Month: March 2014

House (and Senate) Calls

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DFAGunsSharable (1) 

 The NRA is frothing at the mouth again, this time over the President’s nominee for Surgeon General. The reason? The President’s nominee, Vivek Murthy, MD, MBA and a member of Doctors for America, had the audacity to say in a January 9, 2013 letter to Vice President Biden that guns are a public health care issue. In response to the nomination, the NRA sent a letter to President Obama calling on him to reject his nominee.

“Who is this 37 year old foreigner and political hack King Obama has nominated? And why should we listen to a physician regarding firearms?”

I’m glad you asked.

First, this “foreigner” is a US citizen who was born in the UK and moved with his parents to Florida when he was three years old. He graduated as valedictorian from his high school in Miami. He then graduated magna cum laude (in 3 years) from Harvard University with a bachelor’s degree in Biochemical Sciences. He then received an MD from Yale School of Medicine and an MBA in Health Care Management from Yale School of Management, where he was a Paul & Daisy Soros Fellow. He completed his residency in Internal Medicine in at Brigham and Women’s Hospital in Boston. He is currently a physician at Brigham & Women’s and an instructor at Harvard University.

Now, as to your second question, firearms cause injury to human flesh. It is the emergency departments of local hospitals that see the carnage and devastation guns cause. It is the physician’s duty to save lives. A physician does not receive a dossier on the patient in front of them bleeding from a gunshot wound. They do not pause to determine the legality/justification of the gun’s discharge. They only see the damage. Following the horror at Sandy Hook Elementary School in Newtown, Connecticut on December 14, 2012, 52 medical organizations joined forces to send letters to the leaderships of the United States Senate, the United States House of Representatives and directly to the President of the United States. The audacity, indeed.

Of course, it is not the 52 medical organizations calling for change or Dr. Murthy’s CV the NRA really has a problem with, although even the thought of any gun control leads the NRA to a version of reduction ad absurdum apparently leading to tyranny, confiscation, black helicopters, concentration camps and a socialistic New World Order. Rather, it is the position of the organization Dr. Murthy founded, Doctors for America, whose mission statement reads:

“Doctors for America is a national movement of physicians and medical students working together to improve the health of the nation and to ensure that everyone has access to affordable, high quality health care.”

And whose core values and culture are listed as:

    1. We are bold and fearless.
    2. We are creative and flexible.
    3. We value everyone.  Every voice matters.
    4. We cultivate strong relationships and a family spirit with partners and colleagues.
    5. We are accountable to one another in our individual and collective work.
    6. We are open and honest.
    7. We are passionate and determined.
    8. We grow and learn and help others do the same.
    9. We have fun and celebrate!
    10. 10. We ensure every action meets our highest standard: will it help create a healthier America for everyone?

End times, indeed. But it is the group’s position on gun violence prevention that has the NRA exorcised. Once again, facts be damned, Obama’s coming for our guns! And once again, our feckless Congress is caving to the NRA’s demands. Yesterday, in an editorial piece in the New York Times, the editorial board wrote that, “There are now reports that the White House and Senate Democratic leaders might delay a vote on the nomination until after the midterm elections or urge the nominee to withdraw.” Unconscionable.

In Common Sense, Thomas Paine, writing to General William Howe, wrote:

arguing with the dead

Shame on the NRA, but more shame on Congress, should they not vigorously defend this nominee. Gun violence is a public health crisis. To ignore it is an abdication of responsibility, against the wishes of Americans and placating the lowest common denominator of society.

Death and Taxes (or Here’s to the Egg Heads)

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Thoughts at Large

Franklin blood

“Our new Constitution is now established, and has an appearance that promises permanency; but in this world nothing can be said to be certain, except death and taxes.” —Benjamin Franklin to Jean-Baptiste Leroy, 1789.

Right now, on Verizon Wireless, you can get any of eight smartphones for FREE! Now, I’m no Steve Jobs, but a guy selling sand at the Great Pyramid of Khufu charges something, so how is it that a wireless phone company can afford to give away the phone? Of course, the answer is that it is the 2 year contract comprising of a line cost and data package that earns the company their money. As far as they guy selling sand in the desert, I can only suppose it is marketing, charm or preying on tourists that earns him his money.

This business model, the loss leader, is not unique to cell phones. Inkjet printers…

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Death and Taxes (or Here’s to the Egg Heads)

~ thoughtsatlarge ~ 1 Comment

Franklin blood

“Our new Constitution is now established, and has an appearance that promises permanency; but in this world nothing can be said to be certain, except death and taxes.” —Benjamin Franklin to Jean-Baptiste Leroy, 1789.

Right now, on Verizon Wireless, you can get any of eight smartphones for FREE! Now, I’m no Steve Jobs, but a guy selling sand at the Great Pyramid of Khufu charges something, so how is it that a wireless phone company can afford to give away the phone? Of course, the answer is that it is the 2 year contract comprising of a line cost and data package that earns the company their money. As far as they guy selling sand in the desert, I can only suppose it is marketing, charm or preying on tourists that earns him his money.

This business model, the loss leader, is not unique to cell phones. Inkjet printers can be had for less than $50, but the ink they use can cost you well over $100. Under this business model, and without government oversight, one can imagine car manufacturers purchasing oil companies, giving away gas guzzling cars for free and making a fortune on fuel. In this scenario, the Hummer would have lived forever. In short, it is the consumables that garner the profit.

Can this model be used to impact gun violence in America? Absolutely, however, it is the government and not the manufacturers that must act in this scenario. To gun manufacturers, fear drives business. Just as you would never have a meeting with a home security firm representative who would tell you that your neighborhood and your home are impervious to crime, gun manufacturers breed paranoia.

If the goal is to curb gun violence, perhaps the method is to control the consumables, in this case ammunition. Rather than target large capacity magazines or clips, make the price of filling it cost prohibitive. We are all familiar with the bumper sticker mentality of the gun rights groups who love to chant, “Guns don’t kill people, people kill people.” Well, in fact, guns don’t kill people, bullets do. And taken a step further, empty guns can’t kill anyone (short of beating them with it like a club). Right now there are no limitations on ammunition purchases over the internet. In the aftermath of countless mass shootings or arrests prior to any carnage, we always hear that the individual had “X number of guns and thousands of rounds of ammunition.” Thousands!

In 1993, New York Senator Daniel Patrick Moynihan noted that the country had a 200 year supply of guns but only a 4 year supply of ammunition. In the 20 years since then, the easily skirted assault weapons ban lapsed, the right wing has made “patriot” a de facto religion and over 300,000 people have been killed with a gun (CDC statistics: 156,077 killed from 1999-2010, so a conservative estimate of over 300,000). And this does not include the over 400,000 that killed themselves over the same 20 year period (CDC statistics: 208,406 firearm suicides from 1999-2010, so, again, a conservative estimate of over 400,000).

Senator Moynihan’s proposal, as reported in the New York Times, raised under the auspices of public health, was to raise the tax on ammunition from 11% to 50% on the wholesale price of handgun ammunition. In some cases, it would have raised the tax to 10,000%. Of course, some saw it as a revenue raising proposal rather than a public health issue. In typical NRA fashion, Wayne LaPierre criticized it by saying, “I seriously doubt anyone in America believes crime is going to go down because taxes are going to go up. It shows how egg headed this whole debate has become.”

Needless to say, Senator Moynihan’s proposal died like the 30,000 people killed by firearms every year. Perhaps it is time to revisit this proposal, but on a more systematic basis. Rather than an average of a 50% tax increase on ammunition, let’s tax it at 10,000%. Perhaps we should limit the amount of ammunition that can be purchased online. Perhaps it is time to consider gun violence a public health issue and not the sole issue of the tyranny fighting patriot. Perhaps we should study the number of guns sold in the country rather than keep it a mystery. Perhaps we should embrace logic and reason, fact and compassion, egg heads over mouth pieces. Perhaps.