RUSSIA: WHEN WE UNDERSTAND WHY, WE’LL KNOW HOW

The Ukrainian president is ousted. People gather in the streets of Ukraine to oppose the closer relationship he wanted with Russia. Russia feels a direct threat to its naval base in Sevastopol and the ethnic Russians who dominate the population of the Crimea and, most importantly for Russia; it feels a threat to its only all-weather seaport.

Looked at in those terms alone, Vladimir Putin may even be seen as exercising restraint in sending “unmarked” troops to Crimea to “stabilize” the situation without “officially” invading the country, and thus requiring a military response from Europe and the US.  We need to add to this, though, that Putin has always wanted to regain the power and respect he felt in the (now defunct) Soviet Union, not to mention his feeling, shared by many in the West, that a powerful Soviet Union was, ultimately, a stabilizing force in the world (if we discount the Cold War). Finally, we need to add into the mix that Russia has a nearly genetic paranoia about being surrounded by (potential) enemies, and we have a reasonable snapshot of the picture from the viewpoint of the Kremlin.

So, with that being said, what can be done? First, we need to understand that this is more of a political situation than a military one; we’re playing chess, not checkers. That means that we need to find a way, if possible, for all sides to get most of what they want while still leaving our opposition (Russia, in this case) a graceful way out of the situation. Here is what I would propose to Putin (thought the back channels, of course, not for public consumption) if I were the President of the United States.

First, the new Ukrainian government needs to understand that the rest of the world will not fight to preserve an unbalanced status quo. The Crimea was only ceded to the Ukraine as part of an agreement in 1954 and most of the citizens of the Crimea are ethnically Russian, and speak Russian as their primary language. They want to be Russian. Secondly, the remainder of the Ukraine wants closer ties with Europe and the US, and cringes at the thought of being dominated by Russia, like they were as part of the Warsaw pact. Thirdly, there would never be sufficient economic sanctions put into place to make Russia act against its perceived interests because they are a major trading partner of a large part of the world including, increasingly, the US. Finally, neither Russia nor the US wants to meet each other in a “hot” war in the Ukraine because they do not have the conventional power to defeat us, and we understand that their only option, if they feel sufficiently threatened is the nuclear (literally) option.

Therefore, we would agree that:

1. 1.  Both sides would spend the next two weeks blustering and threatening so that their respective populations and political “hardliners” would be satisfied. Once that phase was complete,
2. 2.    Ukraine would cede Crimea and the ethnically Russian part of eastern Ukraine to Russia,
3. 3.   Ukraine would be invited to join NATO, thus ensuring them that in return for ceding the territory to Russia, their new geographic boundaries would be protected by the mutual defense pact with NATO.

In the preceding scenario, Putin would claim a “win” for Russia, at home, because through threat of force, they had Crimea and part of Ukraine ceded to them (despite the rest of the world "knowing" that the threat of Russian force was not the deciding factor). Obama would claim a “win” (at home) because he turned up the rhetoric and rattled the American saber and, thereby, forced Putin and Russia to “back down,” by preventing and guaranteeing no further action on their part with regard to Ukraine. The Crimea and the ethnically Russian population of Ukraine would win by becoming part of Russia, as they wanted. Ukraine would win because NATO protection and a closer (and uncontested) economic alignment with Europe and the US was what they wanted in the first place and, the World wins because we would have averted a potential major crisis.

THE DEFENSE RESTS!

WHICH PATH?

As I write this, rioting is continuing in the Ukraine in what appears to be a “grass root,” uprising by a people yearning for freedom. A video clip aptly entitled, “I Am A Ukrainian,” has become viral on the Internet in which a young woman pleads with the world for assistance to be free. They are fighting both Russian citizens of Ukraine and reportedly, small numbers of Russian troops. I don’t know if all (or any) of this is true at this point. What I do know is that we have a choice to make.

Throughout most of the last three quarters of a century the United States, which had, traditionally been an isolationist nation, found itself the leader of the Western World. Even after the end of the “Cold War,” it remained for a period of time, the only Superpower in the word, and thus the world’s policeman. Now, however, we've once again begun to contract our military, so the question arises, can we, and should we (even if we could) intervene in their struggle? Ultimately, such intervention could lead to a direct confrontation with the Russian Federation of a type not seen since the Cuban Missile Crisis and, while it is unlikely that either country wants a war at this juncture, mistakes can happen.

On the other hand, these people, young and old fighting together, are the reason our Founders fought and died at Concord and Lexington, Camden and Valley Forge; to be independent of tyranny. But for the assistance of the French (admittedly we were a proxy in their war with Britain), The United States of America would not exist. Can we abandon the Ukrainians and others in Europe, Africa and Asia to their fate, or should we; must we be the world’s policeman and try to maintain the Pax Americana just a little longer?

So, do we help them? Do we?

ENDER'S GAME

   I have long been a lover of the books and expected the movie to fall far short. I was pleasantly surprised to find that while there was a significant amount of action and explanation in the first book of the Ender Quintet that was not able to be compressed into the movie, it was well done and never slow. Moreover, it was not merely a group of kids playing video games, but a dazzling display of special effects that draw you into the movie, while not keeping you from feeling the empathy, pain and pathos of the main character - Ender Wiggin. Harrison Ford and Sir Ben Kingsley were the icing on an already delicious cake. I would urge that this be one of your must see movies this holiday season. 

“ATTENTION K-MART SHOPPERS! NOW BEING FEATURED IN ASLE 1 . . .” INTERNET BREACH OF PRIVACY!

 

I was recently on a “Professional” social media site where questions are asked of attorneys, and answers are attempted by the attorneys (without constituting legal advice, of course). While scrolling through the questions, I came across one from a therapist who, having been made aware that a teenaged minor was endangered by her home situation (an abusive parent), wanted to know if she could be “emancipated” and what would be involved. While they should have simply spoken with a local attorney, this, in and of itself, was not the issue.

In the question, the therapist reveals the name of the minor, the town where she lives, and even gives her own name and a telephone number where she can be reached. I have no doubt that the therapist’s intentions were good, and that the perceived urgency of the situation was the reason why she felt it necessary to disclose so much information, but instead of helping her client, she has now violated nearly every confidentiality statue, regulation and ethical standard I can think of, while also opening herself up to lawsuits from almost everyone involved, including the abusive parent. She has even increased the vulnerability of the minor in question to possible predators.

Would she have posted all this information on a bulletin board in the public square? Probably not, yet that is exactly what she did. She may get away with it this time because the site where she posted it is a legal site, and her client and her client’s relatives may not ever see it. On the other hand, we all know how often these things go “viral.” Once again, I offer this warning; when you write about health information (or any information for that matter) on ANY site on the Internet, it is equivalent to shouting it to the world through a loud speaker and posting in the public square.

The rule of thumb that derives from this is:

NEVER POST ANY IDENTIFIABLE INFORMATION ABOUT YOURSELF OR ANYONE ELSE, THAT YOU DO NOT ACTUALLY WANT EVERYONE IN THE WORLD TO KNOW.

OH BRAVE NEW WORLD; the “Provider” as “Patient.”

An article I once read reminded those of us who practiced Medicine that we are all patients, but some of us are privileged to be physicians also. What is it like to become a new patient in a new healthcare “system,” after years of not having to?

Recently I changed my health insurance and made sure to sign up for additional coverage such as vision. My plan says I am entitled to a basic eye exam, a contact lens exam, and either contact lenses (which I’ve worn most of my life) or glasses. I made an appointment with an optometrist that was listed on my plan, G,B., OD, who works with a Bala Cynwyd, PA Ophthalmology practice. I explained my situation and was given an appointment, only to be told by the receptionist when I arrived that their office accepted my insurance for a “basic exam” only, and the rest would be out of pocket. This was never explained to me when I first called, nor was the ability to “cherry pick” the types of examinations covered explained in my insurance benefits information.

This seems to me to be the healthcare equivalent of “bait & switch;” the equivalent of my telling a new patient that I accept their insurance, but when they arrive with chest pain, explaining that I only accept it for checking their blood pressure, but not for an ECG. They got me into their office by not telling me they only accepted part of my insurance, then (I suppose) expected me to simply pay, out of pocket, for services I was supposed to be covered for.

Health care has obviously now become “Caveat Emptor” so, when you make your first appointment with a new physician or other “provider,” be sure to ask about the specific things you need before you go. Otherwise, you may wait for the appointment, wait in the “waiting room” and fill out your “paperwork,” just to find out that the doctor is listed as “in network” but is allowed to choose not to accept those things for which he or she can make more money “out of pocket.” GOOD LUCK!

A CONSTITUTIONAL CRISIS; UP IN SMOKE!

Seventeen states, and the District of Columbia allow “Medical Marijuana;” now Colorado and Washington have gone  the rest of the way and done, by popular referendum, what their politicians have been afraid to do – legalize marijuana for recreational use. The “’60s counterculture” has seemingly begun to win the battle; but what about the “war?”

Despite the changes in state laws, the DEA has kept Marijuana a schedule 1 drug, and thus illegal under federal law. “So,” you ask? The first thing you learn in law school (or a civics class for that matter) is that federal law usually trumps state law. So far, the Feds have not actively tried to shut down the marijuana dispensaries in states where they are legal, but will this be the last straw and begin a federal crackdown, or the beginning of the end for marijuana prohibition?

Regardless of your point of view on this issue, it is likely to explode soon and, most likely, since state officials cannot be mandated to enforce federal law, the federal government will have to file a lawsuit to prevent the implementation of these laws. Moreover, there is no doubt that this will reach the U.S. Supreme Court. There, we’ll find out if this is truly a conservative Court which will side with states’ rights, or a more liberal Court that will side with a centralized federal government. Any bets?

PENN STATE: A FOLLOWUP

After my recent blog about Penn State, I think I need to clear up what my position actually is.

The people who were directly or indirectly involved need to be indicted for criminal activity, including those in the non-athletic part of the administration who had an oversight responsibility and were criminally  negligent because they considered the football program sacrosanct.

I believe the University needs to be punished both for what it allowed to happen, and as a warning to other schools in the same position.

What I also believe, however, is that the NCAA solution was not well thought out or crafted. It allows innocent students to be injured and the entire town of College Park, PA, many of whom are financially dependent upon the football program for their livelihood to be crushed under the weight of their sanctions. In effect they are saying they are willing to accept any amount of collateral damage, no matter who gets hurt, just to punish the few who were really involved.

Indict the criminals, punish the University, discredit the actions of those who through knowledge or willful neglect allowed these events to occur, but do not create more innocent "victims" than are absolutely necessary. That is what the NCAA failed to do, and that is my argument against their sanctions.

PENN STATE; punish the criminals not create more victims!

   There is no question that Penn State deserves a heavy penalty for (apparently) knowingly allowing ongoing pedophilia in its coaching staff. Moreover, those who knew, like Joe Paterno, had an obligation (moral, if not legal) to inform authorities or, at a minimum, take steps to protect children involved in activities at the school. With that said, however, I have two problems with the NCAA solution.

   First, vacating Penn State's wins from 1998 – 2011 simply to hurt Paterno’s record is specious at best and more likely a farce. Whatever Sandusky, Paterno & company did wrong, it did not result in those wins - hard work, pain and some blood from the student athletes did, and vacating the wins from their record creates a total disconnect between the offense and the punishment. Ultimately, the other teams lost those games, and all it will result in is an asterisk in the record books; everyone will still know who REALLY won the games. Moreover, instead of merely punishing Penn State for its actions, or lack thereof, it creates an entire class of innocent new victims - the student athletes whose records will be altered, and whose professional advancement may be forever stymied because of events which they knew nothing about, and over which they had no control.

   Finally, the post season ban will mean that high quality football players who cannot transfer to another highly ranked school in time, may have their NFL hopes dashed, and potentially lose millions of dollars; thus being held responsible and paying a heavy price for the acts of others over whom they exercised no authority. It has long been understood that authority without responsibility leads to tyranny, while responsibility without authority is slavery. The NCAA needs to rethink its "knee jerk" reaction and refocus the punishment on those who deserve it, not the innocent athletes. We should strive for less crime, not more victims.