Opinion
It's no secret that our older population is increasing in size, and living longer. That means more of us are going to develop chronic conditions of some sort and need more medical care, probably some stays in nursing homes.
At last Tuesday's Board of Supervisors hearing on Sutter Lakeside's plans for change, we heard medical director Dr. Diane Pege say that medical care has changed radically. Because of the near-miraculous nature of today's medical technology, operations which used to require several days hospital stay now are outpatient surgery. You're in and out on the same day, with no need for heavy duty nursing care.
But if you live alone, as more of us do now, you may not feel able to go home and back to fully taking care of yourself – shopping, cooking, bathing, dressing. A convalescent home could be just the ticket.
But will we tolerate the typically awful food of nursing homes? The constant blare of competing television sets from every room? The distressing and rather frightening presence of mentally ill patients mixed in with those who only have a broken ankle?
Probably not. At the Tuesday hearing, Sutter Lakeside CEO Kelly Mather said chronic conditions are the big problem, and full hospital care for most of them is just too expensive, and unnecessary.
Time for some change
We're in a transition stage, and those are always uncomfortable. It's a relief to know that Sutter Lakeside has been working to upgrade the standards at a local nursing facility. We certainly need a new model. Many convalescence periods don't need fancy machinery or 24-hour nursing, just a cheerful setting, a little peace and quiet, maybe some intensive physical therapy, at which Sutter Lakeside excels, and which they can certainly provide in a less expensive setting.
There are serious questions about why hospital care and insurance are so expensive, and why insurance is so complicated. The hospitals didn't create that situation. They buy expensive technology because we want all the latest gadgets, just as we want prescriptions for all the latest drugs we see advertised on television. Insurance is a world unto itself, which many legislators have allowed to run wild as the campaign contributions roll in. Those are issues to deal with on a political level.
On a personal level, we need to examine our assumptions. Is a high-tech hospital the only place for long-term recovery, or the best place to give birth or to die?
Maybe not.
Sophie Annan Jensen live in Lucerne.
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- Written by: Sophie Annan Jensen
To begin, there is the Patriot Act, which made vast inroads to whatever privacy we thought we had. Also, dozens of U.S. Supreme Court decisions (since the Warren Court of the sixties) have been chipping away Fourth Amendment protections in the criminal context, mostly because the justices are loath to let suspected criminals go free because of an illegal search. There are exceptions, of course, but the overall effect of recent Supreme Court decisions has been to vastly expand the circumstances in which the police may search without a warrant.
Whatever the state of the law in our criminal courts, the federal executive branch will use whatever technology is available to ferret out the “enemies of the state,” with or without judicial permission. Our national budget allots many billions of dollars to the National Security Agency (NSA), the agency responsible for monitoring the electro-magnetic spectrum, and we the people haven’t a clue as to how the money is spent under what’s known in Washington as a “black” budget. We can rest assured, however, that the NSA is hard at work to make sure it has access to every communication that occurs in or out of the U.S, save only those disseminated by carrier pigeons (and who really knows about them).
By their nature, civil libertarians oppose the proposition that the executive branch can, without a warrant, legally intercept any and all communications – domestic and foreign – if it (in its executive wisdom) thinks terrorists are somehow in the mix. Unlike the FISA, which required judicial approval of wiretaps, the new version of the PAA advanced by the senate, and sponsored by Senator Jay Rockefeller, makes the government the sole arbiter of whether any particular communication qualifies for warrantless surveillance. This, in the opinion of the ACLU and other similarly-inclined organizations, clearly tramples on the checks and balances inherent in our constitutional form of government. And in doing so, the legislation obliterates our Fourth Amendment protection against unlawful search and seizure. Who can argue with that?
Not me. But I don’t much give a damn. Most of my adult life I’ve assumed that the government is listening in to my calls and emails. And why not? In the 1960s, we were convinced that the FBI or the local cops had taps on our phones, tape recorders in our meetings, and cameras trained on our protests.
Whether this was because of our political activities or illegal drug transactions (consisting primarily of buying and selling bad Mexican marijuana in matchboxes), our sense of self-importance led us to believe we were the center of a law enforcement campaign to put us away for years if not decades. When using the phone we were very careful to speak in what we hoped was undecipherable code, whether about a particular drug transaction or experience, or about plans to engage in civil disobedience. We never doubted that eager law enforcement ears were just waiting for the right words to launch a bust.
Now, of course, we are much wiser. We know there are only so many hours in the day and the government can only listen to so many conversations in real time – and that ours were and are probably not among them. But the point is, we always assumed we had no privacy when using telephonic communications or engaged in civil rights activity or protests against the Vietnam war. This wasn’t paranoia, but rather an understanding that the government had the capacity to listen in, and watch, if it wanted to. And we were pretty sure it did.
Also, back in the 60s, we always assumed the government could get a warrant if it wanted one, and that the only protections we had under the Constitution were if they busted us and we could prove in court that they somehow screwed up the warrant process. As a latter day criminal defense attorney, I’m of the opinion that the warrant requirement didn’t (and doesn’t) provide much protection. There are numerous loopholes in the warrant requirement itself, and even when one is technically required under current case law, most judges rubber-stamp the applications submitted by the police, and most trial judges uphold warrants issued by their brethren no matter how flimsy the factual basis put forth in the supporting affidavits. There are exceptions, of course, but as the old bromide goes, the exception proves the rule.
There also have been rare instances when the ACLU successfully sued transgressing government agencies for Fourth Amendment violations. For the most part, however, there has been little or no accountability for illegal surveillance that does happen to come to light. The only real accountability for a Big Brother administration is regime change, and even then, the new government will be just as likely to spy on its (or America’s) perceived enemies as the last regime. My reading of history is that the level of government surveillance never goes down regardless of who is in power.
In a democracy we theoretically could bring the government to heel on these privacy concerns if, as a people, we were more concerned about privacy. But the fact is, we don’t really hold privacy in high regard no matter how we respond to the polls. We are, in fact, addicted to gossip (something common to the entire human race and thought to be the reason we have speech in the first place), and a large part of our entertainment is based on privacy violations of one type of another. It would be nice if we could distinguish social privacy from privacy against government intrusions, but that doesn’t seem likely. Our lives are laid bare to the world, and we rather get off on it.
In summary, since we don’t have much if any privacy in the first place, we shouldn’t worry about what powers the government has under the FISA act, or its amendments and provisions. If you want your communications to remain confidential, stay away from the telephone or figure out a code that is unlikely to trigger the government computers to alert their minders that the conversation warrants further processing. The government has been Big Brother for a long time and, as in 1984, little brother ain’t coming back.
Attorney Steve Elias lives in Lakeport.
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- Written by: Steve Elias





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