The Crime of the Century

THE CRIME OF THE CENTURY
By Richard D. Lamm

I have just participated in the greatest embezzlement in all of history. In my sixty plus years, I have never seen such a perfect crime. Like most other master criminals, I am heady with success and feel a need to brag. I kid you not — never before has one group appropriated as much money that belonged to another group in the history of crime. The victims, while they are increasingly suspicious, still do not know they have been had. It was literally and figuratively as easy as taking candy out of the mouths of babies.

Here is how we did it. The first rule of embezzlement is to find some naive patsy. We sensed thirty years ago the younger generation was not paying enough attention to public policy, so we quietly found ways to maintain our lifestyle and charge it to the next generation. While those of you under 45 were preoccupied with other things, my generation dumped the largest load of debt on you that history has ever seen — and found ways to maintain our lifestyles on your credit cards.

A good scam needs a compassionate come-on. In our case, we developed a new word: “poor elderly.” To this day, most Americans do not understand that this is actually two words, and that “poor” no longer describes the elderly as a class. There are, of course, poor elderly; but as a class the elderly have the most discretionary income of any group in America (except those in the age bracket of 55-65).

Next, we devised a number of systems that allowed us to charge our retirement to the next generation of Americans, who will wake up to find they are on the losing side of a Ponzi scheme. Like all good con artists, we relied on “trust.” We told them there was a “trust” fund for both Social Security and Medicare. Of course, this was a lie. There is no “trust” fund, in the normal sense of the word, because we take this month’s Social Security taxes from today’s workers and pay them to today’s elderly.

Then, we tell today’s workers not to worry — the money is being held “in trust.” In actual fact (as Senator Ernest Hollings of South Carolina has observed), they would be no better off if the fund was invested in confederate war bonds. The trust fund is a sham because it only contains IOU's that tomorrow’s generation of workers will have to (mostly) pay off themselves. They will have to pay for both our retirement and their own. Not bad. We succeeded in taking money from poor workers in St. Paul and sent it to wealthy retirees in St. Petersburg — and no one was the wiser. But, I have hardly begun.

The perfect embezzlement maximizes its take. We soon found there was money left over after paying the Social Security funds to today’s elderly, and we did not want to stop half way. What self-respecting crook would leave money lying in the bank vault after a robbery? Hell no. We completed the job by something called the “consolidated budget.” This allowed us to quietly take the Social Security funds left over to reduce our taxes by spending the money on current government services. Under the “consolidated budget,” we could legally “borrow” the money in the “trust fund” left over every year, and spend it on current government services; thereby, reducing our yearly taxes.

Virtually every year for the last 35 years we understated the yearly deficit and understated the total federal debt. Even though the official federal debt is approximately $6.5 trillion, the amount actually passed on to the next generation is closer to $20 trillion. My generation is master embezzlers. The entire scheme was done with clever accounting gimmicks, which allowed us to minimize our taxes and maximize our spending while we passed the bill on to the next generation. Like many victims of a crime, by the time they figure it out I will be long gone.

I have completely and totally spent the Social Security Trust Fund and left nothing in trust, absolutely nothing, for today’s workers to pay future obligations. They will have to either raise their taxes substantially, or dramatically reduce their benefits under the system. They have no other practical alternatives. They may, of course, try to do the same thing that my generation did and try to perpetrate the Ponzi scheme, but I doubt it will work. Young people catch on at some point. The true perfect crime only works once.

The next generation will wake up to the magnitude of the fraud. They will recognize they are working long hours (or two jobs) and make less working than I make in retirement. Yet, every month they transfer money to me to pay for my health benefits. I have plans for that also. When they start to blow the whistle, I will say with shock and horror, “You can’t start a intergenerational war.” I will tell them about how hard I fought for this country (6 months in active service — most of it at the officer’s club bar). I will shame them by accusing them of breaking the “generational contract,” neatly covering the fact that it was really my generation who “broke” the contract by leaving them an unsustainable and insolvent system. Like any successful crook, I cover all my bases.

When health care costs became a larger factor in our budgets, we found a system to subsidize our health care costs at the expense of following generations. We called it Medicare. The average senior who turned 65 in 2000 got back $4 from today’s workers for every $1 that he/she paid into the system. Today’s retiree receives on the average a $100,000 subsidy toward his health care costs — from a system that is slated to go broke not far into this century. I am looking forward to playing golf and living high and sending much of the bill to today’s workers who make less working full-time than I make in retirement. Après moi, le deluge.

The story does not end there. My generation screwed up the savings and loan industry. What did we do to get out of it? We issued thirty-year bonds! Why should I pay for my mistakes when there is a gullible generation right behind me? Will I be here in 30 years? No. Will you? I leave it to my kids to pay off.

My wife and I bought our first house in 1963 for $11,900. Our first mortgage payments were $49 a month because we had a VA loan subsidized by the federal government. Everyone in my generation could buy his or her own home. It is estimated that thirty percent of the current workers below age thirty will never be able to own their own houses. It does not end there. I, to this day, get more money in housing allowance every year from the federal government than the poorest American. It is simple. I get to deduct my mortgage interest and real estate taxes, which is worth to someone in my income bracket more than the cash equivalent that any poor person in this state receives for housing. Ditto health benefits. By not taxing my health insurance paid for by my employer, I also receive more health benefits from the federal government than most poor children on Medicaid.

Do I feel guilty? Well, occasionally. The other night I was standing in the line for the movies, getting a senior citizen discount. There was a struggling young couple in front of me who were wondering how they were going to pay the baby-sitter. My wife and I had driven to the theater in our fancy foreign car from our debt-free house — but we got a $6 discount from the price the young couple paid.

I try not to spend too much time thinking about it. I keep busy. Right now, I have to go down to the State Legislature to lobby for free fishing licenses for seniors. Why not? We already get free state park admission. See you around.

Immigration: The Ultimate Growth Issue

IMMIGRATION: THE ULTIMATE GROWTH ISSUE

Sustainable population a key concern for state

By RICHARD D. LAMM

One of the great challenges of public policy is to anticipate challenges. If I could leave anything carved on the Colorado Capitol after my 12 years, it would be something like "Beware of solutions appropriate to the past but disastrous to the future." It is easy to talk about yesterday's issues, but the real policy challenges involve understanding and anticipating the issues of tomorrow.


A new, pressing public policy question faces America: What is our demographic destiny? How big a country do we want to become? How many people can live satisfied lives within our borders? These issues will not go away and will only grow more complicated.

Our natural American birth rate will lead to a stable U.S. population around 2050; with the current level of immigration our population will be about 400 million, on its way to a billion.

I have yet to meet an American who wants l billion neighbors. Or 400 million. This is not an issue of immigrants, but of immigration. What possible public policy advantage would there be to an America of 400 million? Do we lack for people? Do we have too much open space, parkland and recreation area? What will 400 million Americans mean to our environment? Do we need a larger military? Are our schools underpopulated? Do we not have enough diversity? Will our children live better lives if Atlanta and Denver double in size? Do you want a Georgia of 16 or 20 million people? These questions seem to answer themselves.

The growth issue in America is largely an immigration issue. We have a public policy choice: One, to stabilize population or two, to double it and double it again through our current policy of mass immigration.

If we continue with our present policy (America takes twice as many immigrants as the rest of the world combined) we will continue to grow and grow. The geometry is relentless.

The first census in 1790 found 4 million Europeans in America. Two hundred years later we had about 260 million Americans. Please note that two more doublings give us more than a billion people sharing America. Have you ever been to India or China? Is that what you want to leave to your grandchildren?

Of course immigration has been good for America and, yes, we are all immigrants. But is that the extent and depth of the immigration argument? I governed a state like Georgia for 12 years. In my experience, immigration made virtually every problem I was trying to solve more difficult. I have been working all my political life trying to get health insurance for low-income citizens. How can this be done when our borders allow an endless stream of people needing medical care?

A majority of the patients at our large Denver Public Hospital are illegal immigrants. Our standard school scores go down rather than up partly because of the large numbers of immigrant children. Housing? Public housing is filled with legal and illegal immigrants. Crime? Twenty percent of our prison space is filled with the foreign-born. Growth? Colorado, like Georgia, is being flooded by people from other states who move here because they don't like what's happening in their own states.

Bottom line: What problem in America, or Georgia, will be made better by continuing to add massive numbers of people? America before immigration reform averaged about 250,000 immigrants a year. If we would return to those numbers, we would take a great step toward leaving our children a sustainable America.

It is time for a new vision for America. When the Statue of Liberty was erected, we were a relatively empty continent. Now 4 billion people live below the U.S. welfare level (with 80 million more born each year) and dream of America. We must decide how many we want or need.

I would argue that we should move toward a stable, sustainable population. The world's ecosystem does not need 300 million more Americans, nor do we. Immigration has gone from a solution to a problem, and the sooner we recognize this the better America we will leave our children.

After teaching for five months at the University of Canterbury in Christchurch, New Zealand, Richard D. Lamm is resuming his position as director of the Center for Public Policy and Contemporary Issues at the University of Denver. Lamm was governor of Colorado from 1975 to 1987.

The High Cost of Cheap Labor

The High Cost Of Cheap Labor
by Richard D. Lamm


It is easy to see why illegal immigrants are attractive to employers. These are generally good, hard working people who will quietly accept minimum wage (or less), who don't generally get health or other benefits, and if they complain, they can be easily fired. For some employers it is an abused form of labor. Even minimum wage is attractive to workers from countries whose standard of living is a fraction of ours.

But it is not "cheap labor." It may be "cheap" to those who pay the wages, but for the rest of us it is clearly "subsidized" labor, as we taxpayers pick up the costs of education, health, and other municipal costs imposed by this workforce. That has become a substantial and growing cost as the nature of illegal immigration patterns has changed.

For decades, illegal immigrants were single men who would come up from Mexico or Central America alone, pick crops or perform other low paid physical labor and then go home. They were indeed "cheap labor." But starting in the 1960s, these workers either brought their families or smuggled them into the country later. They become a permanent or semi-permanent population living in the shadows but imposing immense municipal costs.

Illegal immigration today isn't "cheap" labor, except to the employer. To the rest of us it is "subsidized labor," where a few get the benefit and the rest of us pay. These costs ought to be obvious to all, but the myth of "cheap labor" and "jobs Americans won't do" persists.

It is hard to get an exact profile of the people who live in the underground economy, but the average family of illegal immigrants has 2 to 4 school-age kids. It costs U.S. taxpayers more than $7000 a child just to educate them in our public schools. Now no minimum wage workers, or even low wage workers, pay anywhere near enough in taxes to pay for even one child in school. Even if their parents were paying all federal and state taxes, Colorado's estimated 30,000 school-age children of workers illegally in the U.S. impose gargantuan costs on other taxpayers.

The dilemma is compounded by the fact that approximately 50 percent of illegal workers are paid in cash, off the books. Go to any construction site almost anywhere in America, and you will find workers paid cash wages. Virtually every city in America has an area where illegals gather and people come by to get "cheap" cash-wage labor.

The health care cost of this "cheap" workforce is also significant and subsidized by U.S. taxpayers. The total cost of this "subsidized” labor is impossible to ascertain and difficult to even estimate, but it is immense and growing as our population of these workers grows. A few benefit, many pay.

Americans pay in more ways than taxes. Cheap labor drives down wages as low income Americans are forced to compete against these admittedly hard working people. Even employers, who don't want to wink at false documents, are forced to lower wages just to be competitive. In many ways it is a "race to the bottom," fueled by poor people often recruited from evermore-distant countries by middlemen who profit handsomely.

Professor George Borjas of Harvard, an immigrant himself, estimates that American workers lose $190 billion annually in depressed wages caused by the constant flooding of the labor market from newcomers.

Let me suggest that correctly analyzed, the fight against illegal immigration is both a liberal and conservative cause. There is no moral or legal justification for this abused form of labor.


Richard D. Lamm is Co-Director of the Institute for Public Policy Studies and a professor at the University of Denver. He is a member of the Board of the Federation for American Immigration Reform. He served three-terms as governor of Colorado, and is the past president of Zero Population Growth.
Email Dick Lamm at rlamm@aol.com.

Terrorism and Immigration

Terrorism and Immigration
Address by Richard D. Lamm, Former Governor of Colorado
Delivered to the Franklin L. Burns School of Real Estate and Construction Management
Daniels College of Business Seminar entitled
“Real Estate – Can We Be Secure?”
Denver, Colorado, January 17, 2002


September 11, 2001 is the date on which the nature of warfare changed. It is not enough to say—as many do—that “everything changed” or that “the world will never be the same.” We owe our country and each other to be specific and comprehensive. We need to assess what we learned and speculate and debate what we have yet to learn. The lessons we do not learn from September 11th will come back to haunt us.

I would suggest the most important factor that changed on September 11th was the type of warfare that we must protect ourselves against. One of the most important but most neglected subjects of the new national agenda is the relationship between immigration and terrorism. The 19 Islamic fundamentalists who wrought the destruction of September 11th and killed over 3,000 innocent people were all foreigners who had been in the United States from a week to three years. They apparently all entered the U.S. legally, though some of their visas had expired before September 11, 200l. No official of the U.S. knew where they were, what they were doing, nor did any alarm bells go off when they overstayed their visas. This was not unique, as approximately one-half of the 8 to 11 million illegal aliens in the U.S. entered with valid visas but overstayed their legal duration.

Gary Hart and his National Commission on Terrorism warned of this immigration/terrorism relationship over a year ago. The National Commission on Terrorism concluded in a 2000 report that, “In spite of elaborate immigration laws and the efforts of the Immigration and Naturalization Service, the United States is, de facto, a country of open borders.”

We must understand that the border is a critical tool for protecting America and we have to recognize and admit to ourselves how vulnerable we are. According to an article in the Atlantic Monthly we have 86 football stadiums that seat more than 60,000 people and 10 motor speedways with capacity over 100,000 spectators. The Indianapolis Speedway seats more than 250,000. We have 50 of the 100 tallest buildings in the world and the Mall of America gets 600,000 visitors a week. What good is the best airport security if our borders are open and we present targets like this?

The actions of September 11th were acts of war carried out against our civilian population by foreign civilians who came here legally and who lived, played, worked, and went to school in the United States. There is every reason to suspect that a number of additional terrorists are here in the U.S. right now. Many more have vowed to come here and commit their own acts of terror. Thousands of Islamic schools in various parts of the world are teaching millions of impressionable children to “hate America” and that we are "The Great Satan". A chorus of voices warns us that there will be additional acts of terrorism on American soil and that these terrorists are either hiding in plain sight or seeking lawful admission. We ignore the immigration lessons of September 11th at our great peril.

We face a ruthless, fanatical foe that flies civilian airplanes into buildings and is dedicated to killing Americans. In other wars the nation had to deal with domestic security, but as an extension of some foreign war. The new reality is that America is now the battlefield and every American is a potential target. The problem is larger than “foreigners” of course. Let us not forget that Timothy McVeigh was an American and the FBI's best guess is that the anthrax attacks were most likely domestic terrorism.

The border is an important tool in preventing terrorism. As every house has to have a door, every country has to have a border. We have been singing, “We are the World” more that we have been singing “America The Beautiful.” It is now imperative that we better monitor who we admit into this country, and insure that people honor the terms of their admission. We must monitor whom we admit, where they are, whether they are going to the schools they were admitted to attend, and we must know when they leave or don’t leave. The INS admits that there are 300,000 foreigners who have been ordered out of the country but have disappeared before they could be deported. THREE HUNDRED THOUSAND: that's as many people as live in Ft. Collins.

Interpol and our own intelligence people have found that the twentieth terrorist was not able to enter the U.S. from Germany because the U.S. refused him a visa. The border worked; the score -- 1 out of 20 terrorists coming here to do us harm. We should be thankful for that one, but this is not a good score. But because of that one visa denial, we can reasonably speculate that the plane that crashed in Pennsylvania missed its Washington D.C. target because it only had 4 terrorists (instead of 5) and that Todd Beamer and his “let’s roll” brave band were able to frustrate the fourth plane’s unidentified target in Washington, D.C.-- albeit at the cost of their own lives.

Immigration reform will not solve the problem of terrorism, but this problem will not be solved without immigration reform. We talk a lot about non-immigration solutions to terrorism that are not realistic. According to the same Atlantic Monthly article, we would need 14,000 Air Marshals to cover every domestic flight, which is more than the total number of special agents in the FBI. We can run but we can’t hide from the fact that we have an immigration/terrorist problem. We cannot fully protect America once people enter this country. It is now clear that all hijackers had documents and came in at an U.S. port of entry. Their names were checked against a “Watch list” and apparently no alarms went off.

We must do better. We must better evaluate the potential for harm that comes with visitors, students and immigrants. I suggest this visa part of the problem has at least two parts: (l) that many students and visitors received their visas in a country where it was impossible for American officials to do an adequate background check (2). That the US counselor offices worldwide are understaffed and cannot adequately do background checks even if the sending country cooperates.

America had about 500 million border crossings last year, 350 million of them non-U.S. citizens. Over seven million visas were issued to foreigners last year and another 2.4 million applicants for visas were denied. Most of the 31 million foreigners who enter the U.S. temporarily each year do so without visas under reciprocal visa waiver policies that permit nationals of 29 countries to enter the U.S. for up to 90 days without visas. One of the hijackers was a recently naturalized French citizen who entered under this waiver program. No visas are required for Mexicans and Canadians entering the US. with Border Crossing Cards that permit limited travel in the U.S.

What to do?

First, I suggest we pass into federal law a suggestion of Senator Diane Feinstein who submitted a bill for a six-month moratorium on visas from countries who sponsor terrorists. In 1998 America issued 564,683 student visas including over 7,999 from Saudi Arabia, 4,500 from Pakistan, 2,000 from Jordan, and 1,600 from Egypt. I think it is a reasonable question whether we are or even can do adequate background checks from these terrorist sponsoring countries. While a moratorium on visas pending a review of the procedure for the issuance of visas seems only common sense to most of us, America’s universities, including my own, vehemently protested this legislation and it died. It should be resurrected. How could we possibly take the risk of giving a student or tourist visa to someone from Iran, Iraq, Syria, Sudan and Libya? Why not at least a six month moratorium? If Americans have to wait in long lines at airport security, it is not unreasonable to make people from these countries wait longer for their visas so we can be reasonably sure they will not do us harm.

Related to this, America needs an increase in consular officers assigned to issuing visas and increased scrutiny and background checks for each applicant. There are U.S. embassies in some foreign countries where less than 5 minutes is average per applicant.

The second way that illegal immigrants enter the country is through the “back door” of slipping across our border. The United States has 93,000 miles coast line in addition to a 2000-mile border with Mexico and a 4000-mile border with Canada. There are 400 border agents on the Canadian border to cover 3 shifts and 4000 miles. We have Swiss-cheese borders without adequate policing.

The gargantuan number of illegal aliens who come (mostly to find jobs, not engage in terror) undercuts national security and border control. The Clinton administration, with the tacit approval of much of corporate America), substantially crippled the interior enforcement of our laws against illegal immigration. We must better protect ourselves against illegal immigration so we can better protect ourselves against terrorists. Even though vast majority of the illegal aliens come seeking jobs, the enormous numbers of illegals prevent the U.S. from coming close to knowing who is legally in this country or not. It is essential to identify and remove the millions of aliens who enter legally and then stay on illegally as well as those who enter illegally from the start. If we can deny jobs to illegal aliens, we will not eliminate but we will go a long way towards reducing illegal immigration.

For those who over-stay their visas we need a comprehensive I.D. reform that includes machine-readable visas and documents for all entrants to the U.S. to minimize forged entry documents, and a database of entry and exit information. An electronic work eligibility document will make it more difficult for unauthorized aliens to work and support themselves while in the U.S. Several pilot programs have been proven successful and must be made mandatory in all work places by Congress.

What do we do about illegal immigrants who sneak across our border? I believe that border enforcement is not enough. I believe that we also need a national I.D. card. There is a simple and reliable system already in Germany, Austria, France, Greece, Spain, Hong Kong, Belgium and the Netherlands. Every citizen and lawful resident would be required to obtain a tamper-proof national identification card. It would be encoded with some type of biometric date—a fingerprint, retina scans, or voice pattern and have a hologram, like we see today on most drivers’ licenses. Fingerprints or a retina scan is much harder to fake or forge than a picture. This ID will not only help us dramatically cut down illegal immigration, but will help with the growing problem of identity theft.

After a certain date, ID cards would help identify people here illegally two ways: First it will be impossible for people without ID cards to remain unseen though the American landscape. They would not be able to get on a plane, collect federal benefits, open a bank account, obtain health care, cash a check or get a job without a national ID. This is how most European countries help control their borders. For a foreigner, not having an ID card would be grounds for deportation. For all stops, detentions and arrests, police would require ID cards.

It is not adequate merely to have to show a drive's licenses or equivalent ID's issued by the state. Three of the nineteen Sept. 11th terrorists had Virginia ID's-issued under a permissive Virginia policy. I believe me must adopt a national standard for drivers license issuance and design. All states must protect these vital identity documents by cross-referencing them with the Social Security database and adopting anti-tampering laws.

We may choose to start with some sort of voluntary ID issued under uniform rules by states on a voluntary basis. This might be an alternative or a first step. A separate line at Security gates could be available for those with a proper ID with a biometric identifier. If you wanted to avoid the long line, you would get a government issued ID.

Understand that all U.S. citizens would also have to acquire and show the national identification card. For the average U.S. citizen, it would be little different than the present. When you get a job, cash a check, get on a plane, or collect a benefit, you will have to show your ID card instead of your driver’s license. Police would still need reasonable suspicion to stop anyone. It would save American citizens billions in tax and welfare fraud and identity theft. It is not a silver bullet against terrorism; there is no silver bullet. It would not catch Timothy McVeigh or other citizen terrorists, but it would help us to start to get a handle on who is in our country legally.

Then there is the question of legal immigration. In 1998, the United States took 7,883 immigrants from Iran; 2,220 from Iraq; 4,831 from Egypt; 13,094 from Pakistan, 2,840 from Syria, and 166 from Libya. The same question applies here as it does in the question of visas: Can we really do an adequate background check from places like Libya or Sudan?

One of the most intriguing issues to me is the question of profiling. There is a lot of jerking of knees on the subject , but it seems to me that we should pay more attention to someone with a visa from a terrorist-supporting country than from Hong Kong or Peru. It would be public policy malpractice not to. It would not make sense in the name of non-profiling to check everyone equally. Some people are obviously more of a security risk than others. It may well be that an elderly Thai woman with a visa might cause us harm, but it is far less likely than someone with a visa from Libya, Iraq or the Sudan -- or someone wearing an Osama Bin Laden T-shirt.

CONCLUSION

The famous military strategist Von Clauwitz observed that "Generals always fight the last war." Are we not doing the very same thing? We are thousands of time more likely to be invaded by a foreign terrorist than a foreign country. We need a military but we also need a border. The front line in this phase of warfare is the border. We ignore it at our peril.

The Ten Commandments of Community

The Ten Commandments of Community

This article first appeared in Chronicles, November, 1996.

by Richard D. Lamm



We are sailing into a new world of public policy -- a world as strange and new as Columbus discovered. It is a world where infinite government demands have run straight into finite resources. It is an America made up increasingly of diverse people. At current immigration patterns, by 2040, there will not be a dominant ethnic group in America. We will all be minorities. We are the only country in history that ever deliberately changed its ethnic makeup, and history has few examples of "diversity" creating a stable society.

America is an aging society whose wealth is not accumulating at historic rates. Most of our institutional memories and political culture come out of the 1950's and 1960's, when America was largely European in makeup and was doubling its per capita wealth every 30 to 40 years. Government had a substantial yearly growth dividend it could spend. Now, a much more diverse America is the worst country in the industrialized world at creating wealth (it now takes approximately 130 years to double our per capita wealth). We go into debt to maintain current levels of government. Being in government today is like sleeping with a blanket that is too short: we do not have the resources to cover all our current promises. Compounding the problem is the growing economic disparity, with a small percent at the top of the economic ladder creating most of the new wealth.

We already live in a time of unprecedented tension between the races, sexes-even generations and religions. Because a more crowded, more diverse, and less wealthy country must give serious thought to what "social glue" is necessary to hold it together, it is imperative for us to understand what a "community" is and how it is formed and reinforced. As Marcel Proust has said, "The real voyage of discovery consists not in seeking new lands, but in seeing with new eyes."

Let us look with "new eyes" at community. A community is much more than a place on a map. It is a state of mind, a shared vision, a common fate that is forged by dedication, work, tolerance, and love. The community passed on to us by our forefathers will not inevitably be passed on to our children, for community is not a guarantee but a continuing challenge.

The results of not building a community are evident everywhere, in Bosnia, Chechnya, Sri Lanka, Quebec, and Rwanda. What is going on today -- in Azerbaijan and Bosnia -- is not a failure of communism; it is failure of community. The Serbs, Slovenians, Croats, and Bosnians were killing each other long before Marx was born. Bosnia, in fact, traumatized as it is, is far less diverse than the United States, but we formed a community (E Pluribus Unum ) and Bosnia did not.

In light of our new social and economic realities, therefore, we must reconsider those elements that build community and those that tend to pull community apart, such as race, religion, and ethnicity. Melting pots that do not melt become pressure cookers, and diversity carried too far is dangerously divisive.

Building better communities, then, should be highly important public policy and critical to our public and private futures. I should thus like to offer "Ten Commandments of Community" -- ten building blocks which are imperative as we try to renew and expand our sense of community.

Commandment I: The future is not something we inherit, but something we create.
Too many Americans believe that God is an American who will watch over us no matter how hedonistic selfish, myopic, or inefficient we become. This is a dangerous hubris. No great nation in history has ever withstood the ravages of time. Toynbee warned us that all great nations rise and fall, and that the "autopsy of history is that all great nations commit suicide." Because God will not automatically save America, with God's help, we must save ourselves.

There is an Amazon legend about a priest speaking with God about heaven and hell. "I will show you hell" said God. They went into a room which had a delicious beef stew on the table, around which sat people who looked desperately famished. They held spoons with long handles which reached into the pot, but because the spoons were too long, they could not get the -stew into their mouths. Their suffering was terrible. "Now, I will show you heaven," said God. They then went into an identical room with the same savory stew on the table around which sat people with identical spoons and handles, but they were well nourished and joyous. The priest was baffled until God said, "Quite simply, you see, these people have learned to feed each other."

We can create chaos, as in Bosnia, or we can create community. The decision is up to us.


Commandment II: A great community needs great leaders and great citizens.
How do we expect to build community when 30 percent of our births (67 percent of black births) are illegitimate, and when we know that illegitimacy is a "leading indicator" of almost every social pathology (e.g., juvenile delinquency, crime, spousal abuse, drug abuse, etc.)? How do we hold the urban centers of this nation together when 70 percent of the students in public school come from families that qualify for the "free lunch" program and the wealthy live in "gated communities"? What should we expect in the 21st century after my generation has witnessed a 560 percent increase in violent crime, a 419 percent increase in illegitimate births, a 400 percent increase in divorce rates, a 300 percent increase in children living in single-parent homes, and a drop of 80 points in SAT scores?

Commandment III: A community must have economic stability.
Economic instability preceded Lenin's Russia, Mussolini's Italy, and Hitler's Germany. My generation has lied about our country's deficit by borrowing from various federal trust funds, masked the true extent of our debt, and run up a staggering trade deficit. Look at the figures: the federal debt that we admit to has been growing steadily both in actual numbers and as a percentage of our GDP. When I was elected to my second term as governor of Colorado in 1979, the federal debt was $1 trillion and the GDP $3 trillion. When I left office in 1987, the federal deficit was $2 trillion and the GDP $4 trillion. Today, the federal debt is $5 trillion and the GDP $7 trillion. This is bad enough, but when the "unfunded" liabilities for programs that we have enjoyed (like military pensions, federal civil service retirement, and Social Security) are added into the mix the actual costs that our children and great grandchildren will have to pay are between $14 and $17 trillion, if not more. The trade deficit gives people outside the United States a claim on our assets. It is essentially an IOU for goods we imported in excess of those we exported.

Never has a generation of Americans also prespent our children's money and mortgaged their future. We are the most fiscally irresponsible generation in our nation's history, and many thoughtful people, there will come a day of reckoning for our irresponsible actions.


Commandment IV: A community must generate tolerance and yet set limits on that tolerance.
Tolerance is a word easy to say -- hard to apply. But what a community should and should not tolerate often depends on context. It is your right to read your Bible, your Koran, your Torah, but it is not your right to force these readings on others. We can tolerate almost any idea, and the community should be alive with argument. What should be taught in public schools is a thornier issue. We are entitled to believe in creationism, for example, but are we entitled to teach it as fact in the public schools? I suggest not.

The standards for teaching and tolerance are not coterminous. It may be that you deeply believe that it is the trees moving that makes the wind. This is your prerogative, but you cannot teach it to my kids in public institutions. Science and rational thought have put to rest certain arguments, and knowledge must move forward if we are to survive in a competitive world. We can tolerate many private beliefs but should stand strong against institutionalizing nonscience and falsehood in our school system.

Commandment V: A community can be a Joseph's coat of many colors and creeds, but it must have more things in common than differences.
"Diversity" is a word sweeping America and, in particular, our college campuses. I am suspicious of the "eulogization" of that word. I recently traveled around the world and in no place, with the possible exception of Hawaii, did I see "diversity" working. The people of the world's more diverse regions are mostly engaged in hating and killing one another. A peaceful and stable society built on "diversity" is much harder to achieve than most Americans acknowledge and I am sobered by how much unity it takes. Dorf's World History tells us that "the Greeks believed that they belonged to the same race; they possessed a common language and literature and they worshipped the same gods. All Greece took part tin he Olympic games in honor of Zeus, and all Greeks venerated the shrine of Apollo at Delphi. A common enemy, Persia, threatened their liberty. Yet all of these bonds together were not strong enough to overcome two factors . . . local patriotic and geographical conditions which nurtured political divisions."

The Los Angeles Times, whose market area is now a seething land of ethnic tensions, warns, "If ethnicity begins to replace citizenship as the basis of statehood, chaos would ensue." But this is exactly the situation today. Hispanic students demand separate education, at which the Mexican, not American, flag is flown. There is more talk of "reclaiming" the Southwest of Mexico than there is of allegiance to America. Is this just a passing phase? The history of multiple cultures living together without assimilation is not encouraging. The United States runs the very great risk of creating a "Hispanic Quebec" if we do not develop and apply the right social ties. As Benjamin Schwarz said recently in the Atlantic Monthly, "The apparent success of our own multiethnic and multicultural experiment might have been achieved not by tolerance but by hegemony. Without the dominance that once dictated ethnocentrically and what it meant to be an American, we are left with only tolerance and pluralism to hold us together."

This is not enough. We must be more than a diverse people living in the same place and sharing only a standard of living. In short, "diversity" is only an asset if it is secondary to unity. The emphasis must be on the unum not the pluribus. We should respect diversity, but we should celebrate unity.

Commandment VI: A community cares about its future and builds for that future.
Dietrich Bonhoeffer observed during his fight against Hitler that "the ultimate question for a responsible man is . . . how the coming generation will live." As explained above, my generation has not been good trustees for America. We have not met the most basic of history's tests: instead of leaving our children a sustainable society, we have left them fiscal time bombs. We have not maintained strong, vigorous, and sustainable institutions.

As already detailed, we have hung an albatross of debt around the necks of our children. Social Security, Medicare, military pensions, federal civil service pensions, state and local pensions -- all these and more are chain letters to the future. Medicare is one recession away from bankruptcy. The average person retiring today will receive from Social Security three or four times as much money as he paid into the system, while our children will be lucky to even get their contributions back. Programs that worked and were good social policy when we had a society with many children and when people died in their 60's and 70's does not make economic sense in a society which has fewer children with a less productive economy and whose citizens live well into their 80's.

The elderly make up 13 percent of America, and they receive 61 percent of federal social spending, despite the fact that the elderly are no longer disproportionately poor. It is political power, not social justice, which sets priorities, and money desperately needed to prepare the next generation is being transferred to the last generation whether they need it or not. Money desperately needed by poor children in St. Paul is transferred instead to wealthy retirees in St. Petersburg.

The status of a community at any given time is like starlight. What you see is, to a large degree, not what is but what was. Just as the star you see is light which left the star years before, so also community is the result of a previous generation saving, investing, educating, and building. Communities are the result of generations of caring.

In all cultures, in all nations, and in all religions, there is a universal theme against profligacy, one urging justice for future generations. A community cares about posterity. An old Middle East proverb observes, "The beginning of wisdom comes when a person plants a tree, the shade under which he knows he will never sit." Alas, my generation has cut down many of the shade trees we inherited.

Commandment VII: A community needs a shared culture and shared language.
John Gardner, former Secretary of the Department of Health and Human Services, has said:


If the community is lucky, and fewer and fewer are, it will have a shared history and tradition. It will have its "story," its legends and heroes, and will retell that story often. It will have symbols of group identity-a name, a flag, a location, songs, and stories . . . which it will use to heighten its members' sense of belonging . . . To maintain the sense of belonging and the dedication and commitment so essential to community life, members need inspiring reminders of shared goals and values.
I am convinced that one of the "shared values" we must have is a shared language. It is a blessing for an individual to be bilingual-it is a curse for a society to be bilingual.

The United States, in my opinion, is at a crossroads. It must move toward either greater integration or greater fragmentation. It will either have to do a better job of assimilating its peoples or witness increasing alienation and balkanization. We found in the 1950's that "separate was inherently unequal," but it is also inherently divisive.

Commandment VIII: A great community is one that has developed a great culture.
Why do certain people succeed in disproportionate numbers and others fail? The answer, I believe, is culture.

Daniel Patrick Moynihan says that "the central conservative truth is that it is culture, not politics, that determines the success of a society. The central liberal truth is that politics can change a culture and save it from itself." The most economically successful people in America today are in fact minorities who have been discriminated against. Regarding family income, the top earners in America are Japanese, Chinese, Jews, and Koreans. Why? I believe it is because they come from cultures which promote education, delayed gratification, ambition, and hard work, and other traits that are most often equated with success.

Commandment IX: Ask not what your community can do for you but what you can do for your community.
I believe a quality community is one which balances rights and privileges with duties and responsibilities. No society can live on rights and privileges alone, as we have tried to do for too long. Our community and our nation now need something in return.

A free republic demands a far higher degree of virtue than any earlier society. It demands a profound sense of personal responsibility, a willingness to govern one's own passions, a capacity of initiative and self-reliance, a taste for personal independence, and a sustained spirit of civic cooperation. Saul Bellow said it well, that "America is as threatened by an excess of liberty as Russia was by the absence of liberty." Those are important words. An 18th-century philosopher put it another way: "Freedom is the luxury of self-discipline." "America, the Beautiful" mirrors this same thought: "Confirm thy soul in self control by liberty and law."

A breakdown in community because of a lack of cooperation, self-control, and common sense was recently witnessed in South Carolina, where the state's Supreme Court upheld Beaufort City's ordinance banning excessive noise. The ordinance was challenged by street preachers who asserted a right to shout as loudly as possible for a sustained period regardless of the effects on pedestrians, the area's businesses, and the community well-being. Despite three attempts by the city to compromise, the street preachers refused to limit either their volume or the hours they engaged in shouting. In response, the City Council passed an ordinance prohibiting such "speech." Under the ordinance, dozens of street preachers were arrested as the ministers poured into town preaching for hours on end. One preacher was measured at 89 decibels -- the sound equivalent of a symphony orchestra.

The street preachers argued that their First Amendment rights overrode the interest of the community, and that street preachers could not judge what volume was too high under the dictates of the ordinance. The City Council replied that "the vitality of a nation's cities and towns depends upon the ability of local government to enact reasonable laws which promote the quality of life of the community." One owner of a downtown shop testified that it was impossible to carry on a conversation and that customers often fled to escape the noise. City officials feared that economic viability of the restored downtown area was at stake. Fortunately, the South Carolina Supreme Court deemed the ordinance constitutional.

Recently, my wife and I spent a fall in San Francisco. We saw the most aggressive begging we had ever encountered. One man told us that if we did not give him a donation, he would rob us next time. A clampdown on aggressive begging is underway in San Francisco, as well as in many other cities. The issue is not homelessness, as social activists like to claim, it is community, and the desire to stave off urban decline.

In both Chicago and St. Louis, groups of welfare mothers have tried to strengthen their local communities by cleaning up their housing projects. They passed tenant rules which forbade carrying guns or selling drugs within the projects. The ACLU predictably sued, arguing that the rules, which required searching each person upon entry, infringed on people's rights. The courts, however, upheld the women's actions, pointing out that the tenants could indeed set standards and evict people who violate those standards set by and for the community. In short, tolerance in moderation is a safety-net, but unlimited tolerance breeds chaos and crime, the very opposite of community. Adam Smith's model of the "invisible hand" -- with every person pursuing his own selfish interest -- may produce a prosperous economy, but it does not build a community. It leaves us a collection of disparate, autonomous, and unconnected individuals.

Commandment X: A community needs government can trust.
Waco, Whitewater, Ruby Ridge, and the widespread aversion to the special interest money that plays too large a role in the election and reelection of politicians and in the laws they make -- all of these show that we are coming perilously close -- a complete breakdown of faith in our federal government. Poll after poll shows that confidence in government and politics is at an all-time low. Some distrust of government is healthy, be too much distrust leads to anarchy. We must restore some level of confidence in the problem solving machinery of society

The bottom line is this. We can no longer take "community" for granted in the United States. There is too much tension too much misunderstanding, too many separate tribes yelling; each other. It is a dangerous situation, and if our country and culture are to survive and prosper, we must first salvage that elusive concept of community.

How to Destroy a Nation

By Richard D. Lamm

I have a secret plan to destroy America. If you believe, as many do, that America is too smug, too white bread, too self-satisfied, too rich, lets destroy America. It is not that hard to do. History shows that nations are more fragile than their citizens think. No nation in history has survived the ravages of time. Arnold Toynbee observed that all great civilizations rise and they all fall, and that "An autopsy of history would show that all great nations commit suicide." Here is my plan:

I. We must first make America a bilingual-bicultural country. History shows, in my
opinion, that no nation can survive the tension, conflict, and antagonism of two competing languages and cultures. It is a blessing for an individual to be bilingual; it is a curse for a society to be bilingual. One scholar, Seymour Martin Lipset, put it this way:

The histories of bilingual and bicultural societies that do not assimilate are histories of turmoil, tension, and tragedy. Canada, Belgium, Malaysia, Lebanon—all face crises of national existence in which minorities press for autonomy, if not independence. Pakistan and Cyprus have divided. Nigeria suppressed an ethnic rebellion. France faces difficulties with its Basques, Bretons, and Corsicans.

II. I would then invent “multiculturalism” and encourage immigrants to maintain their own culture. I would make it an article of belief that all cultures are equal: that there are no cultural differences that are important. I would declare it an article of faith that the Black and Hispanic dropout rate is only due to prejudice and discrimination by the majority. Every other explanation is out-of-bounds.

III. We can make the United States a "Hispanic Quebec" without much effort. The key is to celebrate diversity rather than unity. As Benjamin Schwarz said in the Atlantic Monthly recently:

...the apparent success of our own multiethnic and multicultural experiment might have been achieved not by tolerance but by hegemony. Without the dominance that once dictated ethnocentrically, and what it meant to be an American, we are left with only tolerance and pluralism to hold us together.


I would encourage all immigrants to keep their own language and culture. I would replace the melting pot metaphor with a salad bowl metaphor. It is important to insure that we have various cultural sub-groups living in America reinforcing their differences rather than Americans, emphasizing their similarities.

IV. Having done all this, I would make our fastest growing demographic group the least educated – I would add a second underclass, unassimilated, undereducated, and antagonistic to our population. I would have this second underclass have a 50% drop out rate from school.

V. I would then get the big foundations and big business to give these efforts lots of money. I would invest in ethnic identity, and I would establish the cult of Victimology. I would get all minorities to think their lack of success was all the fault of the majority – I would start a grievance industry blaming all minority failure on the majority population.

VI. I would establish dual citizenship and promote divided loyalties. I would “celebrate diversity.” “Diversity” is a wonderfully seductive word. It stresses differences rather than commonalities. Diverse people worldwide are mostly engaged in hating each other—that is, when they are not killing each other. A diverse,” peaceful, or stable society is against most historical precedent. People undervalue the unity it takes to keep a nation together, and we can take advantage of this myopia. Look at the ancient Greeks. Dorf’s World History tells us:

The Greeks believed that they belonged to the same race; they possessed a common language and literature; and they worshiped the same gods. All Greece took part in the Olympic games in honor of Zeus and all Greeks venerated the shrine of Apollo at Delphi. A common enemy Persia threatened their liberty. Yet, all of these bonds together were not strong enough to overcome two factors . . . (local patriotism and geographical conditions that nurtured political divisions . . .)


If we can put the emphasis on the “Pluribus,” instead of the “Unum,” we can balkanize America as surely as Kosovo.

VII. Then I would place all these subjects off limits – make it taboo to talk about. I would
find a word similar to “Heretic” in the 16th century – that stopped discussion and paralyzed thinking. Words like “racist”, “xenophobe” that halts argument and conversation.

Having made America a bilingual-bicultural country, having established multiculturalism, having the large foundations fund the doctrine of “Victimology”, I would next make it impossible to enforce our immigration laws. I would develop a mantra – “that because immigration has been good for America, it must always be good.” I would make every individual immigrant sympatric and ignore the cumulative impact.

VIII. Lastly, I would censor Victor Hanson Davis’s book Mexifornia – this book is dangerous -- it exposes my plan to destroy America. So please, please – if you feel that America deserves to be destroyed –Please, please – don’t buy this book! This guy is on to my plan.

What If It Were Your Mother?

WHAT IF IT WERE YOUR MOTHER?
By Richard D. Lamm

Let me answer for myself, up front, one of the most commonly asked questions in health care: What health care would you deny if it were your mother? My answer is the universal answer: Deny her nothing; I want her to have everything! Of course we all would do everything to save a loved one.

But you cannot build a health care system, or any public system, a mother at a time. This is an unfair and unrealistic standard for public policy. I would also want to locate a police station near my mother’s home, and I would wish to double her Social Security check, and I want a floodlight in her backyard and an emergency response system in her every room. And I would hope not to pay for any of it. But applied to all our mothers, that road leads to national bankruptcy. The “mother test” is a good yardstick for your own money but not a sustainable yardstick for a health plan however heartfelt. Every health plan must look dispassionately and intelligently at what is and what is not to be funded. They must set rules and parameters that apply to all their members equally: mothers cannot be exempted. If some medical procedure is futile, or inappropriate, or has only a slight chance of succeeding, those procedures can legally and morally be excluded from coverage for all the membership. We can neither give "mothers" a different standard of care, nor can we bring up the standard of care for all subscribers to the "what if it were your mother" standard.

We are all free to provide our mothers extra safety, income, housing, clothes, but we cannot use either a health plan or government money to do so. When we pool funds, as we do with taxpayer monies or health premiums, we have to set and live by rational distributional roles. No commonly collected pool of funds (taxes or premiums) can maximize all beneficial care to all stakeholders. This is a reality that must be understood by both citizens and doctors.

American doctors were trained in a culture that maximizes everything in health care. As Hafdan Mahler, former head of the World Health Organization, noted: “Everywhere, it appears, health workers consider that the ‘best’ health care is one where everything known to medicine is applied to every individual by the highest trained medical scientist in the most specialized institutions.”

It goes without saying that this is an unsustainable yardstick. The price of doing something with commonly collected funds is always that we cannot do everything. The price of joint action is the need to set limits.

Both Medicare and health plans owe a duty to their policyholders, including our mothers, but not only our mothers. We cannot pay limited premiums and limited taxes and receive unlimited care. We cannot make our fondest hopes and dreams the common dominator for demands on common resources. We are entitled to our equitable share and no more. The good news about modern health care is that we can expect a lot. The bad news is that we cannot expect everything.

A wise person once told me “maturity is a recognition of our limitations." A mature nation must recognize that no health plan and no nation can meet the mother test.

Are Mexicans Italians?

ARE MEXICANS ITALIANS?
Richard D. Lamm

One of the most important questions America and the Southwest are faced with is: are Mexicans Italians? Italians were the last immigrant group to come to America under antagonism and suspicion. Prejudice was palpable, discrimination widespread, intergroup relations difficult. Italians 100 years ago, like the Mexican immigrants today, had poor graduation rates, high rate of dropouts, higher crime rates, fewer college graduates per capita and fewer professionals. It seemed for a time that Italians would be a permanent underclass of blue-collar workers.

But the Italians, while they took longer to succeed in the traditional ways, took on the educational and success patterns of the majority community and now they equal or exceed the performance of the majority community. They are among the proudest Americans with family income and professional status higher than the national average. Took longer, but succeeded brilliantly. Are Mexicans Italians?

Samuel P. Huntington, who gave us the perceptive The Clash of Civilizations, has a new book, Who are We? which should be much debated by those who care about American’s future. Huntington states: “The persistent inflow of Hispanic immigrants threatens to divide the United States into two peoples, two cultures, and two languages. Unlike past immigrant groups, Mexicans and other Latinos have not assimilated into mainstream U.S. culture, forming instead their own political and linguistic enclaves-from Los Angeles to Miami- and rejecting the Anglo-Protestant values that built the American dream. The United States ignores this challenge at its peril.”

All American history is opposed to Huntington’s thesis and is on the side of success of our new immigrants. America has been a powerful assimilating machine, and there have always been doubting xenophobes and good-hearted skeptics. But there are three big differences, which, in my opinion, make a Hispanic Quebec an equally likely scenario. Those three all began with “D”.

Distance: previous generations of immigrants had to come a long way and didn’t have much option to go home. They had to become Americans; today many of our immigrants can go back to their homes for a weekend. The pull to assimilate is considerably less. With dual citizenship they can vote both for Vincente Fox and George Bush.

Diversity: the only way past immigrants could talk to each other and live their lives, was to learn English and assimilate. America has allowed its immigration policy to accept a disproportionate percentage of Mexicans. (See chart) Today over 50% of our immigrants are Spanish speaking and America is backing into becoming a bilingual/bicultural country. I know of no bilingual/bicultural country in the world that lives at peace with itself.

Discontinuity: the history of American immigration is times of large immigration followed by periods of low immigration (war, depression), which gives the new immigrants a chance to assimilate and join our community. Today we take approximately one million legal immigrants and have 9 to 11 million illegal immigrants residing here, with massive numbers of illegals being added year after year. Do we not risk the melting pot becoming a pressure cooker?

I believe that America and the world will have to develop sustainable lifestyles and policies. I am skeptical of mass immigration because one of those policies has to be to move to stabilize the population of the U.S. A second equally imperative agenda is to assimilate and acculturate our newcomers. I suggest that these two issues are among the most important issues facing Colorado and America.

Death: Right or Duty?

DEATH: RIGHT OR DUTY?
By Richard D. Lamm

Too often, the limits of our language are the limits of our thinking. “If thought corrupts language, language can also corrupt thought,” warned George Orwell. How we label something too often controls how we think about it. We get particular concepts in our head and they are hard to change. They govern how we think and how we act. “Disease” and “death” used to be considered as “God’s will,” and it took hundreds of years and no small number of martyrs to get that corrected. It was very hard to develop modern medicine when so many factors were thought of as outside of human control. Similarly, the number of children a woman had was thought to be “God’s will,” and that has made the development of contraception controversial to this day. Human control over any part of human destiny is usually opposed vigorously. Change comes slowly. Humankind has the tendency to confuse the familiar with the necessary.

Science finally overcame (many) such outmoded concepts, however sincerely held. Medicine has developed ever more inventive and expensive things we can do to the body as it ages and approaches death. Now, language limits us in a different way. Today, we have so changed the concept of death that we talk about the “right to die” as if death were an option. “Right to die” is a useful term in some contexts, but it implies death is a matter within our individual control. Too many Americans think themselves “entitled” to all health care technically possible no matter how marginal, and will spend unlimited insurance or government money on long-shot attempts to delay death. We have gone from superstition to hubris.

This has its own trap. Death is not an option. Shakespeare said it so well, “We all owe God a death.” Humanity has a hard time putting death in perspective. Over the history of humankind, we are alternatively paralyzed or dismissive. Both concepts of death are wrong and cause substantial harm. We are not helpless in the face of death — there are a myriad of things we can do to postpone death. Likewise, death is not an option. Thinking of death as a “right” to be exercised misallocates tens of billions of dollars a year. America spends 27 percent of its health dollar on the sickest one percent of the population, 55 percent on the sickest 5 percent. This “concentration of expenditures” is far above spending patterns in all other developed countries. Insulated against the costs and petrified by the results, our culture, which considers death the enemy, spends more and more on less and less.

We do not have a “right to die.” Humans are mortal. Death is neither a right nor an option. Yet, there is a public policy tragedy in our misconception. Money desperately needed elsewhere in society is being spent on marginal and low benefit medicine throughout the system, but particularly on the dying process. No other society would take a 90-year-old with a terminal disease or terminal cancer out of a nursing home and put them into an intensive care unit. My wife and I were recently at the bedside of a 93-year-old man with three fatal diseases (metastatic cancer of the prostrate, end-stage kidney failure, and he had just been brought into the intensive care unit with a serious stroke). Massive resources were being poured into this gentleman, while blocks away people were going without primary care and kids were going without vaccinations.

Ten percent of U.S. hospital beds are ICU beds, while the rest of the developed world uses three percent of their hospital beds as ICU beds. What do we get for our extra intensive care beds? Mostly we get expensive deaths. There is no evidence we save more critically ill people than other societies. We have failed to develop policies that rationally limit the use of intensive care beds to those who truly benefit. An ICU bed was designed for a realistic salvage attempt, not end-stage care.

I would suggest the sum total of all “ethical” medicine, as now defined and practiced, is unethical health policy. The hubris in thinking that medicine can deliver to an aging society all the “beneficial” medicine its inventiveness has developed is misplaced.

Proust observed, “The real voyage of discovery lies not in seeking new lands, but in seeing with new eyes.” So, also, we must see with new eyes. Everything we do in health care prevents us from doing something else. We live in a new world of trade- offs, but without either the ethical standards or yardsticks to decide those tradeoffs.

It is imperative we question this concept. My generation’s bodies are developing ailments and chronic conditions faster than our economy can fund the treatments. We are spending too much money on the last generation at the expense of the next. We have run into the “law of diminishing returns.” Modern medicine has presented us with a Faustian bargain: Our aging bodies can bankrupt our children and grandchildren. Health care is important, but it cannot trump every other societal need. We must begin a dialogue by thinking clearly about death and its costs.

Compassion for Unidentified Lives

COMPASSION FOR UNIDENTIFIED LIVES
“Statistics are people with the tears washed off.”

Paraphrasing economist Kenneth Boulding, one of the basic dilemmas of public policy is that all of our policy experience deals with the past, and all our decisions relate to the future. These policy decisions will be exacerbated by the very successes of our past. The incredible bounty of the interaction between a sparsely populated continent filled with abundant resources and an energetic people has masked the need for making hard choices. It has allowed us to fool ourselves that we can satisfy more desires and expectations than we realistically can afford.

Public policy is too often driven by identified needs and identified individuals to the exclusion of other public goods. One of the great challenges of the 21st Century will be to learn the wisdom of George Bernard Shaw’s aphorism; “The mark of a truly educated man is to be truly moved by statistics.” Public policy is burdened by the difficulty of making unidentified lives equal to identified lives. Statistics often represent people not numbers. But, as a nun once told me, “Statistics are people with the tears washed off.”

Professor Alan Wertheimer raises the following provocative questions: Suppose the following were true, he asks:

At least some of the money spent on open-heart surgery could be used to prevent heart disease. True, patients in need of such surgery might die, but many more lives would be saved.

Some money spent treating tooth decay among low-income children might be used on fluoridation and dental hygiene. True, some decay would go untreated, but fewer children would ever need such treatment.

He points out “all involve choosing between a policy designed to help specific persons and one that seeks to prevent the need for such help.” These choices are especially difficult because we know who needs the help. “...we must often choose between helping identifiable lives and saving statistical lives.”

Public policy inevitably has to accept casualties. We do not ban automobiles, guns, or alcohol despite annual loss of life, because we judge their utility to be greater than their cost. It is seldom an equal weighing. Identified lives loom so much larger because they have a human face. Statistical deaths, no less human and no less dead, do not have a face — only a number. Not nearly as visible, but human nevertheless. It is not good public policy to ignore these “statistics.” As one author observed:

"The statistical life is one of the fifty lives that will be lost in a year because of a government decision not to pursue a particular mine safety regulation. The identifiable life is the one miner trapped in the collapsed mine. We are held hostage to these identified lives — much like a kidnapper holds his/her victim's hostage. It is hard not to give in to a ransom note. What seems cruel in an individual case is often actually the most lifesaving and compassionate for the general society." (David Eddy)

Joseph Stalin once said: "One man's death is a tragedy; a million men's deaths-- is a statistic." In a horrible way, Stalin was right, and his reasoning applies to the American health care system. "We don't mind throwing people overboard," says one wag "we just don't want to hear the splash." In the same spirit, Governor Kitzhaber has said: “Legislatures have never had to confront the victims of silent rationing or be accountable for the very human consequences. It is like high level bombing where the crew never sees the faces of the people they are killing." George Bernard Shaw had it right: we must be educated and compassionate enough to be moved by statistics

We do many things at great expense to avoid having to say no to identified lives. The United States has approximately three times the percentage of intensive care beds than other industrial nations and yet we don’t save any more of the critically ill. We have far more specialists than other industrial countries. We spend billions of dollars to avoid having to make the everyday life and death decisions that other countries make routinely. Then we turn around and leave over 40 million Americans without health insurance.

We spend more billions on expensive neonatology units, often to save preemies who will cost more millions and have little or no quality of life, but we do not give prenatal care to many American women. That is neither good nor compassionate health policy.

Two Wands

Two Wands
Richard D. Lamm, Co-Director
Institute for Public Policy Studies
University of Denver


Let me offer you, metaphorically, two magic wands that have sweeping powers to change society. With one wand you could wipe out all racism and discrimination from the hearts and minds of white America. The other wand you could wave across the ghettoes and barrios of America and infuse the inhabitants with Japanese or Jewish values, respect for learning, and ambition. But, alas, you can’t wave both wands. Only one.

Which would you choose? I understand that many of us would love to wave both wands; no one can easily refuse the chance to erase racism and discrimination. But I suggest that the best wand for society and for those who live in the ghettoes and barrios would be the second wand.

This metaphor is important in correctly diagnosing one of the most significant problems facing contemporary America: the large economic, education and employment gap between Black/Hispanic America and White/Asian America. The problems of crime, educational failure, drugs, gangs, teenage pregnancy, and unemployment that burden certain groups threaten our collective future. They form a nation-threatening social pathology that must be addressed in broader terms than we have done to date.

Most discussion of minority failure blames racism and discrimination, and calls for more governmental action. I’m an old civil rights lawyer and such racism and discrimination clearly still exists. But the problem, I fear, is deeper than the current dialogue. We need to honestly think about these problems with a new sophistication. One of these new areas is to recognize that increasingly scholars are saying "culture matters."

I’m impressed, for instance, that the highest family incomes in America are earned by minorities that have been discriminated against. Japanese Americans, Jews, Chinese Americans, and Korean Americans all out-earn white America by substantial margins and all have faced discrimination and racism. We put Japanese Americans in camps 60 years ago and confiscated much of their property. Yet today they out-earn all other demographic groups. Discrimination and racism are social cancers and can never be justified but it is enlightening that, for these groups, they were a hurdle, not a barrier to success.

The Italians, the Irish, the people from the Balkans — America has viewed all these groups and many more with hostility and suspicion, yet all have integrated and succeeded. Hispanic organizations excuse their failure rates solely in terms of discrimination by white America and object vociferously when former Education Secretary Lauro Cavazos observes that Hispanic parents “don’t take enough interest in education.” But Cuban Americans have come to America and succeeded brilliantly. Do we discriminate against Hispanics from Mexico but not Hispanics from Cuba?

I suggest that those groups whose culture and values stress delayed gratification; education, hard work, success and ambition are those groups that succeed in America — regardless of discrimination. I further suggest that, even if discrimination was removed, that other groups would still have massive problems until they developed the traits that lead to success. Asian and Jewish children do twice as much homework as Black and Hispanic students, and get twice as good grades. Why should we be surprised?

A problem well-defined is a problem half-solved. We must recognize that all the civil rights laws in the world are not going to solve the problem of minority failure. Ultimately Blacks and Hispanics are going to have to see that their solution is largely in their own hands. Lionel Sosa, one of America's leading Hispanic businessmen, in his book The Americano Dream, titles his first chapter "Escaping the Cultural Shackles.”

Daniel Patrick Moynihan has insightfully observed, “the central conservative truth is that it is culture, not politics, that determines the success of a society. The central liberal truth is that politics can change a culture and save it from itself.”

Thus, morally, I would want badly to wave both wands; if I had to choose, I would wave the second wand. A Confucian or Jewish love of learning would gain minorities far more than any affirmative action laws we might pass.