Friday, December 31, 2004

Frist in the Hearts of His Countrymen

Jay Leno Quote
"Senator Bill Frist's son, William Frist Jr., who is a student at Princeton, was arrested this week in New Jersey for drunk driving. A very serious charge. So let's see, he's got the same name as his father, who is a powerful Republican leader, went to an Ivy league school, got arrested for drunk driving. You know what that means? He could go on to become president of the United States." —Jay Leno

Thursday, December 30, 2004

And how are you, little brother?

Deja Vu Already?

Candidate in Wash. Gov. Race Seeks Revote

Thu Dec 30, 4:59 AM ET

By DAVID AMMONS, Associated Press Writer

OLYMPIA, Wash. - Edged out of the closest governor's race in state history, Republican Dino Rossi urged his opponent to accept a revote, saying the uncertainty surrounding the back-and-forth election was bad for the state.

I can think of some other States and other Years...

Wednesday, December 29, 2004

Kicking and Screaming

The news conference was Bush’s first public statement since the tsunami struck on Sunday, and came after critics faulted the president for not interrupting his vacation at his Crawford ranch to talk in person about the disaster.

Only three days late. Where's the money coming from? Social Security?

Just a Little Testy?

Just in:
In his first remarks since the weekend disaster that so far has killed more than 76,000, Bush — like some in his administration previously — took umbrage at a U.N. official's suggestion that the world's richest nations were "stingy," and indicated much more is expected to be spent to help the victims.

The Tsunami Inaugural

Washington, DC, Dec. 10 (UPI) -- The inaugural committee for U.S. President George Bush is looking to raise more than $40 million -- a record price tag for the event

The United States is planning to add an extra $20 million to its initial Asian earthquake relief package. That would more than double the $15 million package the U.S. announced Monday, one day after the world's biggest earthquake in 40 years.

Any comment on this would detract from its poignancy

Friday, December 24, 2004

On Medicine

By all accounts we have a crisis in the medical world here in Maryland. This takes various aspects, but the most immediate is a sharp increase in the number of physicians who are either retiring early, leaving the State, or restricting their practice. All of this is principally due to a dramatic increase in the malpractice insurance premiums. Some obstetricians now have yearly costs of over $100,000 just for this malpractice insurance.

To be honest, this is just the tip of the iceberg. There is a myth that is circulating that if only the Governor (a Republican) and the chief legislature figures (Democrats) can agree on a "fix" that everything will be fine in medicine. It won't. And it won't for a number of reasons.

To understand what kind of a mess medicine is in at this time one needs to go back 30-40 years. Medicine was much different then. For instance, when I rotated as a student at D.C. General Hospital (since disappeared), I.V.'s were still started with hypodermic needles which were reused (after sterilization). There were no I.V. pumps and one regulated the flow by counting the "drips." Interns determined sugar levels themselves in the laboratory and we plated cultures of spinal fluid and blood. Blood counts were done by hand and a Coulter Counter was an experimental machine. Most dramatically, there was no CAT scanners and if one wanted to know if there was something in the brain, one had to do a pneumoencephalogram which involved injecting air into the spinal column giving the world's worst headache. Needless to say this was a last resort.

I encountered the same level of technology ten years ago when I visited a children's hospital in Siberia. While the level of expertise (book learning) was very high there, the instruments available for diagnosis and treatment, including pharmaceuticals, were dismal.

Fast forward to December, 2004. Medicine has entered an era of rocketing technology. It is said that knowledge doubles every ten years. I believe it. But it is hard to say whether technology "doubles" since the difference between a pneumoencephalogram and a CAT scan or MRI scan cannot be measured. Particularly with respect to patient comfort.

In spite of all this advancement (and we should probably talk about the pharmaceutical side of it at length), there are still certain areas that cannot be totally automated. One of this is childbirth. Although ultrasound has revolutionized the prenatal diagnosis of abnormalities, it can do nothing to fix them. Up to five percent of all births will have an abnormality.

Birth abnormalities are rarely the result of obstetrical error.

Let me repeat, birth abnormalities are very, very rarely the result of obstetrician error.

So, we have a heady mix. We have expotentially increasing levels of knowledge (a level in 1960; twice that in 1970; four times that in 1980; eight times that in 1990 and 16 times that in 2000), escalating technology, and a pharmacopeia that promises a cure for every little thing that afflicts you. (I am reminded by the availability in the South 20-30 years ago of a homeopathic remedy called Doan's pills. There were apparently 100 different pills. If you had a hangnail, you used pill number 46; forlorn love was pill 52; etc.).

Enter the mere human, which is all that a doctor is. There is absolutely no way that mere humans can encompass the full gamut of this knowledge and technology. But doctors are expected to know it all. And, to be truthful, we sometimes pretend that we do. What are we supposed to do? Say we don't know everything? Since everything is out there, we would soon be without patients. We have to hope that what we do know approximates the problem that we are facing.

With all of this technology out there, if something goes wrong, someone must be blamed. And that someone is a doctor. Since there are always going to be bad outcomes in certain pregnancies, there will always be disasters, no matter how advanced the knowledge and technology. And humans being what they are, they will always seek to attach blame for bad outcomes. Particularly when there is a million dollar reward for making it stick. Its the American way.

It is interesting that American society can be so hypotcritical about assigning blame. God knows that there have been mistakes made. Obstetricians invariably get sued for bad outcomes but Donald Rumsfeld hasn't been sued for screwing up Iraq. Kenny Boy Lay is still at large having bilked millions of dollars out of a lot of innocent people. Johnny Depp doesn't get sued for acting in "The Secret Window."

One of the differences is that the mechanism for suing a doctor has been honed to perfection. It costs the family nothing to sue an obstetrician for the birth of a child with cerebral palsy even though the overwhelming majority of times this is not the fault of the obstetrician (there are cases where it is; these are legitimate and there should be consequences). As the case goes forward, the physician is put under tremendous duress: his or her competence is questioned, citations go into a national data bank never to be erased, even if the suit is shown to be trivial. And, most importantly, lawyers and expert witnesses make a lot of money.

If the suit gets to the point of a jury trial (most never make it; many times the physician gives up and settles out of court just to avoid the hassle), you have 12 people who are not familiar with all that knowledge and technology trying to decide if a mistake was made. It is hard not to make that decision in favor of the plaintiff when presented with an unfortunate child who is physically and mentally handicapped. Your intuition tells you that somebody is to blame. The doctor is the only somebody available. The result is well known; multimillion dollar settlements with the plaintiff's lawyer taking his 40%.

That money has to come from somewhere. That somewhere is other physicians via the mechanism of increased fees for medical malpractice. As stated above, the current fee in Maryland for an obstetrician is over $100,000 a year. One doc told me he would have to work until August just to pay his malpractice.

I can assure you that doctors do not get a break on rent for their offices, cost of electricity, cost of equipment, and, most of all, cost of their employees (including their employees medical insurance if they pay it).

Thus the crisis.

All of this said, I have no solution whatsoever. To me it is as intractable of solution as gravitational relativity was for Einstein. I expect that it will get a lot worse before it gets better. But people should realize that physicians are human too. Furthermore, if you grind physicians into the dirt, if you strip them of their aura, if you do not respect them as healers, it will only come to rebound on yourself.

People shout out "Physician Heal Thyself!".

They will shortly be faced with healing themselves.

Tuesday, December 21, 2004


It is appropriate at Christmastime to focus on children. Unfortunately, many children in the World are in very desperate straits:
Globally, an estimated 12 million children under the age of five die every year, mostly of easily preventable causes.
Some 130 million children in developing countries are not in primary school and the majority of them are girls.
About 160 million children are severely or moderately malnourished.
Some 1.4 billion people lack access to safe water and 2.7 billion lack adequate sanitation.
Some States are moving toward increasingly punitive systems of juvenile justice, with children beaten and arbitrarily detained by police and forced to share prisons with adults in inhumane conditions.
Many unwanted children languish in orphanages and other institutions, denied education and adequate health care. These children are often physically abused.
An estimated 250 million children are engaged in some form of labour. There are few examples of systematic actions to end child exploitation that are sensitive to children's needs.
Armed conflicts around the globe continue to shorten and ruin the lives of millions of children. Last year, about 300,000 children served as soldiers in national armies. Many of these children were killed or maimed in combat; and many children were forced to kill and maim others.

One of the ultimate ironies of the early 21st Century is that the United States of America, ostensibly the leader in civilization HAS NOT RATIFIED THE CONVENTION ON THE RIGHTS OF THE CHILD. We share this distinction with only one other country, that paragon of human rights, Somalia. This Convention has had a major impact on the welfare of children in the last 10 years.
More progress was made in realizing and protecting children's rights in the decade following adoption of the Convention on the Rights of the Child than in any other comparable period in human history and children's rights are now higher on public and political agendas than ever before. Gains in democratic governance and rising respect for human rights in many countries have contributed to this progress.

It appears that our President is more interested in aggregates of 8-16 human cells than he is in real children. As we have pointed out in this column before, he also doesn't seem to feel that killing children is any big deal either. In spite of George W. Bush's protestations to the contrary, e.g. that he is a Christian, his actions declare him to be indifferent to the plight of so many millions of the world's most vulnerable citizens. They also point out that all the blather about values that he and Rasputin spew out is just that; hypocrisy in the service of politics. God save us from these people.

I am now beyond mad at this situation. Getting upset about it does nothing but clip terminal residues off my teleomeres (i.e. accelerate my aging). While I have little time left on the planet, I still want to feel that I am doing something for all these children. What to do is the question. I need to think long and hard about it.

Wednesday, December 15, 2004

On the God Thing (2)

I received some interesting comments from BK to the last post:

BK says: 1. Hitler was not a Christian. Like many, he used Christian language to try to impassion his followers, but any legitimate reading of Hitler and any look at his action absolutely rules out the idea that he was a Christian. I have not spent much time reading up on the Catholic Church's relationship with Spain and Italy, but I sincerely doubt that it was any more than a cowardly willingness to "look the other way" rather than face attack from these very close non-Christian governments.

Reply: The data seem to be confusing whether Hitler himself should be considered a Christian. Certainly his actions were not Christian. But, consider this quote from here:
"I believe that I am acting in accordance with the will of the Almighty Creator: by defending myself against the Jew, I am fighting for the work of the Lord.." (emphasis added)

As a boy, Hitler attended to the Catholic church and experienced the anti-Semitic attitude of his culture. In his book, Mein Kampf, Hitler reveals himself as a fanatical believer in God and country.

On the other hand, apparently a group at Rutger's University has concluded that Hitler was out to destroy Christianity.

Be that as it may, I still believe that the German people considered themselves Christian (mostly Lutheran and Catholic) and there was not a lot of resistance to the regime from the organized Church.

Spain, Italy and other Fascist regimes, including those in South America, frequently have cozy relationships with the Catholic Church because, in my opinion, the power structure of fascism and the Catholic Church is the same. This is less true in the last 20-30 years. One could debate this but it is off the point.

More interesting is BK's use of the language "any legitimate reading." BK assumes that his reading is legitimate and mine is not (unless it agrees with his). This assumption carries through the rest of his post, as you will see. "I am right and you are wrong." Unfortunately, as I was attempting to show, he involves himself in a deep quandry.

BK Says: 2. He is obviously referring to public schools.

So, Mr. BK, who would the students pray to? You cannot deny that there are students in public school who are not Christian. Are they to be forced to pray to your God? Who decides which God, which prayer, and whether those who don't pray are lashed with a cat of nine tails? There IS this problem. Incidentally, many of the founding fathers were Unitarian (e.g. John Adams)!
Most people are a bit baffled about the Unitarian religion, since it doesn't have any dogma, no holy book, no 'bible', no central ecclesiastical authority figure and no ecclesiastical hierarchy - no 'Pope', no 'Cardinal', no 'Guru', no 'Spiritual Leader'

In other words, one should only enforce prayer for all children in a public school where there is a universal orthodoxy. No orthodoxy, no prayer. If you wish to have your children pray in school, send them to a parochial school. Do not use my tax dollars to support your religion.

BK says: 3. Its a difficult concept to anyone who understands that the history of this country is replete with references to God (i.e., the Christian God), and the Old Testament giving of the law in the 10 Commandments is every bit a part of that history. Setting them up in public is as legitimate of an exercise as setting up statutes of the various Greek and Roman gods (whose statutes also adorn public buildings apparently without any protest from people who demand a strict separation).

As pointed out above, many of the references were to a Unitarian God which didn't necessarily include Christianity. And, yes, there is a statue that depicts law, or rather justice. And it wasn't set up in Greece or Rome, but in Washington D.C. However, to make an analogy between the statues of gods on, say, the ascent to the Delphic Oracle, and the placement of a bronze Ten Commandments in a Southern Courthouse is stretching the point just a bit, don't you think? Again, I don't want my tax dollars supporting any religion or its accoutrements.

BK says: 4. He has a right to his opinion, and it may not be so misinformed as you may think. (For the record, I passed law school and got a license to practice law in both state and federal courts, plus I taught Constitutional law for 10 years at the undergraduate level). However, without knowing more specifically his complaints, there is little else I can add.

The truth comes out. BK is a lawyer and has taught Constitutional Law! I thought lawyers were full of things like precedents and parties of the second part (A Night at the Opera comes to mind)and codicils. In any case, I would like to hear the argument from A to B in a concise and rational manner.

BK says:5. His opinion on this point is a valid opinion which the Supreme Court has rejected in favor of a mess of contradictory opinions on the First Amendment. As far as James Madison goes, you are quoting from his writings when he was a bitter old man. His writings closer to the time of the actual writing of the Constitution (in which he had a major hand) and the writing of the First Amendment (of which he was one of the authors) reveals a point of view much more welcoming of religion into public discussion and law.

So, our beloved Supreme Court is a "mess of contraditory (sic) opinions." (Must be one of those lawyer words). And James Madison is a bitter old man.
Well, here is a quote from 1785, before the Constitution was written:
What influence, in fact, have ecclesiastical establishments had on society? In some instances they have been seen to erect a spiritual tyranny on the ruins of the civil authority; on many instances they have been seen upholding the thrones of political tyranny; in no instance have they been the guardians of the liberties of the people. Rulers who wish to subvert the public liberty may have found an established clergy convenient auxiliaries. A just government, instituted to secure and perpetuate it, needs them not. [Pres. James Madison, A Memorial and Remonstrance, addressed to the General Assembly of the Commonwealth of Virginia, 1785]

In summary, there is no cogent argument for the inclusion of religion in public life as a requirement (e.g. praying in schools). We should not require the Jewish child to pray to Christ. We should not require the Christian child to shout "Allah Akbar!" We should require neither.

It is true that our forefathers were imbued with religion. But many, particularly Jefferson, wished this to be a private affair. Making religion public, as is the case in many Muslim countries and, in some sense, India, is a recipe for disaster.

Monday, December 13, 2004

This God Thing

We should take Thomas Jefferson to heart:
Believing with you that religion is a matter which lies solely between man and his God, that he owes account to none other for his faith or his worship, that the legislative powers of government reach actions only, and not opinions, I contemplate with sovereign reverence that act of the whole American people which declared that their legislature should 'make no law respecting an establishment of religion, or prohibiting the free exercise thereof,' thus building a wall of separation between church and State.

-Thomas Jefferson, letter to Danbury Baptist Association, CT., Jan. 1, 1802 (courtesy of here)

But, then we have Alex Ray who is a syndicated columnist in our Star Democrat. This is some of what he has to say under the banner:

The attacks on Christianity in our America continue
1. In the last century, Nazism and Communism tried not only to conquer countries, but to stamp out both the Christian and Jewish religions.....
2. The campaign to destroy Christianity has had great success in the schools where prayer is forbidden.....
3. I think back to last year when Alabama's supreme court chief justice was removed from office because he ordered the Ten Commandments displayed in the lobby of the courthouse....
4. Liberals have misinterpreted our Constitution and the courts have upheld them....
5. The Establishment Clause of the First Amendment to the U.S. Constitution was intended to prohibit the federal government from declaring and financially supporting a national religion, such as existed in many other countries at the time of the nation's founding. It never declared that religion should be kept out of government or our educational system (emphasis added).

Please note that this is a syndicated columnist and is displayed prominently in our newspaper. Let me address this points in order:

1. I was unaware that the Nazi's tried to stamp out Christianity. In fact, Hitler and most Germans were Christian. The Fascist regimes in Spain (Franco) and Italy (Mussolini) were openly allied with the Catholic Church (of course the Catholic Church may not be Christian to Mr. Ray).
2. Prayer is not forbidden in parochial schools. Prayer is forbidden in public schools. It is a rather elementary exercise in deduction, Mr. Ray. Who would the student's pray to? Which God? Christ? Muhammad? Buddha? Confucius? Yahweh? For your information, here are some demographics:
World Population: 6.42 billion
Christianity: 2 billion
Islam: 1.3 billion
Hinduism: 900 million
Secular/no religion/atheist/agnostic: 850 million
Buddhism: 360 million
And so on
(Judaism 14 million)
It is the wisdom of the American Constitution that no religion is preferred. And I, for one, don't want Mr. Ray's (for reasons that should be obvious from my posts on this blog).

3. The Ten Commandments are an official part of Judaism and Christianity. Setting them up in a public place would be supporting those religions in preference to others (or none). Why is this such a difficult concept?

4. I assume Mr. Ray has gone to Law School, has passed the Bar and has been admitted to practice before the Supreme Court with a specialty in Constitutional Law. Otherwise, he is not competent to pass judgment on what our courts say about this issue. Opinions he may have until the cows come home. Its just that they are un-American, those opinions. He should support our government and the courts like he pretends to.

5. In my opinion, this is exactly what our Constitution says, except for the last, italicized phrase, which is total junk. And I bring Thomas Jefferson into the argument to support me. It DID declare that religion should be kept out of our government (and, by extension, our educational system which didn't exist when the Constitution was written). And in case Mr. Ray still doesn't believe it, here is the word of the Father of the Constitution, James Madison:
An alliance or coalition between Government and religion cannot be too carefully guarded against......Every new and successful example therefore of a PERFECT SEPARATION between ecclesiastical and civil matters is of importance........religion and government will exist in greater purity, without (rather) than with the aid of government. [James Madison in a letter to Livingston, 1822, from Leonard W. Levy- The Establishment Clause, Religion and the First Amendment,pg 124]

Friday, December 10, 2004

A Gigantic Failure

More than one billion children around the world face a brutal existence because of poverty, war and AIDs, the UN children's agency reports. UNICEF estimates that nearly half of the 3.6 million people killed in wars since 1990 have been children. Millions more were displaced by conflict, or even forced to take part as child soldiers.

There is much more in the Report on the State of Children 2005.

Here are the seven "deprivations"
640 million children do not have adequate shelter
500 million children have no access to sanitation
400 million children do not have access to safe water
300 million children lack access to information
270 million children have no access to health care services
140 million children have never been to school
90 million children are severely food-deprived

These, dear reader, in case you didn't notice, are numbers in the MILLIONS! There are less than 300 million people in the United States,adults and children. This is a gigantic failure.

And, 1,800,000 children killed in wars?

I realize that we are in a theocracy, (especially after reading Alex Ray in this morning's paper), and I realize that Christ said something to the effect of "suffer the children."

But really, is this what we are heading for? Maybe Bellamy, the director of UNICEF, can put in in perspective:
"The quality of a child's life depends on decisions made every day in households, communities and in the halls of government. We must make those choices wisely, and with children's best interests in mind. If we fail to secure childhood, we will fail to reach our larger, global goals for human rights and economic development. As children go, so go nations. It's that simple."

Monday, December 06, 2004


The American excursion into Afghanistan after 9/11 is coming up for grabs these days along with Michael Moore. Apparently, anyone who questions this war is a far left peacenik and not worthy of a crumb from the great blog bloggers (did THE Big Blogger die in a plane crash in 1957 with Buddy Holly?). Well, I didn't agree with the invasion of Afghanistan in the way in which it was carried out. What we did, as best as I can determine, was to join a rag tag army against another rag tag army and blow the living shit out of them with "daisy cutters."

The BLU-82B/C-130 weapon system, nicknamed Commando Vault in Vietnam and Daisy Cutter in Afghanistan, is a high altitude delivery of 15,000 pound conventional bomb, delivered from an MC-130 since it is far too heavy for the bomb racks on any bomber or attack aircraft. Originally designed to create an instant clearing in the jungle, it has been used in Afghanistan as an anti-personnel weapon and as an intimidation weapon because of its very large lethal radius (variously reported as 300-900 feet) combined with flash and sound visible at long distances. It is the largest conventional bomb in existence but is less than one thousandth the power of the Hiroshima nuclear bomb.

In other words, we used 21st century warfare against a bunch of Taliban in pickup trucks. Not that I have any love for the Taliban, its just that we became enchanted there of killing nameless peasants and this set the stage for Iraq. There must have been fifty ways to do Afghanistan. In my opinion, we picked the wrong one.

And, I like Michael Moore. I liked Bowling for Columbine and I really liked Fahrenheit 9/11. I liked them because they showed the chicanary that exists on the highest level of our government. Unforunately, we will never know the truth about the Afghan War. It will only come out much later in the history books (if we have history books anymore.) But I do resent the pundits telling me what to think about something that I have a right to make my own mind up about.

The Afghan War killed a lot of innocent people(3,000-4000), probably more than were killed in the 9/11 attack. The Iraq war has led to the death of anywhere from 40,000 to 100,000 innocent civilians, many of them children. We didn't have the right to kill those people. It is as simple as that.

Sunday, December 05, 2004


So, how are we going to change so that we can get back on the straight and narrow. For sure, if we keep going like we are, we are going to go over the edge.

SANYA, China (AP) -- Miss Peru, Maria Julia Mantilla Garcia, an aspiring high school teacher, was crowned Miss World 2004 on Saturday night in the southern Chinese beach resort of Sanya.
The title carries a US$100,000 (euro75,000) prize.

Now, this is interesting from a lot of standpoints. First of all, Peru is a very poor nation, so its interesting that they had the resources to field a world class contestant (not that I don't think beauty pageants aren't a little silly in the 21st Century).

Secondly, the contest was held in China no less. China has a beach resort? Well, that's what they are doing with all the money they are making off of lending us money. China, Japan and Korea have bailed the US treasury out over the last four years to the tune of trillions of dollars (our kids are going to have to pay this back).

But, the most interesting thing is to see that the dollar has slid to such an astounding level. I predict that, very soon, it will crash. Then, all hell will break loose.

There is no doubt in my mind that the course of America must change. Change dramatically and rapidly. The problem is, of course, is that we have a president, congress and judiciary that are locked into a view of things that is the antithesis of what we should change to. Dramatic and rapid change has the potential to become violent because we are so polarized. Somehow, we feel that America is immune to this kind of thing. We're not.

I don't advocate this change. In fact, I fear it. But I do think it is inevitable.

Friday, December 03, 2004

This is Outrageous

U.S. Can Use Evidence Gained by Torture
This is not acceptable. It is not right. It is not courageous. It is not fair.
It is evil. It flys in the face of everything that I stand for as an American.
I cannot imagine our children looking back on this with anything else but revulsion.

Thursday, December 02, 2004

Iraq's Children

This from the Guardian:
Medact said Iraq had also experienced an alarming recurrence of previously well-controlled communicable diseases, including acute respiratory infections, diarrhoea and typhoid, particularly among children, the report said.

One in four people in Iraq were now dependent on food aid, and there were more children underweight or chronically malnourished than in 2000, the report found. The near disappearance of immunisation programmes had contributed to the recurrence of death and illness from preventable disease, and infant mortality rose due to a lack of access to skilled help in childbirth, as well as to violence.(emphasis added)

Excuse me Mr. Everything-Is-Going-Well-In-Iraq. You can't even immunize the children? Why even the poorest countries in the world have immunization programs. Where's UNICEF? Oh, I forgot, they got bombed to little, tiny bits.

I know, give them a Tax Break. Damn.

Roughing It

Its going to be a tough four years. We found that out last night at a meeting with several of our State Delegates concerning the issue of Mental Health. I have never seen politicians quite so crass. They offered us nothing. To the question about impending funding cuts, they were oblivious. There was a lot of lip flapping and little humorous asides, but, absolutely nothing positive. And, of course, they blamed all the troubles on the previous, Democratic, Administration.

I don't think its funny at all. The pinnacle of the night came when one of the delegates, a nurse, began to upbraid families who made less than $40,000 for using Medicaid for their kids instead of, "buying insurance through their employer." For openers, many small employers here on the Eastern Shore are in the process of getting out of the business of offering health insurance. What then, my dear? Also, we are one of the richest counties in the WORLD. And she feels we can't afford to offer health insurance to some lower, lower middle class kids so she can get her tax break AND balance the State Budget. Give me a break.

This tremendous financial catastrophe that we are entering is the direct result of George W. Bush and his tax cuts. The rich and powerful (including State Delegates) are going to lord it over us until we somehow, effectively, change the system.

It will change, but it will be a long time. We can't stop working for this change. Our children's lives and livlihoods depend on it.