Health care: "I guess that's right..."

Health care today operates with QA (quality assurance) equivalent to that of American and Japanese manufacturing in the 1950's, before formal QA techniques and analysis were introduced.

Yes, our system is incredibly improved over the past 60 years, it is now better.

'Better' is not necessarily even 'poor.' (If I cut smoking from 2 packs a day to 1 ½ packs per day, I am now 'better' but the prognosis is still 'bad.')

As a systems analyst and a patient, reviewing my personal experiences with the health care industry I find myself appalled at the level of QA which the industry finds acceptable.

No major manufacturer could stay in business with QA at this level.

Policy is irrelevant if not followed and properly executed, and there appears to be little effective QA information gathering, verification or analysis.

I realize that my experience isn’t scientific evidence, but as it covers 35 years and several clinics & hospitals located around the country, I do believe it is indicative (if only because only a single error elicited any real response from the physician who discovered it.)

I’m not a Dr. (though I was an EMT for a time,) I’m an analyst. For two decades my work has been to examine operations of companies and locate extraneous, faulty, duplicative, obsolete and other costly interruptions of the work which exist in the work flow. I then make recommendations based upon my findings. My intent is always the same: reduce error, reduce cost, increase safety, increase processing speed, and generally improve the overall efficiency, effectiveness and profitability of the entire organization.

In my experience with health care I have had; diagnostics performed multiple times when even I as a layman knew that previous procedures would render the results useless, improper IV treatment, deadly medications prescribed, unnecessary surgery, symptoms ignored, expected organ failure go unnoticed, over-prescription of drugs, been consulted on my treatment by a Dr. while I was under the influence of narcotics he had just prescribed, instructions given w/o followup and other systems failures. I’ve been given complex instructions w/o verification that I truly understood them--with no followup.

I’ve been asked questions which weren’t properly designed to elicit necessary information, given vaguely worded information, been mis-heard, misunderstood and had these errors entered into my record.

Thankfully, none of these killed me, but I have lost years of my life to some of these simple errors--of which no action or recognition of the error seemed to be taken where other than to revise treatment.

The single, simplest, cheapest option to improve health care is to bring QA out of the dark ages and provide a system with transparency, system failure identification and correction, and solid metrics by which success can be determined.

I know that there are problems, I know the type of problems I've personally encountered in my limited contact with various parts of the system.

Obviously, I have had contact with only the tiniest bit of the system, but the number of errors convinces me that my case is not unique.

A full-scale analysis will reveal numerous places in which the system fails both the patient and the caregivers at unthinkable expense. Many of these will be easy and inexpensive to repair.

Perhaps the industry is awaiting a huge class-action suit charging thousands of facilities and individuals with incompetency. Win or lose, such a suit would waste billions which could be used not only to repair the system faults, but provide better facilities and infinitely better levels of care.

The Closing Cage?

The phone tapping problem is indeed global:

http://eolake.blogspot.com/2011/11/secret-software-on-millions-of-phones.html

Besides the security concerns for your own property and information this offers another, considerably more disturbing possibility.

What's more disturbing than having your identity and everything you own stolen?

News media are at best, unreliable, at worst, fabrications and fantasies.

The only reliable news from many places comes in tweets, sms/txt & such.

If you can intercept those, you can rewrite or block them:

"There's rioting in the streets, and the police

have opened up with automatic weapons fire on the crowd."

Sent from China, or Malaysia or London, anywhere--

Becomes:

"Hey! Having a great time. Getting ploshed & laid. Glad you're not here. :)"

Combine this with an unstable global economy, potable water shortages tottering governments, rapidly changing weather patterns (10-20xfaster than is being reported,) whatever the current threats of the day happen to be--the knowledge about them can be contained, if not forever, for several days.

Most, if not all governments (and probably corporations) monitor internet and phone traffic already. With only a slight change in programming, this traffic can be edited or blocked almost in real-time and that includes revising voice messages.

That leaves radio amateurs (who are registered to their governments,) and travelers for news sources--news then travels at the speed of transport. All vehicular traffic, air, ground & water is monitored at the boarders—and elsewhere in most places those traffic and stoplight cameras everywhere. If the government where you are, shuts down travel, anything moving becomes a readily seen target--day or night.

Combine this with remote or automated piloted armed drone aircraft (their abilities only limited by their programmers abilities and the powers-that-be desires.)

If it moves. Kill it.

That this can be done should scare the pants off everyone who's not the powers-that-be. That it hasn't happened isn't any real comfort.

The only thing makin the 1984 style tyranny impossible in the past was that you eventually end up having everyone watch everyone else, nothing gets done--and people are unreliable. In the US we have successfully trained the children for the past 30 years to report suspicious activities (mom & dad = terrorist/drug dealer|user?)

Wireless phone dependence is nearly universal in many countries--the only communications in some--in the developed countries nearly every child who can dial a phone--which means: push a button—has a phone. One button with speed dial (how often do you get butt calls? If people can dial their phone with their butt, which has no intelligence, it's reasonable to assume that most humans from about age 3 on up can do so.

The most successful tyrannies are, like the best cons, those in which the victims beg for it. It's how Hitler and Peron did it, and it's how the USA has effectively lost all rights for individuals. For those elsewhere, the USA's vowed to go anywhere to fight the "War on Terror" and the "War on Drugs"--which even the US government admits have only made the problems worse.

Even before the current threat in the Senate was written--as far back as 2001, it has been possible for the US government to 'legally' abduct and--whatever--anyone they decide is a 'terrorist.' And few governments have ever bothered to get permission to abduct whoever they're after, wherever they are, in a covert operation.

It's really only about 1% of the population that is an active threat capable of leading others and seriously thinking about situations.

Most governments already track such people--they tend to be visible.

Most governments in the developed world could 'disappear' the majority of these people overnight.

In the morning, a few journalists, teachers, lawyers and other professionals aren't to be seen at work--and no one knows anything about it.

Krystallnacht was, by comparison, a larger operation, more difficult to coordinate.

I'll admit, that this sounds like the ravings of mad-man--until you verify and examine what technology and laws are in place. Am I crazy? Is this just in my head? I certainly hope I am just crazy.

If you control information, laws become irrelevant.

People are conditioned to believe that 'conspiracy theories' are all just wackos. Part of this is that if the government explanation is conspiracy, they never call it that...it's aways “ organization” responsible.

A conspiracy exists any time a group plans an illegal act. Whether they call themselves "Al Qaeda," the Senate, or have no name at all, they exist. And most world-shaking human events have involved one or more conspiracies: From the murder of Caesar, to the founding of governments of the USA, France, Argentina, Egypt, Germany and many more, conspirators have succeeded and changed the world.

History is written by the winners.

Every monarchy in Europe has it's origination in a few men grabbing control of a group. Legitimacy is made up afterwards.

Sitting Duck with Broken Wing

Health Care: The One Required Change

There is one change to America’s Health Care system which is required in order to actually improve the care and reduce costs.

It’s the change that HMO’s were supposed to make, but failed.

Currently, healthcare workers and companies from insurors to orderlies are paid based upon the number of treatments.

Insurers make a percentage of the insurance premiums--so the higher the premium, the more the insurance company makes.

Hospitals and clinics are paid based upon the number and kind of treatments given. And Healthcare workers are paid either by the hour or by the year or by the treatment.

Currently, nobody in the system except the patient has any real incentive to actually keep peo[le healthy--financially it is best for them if the patients stay ill enough to require services, but not so ill that they die.

We need to design the system to give those involved a financial advantage for a healthier people.

While complicated in detail (what multi-trillion-dollar industry isn’t complex?) the concept itself is quite simple:

First, insurance premiums are only paid when you are healthy--illness/injury stops the premium payments.

This provides the insurance industry an incentive to make certain that treatments are effective AND cost-effective.

As it is considerably cheaper to keep people healthy than it is to attempt to repair them when they are sick or injured, maintaining premiums at a stable rate causes the insurance companies to make higher profits from healthy policy holders on the same premiums.

Providers could concentrate on getting, keeping and training the best possible workers if their income depended upon the cure rate rather than the treatment rate (again, there are lots of details.)

Like a well run modern manufacturing plant, you would be able to tell by looking at how busy people were treating patients to determine how well things are going--the nost profitable days are those where the staff spends their time learning and teaching instead of treating.

Fewer patients would permit us to eliminate some of the least safe practices of our system: workers would no longer be over-worked and short of sleep--both of which are major contributors to the accident rate in treatment..

My original impetus for this came from wondering why insurance companies woudn’t cover drugs and treatment to help people stop smoking--but instead seem to prefer treating lung cancer and other diseases which often result from smoking.  It doesn’t take genius to realize that paying $100 to help someone quit is cheaper than spending 10’s of thousands to attempt to repair them after they have a disease!

But if cancer rates drop, the amount spent on treating it drops and everyone in the system loses money--including insurance companies who base their premiums upon actuarial statistics and compete on having the lowest premium or ‘best’ coverage.

Currently, it is far more profitable for a patient to come frequently to the provider for expensive (profitable) treatments which never actually cure them!

Without this change, no change to the system will result in improved health care at lower costs.

The healthcare industry, like defense contractors on “cost plus” contracts, have far more incentive to raise costs than to lower costs.

Charles Barnard

Water Alert! The North American Water War Begins

Waukesha, Wisconsin has fired the first shot in the water war in the Great Lakes.

They have filed a request to divert water from the Lake Michigan watershed.

I won't bother to argue their reasons--they're irrelevant to the actual problem.

If this request is permitted, it will set a precedent which we will regret.

The Great Lakes are one of if not the largest masses of fresh water on the planet.

There is an international agreement between Canada and the US prohibiting the movement of water outside the Great Lakes Watershed.  This request will either violate the treaty, and/or set a precedent for permitting the export of Great Lakes water.

Waukesha won't take much--but the precedent will permit places like Los Angeles, Phoenix & many others to put in their requests.

The treat exists for good reasons, and so far, there have been no life/death issues raised to justify the request--and it probably shouldn't be honored anyway.

As is, many people living in the desert SW already believe that when they run through their own water, they can simply take the Great Lakes.

This request, if honored, opens the door legally for the government to remove what is likely to be the next extremely scarce resource on the planet--taking it 'elsewhere.'

This water and the ecosystems in and around it, are vital to the entire continent merely in their influence on weather. But removing water will eventually destroy the current situation and create a new, scarce water ecology. Incidentally putting the people who live around the lakes in a position similar to that which the SW put itself into by overpopulation and poor water management.

There are thousands of ways in which Waukesha's request is different in character and result from what will happen when we pipe it to SoCal. none of which matter, for it is not their needs or use which is the problem, it is the potential problem that it creates in easing the ability of others to steal this resource.

Like the little Dutch Boy with his finger in the dike, the drain may be unnoticeable at first, but will extend inevitably until the Lakes run dry.

Please note my NEW blog!

my new blog xrystlbali is a bit more focused than this one...check it out!

On Games

Life's a game.
Life's not a game.

Let's begin where most discussions ought, and define what a game is.

Dictionary says:

...oh my! Long, confusing and in places contradictory!

That simply won't do. It's amazing that people even think that they communicate.

Games have rules.
Often the rules themselves have rules, including rules about how to create new rules.

Games can be played simultaneously--rules between simultaneous games can conflict or reinforce each other.

Hmmmm. It looks really messy from here.

As I sit, the children in my neighborhood, who range from 5-15, are playing across the street.

One of them just said, "Let's have a rule like...."

Some rules are assumed, unspoken--and some of those may be secret until someone initiates you into the local game by popping one of these rules on you--and it is often permitted to attempt to foist a 'new' rule upon a noob.

It appears that whatever humans do, they are likely to turn into a game or a competition. "Just to make things interesting."


The question becomes not: "Is life a game?" But; "Which rules and games will I play?"


Without humans, the rules of the game become the rules of physics as translated into matter/energy interfaces. Humans can choose, and in choosing change the universe.

Rules are limits which we set upon ourselves. Nature doesn't care.

Except that the fact that many lifeforms appear to create games. From cat's playing predator-prey to tigers sliding down hillsides in the snow to dogs chasing each other, games exist or are created. Often, they are quite obvious practice for 'grown-up' existence, but many appear to satisfy some itch deep down.

Beneath it all like the real world--a game for high stakes in which luck has a large role.

This just in....

I have a question….

Nagasaki 1945, after the atomic bomb

Nagasaki 2011, after the Tsunami.

What the (&^$ is that arch made of? And why didn't we build the World Trades Center out of THAT!!

Water

As I write this, it's a sunny & hot afternoon. There is rain in the forecast for tomorrow night and high probability that we'll see a reasonable amount of rain this week.

My neighbors are watering their lawn.

Wasteful.

For several reasons.
1) Watering in bright sunlight wastes water and risks injuring the lawn.
2) Using well-water to water a lawn or garden is using a very valuable limited resource when rainwater is available.
3) Sprinkler systems are incredibly inefficient, much of the water evaporates.
4) Lots of shallow waterings tend to increase root mass near the surface--fewer deep waterings encourage the roots to follow the water deeper--making the plants more resistant to short-term water shortages.

Very short grass (most grasses are recommended to be maintained at 4"-6") does not provide any shade for the ground, increasing evaporation of the water near the surface--drying out everything much faster.

We are very lucky to have the well-water we have in Menomonie--our water is sweet and lacks any strong mineral flavor, nitrates or pesticides--not to mention much worse things some local water contains elsewhere.

Our water isn't unlimited. It has very definite limits to how much may be pulled from the aquifer...limits based upon soil area and permeability as well as precipitation. Expanding roadways, housing, pavement, converting woods to lawns all reduce permeability and increase evaporation.

Good potable water is currently inexpensive in Menomonie, but it is a limited resource, we can use it too rapidly and it can be depleted.

It will be expensive as it becomes scarce; the time to conserve resources is before you begin to run out.

Unless you are anxious to begin using Lake Menomin as a drinking water source....

America's Unofficial Fool

Just watched Abel Raises Caine on Hulu.

Alan Abel,

master hoaxer has been called many things--many of which are not very polite. He's known for pulling the leg of the American Media and Public until both legs are in his hand.

But the one thing I haven't seen him called is a 'fool.'

But that is precisely his occupation, in the old sense of the word.

His antics defuse tension, irritate, anger and amuse the people--while pointing subtly to the everyday manipulation of their emotions for profit by industry, government and individuals.

The job of Fool, traditionally is a very hard lot. Th job description is to point out errors to people who are extremely powerful, and do not want to hear about any errors of judgment. Using humor allows you to point at serious issues without being attacked for it: "it was only a joke!" But, of course, few jokes are "just a joke."

Very traditionally, humor is a way to deal with issues without having anyone lose face while pointing it out. Some rulers have no sense of humor--and the Fool ends up dead.

Despite modern attitudes, a Fool is an intelligent, quick-thinking person--with the courage to joke about things which if talked seriously about, might end in death.

Alan is a grandmaster Fool. A major asset to humanity.

The American Myth

One would think that myths could do little to trouble a society, and one would be wrong.

Myths are memes. Memes are patterns which shape thought and action-ideas.

Memes are the reason the pen is mightier than the sword.

Memes can be infectious:

Fads, political parties, fans, fanatics, etc.

The particular American Myth which is splitting the USA, is the "Self-Sufficient American Frontiersman."

It is a myth all, self-sufficiencies are partial at best. Perhaps that may change in the future, but for all of history humans have survived largely because they live in groups.

A human being with no contact to others is a pathetic creature which is most likely to expire rapidly as humans are ill-equiped to deal with the universe without tools and/or help.

Humans are social. We live and work in groups.

All of our greatest deeds and artifacts are the result of many people cooperating.

So how come it's dangerous?

There are several different ways it causes problems.

For starters, if you believe in the myth, your beliefs will cause you to act in ways which are harmful to yourself and others.

If you are doing well, it encourages you to think that it's because you, yourself have somehow earned what you have...which is often at least part of the truth--but never the entire truth.

The assumption is that the primary reason people do what they do & have what they have is entirely determined by their own actions.

In turn, this infers that those with less favorable situations earned what they have not by their own actions, and thus have 'chosen' to be sick, or poor, or damaged.

The belief in self-sufficiency inhibits the social nature of humans to assist one-another.

It encourages selfish use of resources by the use of the favorite word of infants: mine!

Truth is, none of us could survive without others.

Can someone please explain...?

Why it is impossible to go after Somalian pirates, who we know both who and where they are, and whom have no government protecting them; but we can chase 'terrorists' anywhere in the world while barely acknowledging the governments in which they live ?


Somali: No government, little infrastructure, available small arms.

Pirates: Cost the world millions of dollars in cash and millions in delayed or destroyed cargoes and a few lives of innocents along the way.

Costs of Invasion:


Somalia: A division of marines could take the entire country--or round up all pirates. The pirates towns could be destroyed with a few bombing runs.

Why aren't Pirates classed as terrorists? They have terrorized crews and owners for years.

Panama Pipe - Geoengineering for profit & possible climate stabilization

Panama Pipe was first proposed by Charles M. Barnard in 2008 as a possible means of moderating climatic change while producing income and energy for the country of Panama. At it's simplest, it consists of an underground pipeline connecting the Western Caribbean with the Eastern Pacific, permitting the flow of cold Pacific water to the East.

Logic behind the proposal:

Currently, the Western Caribbean near the coast of Panama is a dying ecosystem--it's being cooked as water temperatures continue to rise. It is nutrient and oxygen starved.

Before the Isthmus of Panama blocked the currents some 3 million years ago, this would not have been possible, as there was a continuous flow of cold Pacific water upwelling which crossed into the Caribbean. (The Pacific sea level is some 8"/200mm above the Caribbean.)

At that time, this cold current was associated with a conveyor current running across the bottom of the Caribbean from West to East and a matching surface current running East to West.

We know that world weather was far more stable before this closure--stable for hundreds of thousands of years rather than mere hundreds or thousands since that time.

The Panama Pipe would reattach the Pacific to the Caribbean, bringing large amounts of cold, deep, nutrient rich water into the surface of the Western Caribbean.

Enough cooling has a probability of restarting these conveyor currents, cooling the entire Caribbean.

Even without such a major climatic effect, it would provide a solution to restoring the Western Caribbean ecosystem, thus the fishing industry.

The pipe itself would run below sea level, with the Western end located about 350 meters below the surface, near the edge of the uplift current. The Eastern end would be at or below sea level--dumping into fish farms.

While the amount of head in the system is only 200mm, we're talking about millions of cubic feet--sufficient to extract energy via turbine generator, and a temperature difference of 60C which could provide thermoelectric power.

Panama currently imports nearly all of it's energy. This project could make Panama energy self-sufficient.

Anywhere along the pipeline route, the pipe can be tapped for cooling, greatly reducing costs for indoor climate control.


Project feasibility & costs:

The proposed pipeline would be about 100 miles long, through a seismically active zone.
Luckily, we now have a lot of engineering experience in tunneling in such areas thanks to Japan's undersea train tunnel completed a few years ago at a cost of ~$7 billion.

While the proposed pipeline is almost twice the length of the Japanese tunnel, it is a far less complex structure, as it doesn't require most of the costs associated with a tunnel which has to transport people.

It is expected that the entire project could be completed for a similar amount of money, perhaps in less than the 7 years that the Japanese tunnel required.

Preliminary projections indicate that the combination of fishing and energy would provide sufficient income to provide payback in under 50 years--without any projected larger scale weather change. Indoor climate cost reductions are not included in those calculations.

Risks:

Disruption of the already dying Western Caribbean ecosystem is certain. More study is required to determine exactly what that encompasses.

Disruption of the Eastern Pacific ecosystem could vary from minimal to major depending upon the exact solutions implemented--ranging from a simple screened pipe to a large tidal dam designed to maximize the 190cm tidal difference between East and West. The more ambitious proposal provides more constant flow and a higher average volume.

The actual impacts upon weather can only be roughly approximated using currently available tools, so there may be no non-local weather effects.

Small shops are dying...Is this a bad thing?

Is more efficient shopping where you spend less effort, less money and impact the environment less a bad thing?

I live in a town of 15,000. The nearest larger city is 25 miles away. The nearest metro area is 50 miles.

If I need something I can't find in town--a frequent case as I have odd requirements, I can't afford to go anywhere else.

It costs me $1.08 per round trip mile to drive, and the travel time to the nearest city is an hour round-trip.

If I shop, I have to go to multiple locations, and physically walk around...which takes time, and I am disabled enough that even a fairly brief walk is tiring. When I find what I was looking for, the price is often significantly higher than online.

The overhead of getting to and from the stores is  killer unless I am spending hundreds of dollars.

This is why Sears & Roebuck did so well...shopping became convienent, quick and cheap.

Taxes aren't without benefits...

Been thinking about taxes and how much people hate them, and I came to the conclusion that part of that is due to the fact that unlike every other product or service which people buy, government entities rarely if ever spend any effort to 'sell' the services and products they provide.

The fact is, people don't appreciate things which they get without cost--and most government stuff doesn't tie the delivered product/service to the cost which is paid.

This separation leaves people feeling discontent when they receive a service or tax bill, since they don't associate it with anything that they have received.

For example, the City provides clean, healthful, and good tasting water at a very low cost. But people don't compare that to the prices they pay for bottled water-which is often no better and sometimes much worse than the city water.
(I've had bottled water which came from "The Kansas City Municipal water supply." Otherwise known as the Missouri River.)

I've noticed that incoming students seem to assume the city water is bad, without tasting it-- since the city flushes the mains in the summer, it is likely that the first few gallons of water in the dorms will taste bad, so perhaps some at least taste it.

Now,it takes at least 1 gallon/day per person for minimal cooking, drinking and cleaning--most people use much more, since a short shower takes up to 20 gallons.

Purchased by the gallon from W-M @ $.78/gallon that is $284.70 per person per year, or $71.17 per quarter. That is just drinking, cooking and a sponge bath/tooth brushing. A five minute shower each day would bring that up by $7.80/day, or $2839.20 per year, for a total of $3123.90/year/person, or $780.97 per quarter per person!

By way of contrast, my quarterly water bill is under $35 per quarter per person.

Merely providing this information on the billing and information sheets put out by the water department would help connect the product to the cost.

Adding a comparison of the current quarter with the previous quarter and YTD usage would make people more aware of sharp changes in usage--usually caused by a leak, but unless the difference is substantial for some time, we currently don't notify people. This would save people money, and make them more aware of their usage of this limited and valuable resource.

Similar comparison sheets could be issued with tax bills, listing by line item what was included, and detailing what each means--for instance, not only the cost for the street department, but a cost/mile of roadway and a statement of how much roadway there is (most people seriously underestimate how many miles of road are in an area.)

Schools have a monetized value to society, but it is almost never brought up in the same breath as school taxes.

Since it's not highlighted, many people without children feel that they are getting 'nothing' for their tax dollars.

This is far form the case. Well educated people cost society less in services, pay more in taxes, and are healthier, happier and more productive--education makes a city a much more enjoyable and safer place to live.

Educated people are less likely to be victims of fraud, more likely to vote after consciously choosing a candidate, less likely to permit public officials to become corrupt.

Pointing out the safety value of street lights, police response time, road repairs etc--all of which can be monetized and all of which are worth more than they cost would make these things more valuable. An itemized list and a comparison on the bill of each line item's cost and it's monetized value, would go a long way to showing people what they are getting for their money.

As a friend recently pointed out, you can easily move to places with much lower taxes--and nearly no services.

Compare my $35/quarter water bill with a $780.97 value, it's a bargain!

Were this to be done on all levels of government, many people might be less critical of how much many social services cost for what they deliver.

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human embryonic tissue for research

Currently there is yet another court battle about the use of human embryonic tissue for research.

The controversy is centered upon whether or not an embryo is human.

Since the embryos used are going to be destroyed, using their tissue is exactly the same as organ transplants from the dead.

You're not killing an embryo to use it for research, you are using a dead embryo to supply research which will save many lives, just as you are using the organs of a dead accident victim to save lives.

The matter of humanity is irrelevant.

If you're against transplants and the use of corpses for medical research, then say that, don't try and confuse the issue!

"The best way to think outside the box is to avoid drawing one in the first place." - C.M.Barnard

Innocent until proven guilty

“Innocent until proven guilty in a court of law.”

Are we keeping this promise to ourselves?

Too often we create laws later found unconstitutional. And an unconstitutional 'law', never was a law.

When this happens, thousands of people, have suffered injustice needlessly.

Congress and the President do a lousy job of validating legislation. But neither are required to know anything about the Constitution.

This is easily changed: Have the court system review all laws after they are signed, but before the law takes effect. It makes far more sense to validate before enforcement than after people's rights have been trampled. Such law would still be subject to the Supreme Court finding it unconstitutional, but they'd have far fewer cases.

The number of 'laws' rejected by the court is an excellent measure of our leader's work based upon their primary duty--protect the Constitution. Each rejected 'law' represents wasted taxpayer money and the prevention of grave injustice.

Providing an objective measure of our leader's job performance.

Law enforcement, the courts and prisons could concentrate on those breaking actual laws.

Saving hundreds of millions of dollars annually.

As we keep our promise of justice.