America now being challenged by a crisis of integrity

 Integrity is defined as adherence to moral and ethical principles; soundness of moral character; honesty. As a society we have moral values, professional ethics and other rules that we are expected to uphold at all times and under all circumstances. When we adhere to professional ethics, the rules of life, and the body of laws, we have a desirable society that is principled, and functions smoothly and efficiently.

In today’s America, evidence of lost integrity is all around us: millions of out-of-wedlock children, people who are not needy collecting welfare benefits, frivolous or questionable lawsuits, and a long list of crimes.

And in the political realm we witness inflammatory language, protests shutting down protected free speech, media taking sides, mob violence and other outrages that have grown to epidemic proportions. These activities are strong evidence of the abandonment of basic human integrity as well as professional integrity.

An immediate danger to the nation and its people is the insanity that has evolved since the election of Donald Trump as president. Lots of people – Republicans, Democrats and the politically unaffiliated – show signs of hysteria. Many are dedicated to bringing Trump down, and seem to be devoted to a “damn the torpedoes, full speed ahead” philosophy, giving little thought to the repercussions this ill-advised path may likely produce.

Trump’s enemies say that he lit the fuse, and he undoubtedly contributed to the current atmosphere. But just because you dislike or hate Trump and his policies, does not entitle you to lie, cheat, commit acts of violence, and behave in a manner that subverts America. If you didn’t support Trump in the election there is only one sensible and honorable path for you to take: Get over it. And remember that you are an American and he legitimately is America’s president.

Three areas are very dangerous for integrity failure: News journalism, the federal judiciary and government bureaucracies.

Last week The New York Times published an editorial stating as fact that when a gunman shot Arizona Democrat Rep. Gabby Giffords in 2011, he was reacting to a political map created by Sarah Palin showing areas that were “targeted” in the coming election. That was untrue, discredited years ago, and The Times corrected its humiliating blunder. But doesn’t journalistic integrity demand that such known details be found before publication? Clearly, integrity sometimes takes a holiday at The Times.

It is very common these days for a news organization to attribute information to an “anonymous” or “unnamed” source. Sometimes, of course, a legitimate source needs the protection of anonymity. But the downside is that this tool can be overused, can be used to cover a non-credible source, or even used when there is no source at all. Add to this the tendency to exaggerate, and even create false stories, and the information upon which we all rely becomes unreliable.

If you’ve ever worked with an attorney you probably noticed how detailed legal language is, so that the exact intent of a document is clear. Yet, we find judges today who abandon the plain language of an Executive Order in favor of what they imagine was in the mind of its author in ruling in favor of a challenge to the Order. It looks as if political desire replaced judicial integrity.

And what about administrative agency employees who abandon their duty to their country, the American people they are paid to serve, and their ultimate boss, to play politics, leaking sensitive information, and even classified information in a cheap and disgusting ploy to damage a duly elected president?

Those who foolishly undermine national security because of their emotional inability to adapt to reality may someday wonder what exactly their behavior has done to their once free and wonderful country.

A lot of political hay can be made in such an atmosphere, and the beneficiaries of this are some elected public servants as well as appointed bureaucrats. Such behavior is the stuff of third-world hellholes, and the abandonment of professional and personal integrity moves America ever closer to becoming one of those.

On the one hand anti-Trumpers denigrate and belittle Trump, and on the other hand they raise him to a high level, one so great that they use it to justify abandoning near-sacred elements of their professions and common decency. It is Trump’s fault, they assert, that they indulged in behavior that is dangerous and often illegal.

Commentator Charles Krauthammer said on Fox News recently, “When you say ‘unless we stop Donald Trump, the republic will not survive,’ then that justifies anything. That’s the language, the ideology, the rationale of terrorists...” And, it produces behavior that will destroy the republic.

We cannot and must not excuse criminal behavior, like the shooting at a Republican Congressional baseball game practice earlier this month, or even the mob violence of late, as the result of foolish and inflammatory language. But it does not help diffuse the raw craving of those who consider resorting to violence when politicians speak rashly, the news media takes a partisan position, the judiciary abandons plain language in favor of political expediency, and other examples of acting outside the narrow path dictated by integrity and moral character.

Did you slip and fall into your garbage can? There’s a code for that!

The Affordable Care Act has forced insurance costs higher, encouraged many employers to bail out of providing health plans for their employees or cut employees or reduce hours to below the full-time threshold to avoid the higher costs, and has unleashed thousands of pages of new regulations. But intrepid federal bureaucrats charge ahead with even more requirements for providers, one of which is a revamping of the codes used to identify the medical services that providers use to bill insurers.

Currently, there about 18,000 such codes and one might be fooled into believing that is enough. But the devoted folks who get paid to generate new codes have been hard at work revamping the code system and the new list contains nearly 8 times the former number, checking in at 140,000 medical codes. The feds reason that more specific information is needed to adequately communicate what doctors and hospitals do for their patients, as well as what patients may have done to require a visit to a provider.

New codes describe precisely what bone was broken, or which eye was blackened, and tell insurers whether your injury occurred in, for example, an opera house, an art gallery, on a squash court, or in one of nine locations in and around a mobile home.

Some of them push the limits of propriety. Code R46.1 is for "bizarre personal appearance," while code R46.0 is for "very low level of personal hygiene." Others tell insurers whether an injury caused by walking into a lamppost was the "initial encounter," or a "subsequent encounter."

There is a group of codes that clarify whether you were injured while sewing, ironing, crocheting, doing handcrafts, knitting, or my personal favorite, playing a brass instrument. (Brass players are now churning out imaginative scenarios for how these injuries might have occurred.) There is also a code indicating that a patient's injury occurred in a chicken coup.

Speaking of birds, there are 72 codes for patients who have run afoul of these creatures, and being bitten by a parrot has a different code than if said parrot flies into you, or if you are bitten or flown into by a macaw or a goose. There are nine different codes for each of the six different species of bird.

The folks that developed the system—generally known as ICD-10, for International Classification of Diseases, 10th Revision—say "the codes will provide a more exact and up-to-date accounting of diagnoses and hospital inpatient procedures, which could improve payment strategies and care guidelines," and their use is scheduled to be required in two years. Pat Brooks, senior technical adviser at the Centers for Medicare and Medicaid Services explains that "It's for accuracy of data and quality of care."

As a side note, healthcare reform, known more commonly as Obamacare, is deemed so important that the furloughs that befell air traffic controllers did not extend to Obamacare regulators and code generators, according to Gary Cohen, director of the Center for Consumer Information and Insurance Oversight, who said that his office has not cut its workers’ hours and pay as a result of the automatic budget cuts that went into effect in March. This information should help convince doubters that the pain of the sequester is a conscious political choice of the administration, and not a requirement of the sequester.

While federal bureaucrats are busy, busy, busy improving the healthcare system with mountains of new regulations and charge codes, some of the people who actually provide care are taking different approaches, some of them good, and some not.

A recent Deloitte Center for Health Solutions survey of over 600 doctors reveals that 6 in 10 may retire earlier than they had planned, and will do so in the next three years, due to the effects of the Affordable Care Act on how they practice medicine.

Further, many providers will leave the private sector to work for hospitals or accountable care organizations, and others are fighting back against massive government interference in the doctor-patient relationship by reverting to an older direct primary care model that eschews health insurance in favor of fee-for-services, such as an office visit for $20 or a house call for $100. Some offer a membership plan where patients pay a set fee per month for physician services.

Getting away from health insurance, government regulations and other requirements reduces costs substantially, allowing doctors to provide services at affordable prices, and has the further advantage of allowing doctors to escape "assembly line medicine," all of which may benefit the relationship between providers and patients. In contrast to Obamacare, this is a real improvement in the system.

Finally, even supporters of this Rube Goldberg-like contrivance are starting to realize its boundless weaknesses. Senator Max Baucus, (D-Mon.), one of the Affordable Care Act’s designers and strong backers, told Health and Human Services Secretary Kathleen Sebelius during a Senate committee hearing that he sees "a huge train wreck coming down."

It's a shame Sen. Baucus and the other blind supporters didn't do their homework before the measure passed the Congress, and save the country much pain and suffering. But perhaps it’s not too late to reverse course.