Good morning to you all. We had some snow yesterday. Thankfully, nothing like the system that hit the northeast. I noticed that everyone is scrambling to explain this years snow phenomenon. I am not so interested in an explanation--I simply want to know when to hibernate.

Well, this didn't take long. The Republicans are once again floating the notion of Medicare vouchers to 'reform' the system. Thank you, Paul Ryan. (sarcasm alert). Look, I can agree that we do need to do something but our politicians are, as usual, attacking the problem from an angle likely to give the least benefit in terms of the desired action (curtailing costs) and the most pain to those who have the least impact on rising costs (the patient). We have a medical education system from which doctors graduate with (if they are lucky) debt in the mid to high six figures. It has to be paid back somehow. We have a high tech medical system whose practitioners show little discernment (I would say discrimination but people often forget that the term has a good meaning) in how, when and why the high tech toys are used and use those high tech toys to cover their asses rather than treat patients effectively. We have a medical malpractice system in which the malpractice insurance providers whose premiums are more correlated (inversely) to stock market losses than malpractice judgements, and we have a professional association that is more interested in covering everyone's asses than getting rid of bad actors. Furthermore, we have consumers who demand a medical cure for all ills with no negative side effects. Vouchers will make effective medical care far more expensive for those who can least afford the expense and will do nothing to curtail the costs (read profits) of drug companies, hospitals, medical insurance providers, and the medical technology industry. Perhaps that is exactly what many of our politicians want.

I noticed yesterday that resistance is growing among some of our Senators and Representatives to the proposed cuts in the defense budget. I wasn't surprised. After all defense contractors are among our most profitable companies upon whom many of our politicians rely for the massive amounts of money it takes now-a-days to get elected and many of our communities rely for jobs and other economic benefits. Andrew Bacevich has a very good piece on Tomdispatch this morning explaining how very well protected the military sacred cow is and how difficult it will be to do more than restrain the growth of military spending even though it has been pointed out repeatedly that we spend more than all other countries combined and are getting very little in return on that investment. And, as Bacevich points out, corporate profits, though not negligible, are not the most powerful factors in this debate. More important are historical, cultural, psychological, and institutional investments in the system as it is--however inefficient or ineffectual.