RKS Health; Skyrocketing Health Costs in the United States and Decreasing Healthy Life Expectancy

“Back in 1980, the United States spent 8.2% of GDP on health-care, virtually the same as the second highest spending country (Germany at 8.1 percent) and just 1.7 percent above the average of ten comparable countries. But as discussed in the introduction, by 2019 American health-care spending had skyrocketed to 17.7 percent of US GDP. At 7 percent more than the average of ten other wealthy countries, this adds up to $1.5 trillion in excess spending.”

“The United Sates ranks lowest in quality and access to health care among eleven wealthy nations, and it is the only country to have declined on this measure since 2010, despite the expanded access provided by Obamacare. And since 2000 American’s healthy life expectancy has plummeted from 38th in the world to sixty-eight in 2019 (now behind China, Cuba and Jamaica). Citizens of Japan live 8 years longer in good health and Canadians live 5.2 years longer in good health than Americans do.”

John Abramson, MD, MSc: “sickening: How Big Pharma Broke America Health Care and How We Can Repair it”: Mariner Books 2022

“The Penniless Pensioner: Misaligned, Maligned but Marvellous”: Chapter 31: My One on One with Don Lupara (the Fat Fox): Invited to Join the “Family”

I knew Don Lupara wanted to speak to me in private. Hopefully it was not to slit my throat! So after dinner one night Don Lupara “invited” me for a chat, just him and me! We had yet another coffee and grappa. Boy those Italians drink coffee like water and just as fast!

Don Lupara got right to the point saying he had wanted to kill me after I violated his little “Sugar Cube” namely Ginevra his daughter. Yes sir that made me feel mighty comfortable. But it was clear to him Ginerva was mad about me and for that I would be spared a swim with the fishes.

He then told me about himself most of which Ginevra had already related to me. At a young age he was smuggling cigarettes making contraband runs around the Bay of Naples. As a young teen he was useful to the Camorra as authorities rarely pressed charges against minors. He moved on to starting his “new business” of importing and distributing hashish and cannabis. Then he dropped a bomb saying essentially, we were of the “same blood”? Don Lupara knew my father Paneer Gurdeep as he imported from him super premium hashish the Neapolitans loved. His rivals had inferior Moroccan hashish they sold at the identical price and subsequently lost almost all the hashish market. Did Lupara think I was a drug exporter? I made it clear I was not a narcotics exporter and treading on fragile ground I said narcotic importing and distribution were “honourable professions”. This pleased Lupara immensely.

Lupara asked me to join the “family”. Was this an offer I couldn’t refuse? Don Lupara had moved on from soft drugs such as hashish and cannabis to cocaine and heroin as the latter were easier to transport and more easily concelable.

Lupara “invited me” on a tour of his operations warning me if I ever double crossed him or his daughter. He would “dispose” of the problem which such a problem being me! With his track record of murder and assassination and remembering the goat head delivered to me in New York this man was not to be taken lightly.

RKS 2023 Wine: Chateau Perbal Carménère: Chile Chugs Along

This Carménère is from the Maule Valley in Chile’s Central Valley Region. The Maule Valley, unlike many Chilean wine producing regions, does not have any maritime influences. Maule Carménère is reputed to be spicy with aromatic intensity.

So what does the Chateau Perbal 2018 Carménère have in store for us?

Aromatics: Telltale Carménère aromas of cherry and raspberry predominating with a little blackberry nibbling on the edge.

Palate: As on the nose plenty of raspberry and cherry with a small bit of pomegranate, red plum and smoke. Moderate tannins. Very light on its feet yet refreshing and vibrant. Moderately long finish.

Personality: Many of my Carménère Chilean brothers are more intense and richer than I am. It does not make them better than me. I am just different. I am lighter and you might find me a bit fresher.

Cellaring: Might improve up to end of 2024 but will hold until mid 2026.

Food match: For those favouring the Portuguese national dish of Bachalau this wine is a match made in heaven. Red wine with fish. Hard to beat me on that dish!

Price: $19.95 (Ontario).

RKS 2023 Wine Rating: 90/100. Jamessuckling.com 91/100.

In a nutshell: Another can’t go wrong Carménère from Chile. A light version if you like. A great sipper. A red wine that can be easily enjoyed in the summer.

(Chateau Perbal Family Selection 2018 Carménère Maule, Chateau Perbal, Pirque, Chile, Liquor Control Board of Ontario # 27578, 750 mL, 14%)

“The Penniless Pensioner: Misaligned, Maligned but Marvellous: Chapter 30: Meeting the Cocaine King in Naples: Better Toasted than Being Toast!

Ginevra and I flew to Naples via Frankfurt in mid November. Naples was almost warm when we arrived at 11 a.m. We were met by two burly men in the arrivals area. And wouldn’t you know one of the men was that heavily tattooed man with a scar on his face and Iroquois haircut that had been watching us in New York. We were whisked way in a huge black Mercedes. There was a car behind ours and another one in front. Our driver had a pistol lying on this front seat. What did I get myself into! Not much to see on the drive but Mount Vesuvius in the distance was impressive if not a bit chilling.

We pulled into the family compound and six heavily armed men stood in front with their hands folded This is the business model for a cocaine king? Don Lupara gave an enormous hug to Ginerva and to me a handshake accompanied by glowering eyes. Like it was I am gonna kill you for violating my daughter you swine was the stare I endured.

Her mother Malvagia was far more welcoming and effusive. She gave a look to her daughter as if she was expecting some momentous news.

Man what a mansion but the furniture was exceedingly gaudy. Leopard patterned furniture and television sets hanging on the wall encased in gaudy golden frames. Camorra decorative brilliance?

After a nap, in separate rooms we headed down to a “small family dinner” of 30 or so relatives. I can’t recall who all these people were but Ginevra seemed to know them all calling them “aunt” and “uncle”. They were a jovial bunch and many wanted to know me better. What a feast although served in very ornate vessels. The wine glasses had bands of gold around them. The food was delicious entirely seafood. A huge welcome home cake.

After cake and coffee Ginevra and I let it fly. We announced our engagement. There was stunned silence and the relatives all focused on Daddy who suddenly flashed a huge smile and ordered champagne be opened for a celebratory toast. I had the feeling of relief sweep over me. I would rather be saluted by a Don Lupara toast than be toast. The relatives thundered cheers and applause. Could Don Lupara (aka The Fat Fox) be a decent fellow?

RKS Health: The Central Strategy of Big Pharma

“Between 1991 and 2017, drug companies paid more than $38 billion in fines and settlements to federal and state governments: many of those companies-including Merck pleaded guilty to having misled doctors and the public about drug safety and efficacy. (GlaxoSmith Kline led the pack with $7.9 billion in financial penalties). Even so that seemingly enormous amount of money represents a miniscule percentage of drug company profits over the same period, and drug company executives were rarely jailed for wrongdoing. Increasing sales by misleading American doctors (even when this involved breaking the law) had become central to Big Pharma’s business strategy.”

“John Abramson, MD, MSc: ”sickening: How Big Pharma Broke American Health Care and How We can Repair it”: Mariner Books 2022.

RKS 2023 Film: “Backlash: Misogyny in the Digital Age” (Je vous salue salope, Backlash): Revulsion, Disgust and Frustration

When you watch “Backlash: Misogyny in the Digital Age” unless you are a Proud Boy or a January 6th insurrectionist you might be thoroughly disgusted.

Women and men from the United States, Canada, France and Italy tell their story of on-line harassment of themselves or their loved ones by woman hating rednecks. It is not pretty. In fact it is revolting and disgusting. Some of the abusers are identifiable and some are anonymous cowards hiding in the reeds. Squirm in your seats when you watch. “Bitch”, “slut” and so forth and then its rape, beat and murder playing on the misogynist trumpet on social media.

The documentary was the number 1 box office documentary in 2022 in Quebec and currently ranked #10 in the list of highest grossing documentaries in Quebec history.

Listen to the stories of women hating social media attacks from Laura Boldrini, the former President of Italy’s Chamber of Deputies, Kiah Morris an Afro-American Democratic representative in the Vermont State legislature, Marion Seclin a Parisian based actor, the father of Rehtaeh Parson driven to suicide by vicious and relentless social media-based attacks and Laurence Gratton an elementary school teacher in Montreal.

It is an epidemic and its extent may be vast and, in some cases, deadly. Sickening. But the inability or willingness by law enforcement to investigate and prosecute is even more sickening. Law enforcement is at best only beginning to recognize the savage nature of digital misogyny. As a lawyer I find the attitude of law enforcement puzzling and frustrating. I recall as a law student years ago learning that verbal abuse may constitute an assault. In this documentary verbal abuse is clear and in some instances the abuser is identifiable so why not prosecute?

Perhaps this documentary begs the question of why the law has not caught up with social media abusers in most jurisdictions? Why aren’t social media platforms eliminating misogyny? Could it be that they are user generated platforms and hatred generates traffic? I note in the documentary Donna Zuckerberg the sister of Marc Zuckerberg says, “Social media has elevated misogyny to new levels of violence.”

Read social media posts and query are they jokes or a vicious attacks? The misogynist comments are so blatantly idiotic it would appear they are moron generated and akin to a joke. However this is a comment made by an outsider and not in the mind of the recipient who is threatened with all sorts of vile acts and very sick comments coming from the mouths of out of the closet misogynists.

Digital misogyny is a combination of idiocy and psychopathic behaviour, potentially life threatening. Aside from being disgusting it is disturbing that in the instances where the perpetrators are identified law enforcement appears reluctant to prosecute. Is this just as sickening as misogynist palaver in the social media or is social media these days unsociable and full of devious distorters of reality? As one woman remarked what person emerges these days that is raised on social media?

One point of criticism and that is the documentary can be seen as a broad-based attack on all men. You know we aren’t all evil. What might have rounded out the documentary is an explanation why misogyny flourishes in the first place instead of simply documenting it.

The documentary has been a smash hit in Quebec and will have its English theatrical premiere in Toronto at the Hot Docs Cinema on 13/14/15/17 January. After that it will be showing throughout Canada.

RKS 2023 Film Rating 86/100.

You can see the trailer here https://www.youtube.com/watch?v=voEsn8BysG4

RKS 2023 Wine: Perez Cruz: A Tsunami of Winners: Confessions of a Carmenère Convert!

At the Drink Chile 2022 event held last November in Toronto I tasted the Perez Cruz Limited Edition Carmenère and it suddenly dawned on me that perhaps Chilean red wines had turned the corner and escaped their minty characteristics of a decade ago. That was one reason I took a Chilean red wine hiatus for a decade but the Drink Chile event caused me to rethink my rather dated thoughts about Chilean red wine. Subsequent tastings have verified, at least for me, Chile and red wines seem to be meant for each other at least with the limited tastings I have done.

So can the positivity continue with a 2020 Perez Cruz Carmenère Limited Edition from the Maipo Valley?

Aromatics: Yet more of that Chilean raspberry and cherry encountered! Rich plum and blackberry with a hint of milk chocolate.

Palate: Full bodied yet smooth despite its firmness. Raspberry, blackberry, Greek fig and black cherry with a long finish with some tat tat tat of pepper.

Personality: Chatting and cheerful on the palate and on the nose but I become very serious afterwards but not overbearing.

Food match: Cornish hen and roast potatoes.

Cellaring: Drinking beautifully now. It should improve over the next two to three years and will coast into 2028.

In a nutshell: The wine is approachable and inviting supporting my conjecture that raspberry and cherry just may be a characteristic of Chilean reds. A high quality Chilean red wine at a very reasonable price. So says this Carmenère convert!

Price: $19.95 (Ontario)

RKS 2023 Wine Rating: 94/100. Patricio Tapia 93/100.

(Perez Cruz 2020 Limited Edition Carmenère, D.O. Maipo Andes, Pérez Cruz LTDA, Huelquén-Paine. Chile, 750 mL, 14%, Liquor Control Board of Ontario #670539)

RKS Health: Misleading Physicians to Increase Sales

“The Kaiser v. Pfizer trial provided two key lessons about drug company marketing: First, because drug companies fund most of the research about their drugs and control the resulting data, they can (and do) mislead physicians in order to increase sales. And, second, under our current system, it is more profitable for large pharmaceutical companies to commit crimes and pay the fines than to obey the law.”

John Abramson, MD, MSc: “sickening: How Big Pharma Broke American Health Care and How We Can Repair it”: Mariner Books 2022.

RKS 2023 Wine: Viña Tarapacá Gran Reserva Cabernet Sauvignon

It is quite remarkable Chile can offer us excellent Cabernet Sauvignon in the under $25 category. Why muck about with Californians in that price range. You’ll often be disappointed. Years ago one might have avoided Chilean red wines due to that minty touch on the palate as one would avoid South African reds due to an earthy if not a barnyard influence. Thank goodness that minty taint has largely disappeared and Chilean red wines are ready to take on if not take over reasonably price high quality red wines.

How will a Viña Tarapacá Gran Reserva 2019 Cabernet Sauvignon from the Maipo Valley fare? Cabernet Sauvignon makes up 60% of the total wine production in the Maipo which is in the Central Valley Region.

Aroma: Loads of raspberry and sweet red cherry with blackberry and strawberry.

Palate: Moderate amount of tannins do not detract from the smoothness on the palate. Blackberry and red cherry with a bit of brackishness on the finish.

Food match: Seared duck breast with cherries and Port wine sauce.

Personality: I may be a Cabernet Sauvignon but don’t be misled into think I am a big hulking wine. My cherry and raspberry make me approachable and friendly. Many of my Chilean brothers have this raspberry and cherry streak in them. I am no weirdo in this regard. Just part of the pack.

Cellaring:  Might improve slightly over a couple of years. Consume by 2025-year end.

Price: $18.95.

In a nutshell: Yet another reasonably priced quality Chilean Cabernet Sauvignon that has little in common with Cabernet Sauvignons from California and Washington. Drink on its own or with food.

RKS 2023 Wine Rating: 91/100.

(Viña Tarapacá 2020 Gran Reserva Cabernet Sauvignon, D.O. Valle del Maipo, Viña Tarapacá, Isla de Maipo, Chile,14% 750 mL, Liquor Control Board of Ontario # 18721)  

“The Penniless Pensioner” : Misaligned, Maligned but Marvellous” : Chapter 29: All Shook Up! The Fat Fox Backs Down

I mean how would you feel receiving a severed goat’s head via Fedex! And how would dear Ginerva feel about her little “currykins” (my nickname) being threatened by her Daddy! We both were all shook up. Ginerva requested we not talk about it until our Saturday “Discover New York Day”. She had a few calls to make and set somebody straight. And when Ginerva is mad, as I saw with her knife fight with the Puerto Ricans in Harlem, you don’t want to mess with my little plum who is transformed into a tigress!

Well Saturday came and I met Ginerva at our usual bench at the lagoon on a sweltering hot day. I stopped in at Whole Foods at Columbus Circle and picked up some organic pear juice and two carrot muffins for our breakfast prior to meeting up with her.

Ginerva told me a bit about her Daddy, Don Lupara, with a warning that if I ever repeated what she was about to say she could not guarantee my safety. Daddy was a huge cocaine and heroin importer bringing in hundreds of kilos of cocaine from El Salvador and heroin from Afghanistan for distribution in the Scampia district of Naples. Daddy controlled the retail network operating like a fine-tuned machine. In fact he had so many people working for him (267) they were referred to as the Cattivo Family and he was the don (boss) of that family. His nickname was the Fat Fox. In addition to his illegal activities he owned real estate, restaurants and a cheese factory selling to all the restaurants in Scampia and in Sorrento. Of course, in addition to restaurants in Scampia and Sorrento paying protection money to the Fat Fox they were “persuaded” to buy all their cheeses from the Fat Fox. Don Lupara was not fat but the enormous amount of money he generated made his pockets “fat”. And he required a constant flow of money to pay his family and their funeral costs. Family members rarely lived a full life. Ginerva remembered with dread the “wars” between rival families that Don Lupara survived unlike many other Naples family bosses.

Ginerva let Daddy have it between the eyes threatening never to talk to him again and should she have children that he would never see them. After all she was a grown woman and Daddy must not interfere with her life. And while she had Daddy whimpering like a naughty puppy she told him she and I were engaged! I could have blown up and walked back to Fifth Avenue and out of her life but I liked the idea. Oh those piercing green eyes set in that beautiful face had me saying yes when she asked if that was OK before slipping a ring on my finger.

There was only one little problem. We needed to visit Naples, introduce myself and then I had to ask the Fat Fox for his daughter’s hand in marriage.