The poet Juvenal wrote, “We Romans have forgotten our civic duties; the People who once approved everything, military command, high civic offices, legions, now hold back and anxiously hope for only two things: bread and circuses.”

This was written in the early 2nd century AD when Trajan was emperor. The Latin word circus means arena or amphitheater. The Circus Maximus in Rome was used primarily for chariot races (ludi circenses); it was also used for gladiator sports. The Circus Maximus, originally a wooden structure, burned many times, including in Nero’s famous 64 AD fire. Trajan enlarged and rebuilt the circus to its maximum capacity, probably over 200,000 spectators (Roman writers give various estimates). The Spanish-born Trajan discouraged Christian persecution and was supposedly baptized posthumously by Pope Gregory the Great 380 years later to save his soul or release it from Hell. Trajan was widely respected and often mentioned by Christian leaders as a “noble pagan”.

Americans beg for cheap gas and cheap medicine today.

(As seen from the inside of the healthcare system, a slightly different version will appear at kevinmd.com/blog)

Paul Krugman’s health care columns, the archimedes movement and repairing the healthcare system frustrate me. They represent very different political philosophies, but each focuses on health care in isolation and each keeps repeating the same slogans. Jacob Hacker’s health plan, which is behind the Clinton, Edwards & Obama health plans, is very frustrating.

I agree with Hacker, Krugman, Kitzhaber and Feld that we need major reform. Reform requires more money and the will to offend powerful interests.  We must begin with priorities. Our political system is broken. State and national legislators provide goodies to every special interest group.  That’s how they stay in office. We spend far more money on militarism than most people realize. Check http://www.warresisters.org  the claim that more than half of our federal budget goes to military expenses

Many diaries have touched on Clinton's red phone ad. The media responded (they are much more interested in ads than discussion of complex issues). It surely influenced some voters. Ads distort reality, like any work of art. Ads are works of art; all art appeals partly because it distorts the factual world, think of El Greco and his long faces. El Greco sought to express ideas and promote himself, whereas ads usually promote corporate or other special interests. The red phone ad triggers many memes (1)- we’d all like a wise and powerful parent watching over us, hence religion, and we all want protection from evildoers, hence guns, police and armies. Works of art can be interpreted at multiple levels. Race and class influence almost everything. Do most white Americans think of “uppity blacks” when they see the ad? Probably not. Do they think “strong military, quick response”? Maybe. Does it distort their judgment? It tries to.

The ad evokes the meme of the President as Lone Ranger, springing into vigorous manly action on hearing of threats or evil-doing anywhere in the world.

1. What American actions are you proud of?

2. What American actions are you ashamed of?

3. Can we hope to get out of this mess without facing up to Congressional corruption?

4. Why aren't the Presidential candidates asked to defend their earmarks in the debates?

I am proud of some things that my country has done, mostly non-military, such as the Marshall Plan and Tsunami relief. We did the right thing in Korea, the wrong thing in Vietnam.

I am ashamed of some things that my country has done, such as the trail of tears, which betrays the claim that we are a country of laws and not men. The Supreme Court ruled against Andrew Jackson and his land speculator friends; President J said, “John Marshall has made his decision; now let him enforce it!” Ralph Waldo Emerson and others in Massachusetts who became anti-slavery activists spoke up against Cherokee removal.

Things can go wrong after you get health insurance
The doctor-insurer interface is harsh, it wastes time & money
Insurers are often penny wise and pound foolish, including public programs

I review four scrapes from the first 2 weeks of the New Year.

1. A girl (E) discharged from our hospital after surgery for a brain tumor (craniopharyngioma) was readmitted for avoidable dehydration. Surgery injured the pituitary and hypothalamus, leaving her dependent on replacement hormones. However, she ran out of an important hormone, ddAVP or desmopressin.

What happened? ddAVP was a nasal spray. Mother ran out before the month was up. The pharmacy told her that they could not give her any more medication for 6 days. Lack of medication caused excessively dilute urine, dehydration and an expensive hospitalization. MediCal (Medicaid) pays for only a 30-day supply. The pharmacy had three choices- 1. Give her some of this expensive medication and lose money (at least $100), 2. urge mother to call the child’s physician immediately (that might not have worked as mother met many different specialists while hospitalized and had no idea who was in charge). 3. throw up their hands and say “we’re sorry”. They choose #3.

Stock markets are crashing around the world. We are in a serious recession. Look at food prices and then look at the Government inflation index. Food prices have been rising like hot air balloons, whereas the Government statistics are hot air of another kind. The CPI is bogus. Please visit www.shadowstats.com. You’ll see that this distortion of government statistics began in the 80s and accelerated during the Clinton Presidency. It minimizes inflation (saves money on social security) and exaggerates the growth in GDP (looks good).

Our government spends trillions on warfare and military toys. What’s the point of sending warships into the Persian Gulf if not to provoke trouble? Nobody claims that Iranian ships are preparing to attack the United States. There was a time when Congress  decided whether an incident or attack justified going to war. Today, the Decider decides whether to declare war. Congresspeople keep their heads down. They don’t dare ask what is going on in the Persian Gulf.

Words are tools, which may be misused. You can’t run an organization without words. Corporations spend lots of money trying to find convincing mission statements, and so do politicians. The US of A faces many serious problems- problems without easy solutions. We see words posing as solutions- the FDA was quick to appoint a czar for safety of imported foods this spring, but it turned out that the czar had no budget, i.e. he was a symbolic gesture.

Their minders tell politicians “Whatever you do, don’t make important people or interest groups mad”. Speaker Lousy has some good points, not limited to the fact that she’s our first female Speaker. She avoids decisive action until its success has been established by multiple polls and focus groups. She speaks often about the Iraq fiasco, Congressional corruption, etc but ventures nothing. David Betray.US is a studious fellow, much admired by reporters, legislators, etc. They say that he's another U.S. Grant. He stepped up to the plate with an important Washington Post Op-Ed on September 26, 2004 telling the public that things were looking up in Iraq, helping his patron win the 2004 Presidential election.

Senator Russ Feingold, a respected and decent man, wants to censure the President (http://www.dailykos.com/story/2007/7/22/1077/74921). Only one President has been censured in 200 plus years and that accomplished absolutely nothing. That guy is on the $20 bill. There was a time when I thought voting out the Republicans would resolve most of our important problems. I no longer think so. I don't believe that we can get our troops out of Iraq and stop killing people without diplomatic efforts that Bush, Cheney and Rice will never make. Do we keep on killing and spending billions, do we wait until polls tell us that impeachment is guaranteed to be successful?

My friend AR is 63 years old, divorced and in a hole. Always overweight, like her parents and brother, she had a big stroke 3 years ago, which left one side of her body poorly functional. Her mental ability is OK. Her employer kept her on for a while, but she couldn’t do much and was eventually laid off. She’s on SSI and social security, living alone, using a motorized wheelchair to get around. She hasn’t done well- she could walk 60 feet slowly 18 months ago when employed, now she can barely do 6 if she gets herself upright. She’s on a lot of medication Coumadin, 2 antihypertensive drugs, medication to help her sleep- the medicines probably contribute to her poor function, but  being alone, eating more than she should and lack of exercise are the main factors IMHO. She doesn’t even cook.

AR fell 2 weeks ago, leading to hospitalization. Now she’s in an extended care facility- skilled nursing home for ‘rehabilitation’. She gets about 45 minutes of physical or occupational therapy 5 days a week. She can’t get herself out of bed and at night the facility has only one person in the building. They put on diapers on AR and all the other inmates, except for a handful who can get themselves out of bed safely without assistance. This is psychological abuse.

Michael Vlahos, no leftist, tells us how much America has lost in the post 9/11 debacle:

1. The world assumed that American power was totipotent- when we projected our shock and awe into Iraq with such disastrous consequences, others saw how limited our power was - we could kill but we couldn’t build or control. The failure of the Bush-Olmert Lebanon shock and awe invasion reinforced this. Likely future Israeli attacks into Gaza will increase the disconnect.

2. Foreigners trusted America in 1950 - we were the free world. We rebuilt the countries defeated in World War II, lifted them up. We promised to rebuild Iraq and Afghanistan. What a cruel joke, as we rain death and destruction from the skies onto the people and countryside of Iraq and Afghanistan today. When our bombs kill children, we blame  the insurgents - they surround themselves with women and children. Why don’t they fight fair? Foreigners see it differently-  the American government and the American military are like Samson pulling down the temple on top of himself.

We've got a lot of problems. Some are worsening. We can't leave things up to the Prez who says - "We must win in Iraq for the security of Western civilization".  Iraq is a big problem:
a. We never finished the job in Afghanistan
b. The world's most powerful military creates more terrorists than it kills
c. Our government has serious financial problems- we can't afford to spend 3-4 billion dollars a week in Iraq. We are neglecting human needs and investment for the future.

Our troubled world needs historical perspectives. Sparta offers a good perspective. The Spartans were ferocious and well-disciplined fighters. Some know that 300 Spartan fighters were the core of a Greek force that held off a much larger Persian army at the famous battle of Thermopylae in 480 BC. The much larger Persian force eventually overcame them, but their heroic stand, somewhat like that at the Alamo, became a legendary event, and stimulated a subsequent victory against the powerful Persian empire. Fewer know that Spartan power, like that of the Confederate South, rested on the exploitation of a more numerous slave class, the Helots. The Spartans defeated the Athenians in the Peloponnesian War, but fell when the Helots, first the Messenian Helots and later those from Laconia overthrew their masters and ended the Spartan era.