Grassroot Perspective – July 30, 2003-Liberal ‘Compassion’; How do socialists spell relief”? F-R-A-U-D; Today’s Magicians; The Wrong Question; Non-Participation is Better; Opting Out is Wonderful; Who Are the “Bad Docs”?; Loss of Centerline Light Rail and 176 Others Would End Transportation Aid From Washington”

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“Dick Rowland Image”

”Shoots (News, Views and Quotes)”


– Liberal “Compassion.” As government-provided “free” medical care
threatens to bankrupt the county, and the State of New York doesn’t have
the money to pick up the tab, “Sen. Clinton Pushes for Medicaid Relief,”
according to the Post- Journal headline (10/19/02) from federal

When will this formula for election success begin to break down? When
the public begins to recognize that the “other people” paying the taxes
are all of us. The leftist claim of compassion is nothing more than a
promise to spread the misery. When there aren’t enough other people to
spread the costs to, the socialist myth of free stuff to all will be

– How do socialists spell “relief”? F-R-A-U-D.

By Lawrence R. Huntoon, M.D., Ph.D., Jamestown, NY

– Consumer Choice for the Poor? If being poor means that people can’t be
trusted to make the “right” decisions, say about medical care, what
about those at 150 percent or 200 percent of poverty? And should they be allowed to
climb mountains, a hobby with a high fatality rate? Or to stay on their
farm and continue working with large, potentially dangerous animals?

If poverty makes one incapable, why doesn’t the state make decisions for
college students, who are known to make bad decisions about all kinds of

What about those of us who are descendants of poverty-stricken
immigrants? Should we have been wards of the state?
Linda Gorman, Englewood, CO

– Today’s Magicians. Lawyers have a way of altering reality or intent by
redefining words. For example: the Framers recognized that government
power is restricted to the extent that property is private. So leftist
lawyers turned the concept on its head by creating public-private
partnerships in order to regiment society. Such lawyers are like the
sorcerers of yesteryear who sought answers through magic words rather
than the application of reason.
Robert P. Gervais, M.D., Mesa, AZ

– The Wrong Question. Legislators are trying to design a prescription
drug benefit that will not have disastrous effects, as on new drug
development. But instead of asking how to amortize the costs of research
(or shift the cost of prescriptions), we should ask how to lower costs.
Essentially, the answer has to do with the role of the FDA. And
remember, the largest cost of the FDA is not denominated in dollars but
as the opportunity cost of drugs that are never brought to market, or
brought to market decades too late for patients who might have benefited
from them.
Gerry Smedinghoff, Phoenix, AZ

– Non-Participation is Better. My impression is that the government has
less respect for participating physicians, and treats them as their
workers. The government also has a political fear of angering a large
constituency of senior citizens. Thus, having the senior squarely
situated between the government and the physician is the safer way to
Alieta Eck, M.D., Somerset, NJ

– Opting Out is Wonderful. When Medicare became a reality in the mid
1960s, I initiated my own “medicare program,” which called for a $50 per
year deductible followed by a 20 percent charge for all patient services. Not
only were my patients happy with my plan, but I probably lost little or
no income and filled out no Medicare papers.

After my anesthesia residency (1973-75), I went into a group practice in
which a high percentage of patients were over the age of 65. During that
time, I billed Medicare, as was the common practice. However, by 1997, I
became so disenchanted with Medicare that I decided its constraints far
outweighed the paltry financial returns and began the opting-out
process. I have continued to treat Medicare patients without charge. I’m
in my fifth year of being opted out; I couldn’t have made a better
choice. My advice: try it you might like it.
Donald R. Salmon, M.D., Las Vegas, NV

How I Got Out of HIPAA. I told my billing agent to press the “print”
button instead of the “send” button. He now mails the bills. It costs
less. There has been a slight delay in payment, unworthy of
consideration. If your attorney does not know how to advise you, get
another attorney.
Samuel A. Nigro, M.D., Cleveland Heights, OH

– Who Are the “Bad Docs”? The statement, as by Public Citizen, that the
bad doctors are the problem with liability insurance premiums gives me
comforting reassurance. Family doctors, pediatricians, and psychiatrists
are the good doctors. Neurosurgeons, orthopedists, and obstetricians are
the bad doctors. How do I know? The former, my group, pay the lowest
rates; the latter, the highest.
James Pendleton, M.D., Bryn Athyn, PA

– Hourly Wages. In discussions about the professional liability crisis,
physicians may feel uncomfortable discussing their income, which may
remain in the six figures. I suggest converting it to an hourly wage. If
I use time and a half for overtime, my hourly wage by the end of 2002
dropped to $17- $18/hour, substantially less than I must pay my nurse to
compete with other available opportunities. If I say $120,000, most
people assume that is $60/hr.
L.L. Penney, M.D., Columbus, MO

Above articles are quoted from Association of American Physicians and
Surgeons, AAPS News May 2003

”Roots (Food for Thought)”

SCAG: Federal Funding Guillotone Threatens Los Angeles

– Loss of Centerline Light Rail and 176 Others Would End Transportation
Aid From Washington

By Wendell Cox

Truth in Advertising: Double Standards: What if a major drug
manufacturer placed commercials on national television touting its
latest product as immunizing users from SARS? And, what if, like the
peddler’s elixirs sold from medicine wagons when trolleys were new, the
claims were patently false and misleading? Surely, the Food and Drug
Administration would ban the advertisements. Depending on the gravity of
the situation, even stronger sanctions might be applied. Similarly, if
Wal-Mart were to advertise that $10 would buy all of your 177 favorite
music CD’s, then sold them instead for $10 apiece, regulatory
authorities would rightly take quick action.

But when public officials engage in deceptions the equivalent (or worse)
of those prohibited in the private sector, no one notices. It isn’t even
illegal. Take for example the case of the proposed Orange County,
California “Centerline” light rail project that city of Irvine voters
recently turned down. (1)

Two days after the election, Mark Pisano, long-time executive director
(he was there when I was appointed to the Los Angeles County
Transportation Commission in 1976) of the Southern California
Association of Governments (SCAG) told the Los Angeles Times (2) that
the Regional Transportation Plan had been “counting” on Centerline,” as
well as other projects,” to help meet deadlines imposed under federal
air quality regulations. SCAG is the metropolitan planning organization
for the Los Angeles area. Mr. Pisano went on to say that, if the air
quality regulations are not met, Southern California could lose up to $8
billion in federal transportation funds. Unidentified “regional
planners” told the Times that if the Centerline light rail project is
shelved “something must replace it to keep the area in compliance with
federal requirements to reduce air pollution and traffic congestion.” (3)

It is assumed that Mr. Pisano and the other planners were quoted
accurately by the Los Angeles Times, which seems a fair bet unless NYTS
(New York Times Syndrome) has struck the media outlet that, until
recently at least, liked to fashion itself as the “grey lady” of the
West. One can only sympathize with the plight of the planners and the 15
million other South Coast Air Basin (4) residents who face the nation’s
worst traffic congestion, and whose interests appears to have been so
callously disregarded by the presumably selfish voters of Irvine.

What the Data Shows: To better comprehend the magnitude of the affront,
I went to the Southern California Association of Government’s “Regional
Transportation Plan” and the US Federal Transit Administration “New
Starts Report.” The Regional Transportation Plan contains estimates on
air pollution emissions in the area and projections on how well the area
will do in the future in meeting the federal requirements. The New
Starts Report provides detailed information on the Centerline light rail
line and its projected air quality benefits.

Both the SCAG and FTA sources report two pollutants (Nitrogen Oxide or
NOx and Carbon Monoxide or CO) in common for 2020, which is also the
only common year (Table). A review of the data indicates that any
sympathy is misplaced and that any “callous disregard” applies to the
public officials who appear to have misled, rather than the voters of
Irvine. Indeed, the data suggests that the voters of Irvine heroically
cut through the smog of public deception to make a decision that will
leave their community a better place to live, while more wisely
allocating scarce public resources (something that apparently violates
the instincts of at least some of their public servants).

South Coast Air Basin: 2020 Daily Air Quality Requirements and Plan
Factor NOx
Tons/Day CO
EPA Maximum Allowable Emissions 277.77 1,623.35
Emissions with Full Implementation of Regional Transportation Plan (RTP)
— Includes Centerline 237.92 1,515.62
Difference: Amount by Which RTP Emission Estimates could Increase before
Equalling Maximum Allowable Emissions 39.85 107.73
Centerline Light Rail Contribution 0.18 0.61

Regional Transportation Plan without Centerline Light Rail 238.10

Centerline Contribution % 0.44% 0.57%

Centerline-Equivalent Projects to Equal Difference 227 176

South Coast Air Quality Basin Information from SCAG Regional
Transportation Plan: Appendix H
Centreline Light Rail contribution information from 2002 FTA New Starts
Report (annual figure divided by 365), page A-327.

Nitrogen Oxide (NOx): FTA reports that Centerline will reduce
daily NOx emissions by 64 tons per year in 2020, (5) or 0.18 tons per
day. SCAG forecasts that total NOx emissions (summer) in the South Coast
Air Basin will be 237.92 tons per day in 2020, 39.85 tons below the EPA
limit. In other words, the loss of Centerline would reduce the region’s
safety margin by less than one percent — 0.44 percent to be exact.
With the Centerline light rail project, the South Coast Air Basin would
emit 237.92 tons of NOx per day. Cancellation of the project would raise
NOx emissions to 238.10 tons (Figure 1), still leaving a safety margin
of more than 39 tons before non-compliance would occur. The planners’
hysteria seems a bit premature. They’ll have a real crisis when another
226 projects contributing the same air pollution reduction as Centerline
are also canceled (“Centerline-equivalent” projects). That’s what it
would take, according to SCAG estimates and the data that the Centerline
light rail developer (Orange County Transportation Authority) has told

Figure 1 (Note 7)

Sources: SCAG and FTA

Carbon Monoxide (CO): FTA reports that Centerline will reduce
daily CO emissions by 224 tons per year in 2020 (5), or 0.61 tons per
day. SCAG forecasts that total CO emissions in the South Coast Air Basin
will be 1,515.6 tons per day in 2020, 107.7 tons below the EPA limit. In
other words, the loss of Centerline would reduce the region’s CO safety
margin less than one percent — 0.57 percent. With the Centerline light
rail project, the South Coast Air Basin would emit 1,515.6 tons of CO
per day. Cancellation of the project would raise CO emissions to 1,516.2
tons (Figure 2), preserving a safety margin of more than 107 tons before
non-compliance would occur. But, it must be admitted that doom will loom
quicker in CO than NOx — the margin of error for staying within the
federal air quality requirements drops to 176 Centerline equivalent
projects from 226. Still, there are probably more pressing problems on
the political agenda of Southern California. One can only hope that SCAG
and the other local Cassandras have not begun spending tax money on an
expensive Washington lobbying effort to obtain an extension for
complying with federal air quality standards.

Figure 2 (Note 7)

Sources: SCAG and FTA

What They Should Have Said: An accurate characterization of a Centerline
light rail cancelation would be that “the Regional Transportation Plan
was counting on at least 177 Centerline-equivalent projects, and that
the loss of 176 more Centerline-equivalent projects could place the area
in jeopardy of losing federal transportation funding.” But instead, the
public was led to believe, by people whose job is to be their servants,
that the loss of this project will have serious consequences, and that
“something” will have to replace it to keep within federal requirements.
Nothing could be further from the truth. Nothing needs to be done to
replace the Centerline light rail project, because with or without it,
the South Coast Air Basin will be in compliance with federal regulations
(according to the very same Southern California Association of
Governments’ Regional Transportation Plan). Any way you look at it,
Centerline just doesn’t do that much.

Skyscrapers for a Family of Four: But there are ways to replace the
contribution of Centerline and at a far lower cost. Air quality expert
Joel Schwartz says that “building light rail to reduce air pollution is
like building a skyscraper to house a family of four.” He estimates that
a “gross polluting vehicle” scrappage program (government purchase of
highly polluting cars) would eliminate as much air pollution for no more
than one percent of the cost of the Centerline light rail project.
Indeed, owners of the purchased gross polluting vehicles in Orange
County could be given a $15,000 grant to buy a new car, however modest.
And there still would be enough money left over to buy $15,000 cars for
more than 20,000 of their closest acquaintances. (6) In fact, it is
hard to imagine a more expensive way to improve air quality than the
Centerline light rail project.

Local “Leadership” and Washington’s Distorted Incentives: It is fair to
ask how such an expensive and ineffective project could proceed so
far in the public planning process. Part of the problem is a federal
transit program that encourages local governments to raise local taxes
to attract federal funding for rail lines that do virtually nothing to
reduce air pollution and traffic congestion. Another is the
“infrastructure envy” (the Freudian term) that afflicts starry-eyed
local politicians who’ve never seen a public works project they didn’t
like, especially when someone else is paying. This looniness will
continue so long as the federal government treats taxpayer expenditures
for transit like a hyper-inflating third world currency.

The Mayor and Public Policy Cacophony: Irvine’s Mayor is a case in
point. Having led a well financed campaign that outspent opponents 10 to
one, His Honor told the Orange County Register “It’s about learning and
listening . I expect we will . continue to explore light-rail
alternatives.” Irvine resident Joseph Vranich, who fought to save
Pittsburgh’s trolleys while living there, author of Supertrains and
former member of the Amtrak Reform Council thinks the Mayor has not yet
begun to learn. “My view is that Mayor Agran’s support of a mindless
transportation project that leaves our roadways just as congested makes
Nero’s fiddling during the Rome fire look responsible,” said Vranich.

Urban Rail and Traffic Congestion: Unrelated Subjects: Regrettably, it
is not unusual for public officials to make mountains out of the
molehills that masquerade as urban rail benefits. Go to any metropolitan
area conducting a rail referendum and you’ll find the rail cheerleaders,
from mayors, to planning officials and downtown business interests,
claiming that the latest iteration of their trolley plan will reduce
traffic congestion and air pollution. At least they say that until Tom
Rubin, Randal O’Toole or I come to town to show that the very taxpayer
funded reports commissioned by the same interests predict no such

“Hawking” Swampland: Drug firms can’t mislead and get away with it for
long. Truth in advertising laws now protect people from unscrupulous
used-car salesmen. But the public remains subject to deception by too
many government officials whose moral compasses appear to have been
obtained (doubtless at public expense) from the swampland real estate
agents who have so mercifully been run out of business.

Transitioning to Democracy: Over the last few centuries, much of
humanity has progressed from absolutism and tyranny to what Abraham
Lincoln called “government of the people, by the people and for the
people.” All of government, that is but government itself. Too often,
and especially when serving in their treasured role as brokers for the
lastest spending scheme, government officials act with an arrogance that
would be the envy of George III’s agents on the eve of the Boston Tea
Party. Government, and its officials, should live by the same standards
as it rightly imposes on people and businesses. The present federal
transit reauthorization process is a good opportunity to take away the
vestigial “divine right” of government officials who mislead the public.
Congress should enact a Truth in Transit Advertising Act. It would be


(1) The June 3 city of Irvine contained two light rail issues.
Proposition A, which was defeated 52% to 48%. Proposition A proposed a
specific route for light rail. Proposition B, which would have banned
all future routes, failed 48% to 52%. While losing, support for
Proposition B was surprisingly high because of its blanket prohibition
of all routes. Electorates rarely bind their public officials to such an

(2) “O.C.’s Train Didn’t Come In,” June 5, 2003.

(3) This author is unaware of any federal mandate with respect to
traffic congestion reduction.

(4) Generally, the Los Angeles-Orange County and Riverside-San
Bernardino urban areas.

(5) This is considered a very optimistic figure. It is likely that the
ridership projection for this project, as in the case of so many light
rail projects in their early stages of development, is much higher than
what will be realized. As a result, the pollution reduction impacts are
likely to be similarly overstated.

(6) Since the FTA report, the Centerline light rail project has been
significantly scaled back, however FTA has not published new air quality
data for the smaller project. If the data for the current project were
available, the air quality impacts would presumably be less, fewer cars
would need to be scrapped to achieve the same air quality benefit and
fewer new cars would be funded for acquaintances.

(7) Currently available charting software cannot portray differences as
small as the “with” and “without” Centerline light rail data.


Wendell Cox is a transportation and demographics consultant and a public policy commentator. He is principal of Wendell Cox Consultancy in the
St. Louis area. He also serves as a visiting professor at the
Conservatoire National des Arts et Metiers in Paris. Los Angeles Mayor
Tom Bradley appointed him to three terms on the Los Angeles County
Transportation Commission (1977-1985), during which time he was elected
to chair the American Public Transit Association Policy and Planning and
Governing Boards Committee. In 1999, Speaker of the United States House
of Representatives Newt Gingrich appointed him to the Amtrak Reform
Council, to fill the unexpired term of New Jersey governor Christine
Todd Whitman.

”Evergreen (Today’s Quote)”

“Prices are important not because money is considered paramount but
because prices are a fast and effective conveyor of information through
a vast society in which fragmented knowledge must be coordinated.”
— Thomas Sowell

”’Edited by Richard O. Rowland, president of Grassroot Institute of Hawaii, 1314 S. King Street, Suite 1163, Honolulu, HI 96814. Phone/fax is 808-591-9193, cell phone is 808-864-1776. Send him an email at:”’ ”’See the Web site at:”’