RALLYING CRIES DISTINGUISH POLITICAL CANDIDATES

Now that 2016 is finally here we can at last look forward to getting on top of the political election calendar. Too much may have been made of the campaign already. However, the Iowa caucuses are less than a month away. The New Hampshire primary follows on February 9, just ahead of a series of electoral events leading to "Super Tuesday" when 12 states attempt to clarify their preference among our presidential aspirants. All of these events ultimately lead to national party conventions in Cleveland and Philadelphia in July when our choices are reduced to two. By the time we ultimately arrive at the election on Tuesday, November 8, we will all be exhausted, but we will finally know who is going to lead us during the next four years. In the mean time we attemptr to sort through more than a dozen candidates searching for reasons to select one over the other.

All contestants are busily trying to set themselves apart from each other, a chore not easily accomplished. During the Middle Ages competing entities used flags for the purpose of identification. By looking at a flag, observers were able to identify the status, association, or religion of the flag bearer. In war banners were used to help soldiers identify friends or enemies. Today political competitors have replaced banners with slogans used on posters and bumper stickers. In "How to win any election" Joe Garecht tells us that every campaign needs a message, issues that support the message, and an effective campaign slogan . "Slogans need to be easy to remember, short enough to be said in one breath, and snappy enough to say over and over again." Where combatants used to identify with the flag of their compatriots, today's voters identify with their chosen candidate  through her or his campaign slogan. In a way these taglines become a rallying call-to-action, and they can be used in support of or in opposition to specific candidates. Our electoral history is awash in memorable campaign slogans. Many of these reflect the values of society at the time. The Memorabilia Website of Duke University's Collections Library lists an impressive collection of presidential campaign slogans and catchprhrases. Some of these are quite memorable, pointed, and some are even risque. I selected the following to help us ease into what is sure to confront us this year.

One of the earliest rallying cries came from Patrick Henry, founding father, attorney, planter and politician who became the first post-colonial governor of Virginia, who is best remembered for his "Give  Me Liberty of Give Me Death" speech.

In 1789 George Washington, a reluctant candidate at best, used a poster with the slogan: "Let's Try it. See What Happens."

William Henry Harrison and running mate John Tyler made "Tippecanoe and Tyler Too" part of history.

In 1852 Franklin Pierce, running against incumbent  President James Polk, came up with: "We Polked You in  '44. We Shall Pierce You in '52."

John Fremont, running in 1856, used the slogan: "Free Soil, Free Labor, Free Speech, Free Men and Fremont."

Abraham Lincoln's slogan in 1860 was: "Vote Yourself a Farm." During his re-election campaign in 1864 this changed to: "Don't Swap Horses when Crossing Streams."

In 1884 James Blaine, running against Grover Cleveland who had been accused of fathering an illegitimate child in 1874, ran the slogan: "Ma, Ma, Where's My Pa?"

In 1884 Republicans attacked the opposition for views against prohibition with: "Rum, Romanism and Rebellion."

Herbert Hoover ran using the catchphrase: "A Chicken in Every Pot and a Car in Every Garage."

Hoover ran against Al Smith in 1928. One of the issues debated was prohibition. Proponents were called "drys," opponents were referred to as "wets." A popular tagline during that election became: "Vote for Al Smith and Make Your Wet Dreams Come True."

FDR used various battle cries and became the recipient of slogans opposing his election as well. In 1932 FDR used: "Happy Days Are Here Again." Alfred Landon retorted in 1936 with: 'Life, Liberty and Landon." Wendell Wilkie, running in opposition in 1940 ran posters stating: "Roosevelt for Ex-President." Some of the latter's supporters also circulated literature proclaiming: "No Man is Good Three Times."

Everyone remembers Harry Truman's "Give Em Hell, Harry," and Eisenhower's "I lIke Ike."

In 1960 even prostitutes got into the act proclaiming: "Nixon or Kennedy, We don't Care Who Gets In!"

Goldwater's run for office generated pro and con slogans like: "Goldwater - In Your Heart You Know He's Right."  "In Your Guts You Know He's Nuts."

The 1972 election campaign opposing Democrats saw: "Acid, Amnesty and Abortion for All."

Jimmy Carter flaunted his background in 1976 with bumper stickers that said: "Not Just Peanuts."

Ronald Reagan was the first one to come up with: "Make America Great Again." (Donald Trump adopted the slogan for his own campaign and is actually trying to trademark it.)

Many of us still remember Bill Clinton's slogan: "It's the Economy Stupid," and Barack Obama's: "Yes, We Can!"

This year we should look forward to some new slogans. The better ones, other than the one Donald Trump "borrowed" are:

Ben Carson - "Heal, Inspire, Revive."

Carly Fiorina - "New Possibilities. Real Leadership."

Ted Cruz - "Reigniting the Promise of America."

Bernie Sanders - "A Political Revolution is Coming.

Marco Rubio - "A New American Century."

Rand Paul - "Defeat the Washington Machine. Unleash the American Dream."

Mike Huckabee - "From Hope to Higher Ground."

Jeb Bush - "Jeb!"

Candidates missing from this list have not quite come up with a succinct battle cry most of us can remember.

If history provides a guideline, our message to the candidates should be: "keep it simple," or come November we will have forgotten how you tried to help us focus.

were called "drys," 

FUELING XENOPHOBIC HYSTERIA FEEDS FASCIST ELEMENTS

On December 7 Donald Trump, Republican frontrunner in the presidential election contest, announced that he was calling for "a total and complete shutdown of Muslims entering the United States until our country's representatives can figure out what is going on." His words elicited a firestorm of reaction from domestic as well as foreign pundits. Leaders in both political parties chastised him for making un-American statements. The British Parliament is considering a motion banning him from entering the U.K.. Business associates operating in the Middle East are removing Trump's name from branded properties . A previously scheduled meeting between Trump and Netanyahu was cancelled. And across the globe the GOP frontrunner is being referred to as a Fascist demagogue. Donald Trump says that he does not care, that what he said needed to be said. Upwards of 60% of potential Republican voters appear to agree. He apparently anticipated some of the reaction, and his proposal was obviously designed to feed into a growing Islamophobia permeating the country.

While Trump may have unleashed a political firestorm among mainstream politicians, his remarks mirrored similar utterances coming out of a growing number of far-right populist, nationalist or outright Fascist parties dotting the political landscape in Europe. Many of the elements leading to the development of Fascist parties across pre WWII Europe  are again in evidence. During the run-up of World War II political movements were focused on similar concerns far-right parties agitate about today: The economy, unemployment, immigration, a loss of national identity, and a loss of traditional values. While anti-semitism was a unifying factor for far-right parties during the first three decades of the 20th Century, Islamophobia has become the unifying factor during the early part of the 21st Century.

In our country political demagoguery may eventually be absorbed in platforms of one of the major political parties. In most European countries electoral systems allow fringe movements to organize their support in to political parties with real power. Today in Europe proto-Fascist parties that are anti-Islam, anti-Semitic, and anti-European Union have already become the second or third largest parties in a belt of formerly liberal societies that runs from Norway and Finland  to The Netherlands and France. In Hungary, where the nationalist Fidesz Party already governs, Jobbik, the more extreme and most obvious neo-Nazi party in Europe continues to gain in strength. Prime Minister Viktor Oban , already referred to as a dictator and the "Donald Trump of Europe," continues his movement to the extreme  right in an effort to thwart Jobbik's ascendance. In Poland a new right wing populist government controlled by the "Law and Justice Party" recently took steps to cancel previous appointments of judges to its Constitutional Tribunal, which rules on all legislation. In France Marine Le Pen's Nationalist Front took 30% of the vote in recent regional elections, positioning herself well for an anticipated challenge  in the upcoming 2017 presidential elections. It took collaboration between President Hollande's Socialists and past President Sarkozy's center-right "Les Republicains" to keep her from dominating the election.

The point is that the world is a dangerous place today, but our reaction to the dangers that seem to be lurking around every corner is potentially as dangerous as what we are trying to protect ourselves from. What we may now look at as political theater fed by powerful demagoguery can quickly deteriorate into mass hysteria and morph ideas into political power and control over public resources. While we yearn for a rebirth of traditional values, we tend to lose track of our core values. Witness Europe where ideas similar to those expressed by Donald Trump ultimately developed into political parties with real power running on platforms specifying desires to expel their Muslim population, register Jews and Muslims alike, stop the flow of refugees, reverse the influence of the European Union and its Parliament (one-third of which  now consists of far-right ant-E.U. representatives), restrict democratic values, and essentially reverted to the situation after the Weimar Republic in 1933 Germany. The Nazis who took over never won an election. However, their demagoguery acquired the support that eventually led us to World War II and the deaths of over 60 million people.

Political bluster and grandstanding can produce outcomes we don't imagine, and over which we could easily lose control. If you think that that can't happen here, just remember: we used to ostracize Catholics, we shamelessly allowed anti-semitism to fester and sent thousands of would-be Jewish immigrants back to Germany where most were exterminated, we interred our Japanese citizens, and if we follow Donald Trump's suggestions we will soon make life for our Muslim citizens a living hell.

Hitler's brown shirts were not very educated. They were storm troopers. When he released them  during the night of November 9, 1938 to execute a coordinated attack on Jews throughout Germany - during what was later dubbed as "Kristallnacht" - he destroyed the lives of millions of people and set the stage for what would become his "final solution." When I observed the raucous standing ovation Trump received in South Carolina when he announced his proposal I could not help but feel that he could have asked these people to do anything he wanted, and they would have complied. As we read this mosques are being firebombed,people are attacked, knifed and killed, businesses are being defaced and destroyed, and patriotic Americans are having their lives ruined.

My parents were living 300 miles from the center of activity in Germany in 1938. They were helpless to do anything about it, but they suffered the eventual consequences when my grandfather was enslaved and ultimately killed by the Nazis. We still have a choice. We need to use it, or we may wake up one morning regretting we didn't.

THE ONLY THING WE HAVE TO FEAR IS FEAR ITSELF

Our 32nd President, Franklin Roosevelt, spoke these words during his inaugural address in 1933. Within a decade our government would turn back thousands of Jewish refugees, desperate people fleeing a terrifying blood thirsty regime. We argued that they posed a serious thtreat to our national security, and we essentially returned them to Germany where many would be exterminated by the Nazis. Later in 1939 we rejected a proposal to allow 20,000 Jewish children to come into the country for safety. Three years later Roosevelt signed Executive Order 9066 which resulted in interring nearly 120,000 citizens of Japanese descent while some of their offspring died on the battlefield fighting on our side during the war. At the time well over 80% of residents polled supported Roosevelt's turnabout. Politics trumped what was once a sensible expression of opinion in line with a set of values our country had always stood for. Since that time we have generally expressed regret for what we did back then. However, 70 years later we apparently still have not learned from it.

The terrorist acts in Paris where 130 people died at the hands of, mostly home-grown, criminals are stirring up the same type of political grand standing as what preceded our entry into World War II. More than half of our governors and most candidates running for president have grabbed onto heightened security concerns, misdiagnosed the facts, and again targeted a group of desperate refugees while identifying members of a specific religion to make political points, vastly under estimating real security threats.

This time around our focus is on Syrian refugees and followers of Islam. The House of Representatives passed a bill establishing a pause in resettling Syrian refugees until our vetting process has been reviewed. Mind you, currently refugees admitted to the U.S. undergo between one and two years of screening by multiple intelligence agencies, the State Department and the Department of Defense. Since 9/11 we have resettled 387,938 refugees from majority Muslim countries. Only 2 of these have subsequently been arrested for suspect activities. While pandering to their political base, and while trying to outdo each other, political candidates are falling all over each other making pathetic, pathological, xenophobic statements. Ted Cruz and Jeb Bush are suggesting that going forward we should only admit Christian refugees. Trans-Humanist Party candidate Zoltan Istvan suggested that small microchips could be implanted under the skin of Syrian refugees as part of the process admitting them into the U.S.. Donald Trump wants to close down or monitor all mosques, place Syrians into internment camps in Syria, send Syrians already processed and in the country back, and register all Muslims into a database. Chris Christy pronounced that he would not even make exceptions for orphans under the age of five. In the mean time Ben Carson, at a campaign stop in Mobile, Alabama, referred to Syrian refugees as "rabid dogs."

As the inflammatory rhetoric escalates and becomes less and less American, it is worth observing that the terrorists in Paris mostly carried French, Belgian and Moroccan passports. Given the vetting time it takes before refugees are allowed into the country, it would be highly unlikely that terrorist groups could muster the patience required to infiltrate their flow and smuggle anyone into the U.S.. The real security risk rests with people who carry passports from countries we typically trust and for which we don't require visas. The political pandering does not only undermine security threats we should focus on, the rhetoric has a way of inflaming those who don't think for themselves. As French writer and philosopher Voltaire noted centuries ago: "Those who can make you believe absurdities can make you commit atrocities." Two weeks ago armed protesters showed up at a mosque in Irving Texas, which underscores the point that we should deescalate the discourse before it really gets out of hand.

Finally, one can't escape the fact that, since the attacks on the World Trade Center, we have experienced well over 360,000 gun related killings. In a way these acts of violence resemble a form of domestic terrorism that resulted in more devastation and agony than what we are currently observing internationally. However, these "terrorist" acts don't seem to elicit the same level of outrage. To combat terrorist acts within our borders, the Bush administration suggested in 2007 that we pass a law denying people who we suspect might engage in terrorist activities from purchasing guns and explosives. Almost nine years later this bill still has not passed Congress. Recently Senator Dianne Feinstein and Representative Peter King reintroduced this legislation, which is now dubbed the "Denying Firearms and Explosives to Dangerous Terrorist Act of 2015." The point they make, convincingly in my view, is that if we deny people on our "no fly list" from boarding our planes, we should keep them away from explosives and firearms. Unfortunately the lunatic fringe at the helm of the NRA Institute for Legislative Action, the NRA's lobbying arm which manages its Political Action Committee, and which maintains its grasp over a cowardly Congress, has succeeded in keeping this sensible legislation from becoming law. Their aggressive arm twisting, presumably not by intent, but certainly in effect, appears to support domestic terrorism. Perhaps we should begin re-defining who our real enemies are.

THANKSGIVING - Be grateful for what you are taking for granted.

A few days from now we will celebrate one of our favorite holidays, Thanksgiving. Contrary to popular belief this holiday, initiated in Plymouth Massachusetts in 1621 and not picked up again until President Lincoln made it a national holiday in 1863, is not just celebrated in the U.S. Many countries, including Italy, Brazil, Korea, Vietnam, India and China celebrate harvest. Canada remembers the arrival in 1578 of British explorer Arthur Frobisher who threw a meal for his crew when they, barely, made it to Canadian shores. The Netherlands celebrates in honor of the pilgrims leaving Leyden for the new world. Liberia celebrates American style, but without the turkey.

Many countries generalize popular gratitude. Our Thanksgiving dinners often feature a simple question: "What are you thankful for?" Even though we should expect this conversation, we are often still caught off base. Aside from family focused experiences and feelings we are grateful for, we might consider expressing gratitude for some of the so-called simple things we have in our lives.

If you have a roof over your head - Be thankful!

   In the U.S. more than 3.5 million people experience homelessness each year. This includes 2.5 million children, and 16% of homeless adults are veterans.

If you are having a great meal with family and friends, and if, by chance, you are serving one or more of the 52,000,000 turkeys consumed in our country each Thanksgiving day - Be grateful!

   805 Million people in the world are chronically under-nourished. 18,000 Children die every day from hunger and malnutrition.

If you have clean water and if you are able to enjoy hot showers - Be thankful!

   63 Million people (1 in 10) lack access to safe water. 2,000 Kids under the age of five  die each day from diseases related to contaminated water. That is 1 every 21 seconds! 1.8 Billion people who have access to a water source within 1 kilometer, but not in their house or yard, consume on average 20 liters per day. In the U.S. we use 600 liters a day, which is the highest in the world.

I am certain we can come up with many other experiences we take for granted, and which we could give some intellectual and emotional perspective. The point is that most of us are better off than a substantial number of people in the owrld. While recognizing that even in the U.S. 48 million citizens live below the poverty line - 16 million of which are childeren and 5 million seniors - almost all of us are taking things for granted many others can only dream of. We should be grateful for living where we are and for everything we take for granted. Due to the accident of birth or the ability to choose you are living in one of the most comfortable places in the world, whatever its faults and however much we bicker over how to distribute our resources. We are lucky. After all, the odds of being born American, according to a 2005 W.H.O. report, are only 5%. In fact, given what is involved in the reproductive process, the odds of you coming into the world at all are only about 1 in 400 trillion (Harvard study.)

Finally, certainly not last, we should be thankful for the bravery displayed by the men and women we sent into harm's way. They face danger every day. Many of them will spend the holidays away from their family in the various war zones we are still, and again, involved in. Some of them will pay the ultimate price defending all the things we are thankful for.

With that in mind I think we should all read and re-read the prayer Eleanor Roosevelt carried with her throughout Worl War II:

Dear Lord,

Lest I continue

My complacent way,

Help me to remember that somewhere,

Somehow out there

A man died for me today.

As long as there be war,

I then must

Ask and answer

Am I worth dying for?

Go look at yourself in a mirror and answer the question.

Happy Thanksgiving!

GOP CANDIDATES REBUKE DEMOCRATS FOR PARIS ATTACKS

It did not take long for GOP candidates to blame the Democrats for the terrorist attacks in Paris.

Several of these were illustrative of an ignorant mindset not worthy of intellectual discourse.

Carly Fiorina has an uncanny ability to manifest selective memory. Not only does she re-imagine her professional past at H.P., she also forgets that had George Bush et al not engaged Iraq and Sadam when they did, none of this might have happened. Sadam Hussein was an intolerant and cruel dictator. However, he would not have tolerated Isis. Removing him upended the balance of power in the region. We deliberately banned his mostly Sunny military professionals from continuing to operate. Most of them ended up fighting with Al Qaida and Isis when the Shiite forces filled the void. Fiorina's rant that she is "angry that Barack Obama and Hillary Clinton declared victory in Iraq abandoning our hard-won gains...." which somehow made them responsible for "the murder, the mayhem, the danger,the tragedy that we see unfolding in Paris," is ignorant. George Bush prepped our exit from Iraq while still President. Her lack of understanding of historical context, and her inability to analyze facts, make her entirely unprepared to even run for the presidency. Ignorance is a curse. She should leave that garbage where it belongs, in her head.

Donald Trump's suggestion that the Paris attacks would have been a much different situation had the vistims been armed with guns, is outright stupid.

If this is the best the GOP can come up with we can only hope that our citizens wake up. We can not afford this level of degenerate thinking to rise to a leadership level in the country.

SHOULD WE CONSIDER ADOPTING A SINGLE-PAYER HEALTHCARE SYSTEM?

This is the time of the year when many of us need to consider our health insurance options. Given the steep increases in premiums, this may also be when we re-confront the discussion about what kind of health insurance system our country should ultimately adopt. Since we are in the midst of a poliktical election cycle as well, the pundits argue publicly for and against the Affordable Care  Act (a.k.a. Obamacare), the desirability of adopting a single-payer healthcare system as prevalent in virtually all developed countries, or to stick with the market based private insurance system we supposedly have even under Obamacare.

Single-payer national health insurance, also known as "Medicare for all," is a system in which a single public or quasi public agency organizes healthcare financing, while the delivery of care remains largely in private hands. Under a single-payer system all residents of the U.S. would be covered for all medical necessary services, including doctor, hospital, preventive, long-term care, mental health, reproductive healthcare, dental, vision, prescription drug and medical supply costs. In the 1950s U.S. health statistics were world class: Infant mortality among the lowest, life expectancy among the highest, and health care costs about average. One by one other nations - like Denmark, Sweden, Australia, the U.K., Canada and Taiwan - adopted national health programs. By the end of the 20th century the U.S. was the lone holdout for private, for profit health insurance. Its health statistics lagged behind dozens of countries, while costs soared to twice the average in other wealthy nations.

The U.S. spends 16% of GDP on health. This compares to 8.5% in the U.K. and Australia, and significantly less than 16% in most developed countries. Of eleven nations studied by the World Health Organization and the OECD the U.S. ranked lowest on accessibility, efficiency, and healthy lives outcomes (mortality related to medical care, infant mortality, and healthy life expectancy at age 60.) A similar study done by the Commonwealth Fund in 2014 confirmed these conclusions.

Many countries have realized huge savings by evicting private insurers and eliminating the reams of expensive paperwork they require from doctors and hospitals. Aetna keeps 19 cents of every premium dollar for overhead and profit. U.S. hospitals devote 25.3% of total revenue to administration, which reflects the high cost of collecting patient co-payments and deductibles, and fighting with insurers. Obamacare will  direct an additional $850 billion in public funds to private insurers, and boost insurance overhead by $273.6 billion. Yet, it will leave 26 million citizens uninsured, and similar numbers with such skimpy coverage that a major illness will bankrupt them. By contrast, insurance overhead in single-payer systems takes only 1-2 percent. Proponents estimate (and argue) that moving to a single-payer system would save about $400 billion a year on paperwork and administration.

The controversy surrounding the single-payer system does not seem to focus on the desirability of achieving universal coverage, it is largely concerned with the means of getting there. Thus far the arguments have not changed much over time. Proponents suggest that the system provides universal coverage; diminishes the administrative load on healthcare professionals; significantly lowers cost; eliminates the need for insurance companies; and requires only one buyer which would improve efficiency while providing substantial negotiating power.

Those opposed retort that the system would be government controlled, effectively converting everyone in the system to government employees; would diminish the incentive to pursue research and development; force higher taxes with fewer benefits; contribute to drug abuse; and promote a rising demand for welfare.

This conversation ties into the ongoing dispute over raising the Medicare eligibillity age to help pay for the benefits most of us paid for during our working life. The trust funds paying into Social Security and Medicare are estimated to dry up by the early 1930s. One argument being floated is that raising the eligibility age will over time allow us to free up resources that could be used to achieve universal coverage along the lines of Switzerland's market based system (Avik Roy, Forbes, December 12, 2012). While these discussions continue, we might keep an eye on the outcome of a single-payer "ColoradoCare" proposal Colorado is placing on their 2016 ballot, which is designed to replace Obamacare with a new single-payer system (at a cost of $25 billion per year.)

Fareek Zakaria, a political centrist, journalist and author with a regular program on CNN, answers our opening question as follows: "There is absolutely no question that when we look at the ability to provide good healthcare at an affordable price, lower levels of massive inequality in healthcare outcomes or provisions,  a single government payer and multiple private providers is the answer."

While we may be tempted to add our two cents to the discussion, real change will require political courage, which Washington appears to be lacking. It is easier to express contempt for Obamacare than it is to come up with an alternative. In the mean time we just need to suck it up and pay the premiums, unless we are lucky and old enough to go on Medicare.

PURCHASE PRESCRIPTION DRUGS FROM ABROAD? WHY NOT?

A few weeks ago drug company Turing Pharmaceuticals raised the price of a toxoplasmosis drug, Diatrim, from $13.50 to $750 per tablet, an increase of 5,000 percent. This medication is used with other medications to treat a serious parasitic infection of the body, brain, or eye or to prevent toxoplasmosis infection in people with HIV. Turiing's CEO Martin Shkreli explained that the company needed to make a profit on the drug. The price increase meant that the annual cost of treatment for people who need this medication will be anywhere from $336,000 to $635,000 depending on the patient's weight. The uproar this news caused has led to renewed concern about meteoric price increases in the pharmaceutical industry, generating an aggressive dialogue among political candidates, while resurfacing the question why Americans should not purchase their medications from abroad - especially Canada - since the price for medications in most developed countries is significantly lower than in ours.

It is not difficult to understand why many are tempted to purchase their medications elsewhere. We pay the highest prices in the world for our prescription drugs. Take for example the popular acid reflux drug Nexicum. An insurer in the U.S. pays on average $215 per customer. In the Netherlands the same prescription costs $23. A 30 tablet supply of Abilify costs $711 at Walgreens, but only $200 in Canada. A 10 capsule dose of Tamiflu sells for $112 in the U.S., and less than $50 in Canada. The IMS Institute for Healthcare Informatics, in a 2012 study, estimated that U.S. residents spend about $900 per year on prescription drugs, while the average Canadian spends $420, and Europeans spend on average $375.

During the 1990's travel agencies began organizing bus trips into Canada for seniors who wanted to purchase cheap brand-name drugs. These trips continue to be popular. It is technically illegal for individuals to importy drugs into the U.S. However, officials tend to use enforcement discretion and allow participants to bring in up to a 90-day supply of medication for personal use if they can provide documentation from their U.S. physician.

When I decided to research the viability of purchasing medications from abroad, I thought I would make the case for legalizing their importation. Given the vast differences of drug prices between us and the rest of the world this seemed logical. However, after digging into the subject matter it became clear to me that the issue is not that simple, and that falling in line with politicians who are shooting from the hip to effect legalization could generate troubling advice for people who react to cost alone. 

One reason for not allowing importation of prescription drugs is that the FDA won't be able to guarantee the safety of drugs coming in from a foreign country. This includes Canada. Drugs from foreign pharmacies are not subject to the agency's jurisdiction, could be mislabeled, counterfeit, or otherwise adulterated. Legality aside, bus tours taking passengers to brick and mortar pharmacies in Canada are pretty safe. However, these tours are only practical for residents of border states. The rest of us depend on web-based pharmacies, many of which are illegitimate, and often sell counterfeit drugs.In 2007 the FDA seized 9,600 websites and more than $41 million worth of illegal drugs worldwide. Many sites claimed to be Canadian. However, a sting operation discovered that only 15% of drugs claiming to be Canadian were actually from Canada. The remaining 85% came from 27 different countries. In 2011 the National Association of Boards of Pharmacy reviewed more than 8,300 online pharmacies. Just over 3 percent proved to be legitimate.

Anyone deciding to still take a chance on web-based pharmacies to save on the cost of prescriptions should access one of the following sites. They are designed to help insure that you are dealing with a legitimate online business:

VIPPS - the Verified Internet Pharmacy Practice Site.

CIPA - the Canadian International Pharmacy Association website.

PharmacyChecker

Any of these accredit online pharmacies, and PharmacyChecker also claims that their pharmacies offer drug prices that are up to 80% lower in price than those in U.S. pharmacies. In short, buyer beware. Know who you are dealing with.

Of course this still begs the question: Why do Americans pay two to six times more than the rest of the world for brand-name prescription drugs?

Other countries feature single payer nationalized healthcare systems. They contyrol pricing by negotiating as a single entity with pharmaceutical companies. Their governments essentially decide who can sell what at what price. In the U.S. companies negotiate with individual insurance companies, hospitals and private plans, resulting in an unregulated market driven pricing structure. Besides, by law the federal government-run Medicare system cannot negotiate with the pharmaceutical industry. If Medicare were allowed to negotiate directly, as one of the largest buyers of prescription drugs, it could potentially drive the prices of drugs down. The Veterans Administration has that ability, and within the V.A. system drug prices are 10% to 20% lower than elsewhere. Finally, pharmaceutical companies claim that the average cost of developing a new drug is about $1 billion. Since they are forced to sell at lower prices abroad, U.S. consumers pay higher prices to make up for reduced revenue from foreign sales.

Meanwhile all of us are well advised to do our homework, research the legitimacy of web-based pharmacies, recognize that there is a lot of fraud in the system and, perhaps, just contact several local pharmacies to find the best price.

"DEATH WITH DIGNITY" - What are we really talking about?

Last monday California Governor Jerry Brown signed Assembly Bill X2-15, the "End of Life Option Act", into law, ending a 23 year effort to provide what proponents euphemistically refer to as a "death with dignity" option for California residents diagnosed as having less than 6 months to live. The intent of this legislation made the headlines when Brittany Maynard, inflicted with brain cancer and only months to live, moved to Oregon specifically to be allowed to take advantage of that state's Death with Dignity  Act and take her life peacefully with barbiturates.

Attempting to commit suicide was once a criminal act. It has been decriminalized for many decades in most jurisdictions. Assisted suicide remains a criminal act throughout the country except in Oregon, Washington, Vermont, New Mexico, and by next year California. Although both in the U.S. and most of Europe upwards of 75% of people polled expressed being in favor of some form of assisted suicide, the issue remains controversial and emotional. The controversy centers on legal, social, ethical, moral and relikgious points of contention related to suicide and murder. The question is whether there is a legal right for a terminally ill person to end his or her suffering without interference by the state or the convictions of others. In 1997 the U.S. Siupreme Court ruled that state laws against assisting suicide are not unconstitutional. However, it also held that patients have a right to aggressive treatment of pain and other symptoms even if the treatment hastens death.

Advocatess on both sides of the discussion frequently and mistakenly misidentify substantive components of the argument to make their points. All of us may have different opinions on the subject. However, it could help to clarify some of the substantive elements of that discussion, especially those referring to the most emotionally charged terms referring to the methods used to provide the end of life option - euthanasia and physician-assisted suicide.

Euthanasia in Greek means "good death." This term normally implies an  intentional termination of life by an other at the explicit request of the person who wishes to die. The process distinguishes two forms of euthanasia - passive and active. Passive euthanasia is defined as hastening the death of a person by altering some form of support and letting nature take its course. This is generally performed on persons in a persistent vegetative state, terminally ill, or in a coma. Examples are turning off respirators, halting medications, or failure to resuscitate. This practice is often physician directed and, although technically illegal, quite common. Some people accept this approach because there is no need to articulate difficult moral choices. It has also been charged as hypocrisy since society is pretending to shun doctor-assisted suicide while condoning this form of euthanasia without safeguards.

Active euthanasia refers to causing the death of a person through a direct action in response to a request from that person. This method of suicide grabbed the headlines when Doctor Jack Kevorkian publically administered lethal medication to terminally ill Thomas Youk in Michiggan in 1998. Currently  this form of suicide is only legal in two countries: The Netherlands and Belgium. Belgium does not distinguish between passive and active forms of euthanasia.

Physician-assisted suicide, a term used by all states allowing this, is essentially a hybrid between passive and active euthanasia - also know as voluntary passive euthanasia. In this case a physician supplies information and/or the means of committing suicide to a person, allowing that individual to terminate his or her own life. This is a form of voluntary euthanasia, the preferred method authorized by the laws in place in this country. Physicians don't administer the drugs, and the laws mandate strict conditions to prevent abuse.

For critics of death with dignity laws the argument is moral and absolute. Deliberately ending a  human life is wrong, because life is sacred and the endurance of suffering confers its own dignity. For others, the legalization of doctor-assisted dying is the first step on a slippery slope where the vulnerable are threatened and where premature death becomes a cheap alternative to palliative care. These arguments resonate with a lot of people, and it is perhaps important to recognize that even in Europe only four countries allow the end of life option. Proponents argue however that suffering from a terminal illness with no hope of survival, and the prospect of increasingly intolerable agony, affects their quality of life and should allow them to terminate their lives gracefully.

Every year approximately 40,000 people commit suicide in our country, making suicide the nation's 10th leading cause of death. Each suicide costs society about $1 million in medical and lost work expenses and emotionally victimizes an average of 10 other people. Of all patients requesting information and medication allowing them to take advantage of assisted suicide laws 30% ultimately decide against it. One could argue that these laws could actually save some lives because their beneficiaries are forced to go through a more rational process.

Years ago two of my uncles committed suicide. One stepped in front of a train. The other straightened out a very windy road at 100 milers per hour. Their families were devastated. I also had an aunt who suffered from a horribly debilitating decease. She decided to end her life with her family present, allowing everyone to say their good-byes. She died with dignity.

Immigration could help offset potentially devastating birthrate deficiencies in developing countries

Two weeks ago the Wall Street Journal published an article by Nina Adam headlined "Migrants Offer Hope for German Workforce." In it she discusses that "Germany's population is shrinking and aging at one of the fastest rates in Western Europe, with ominous consequences for pensions, health care and future economic growth." Some analysts are estimating that Great Britain is on course to eclipse Germany as Europe's biggest economy by 2030, thanks in part to its large numbers of young, energetic immigrants.

This is an interesting angle about a topic many developed countries have been facing for some time. Not too long ago the world confronted a concern about high fertility rates and a rapidly growing population, culminating in the, now quiet, zero population movement. The tide has turned, and the worry now is about too few births and a falling population. Over 80 countries have fewer births than required to replace the number of individuals who die each year. Academics tell us that the total fertility rate (TFR), which equals the average number of children born to women over their lifetimes, needs to be at the replacement rate of 2.1. An estimated 48% of the world's populatioon lives in countries where women have children below the replacement rate. Europe and Asia lead the way. This is a significant concern. Retirement incomes, medical care and other social services are largely financed by taxes on the younger working population. Low birthrates eventually lead to fewer men and women of working age and a shrinking tax base. Aside from economic consequences, governments are concerned  about other future demographic shifts. Left unchecked, Russia's population, currently at 144 million, could go below 100 million by the year 2050. One demographer claims that in 1,000 years the Japanese could be extinct. Japan's TFR currently stands at 1.39. In 2012 Japanese toiletries company Unicharm reported that sales of its adult diapers slightly surpassed baby diapers for the first time.

There are a number of reasons why birthrates have been shrinking: Greater access to health care and education; more opportunities for young people, particularly women; enhanced income levels in developed economies, and government regulated birth control - like China's one child policy - are at the top of the list. Whatever the reasons, many countries are now faced with the dilemma on how to encourage higher, or at least replacement-level fertility rates.

Countries with seriously and moderately deficient TFRs, based on 2014 estimates, include: Italy - 1.42; Austria - 1.43; Germany -1.44; Spain - 1.48; China - 1.55; Russia - 1.61 and Denmark - 1.73. Many of these and other countries are openly promoting increasing fertility rates. Denmark has been running an ad campaign asking Danes to book a romantic city holiday and "Do it for Denmark!" Singapore, with an FTR of 0.7, promotes "National Night," a campaign to let "patriotism explode." The audio portion of the ad states: "I am a patriotic husband. You are my patriotic wife. Let's do our civic duty, and manufacture life. The birthrate ain't going to spike itself." Singapore spends $1.3 billion per year on trying to convince its citizens to get busy. Russia, in 2007, declared September 12 as the "Day of Conception," in the hopes that giving couples the day off to do their civic duty would result in a baby spike nine months later on Russia's National Day, June 12. Women who gave birth on National Day could win refrigerators, money, even cars. Without a lot of hoopla France actually managed to improve its TFR from 1.74 in 2002 to 2.08 in 2014, thanks to a variety of pro-natalist initiatives such as tax deductions for dependents and paid maternity leave financed through its national health insurance system .

The highly charged political discussion about immigration, both in the U.S. and Europe, would benefit from assessing the effects today's discussions will have on the not too distant future. Some of Germany's industries face severe labor shortages. During the second quarter of this year it had almost 1.1 million job vacancies. Without immigrants, economists warn, Germany could soon struggle to pay pensions and care for its elderly. About one-third of Germany's population will be older than 65 by 2060. By comparisson our own TFR hovers around a relatively healthier 1.99. Much of this has been attributed to a more robust influx of immigrants. Immigrants have an outsized role in U.S. economic output because they are disproportionately likely to be working and are concentrated among prime working ages. Despite being 13% of the population, immigrants provide 16% of the labor force. The share of immigrants who own small businesses, 18%, is higher than the comparable share among U.S. born workers.

A review of the predicament many developing countries find themselves in should give us pause. Barring other methods of enhancing, or even maintaining, our fertility rate, immigration appears to be one of the elements that could provide a revenue enhancing labor force that may help us prepare for the care of an imminently aging population. However, chances are that our political pundits won't be convinced to make that argument for us.

EUROPE'S MOMENT OF TRUTH - OR IS IT?

Aylan Kurdi might have been killed during the battle for Kobani between ISIS and the Pershmerga a year ago. However, he escaped with an estimated 400,000 refugees searching for a safer and more receptive place, only to be found floating face down in the Aegean Sea a little over a week ago. His father brought his body and that of his brother and mother back to be buried in his hometown, or whatever is left of it after 70% of the city was destroyed. And the world is asking: "What is Europe doing to remedy this refugee problem. After all, it is all taking place on its doorstep."

This begs the question of what the world was doing to help prevent the carnage leading to the tragic migration of desperate people literally running for their lives when the Syrian civil war broke out, and, relative to Europe, how is it alone going to cope with the overwhelming mass migration which, at this point, appears unstoppable.

Since the war broke out over 4 million residents of Syria have been uprooted, being barrel-bombed by their own government, killed by ISIS, and caught up in the cross-fire between competing factions - their lives and livelyhood uprooted forever. Turkey, Jordan and Lebanon absorbed the first waves of refugees. Turkey housed 2.1 million migrants, Jordan 1.4 million and Lebanon 1.2 million. These countries are saturated and underfunded. The World Food Program has had to cut one-third of refugees in these host countries from their voucher program . Lebanon and Jordan currently receive only $14 perperson per month to help feed these refugees.

Enter Europe as a logical destination of choice. Although generally known to be receptive to helping people in need, this choice comes with multiple probems.

Sheer mass - During all of 2014 265,000 migrants entered Europe. By July 31 of this year the number had already reached 326,000 people. Greece alone processed 35,000 during all of 2014. As of July of this year it has had to accommodate 350,000 refugees.

Distance - Although Europe looks close on anyone's map, Germany - a destination of choice - is 2,000 miles from Syria. Traffickers promise to take people there. However, the journey is not only long and expensive ($400 to $2,500 per person), it is dangerous. This year so far 2,600 migrants are known to have died crossing the Mediterranean to reach Europe.

Processing - According to E.U. rules refugees need to register and apply for proper documentation in the country they land in when getting ashore. Given the geography, these countries are Greece and Italy, two countries attempting to cope with a five year debt crisis. They are the least economically viable alternatives for migrants desiring to move on to more stable Northern European countries.

Xenophobic nationalist movements - Most migrants don't want to register in countries they don't want to reside in. Many of them are intelligent professionals caught up in a civil war they did not ask for. They know what they want. Hence, Germany and more receptive European countries are the ones they aspire to. To get there they need to travel through countries not exactly excited to accommodate them. A typical route runs from Turkey to Greece, Macedonia, Serbia, Hungary and north from there. Several of these countries harbor politically substantial movements with strong anti- Islam and anti-ethnic sentiments. Viktor Orban - Hungary's Prime Minister, the man some have dubbed the "Donald Trump of Europe," has stressed that he intends to defend Hungary's borders against the mostly Muslim migrants. He plans to construct a razor-wire fence along his country's border with Serbia. Other countries with significant nationalist elements are also calculating the anticipated political backlash when deciding to what extent to follow Angela Merkel's suggestion about sharing the burden of settling refugees.

Security - Many countries have suggested that this mass exodus contains significant security issues. Isis and other organizations could easily infiltrate the unprocessed masses with devastating effect for vulnerable targets.

Domestic immigration policies - The European Commission in Brussels is slated to compose an E.U.-wide response to the challenge. However, individual countries can, under E.U. rules, adopt their own immigration policies. Germany has committed to accept 800,000 refugees this year. France, the U.K. and Sweden have agreed to lower numbers.

The root cause of this problem lies with the civil war in Syria. The Europeans are not able to correct  this. World powers like the U.S., Russia, China, and perhaps Iran and Saudi Arabia need to get involved to settle Syria. In the mean time helping to process this mass movement will take some of the pressure off, and keep us more secure.

AMENDMENT TO BIRTHRIGHT CITIZENSHIP BLOG

I WANT TO BE EXTREMELY CLEAR - CURRENTLY THE UNITED STATES AND CANADA ARE THE ONLY DEVELOPED COUNTRIES TO GRANT BIRTHRIGHT CITIZENSHIP  TO TOURISTS AND ILLEGAL ALIENS IN THE DEVELOPED WORLD.

COUNTRIES REPEALING BIRTHRIGHT CITIZENSHIP RECENTLY ARE:

AUSTRALIA (2007), NEW ZEALAND (2005), IRELAND (2005), FRANCE (1993), INDIA (1987), MALTA (1989), U.K. (1983), AND PORTUGAL (1981).

PERHAPS DONALD TRUMP HAS SOMETHING HERE.

BIRTHRIGHT CITIZENSHIP AND THE 14TH AMENDMENT

When presidential candidate Donald Trump revealed that his "immigration plan" substantially consisted of deporting 11 to 14 million illegal immigrants, he pointedlly included "anchor babies" - a pejorative term used to identify babies born in the U.S. to parents illegally residing here. The resulting discussion quickly focused on the Citizenship Clause of the 14th Amendment to the U.S. Constitution, which states: "All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are cittizens of the United States and the state wherein they reside."

The 14th Amendment was ratified and adopted on July 9, 1868. It is considered to be a reconstruction amendment adopted after the Civil War to address the equal protection and rights of former slaves. The Citizenship Clause, one of 5 in the amendment, establishes "Birthright Citizenship," which has its roots in English Common Law. In 1608, in a case referred to as "Calvin's Case," the English Court established that: "A person's status was vested at birth - a person born within the King's dominion owed allegiance to the sovereign, and in turn, was entitled to the King's protection."

Over time, the interpretation of this concept became quite controversial. Section 5 of the 14th Amendment does state that "The Congress shall have the power to enforce, by appropriate legislation, the provisions of this article." Several attempts at "clarification" were initiated. In 1873 the Supreme Court decided that "subject to its jurisdiction" was intended to exclude children of "ministers, consuls of foreign states born within the United States." However, in United States v. Wong Kim Ark (1898) the Court confirmed the principle when it held  that any person born in the United States, even from foreign born parents, was an American citizen under the 14th Amendment.

The contested interpretation has been whether Birthright Citizenship is applicable to children born in the U.S. of illegal alien parents. Both Democrats and Republicans have introduced legislation aimed at narrowing the application of the Citizen Clause, and to reduce the impact of so-called "maternity tourism." According to the Pew Hispanic Center approximately 7.5% of all births in the U.S. (about 300,000 births per year) are to unauthorized immigrants. Under current law these children are now U.S. citizens. It is estimated that roughly 4.5 million children claim citizenship because of birthright.

Mr. Trump does not believe they have American citizenship, and he wants to deport them with their families. He, mistakenly, believes that Birthright Citizenship is the biggest magnet for illegal immigration. Research suggests that jobs and economic opportunity are most dominant. Nevertheless, he is reaching a receptive audience with a conversation that started soon after the 14th Amendment was adopted. Deporting American citizens won't be an option. Two fairly recent Supreme Court cases (1967 and 1980) have held that the Citizenship Clause bars Congress from revoking citizenship. To legally change the interpretation of this clause would presumably require a constitutional amendment or constitution-proof legislative action. It took the 27th Amendment 202 years to be ratified. Amending the Amendment may not be a rational option. Some experts do believe that legislative action is not only warranted, it falls within the purview of the Amendment. Those who want to change the interpretation of the birthright citizenship clause will need to focus their efforts there.

HOW DO WE DECIDE HOW TO VOTE ON THE IRAN DEAL?

It is questionable whether our viewpoint on the Iran Deal, and our vote, if we get the chance, will have any significant influence on the ultimate situation on the ground. However, what do we consider when we assess how to approach this agreement?

NUCLEAR WEAPONS

The suggestion that the "deal" allows Iran to develop a nuclear weapon is a spurious one. Iran, by all accounts, is 3 - 6 months away from fielding a nuclear weapon. Rejecting this deal would technically "allow" Iran to complete that process. The agreement would (or at least could) postpone this outcome by 10 - 15 years, and we have the ability to inspect their processes during that time period.

ISRAEL'S SECURITY

Israel has the military capability to defend itself. Israel owns all the nuclear weapons currently operational in the Middle East. It just needs to get behind the political decision to own up to it. Deterrence would be a great defense, and it would be the only sensible posture going forward.

IRAN'S FINANCIAL SUPPORT OF ANTI-AMERICAN AND ANTI-ISRAELI TERRORIST MOVEMENTS AND  ACTIVITIES IN THE AREA

The additional funds Iran would presumably receive (i,e, their "frozen" money) could help supply additional financial support for proxies like Hezbollah and Assad. However, Iran is involved now at a much greater percentage of GDP. This probably won't stop. Greater exposure to the outside world, and a more openly available demonstration effect could generate increased demands for political change. Nobody believes that the Ayatollah will allow adoption of our democratic principles any time soon. But with increased prosperity comes a new set of pressures the ruling theocracy would have to deal with. Without the "deal" nothing would change.

Let's face it, International sanctions are dead no matter what our Congress decides to do. Rejecting this agreement may only serve to keep us out of the loop of the other signatories, and it would probably keep us from participating in the follow-up.

Allow the deal to go forward, and see where it takes us. We have everything to lose.

WHAT IS ISRAEL'S VULNERABILITY UNDER THE IRAN DEAL?

It is sad that our political discourse appears to have been reduced to the use of techniques ad agencies routinely employ. All along the political spectrum we tend to create a 'broken record" effect. Apparently the more we hear the same thing over and over again, the more we believe that what we hear is true. Psychologists refer to this technique as the creation of "the illusion of truth." People are more likely to believe familliar statements than unfamilliar ones. Hence the incessant repetition.

Nowhere does this seem to be employed more that during the current debate about the deal with Iran, especially as it applies to the relative vulnerability of the state of Israel. Prime Minister Benjamin Netanyahu started the mantra by asserting that "the accord is a historic mistake," and that the final deal based on this agreement "would threaten the survival of Israel."

Since this is the beginning of our election cycle, many of our president wannabe's quickly joined the chorus. Senator Lindsey Graham, in a  committee hearing, stated that "Iran's Supreme Leader's religious views compel him over time to destroy Israel and destroy America." Former Arkansas Governor Mike Huckabee went as far as suggesting that the deal has the effect of "marching the Israelis to the door of the oven." Skeptics might inject that some of the most prolific financiers of the republican candidates, like Sheldon Adelson, are among the staunchest supporters of Israel and Mr. Netanyahu. Critique of the latter's assertions could hamper fundraisiing efforts. 

Having said all this, it appears legitimate to actually review the veracity of the statements that predict Israel's survival is at stake once this deal goes into effect. We should determine  Israel's military vulnerability as well as Iran's existential threat to Israel's security. In addition we need to consider the political elements of the conversation.

David Roberts, deputy director at the Royal United Services Institute, believes that Israel's military is the best equipped and best trained in the entire region. Israel's airforce has been called the best in the world. Iran has a population ten times larger than Isrrael's from which to draw its armed forces, but much of its military hardware is of dubious condition. Israel's defense budget is 47% greater than Iran's. Conventionally Iran possesses more mortars, anti-tank weapons, anti-aircraft weapons and troops on the ground. However, given the geographical distance between the two countries - close to 1,200 miles -any direct confrontration between Israel and Iran would likely involve long-distance aircraft, air defense weaponry, small naval craft and ballistic missiles. Both countries have missile delivery systems capable of reaching each other. Israel also possesses five German made Dolphin-class submartines capable of launching cruise missiles with nuclear warheads.

Here is the rub. While Iran may have pursued the creation of nuclear weapons, Israel launched its nuclear program in the 1960's, led by by Shimon Peres in his capacity as a director-general  in the Ministry of Defense. The country has never admitted to having WMDs, and established a policy of "nuclear ambiguity." This policy was shaped between Israeli and American leaders, serving both sides' interest of establishing Israeli military dominance while making it appear as if international norms were not compromised. In 1980 significant information about this program was leaked by a nuclear technician turned whistle blower, Mordechai Vanunu. Over the years bits and pieces of information have come out. It is now largely assumed that Israel has somewhere between  80 and 200 nuclear warheads  in its arsenal. It is the only nuclear power in the Middle East.

Given what appears to be Israel's overwhelming military dominance in the region, one could reasonably suggest that Israel possesses multiple ways of defending itself against Iran. Much has been made of potential preemptive strikes. While Israel certainly has the equipment to pursue these, distance and a complicated trajectory would get in the way. Besides, even though several Sunni states in the region might support the idea in principle, they would most likely object to it for practical and political reasons. Israel could probably not eradicate all suspected nuclear sites in Iran, and it would incite significant pushback in the region.. Besides, even a nearly-nuclear state of Iran would still possess large conventional and chemical rocket forces. Many other thrteatening missiles would remain under the control of its sub-state terrorist proxies. Hezbollah, the well armed Shiite militia, already has more rockets in its arsenal than do all NATO countries combined. It is even less likely than Iran's own leaders to hold back on any preemption retalliations.

According to Purdue professor Louis Beres and retired U.S. Navy admiral Leon Edney "Israel's best security plan, going forward, would be to enhance its underlying nuclear deterrence posture, and to render this ccritical enhancement as conspicuous as possible. This means that Jerusalem should do everything possible to signal any future Iranian aggressor that its own nuclear forces are plainly survivab le, and capable of penetrating any of Tehran's ballistic missile or other active defenses." It would also become necessary for Israel to move beyond its traditional posture of deliberate nuclear ambiguity. In other words, let the world know what you have, and that you are able and willing to use it if need be.

This is obviously not a military decision, it is a political calculation. Israel is extremely well positioned to defend itsel against anything Iran can throw at it. However, it does need to let its adversaries know the extent of its capability. Mr. Netanyahu's calculation appears to be political in intent. He highlights perceived existential threats, and  directs the focus away from domestic problems. However, not everyone in Israel's leadership agrees with that determination.  "I am not underestimating the significance of a njuclear Iran, but we should not give it Holocaust subtext  like politicians try to do," said former Israel Defense Force Chief of Staff Dan Halutz, who commanded the Israeli military during the war in Lebanon in 2006. Former Prime Minister Ehud Barak said in a widely circulated  September 2009 interview that he did not believe that Iran was an existential threat to Israel.

Mr. Netanyahu is known to do what is politically expedient, not always what is rational. It is questionable whether he would be inclined to pursue a defense policy focused on "deterrence," given what would have to happen. A prerequisite of such a policy would presumably be giving up "nuclear ambiguity," and letting adversaries in the region know that Israel  has the capacit to harm any inclined to attack it. Deterrence also presumes that the actors in the conflict act rationally, and are not determined to commit suicide. It worked well during the cold war. It should work again if executed correctly. It beats the alternative.

During previous election cycles Mr. Netanyahu managed to magically "develop" lethal skirmishes with Hamas and Gaza. These "events" did not happen coincidentally, they were designed for domestic consumption. They worked. He was re-elected. Right now his governing coalition is in trouble. Who knows what he will do. I believe he should do what is best for Israel, and position itself defensively. Its vulnerability is not military, it is political.

When is this madness going to end?

When will the callous cowards in Congress begin to recognize that some of the blood spilled during the increasing number of mass shootings in this country is, to some extent, the result of the blood money they accept from the NRA. When will this madness end?

It has been said that one death is a tragedy, one million is a statistic. Charleston, Chattanooga, Lafayette have become the seemingly endless list of communities having to deal with what has become the new normal in an environment of unlimited access to guns - a condition fiercely defended by the NRA and gutless representatives who, on "principle", vote against any restrictions that could sensibly control that situation. Between 2000 and 2010 335,609 people died from guns in the United States. Every 17 minutes a person is killed by a firearm - 87 people on an average day. Those are the statistics, and these obviously don't even include the time period since 2010. Mass killings appear to have become increasingly prominent. In addition to the above, consider Sandy Hook, Isla Vista, Aurora, to add just a few. I suppose Lafayette does not meet the statistical measurement of being considered a  "mass killing", since according to a 2013 law we define those calamities as killings

 of three or more people. Shooters are not included in the stastistic.

After each one of these massacres politicians become active, passing laws protecting their standing with the gun lobby, and suggesting that if only more people would have had guns, these massacres would have been curtailed. Iowa, some time ago, passed a law stipulating that blind people can buy guns and carry them in public. Several municipalities even mandated their populations to own guns. Loaded guns are now allowed in bars in Tennessee, Arizona, Georgia, Virgiunia and Ohio. People bring their guns to school, church and social settings. After all, our Second Amendment - a relic of the distant past -supposedly allows us to own, carry, and do whatever we need to keep our guns. In the entire civilized world only Mexico and Guatemala have adopted similar provisions in their constitution. We don't have to want to eliminate the irrational stranglehold of the gun lobby on our lives. We can simply want to eliminate loopholes and establish rational restrictions on gun ownership. We are not just considering the 32,000 annual gun deaths in this country. Every time someone dies an entire support group suffers as well. What multiplier should we use to assess the real impact of each of these killings? Five, ten, fifteen? At what point are these numbers simply relegated to becoming statistics? When will we acknowledge that we are talking about real people?

The fanatics love to say: "When guns are outlawed, only outlaws will have guns";  or "guns don't kill people, people kill people." These idiotic , circular, "arguments" may work on bumper stickers. They make no sense. People with guns kill people, and as far as the "outlaw" reference goes, I have a magnet on my refrigerator that states: "When lutefisk is outlawed only outlaws will have lutefisk." Tautological, circular, and not very helpful to the conversation.

It is very frustrating to continually ponder how we can frame the argument for sensible gun control and the closing of loopholes. The statistics continue to pile up. Perhaps we should consider letting our our representatives know that if they can't muster the courage to sensibly confront the issue, they are, in effect, facilitating these ubiquitous killings. Too harsh? Perhaps. However, we need to force the issue somehow.

Is Trump trumping himself - does anyone care?

It is probably a no-brainer to respond to Donald Trump's outbursts these days. The comments that are front and forward these days are the ones he uttered about John McCain's status as war hero.

It just seems that more people need to chime in. 

In last Sunday's New York Times Frank Bruni compared Donald Trump with Silvio Berlusconi in Italy. Obviously there are legitimate comparisons - wealth, power and ego being just some of these. However, Berlusconi actually has been a political power in Italy. Trump is just a wannabe. Let's face it, Donald Trump is a narcissistic windbag surrounded by discordant wind chimes who finally developed the courage to voice their disagreement with whatever comes out of his mouth. Most of his Republican  opponents in the presidential race are very happy he made the disparaging comments he made last Saturday. The only contestant not too happy, I suppose, is Hillary Clinton, who benefitted from the extreme move towards the right in the Republican Party. The latest poll still has Trump at 24%, well ahead of Walker and Bush.

Let's see where it all ends up. The contest is getting more interesting. 

EMPATHY IS A CHOICE - ENTER ROTARY

It has been said that one death is a tragedy. One million is a statistic. We appear to have the ability to empathize with individual tragedies. However, when confronting large numbers of suffering people, as in epidemics, earthquakes or genocides we often choose to react less empathetically.

Enter service clubs like Rotary. Service clubs have the ability to harness our collective empathy, and through their size essentially reduce the apparent enormity of overwhelming odds to manageable proportions.

Consider that at this point in time there are 60 million refugees world-wide. 14,000 People die from diseases related to contaminated water - EVERY DAY. 18,000 Kids die from hunger and malnutrition  - EVERY DAY. That is 1.5 million a year. 700 Million people live with disabilities. 20% of the world's poorest people have some kind of disability. 775 Million can't read - 66% of these are women. 32 Million live in the United States.

It is very easy to become overwhelmed by these statistics, throw up your hands, and do nothing. But here comes the strength of service clubs like Rotary. With 35,000 clubs and 1.2 million committed, compassionate members, rotarians are able to make a difference. Rotarians are able to pool the assets everyone brings to the table and effect greater impact.

Back in the 1950s over 55,000 new polio cases developed in the United States. Every year 50,000 plus kids died from polio, and thousands more were crippled, paralyzed or suffered lifeling disabilities. Rotary began to undertake an eradication effort 25 years ago. At the time the estimate was that the project would cost $100 million dollars, and  500 million kids needed to be immunized. Initially the organization set a fundraising goal of $120 million. Two years later, in 1987, that goal was surpassed, with $240 million raised. Rotary linked up with the World Health Organization, and in 1988 the inoculation program was well under way. At that time you would find polio in 125 nations, and every year  350,000 new cases broke out. Since that time, with financial help from the Gates Foundation, over 2 billion children have received Rotary's polio vaccine. They are now living a life without the fear of paralysis and death from polio. In fact only three countries still report new polio cases - Afghanistan, Pakistan and Nigeria. The rest of the world is polio free. What once was an overwhelming statistic was reduced to manageable levels, harnessing our collective empathy and affecting the lives of real people.

Rotary has many stories like this. Individual clubs choose objectives they can confront within their own means. As an example, consider the Rotary Club of Watsonville, California. During its last fiscal year the club produced sufficient funds to give 15,000 kids the opportunity to live polio free; install a water purification system in San Lucas, Guatemala, where, up to that point one third of children under sixteen  died from diseases related to polluted water sources; support a health initiative in a remote area of India giving hundreds of families a chance for a better life, and locally the club spent close to $100,000 on scholarships, infrastructure improvements in schools, literacy programs and support for organizations like Boy Scouts, Papas, the Pajama Project and others.

Multiply this effort by 35,000 clubs, and the potential is enormous. Service clubs like Rotary allow us to show empathy and make a difference in the lives of people who, most often of  no fault of their own, are suffering from the many inequities of every day lives in many parts of the world. Without these   clubs many of these people just become statistics.

Ignorance permeates the conversation about the Iran deal

It seems pathetic how much ignorance is driving the agitation against ratification of the recently concluded Iran deal. Much of the mindless opposition is guided by sound-bites and platitudes generated by candidates running in the 2016 presidential election, none of whom were involved in the discussion leading up to this, and most of whom had no contact whatsoever with any of its key players.

Madeleine Albright suggested, rightly so, that the critics should take the time to study the deal before spouting off on its contents.

Let's look at some of the facts that should be front and center:

1. Since 1979 sanctions on Iran have constantly increased, culminating in sanctions imposed by the United Nations in 2006 - signed off on by Russia and China as well - specifically targeting Iran's uranium enrichment program. Yet, according to the best intelligence we have, Iran is now only 6 months away from developing the capability to field a nuclear weapon.

2. Sanctions are unraveling. Russia announced in April that it will go forward with an old contract selling Iran an air defense system. Iran's Day Bank has already been re-admitted to the international financial system.

3. The agreement is not just between the U.S. and Iran - it was negotiated between the U.S., England, France, Germany, Russia, China and Iran. Even if we renege, chances are that the other participants will go forward with it. Merkel, Hollande, Cameron, Putin and Jinping do not need our congressional consent.

4. Regardless of Netanyahu's political grandstanding, Israel is not in danger of annihilation, and arguably less so after the deal goes into effect than it is currently. Israel has the nuclear arsenal to defend itself if need be. It possesses hundreds of nuclear warheads, and it is not bound by the Nuclear Non-Prolifiration Treaty, since it decided not to be a signatory. (Iran is!).

The information just received was that Netanyahu will aggressively attempt to convince Congress to reject the deal with a veto proof majority.

5. Saudi Arabia is predominantly concerned with the potential of dropping oil prices if and when Iran again enters that market.

6. Energy Secretary Ernest Moniz, a nuclear scientist by training who participated in the negotiations, agrees that the agreement is verifiable even if some of the inspections require a lag time of several weeks.

In short, this agreement considerably improves the status quo. Nothing our Congress does will change the situation on the ground. Foreign policy should not be driven by platitudes and sound-bites. Ignorance is no excuse, it isn't bliss, it is a curse. Do as former Secretary of State Madeleine Albright suggested - study the content, and make up your mind about the merits of the deal intelligently.

Nikki Haley and Hillary Clinton are displaying political courage

This morning two politically courageous decisions stood out to me, and all of our poltical leaders should take a page from the book of these two individuals.

Governor Nikki Haley of South Carolina deserved being in the limelight at the taking down of the Confederate Battle Flag from the front of her State Capitol. Without her courageous leadership this would not have happened, at least not yet. She was able to move the envelope in her state, potentially incurring negative political fall-out.

I also took heart from Hillary Clinton's decision to face the gun lobby head on and make sensible gun control measures an active topic during the upcoming campaign. The NRA stubbornly opposes any control and restrictions on gun ownership - regardless of the 32,000 killings that take place in our country every year - and the issue is politically hyper-sensitive. Her stance probably won't have repercussions for her during the Democratic Party primary, but it could have consequences during the general election, if she gets there. Hillary's husband, President Clinton, and President Obama stayed away from this topic during their election campaigns, fearing adverse political consequences.

These two women showed leadership qualities missing in all the politicians too scared to confront the ignorant rants from that narcissistic bagpipe Donald Trump - perhaps too afraid to get into a public shouting match with him.

Cowardice is not what we look for in our leaders. Having said that, ignorance is a curse, not a crime. Anyone has the right to display it - even Trump.

Marriage equality receives support during traditional marriage ceremonies

Lasty weekend I attended my niece's marriage in Napa. During the dinner following the (traditional) wedding ceremony the couple circulated a framed document the content of which expressed strong support for marriage equality. I experienced an emotional response to their sympathetic gesture. While having been involved in a happy traditional marriage for 35 years, my wife and I have recognized the struggle, despair, bias and condemnation same-sex couples have had to endure over time. All of us have friends and family members impacted by ugly and hostile expressions from, essentially insecure, people when they find out they are gay. This simple gesture gave us hope that we are finally getting somewhere.

This is what was circulated:

"We felt that the timeliness of this historic event needed to be shared with our loved ones on our historic night. As we raise our glasses to celebrate our commitment to each other, we also celebrate our strong belief that the love between any two people should never be questioned nor should the right to marry have ever been restricted." Signed - Michael and Nancy

The statement continues with the following quote:

"No union is more profound than marriage, for it embodies the highesty ideals of love, fidelity, devotion, sacrifice, and family. In forming a marital union, two people become something greater than once they were. As some of the petitioners in these cases demonstrate, marriage embodies a love that may endure even past death. It would misunderstand these men and women to say they disrespect the idea of marriage. Their plea is that they do respect it, respect it so deeply that they seek to find its fulfillment for themselves. Their hope is not to be condemned to live in loneliness, excluded from one of civilization's oldest institutions. They ask for equal dignity in the eyes of the law. The Constitution grants them that right. The judgment of the Court of Appeals for the Sixth Circuit is reversed."  Signed - Justice Anthony Kennedy

It's time to bring sensible gun control back to the top of the agenda

Another massacre and 9 more families suffering from the effects of easy access to guns. If history repeats, our elected representatives will again assume the ostrich position and do nothing.

Two weeks after 35 people were killed in a gun massacre in Tasmania, then Australian prime minister John Howard ushered in a semi-automatic weapon ban. In 1996 a massacre in a Scottish school in Dunblane killed 16 children and one teacher. The following year the private ownership of most handguns was banned in Britain. The day after the Sandy Hook massacre killed 26 in Newtown, Connecticut, demand for assault weapons exploded. One gun shop owner reported that he sold more AR-15 and AK-47 rifles in one week than he normally would sell in a year. Our preoccupation with guns has reached insane proportions. We already own 9 guns for every 10 citizens, totalling 270 million, 30% of the entire world's privately owned firearms.

We lose 31,000 family members to gun violence every year. That is approximately 85 deaths per day. By contrast Great Britain  registers 42 similar deaths per year. On a per capita basis our death rate attributable to firearms is 9.0 per 100,000 population. Japan is at 0.07 and the UK at 0.22. One could legiyimately argue that the reasons behind these morbid statistics, which distinguish us from all other developed countries, is accessibility, the Second Amendment, the National Rifle Association, and perhaps a residual frontier mentality.

The NRA has 4.2 million members who provide in excess of $100 million in membership fees. The organization likes to present itself as a membership organization. In reality it is a lobbying group with immense political leverage funded largely by the gun industry. It has managed to keep congress from adopting effective gun control legislation. Even after Sandy Hook its articulated positiiion has been that to combat similar massacres - and we have had dozens since then - we need more guns. Its members object to restrictions on private ownership of any type of firearm, including rocket launchers. They fiercely object to a national gun registry because they feel that this would allow the government access to information that could be used to confiscate their weapons. They object to mandating background checks when guns are acquired from anyone other than licensed gun dealers, which covers 40% of total gun sales. Their opposition always comes back to a firearm friendly interpretation of "Second Amendment rights."

The Second Amendment, adopted in 1791, was modeled on a condition found in the English Bill of Rights of 1689. In it the king was prohibited from disarming his subjects. During a very tempestuous period leading up to adopting the Bill of Rights, king JamesII, a catholic, attempted to disarm his protestant opposition. During our revolutionary period the fear of being disarmed was real, and the amendment was an understandable reaction to that fear. Since that time the confusing, convoluted language of the amendment has gone through various interpretations of the founders intent, focusing on collective versus individual rights to own firearms. The issue, for the time being, was decided by the U.S. Supreme Court in a 6-4 decision in D.C. vs. Heller in 2008 when it sided with individual rights.

Although the Supreme Court decided in favor of private gun ownership, there is no reason why this right can't be reasonably regulated. The sheer magnitude of the numbers involved makes it unlikely that we can take all guns out of circulation. Besides, few would argue against ownership of guns for gaming. However, military weapons belong with the military. Private clubs could be organized where enthusiasts could go to shoot assault weapons and then leave without the guns. All dealers could be mandated to have a license to sell. Gun owners could be required to have an operating license, just like all of us who drive motor vehicles are required to have a license. A national gun registry could be inaugurated over the objection of the gun lobby. It would make things considerably easier for law enforcement. Background checks could be more exhaustive, and need to be required of anyone attempting to make a purchase, be it at a gun show, on line, or in a store. Finally, some weapons and high capacity ammunition feeding devices simply don't belong in private hands.

In short, if these calamities don't prompt us to change our pre-coccupation with guns and force sensible controls, what will? How many more need to be slaughtered before we wake up and get angry enough to demand change? If not now, when? We all need to contact our elected representatives and instruct them to move the issue back to the top of the agenda.

Same-sex marriage is really a First Amendment issue

Before the end of the month the U.S. Supreme Court will issue a ruling on the constitutionality of same -sex marriage. Opponents have argued that extending constitutional protection to same-sex couples would undercut the conventional purpose of marriage. They generally hold that, by definition, marriage requires two members from the opposite sex, and that same-sex marriage is contrary to God's will, and hence immoral.

Given that these views are held by dominant denominations across the globe, one should ask why a number of countries with large majorities of traditional  opponents of same-sex marriage equality is the law of the land. Argentina, Spain and Portugal come to mind. Currently 14 countries allow same-sex marriage. France, England and Ireland recently joined this group. What allows these countries to pass marriage equality legislation against stiff opposition is that they practice what they preach - separation of church and state.

The first amendment to our Constitution provides that: "Congress shall make no law respecting an establishment of religion, or prohibiting the exercise thereof." Thomas Jefferson reiterated the significance of the principle of separating church and state in a letter to the Danbury Baptist Association in Connecticut in 1802, and the language he used has been cited on numerous occasions by the U.S. Supreme Court.

In most of the countries, allowing marriage equality marriage by the state is the only legal contract recognized under law. Marriage before God is between a denomination and its believers. These are separate events overseen by two separate authorities. In our country clerics have the authority to bind people together in the name of God and the state. Therein lies the rub.

Would we strictly adhere to our First Amendment and recognize that the government has no business getting involved in the institution of marriage, except where it involves a legally binding contract like Civil  Unions, the same-sex marriage debate would be solved. The state could grant all couples, gay or straight, their marriage licenses and individual churches or denominations could decide to bless the committed couple or not.