in babies.  But it does.

Because it does, and because in the public mind its gone from an acknowledged risky conduct in some circumstances to some sort of public right, there's come to become a public concept that there's a public right to birth control. That's nuts.

It's not the only area that's nuts, but its one of them.  There's no reason that a publicly forced health care system should have to provide anything to people in regards to sex, except maybe in the case of catastrophic illness associated with it. Otherwise, hey, you chose to proceed so proceed at your own risk.  

Eliminating coverage under the AHCA for things of that type would go to reduce costs.  If you drop coverage for pregnancy or preventing it, and drop required coverage for anything that's not catastrophic, or at least serious, the costs go way down.  Taking that approach would raise liberal and feminist hackles, but it might make the AHCA capable of working.

Maybe.

Nationalizingng Up the System.

Any other approach begins to get you into the really radical, from the American prospective, but the norm for most of the world's. True nationalized health care.

Americans generally don't like the concept of a really sweeping state run system, but if the systems above don't work, and no system at all isn't an option, that's what's left.

There's a bunch of different ways to do this, but probably the one that would work the best in the US is a system like the Canadian one, which Canadians, in spite of claims down here in the US, really like.  Basically, it's sort of like a giant state administered Workers Compensation system. 

You could do that any number of ways, but the best way would probably be to have everything administered by respective states. So there would be fifty systems, not one, but they'd be easily transportable.  If it was a directly administered state system, you'd probably have to tax nationally for it but have it run by the state.  Alternatively, it could be done by private carriers that bid for entire state, as the insured pool.  That may be more efficient.

In order to make such a system work in a country as large as our, it would have to exclusive where it applied, but also limited in coverage.  Sick with the flu and have costs over, let's say, $250?  You are covered.  Want birth control pills.  You aren't.  Wisdom tooth need to be removed?  You are covered.  Want your boobs inflated?  You aren't.

Of course, nobody is going to propose such a system any time soon. And doctors would really hate it, as effectively there'd be price control, which amounts to wage control, at the Federal level.  A person can get into that, but it is the case that simply being a physician is expensive.  Some make large sums of money, but some don't, and that often varies by specialty.  That would be a problem.

And one of those problems is that medical malpractice insurance is expensive.  It's likely that the insurance for pharmaceutical companies is very expensive. That's because doctors and drug companies are targets for lawsuits.  The point here is that if you drive their returns down, you have to think about driving their costs down.  That can likely be done through damage caps and the like, but lawyers hate that idea.  But that's likely part of it.  I.e., you can't ask surgeons who were making seven figure incomes to come down to the bottom half of six figures and not give them something back in return, and reducing exposure to liability would seem to be part of that.

Do we need to do anything at all?

To the extent that President Obama succeeded in this debate it appears to be that it's now accepted that the Federal Government must have a role in this area.  Indeed, it appears to be the case that large segments of the GOP, including the President, accept that the Federal Government has some role in providing health care (which in fairness it was already doing prior to the AHCA) and that Americans have a Federally protected "right" to health care.

Do they?

Well, if it's accepted at the Federal level, they will, and maybe now do, but it's worth noting that the Federal Government now is in all sorts of things that have created entitlements that really ought to be questioned pretty heavily.  Consider the Federally supported Free and Reduced Lunch program that provides, well, free and reduced cost meals to school children. Yes, we want school children fed, but let's be honest. This program started off to help the really desperate, but if you live an area where its every been in the news, and its been in the news here, its regarded as a right by a lot of people now, including a lot of people who are not recipients.  While this example fits into the crabby "when I was young" type of example, the truth is that when I was young parents who didn't send their kids to school fed, and with lunch, needed to have a really good excuse. Sever poverty was a good excuse, and somebody would have taken care of it, but any other excuse would ultimately have caused a visit from the authorities.  In my view, this program has lapped over the bounds of tax funded charity into something else, and thereby isn't really fair to the taxpayer.

Now, none of the health care proposals that have been floated seriously operated such that they had full Federal funding, but the reason the right wing Republicans balked is that they simply feel that the government has no role.  At least their honest about that, whether you agree with them or not.  The rest of the GOP and all of the Democrats feel otherwise.

This is a trickier topic than it might seem at first, as there are clearly areas where the Federal government shouldn't be playing a "health" care role.  The big one is in regards to sex and reproduction.  Democrats in particularly just go all giddy about this and claim that it's absolutely the case that the Federal government ought to blasting out birth control pills for free or via insurance the way that a AC-130 blast out ammo, because in their view everyone who is an adult or nearly an adult can't control their lustful thoughts and has no responsibly for them.  But, in a more thought out system, there's no rational reason to require one group of people to subsidize another's sex.  None.  Particularly when we consider that some people have serious moral objection to abortifaciants, which include at least some birth control pills.

AC-130. . . the Democratic model of health coverage in the reproductive arena.

Otherwise, however, it may be the case that we've now reached a competitive point where health care has become so expensive, while also being so effective, there's no alternative but for national governmental action, of some sort.  The alternative might be to let people suffer and die, which isn't a just alternative.

Stuck in the road

So, anyway, no matter how you look at it, it would appear that we're at a fork in the road and even though Congress has largely decided to sit in the road and hope a truck doesn't come along, it will.  If we stick with the AHCA we may be cruising for it to break down.  The GOP certainly thinks so and a lot of Democrats are admitting it needs fixing.  If we go back to the old insurance based system more and more people are likely to be forced out of it and we'll need to fix that too, with some of the fixes being pretty radical.  The most radical fix of all would be to go to a system modeled on Canada's, which would work, but which would be hated by most conservatives in the country and most physicians as well.

It's enough to give you a headache.

But that won't be covered.

Pacifist Demonstrate in Washington D. C., April 3, 1917

And occupy the steps of the Capitol as they do so.