Pain Pills Add Cost and Delays to Job Injuries

Workplace insurers are accustomed to making billions of dollars in payments each year, with the biggest sums going to employees hurt in major accidents, like those mangled by machines or crushed in building collapses.

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Now they are dealing with another big and fast-growing cost — payouts to workers with routine injuries who have been treated with strong painkillers, including many who do not return to work for months, if ever.

Workplace insurers spend an estimated $1.4 billion annually on narcotic painkillers, or opioids. But they are also finding that the medications, if used too early in treatment, too frequently or for too long, can drive up associated disability payouts and medical expenses by delaying an employee’s return to work.

Workers who received high doses of opioid painkillers to treat injuries like back strain stayed out of work three times longer than those with similar injuries who took lower doses, a 2008 study of claims by the California Workers Compensation Institute found. When medical care and disability payments are combined, the cost of a workplace injury is nine times higher when a strong narcotic like OxyContin is used than when a narcotic is not used, according to a 2010 analysis by Accident Fund Holdings, an insurer that operates in 18 states.

“What we see is an association between the greater use of opioids and delayed recovery from workplace injuries,” said Alex Swedlow, the head of research at the California Workers Compensation Institute.

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The use of narcotics to treat occupational injuries is part of a broader problem involving what many experts say is the excessive use of drugs like OxyContin, Percocet and Duragesic. But workplace injuries are drawing particular interest because the drugs are widely prescribed to treat common problems like back pain, even though there is little evidence that they provide long-term benefits.

Along with causing drowsiness and lethargy, high doses of opioids can lead to addiction, and they can have other serious side effects, including fatal overdoses.

Between 2001 and 2008, narcotics prescriptions as a share of all drugs used to treat workplace injuries jumped 63 percent, according to insurance industry data. Costs have also soared.

In California, for example, workplace insurers spent $252 million on opioids in 2010, a figure that represented about 30 percent of all prescription costs; in 2002, opioids accounted for 15 percent of drug expenditures.

As a result, states are struggling to find ways to reverse the trend, and some of them have issued new pain treatment guidelines, or are expected to do so soon. These states include New York, Colorado, Texas and Washington. Insurers are also trying to influence how physicians prescribe the drugs.

Doctors in four states — Louisiana, Massachusetts, New York and Pennsylvania — appear to be the biggest prescribers of the drugs for workers’ injuries, according to a review of data from 17 states by the Workers Compensation Research Institute, a group in Cambridge, Mass.

Painkiller-related costs are also hitting taxpayers, who underwrite coverage for public employees like police officers and firefighters, experts say. In February, one major underwriter, the American International Group [AIG  27.21    -1.97 (-6.75%)   ], said that it would no longer sell backup coverage to workplace insurers, citing rising pain treatment expenses as one reason.

There is little question that strong pain medications can help some patients return to work and remain productive. But injured workers who are put on high doses of the drugs can develop chronic pain and face years of difficult treatments. It is not clear how, or if, the drugs are involved in the process, but when pain becomes chronic, the cost of a commonplace injury can equal a crippling one, experts said.

“Some of these claims look like someone who fell down an elevator shaft and had multiple injuries,” said Dr. Edward J. Bernacki, the director of the division of occupational and environmental medicine at Johns Hopkins University in Baltimore.

For decades, workers’ compensation plans, which vary by state, have been plagued by problems like lengthy legal battles over an injury’s financial value. But it is in recent years that opioid painkillers have emerged as a major driver of costs, experts said.

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Accident Fund Holdings examined its claims and found that the cost of a typical workplace injury — the sum of an employee’s medical expenses and lost wage payments — was about $13,000. But when a worker was prescribed a short-acting painkiller like Percocet, that cost tripled to $39,000 and tripled again to $117,000 when a stronger longer-acting opioid like OxyContin was prescribed, said Jeffrey Austin White, an executive with the insurer, which is based in Lansing, Mich.

In a sense, insurers are experiencing the consequences of their own policies. During the last decade, they readily reimbursed doctors for prescribing painkillers while eliminating payments for treatments that did not rely on drugs, like therapy.

Those policies may “have created a monster,” said Dr. Bernyce M. Peplowski, the medical director of the State Compensation Insurance Fund of California, a quasi-public agency.

For patients, such policies had consequences.

Dr. Eugenio Martinez, a physician in the Boston area who specializes in rehabilitative medicine, said one patient, a former waitress who hurt her back five years ago in a fall, recently won a court fight to force her insurer to pay for physical therapy. The insurer had cut off those payments five years ago after a few sessions, and the woman, now disabled, had no option but to take strong painkillers, Dr. Martinez said. “It certainly did not help that she was cut off,” he said.

Nationwide, data suggest that a vast majority of narcotic drugs used to treat occupational injuries are prescribed by a tiny percentage of doctors who treat injured workers; in California, for example, that figure is just 3 percent. Also, the bulk of such prescriptions go to a relatively small percentage of injured workers, including those who might be addicted to the drugs or those who sell them, experts said.

Several companies, like Accident Fund Holdings and Liberty Mutual, have set up programs in which pain experts contact doctors identified as high prescribers to discuss their practices. The State Compensation Insurance Fund of California has also instituted a policy that requires approval for a doctor to prescribe an opioid for over 60 days.

Insurers say they are making progress in reducing overuse of the drugs. But their ability to influence physicians is limited because workers’ compensation plans can allow employees to see any doctor. So several states have or will soon adopt new pain treatment guidelines for doctors who treat workers.

In New York, one proposal would require a doctor to refer a patient who is not improving to a pain specialist when an opioid dose exceeds a certain level, said Dr. Elain Sobol Berger, the associate medical director of the state’s workers’ compensation board. Washington State has already adopted such a policy.

Dr. Sobol Berger added that the New York rules, which are expected to be proposed this year, will also emphasize nondrug treatments for pain. “We know that there is a significant problem with the management of chronic pain and the use of opioids,” she said.

Some insurers, like the California state fund, have also started paying for alternative approaches like specialized psychotherapy or are trying to get addicted workers into treatment. Other companies are also checking on long-disabled workers.

Mark Kulakowski, a 57-year-old former warehouse worker from Peabody, Mass., injured his back more than three decades ago while lifting a box. He has not worked since 1995. Since his injury, he has taken narcotic painkillers and has had a long list of failed treatments.

Recently, his insurer, Liberty Mutual, sought to have a nurse accompany him to his next doctor’s appointment, a suggestion he welcomed if it could lead to taking fewer painkillers.

This story originally appeared in The New York Times

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Shas to Sudanese: You're ruining our dream

Shas to Sudanese: You're ruining our dream 

Article in Shas journal addresses migrants, says 'it's best if we part as friends' 
Kobi Nahshoni

The Shas journal has officially joined the struggle against infiltrators led by party chairman Eli Yishai. The party's journal, Yom LeYom recently published a public letter to the infiltrators containing "serious talk with the serious Sudanese, out of love and decency." The bottom line: "You're ruining our dream; it's best if we go our separate ways."


Rabbi Moshe Shafir opened his letter with a seemingly appeasing tone. "We love you dear Sudanese," he wrote. "The worst a Jew will ever do to you will be better than the live bullets fired at you at the Egyptian border."

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 He soon went on to explain why the two populations cannot cohabitate. "A society personifying a social time bomb of robbery, violence, sodomy as well as assimilation alongside the destruction of the institute of marriage and the proper family unit – such a society must be separate and distant, and the sooner the better."



African migrants in Tel Aviv (Photo: Ofer Amram)


The article stated that the Jewish people returned to their homeland after many years in exile "to fulfill the positive potential of the human race…you have proved this is not 'your thing' and that is why it's best if we part as friends…you're ruining our dream…perhaps you may have helped us in various ways, but under the current circumstances it's probably not the case."

Shafir stressed, "This is not about racism or any racial doctrine but a question of leadership, and social principles of decent human beings."

He further added, "This has nothing to do with Nazi racism, God forbid – where things were the other way around: a corrupt, murderous society disposed of a foreign and hinest people who only benefitted it and balanced it with its pure virtues."

'We'll be glad to help you'

Shafir ended his article by quoting Martin Luther King's famous speech "I have a dream."

"Listen up, dear and kind Sudanese people. In the United States, Martin Luther King's dream came true. Giuliani will tell you how he made it happen. Go forth and implement this in Sudan and Eritrea. We promise to help you, we'll even be delighted to help, as always."

Meanwhile, Interior Minister Eli Yishai met with the Eritrean Ambassador to Israel Tesfamariam Tekeste on Sunday.

In a statement, Yishai said that he had asked the ambassador to convey a message to his people, whereby "Israel cannot become a destination for them and any future infiltrators who may find themselves in detention centers."


The two also discussed possible ways of collaboration in an effort to return the infiltrators back to Eritrea.

According to the Foreign Ministry and Israel's international obligations, the infiltrators cannot be returned at this time.

"We want this Jew out of office": Islamic antisemitism invades New Jersey Congressional primary race

An ugly new development in American politics: Muslim voters lining up to defeat a Jewish candidate. "Jersey Roar: Democratic House primary turns into ethnic proxy war over Israel," by Adam Kredo in the Washington Free Beacon, June 1 (thanks toPamela Geller):

A Democratic primary race in northern New Jersey has devolved into a highly competitive proxy war over Israel, pitting the state’s pro-Israel community against a growing constituency of Arab voters who have accused a sitting congressman of putting Israel’s interests before America’s.

As the race between Democratic Reps. Steve Rothman and Bill Pascrell nears its Tuesday finish, veteran political observers on the ground have expressed concern at the way the battle between the two veteran lawmakers has transformed into a troubling ethnic brawl.

“One side says, ‘We want this Jew out of office’ and, frankly, it’s pretty unsettling,” Ben Chouake, president of NORPAC, a pro-Israel political action committee based in Englewood Cliffs, told the Free Beacon. “They emphasized [Rothman] is a Jewish congressman.”

Others say they simply cannot recall a congressional race becoming a referendum on a candidate’s religion.

“For the first time in recent American political history, we are witnessing a proxy battle between supporters and detractors of Israel, and it’s playing out in the Ninth District of New Jersey,” said one veteran campaign strategist who is knowledgeable about the district.

The race took an unprecedented turn on Monday when an Arabic campaign poster supporting Pascrell surfaced. It urged the “Arab diaspora community” to “elect the friend of the Arabs” and billed the race as “the most important election in the history of the [Arab] community,” according to a WFB translation of the sign.

“I don’t read Arabic well, but I am pretty sure that the pro-Pascrell posters that have appeared across the district are not calling to elect the candidate who supports a strong relationship between America and the only democracy in the Middle East, one which is rooted in progressive Western values—women’s rights, gay rights, tolerance, freedom of speech, freedom of religion, etc.,” said Josh Block, a Democratic strategist and former spokesman for the American Israel Public Affairs Committee.

Observers such as Susan Rosenbluth, publisher of the New Jersey-based Jewish Voice and Opinion, say the race took an anti-Semitic turn in late February, when a prominent Arab supporter of Pascrell accused the state’s Jewish voters of being more loyal to Israel than America.

“Unquestionably, this primary election is pitting two otherwise harmoniously coexisting communities: the Muslim and Jewish communities,” Aref Assaf, president of the New Jersey-based American Arab Forum, wrote in a New Jersey Star-Ledger column headlined “Rothman is Israel’s man in District 9.”

“As total and blind support for Israel becomes the only reason for choosing Rothman, voters who do not view the elections in this prism will need to take notice. Loyalty to a foreign flag is not loyalty to America’s,” Assaf wrote.

The canard—reminiscent of the “Israel firster” controversy that has engulfed the left-wing Center for American Progress Action Fund and Media Matters for America—reverberated through the tight-knit Jewish community, raising alarm among pro-Israel stalwarts.

“A number of Arab-American constituents have come out with outrageous attacks on Rothman,” said Rosenbluth, whose newspaper is based in Englewood. “I haven’t heard a dual loyalty charge for years.”

At that point, things really “started to get ugly,” said NORPAC’s Chouake, explaining that “for the pro-Israel community, it’s not about Jewish or not-Jewish or helping an ethnic culture, but about believing there should be a homeland for a people oppressed and slaughtered for 2,000 years.”

“It’s a little bit scary,” said Chouake, who noted that massive voter registration drives in the Arab community have added at least 6,000 new names to the rolls. Some of those registrations have been disputed....

Oh, I'm sure they are as genuine as the day is long.

Turkey ditches Syrian rebels. Will Israel attack Hizballah's Scuds?

Two radical developments arising from the Syrian conflict are revealed by DEBKAfile: In an astonishing about face, Turkey has just turned away from its 14-month support for the anti-Assad revolt alongside the West and made common cause with Russia, i.e. Bashar Assad.  Further exacerbating fears of a “proxy war” involving Israel, Iran and Syria, the Lebanese Hizballah is getting ready to bring its Scud D missiles, which can reach any point in Israel, and other advanced weapons, including anti-air missiles, out of secret storage in Syria and transfer them across the border to Lebanon. Two years ago, Israel issued an ultimatum through Washington that the Scuds would be destroyed if they were moved over to Hizballah’s launching pads in Lebanon.
The Lebanese Shiite group has since kept its most advanced hardware stashed at the Syrian Al Hame and Al Zabadani military bases near Damascus.

Now that Syrian rebel attacks are closing in on Syrian military targets, Tehran and Hizballah leaders are working on plans to get them across into Lebanon without exposing them to Israeli attack.
One plan is to enlist the Palestinian Jihad Islami in the Gaza Strip and exploit a clash over the Scuds’ transfer as a trigger for an all round military offensive against Israel. It would be timed for the moment the Western-Arab intervention in Syria against President Assad crosses the line between covert and overt military action and begins an operation to establish safe zones as bases for rebel operation.
Washington, London and Paris began rushing forward contingency plans for this eventuality upon discovering that Ankara had secretly notified leaders of the rebel Free Syrian Army Thursday, May 31 that it had withdrawn permission for them to launch operations against the Assad regime from Turkish soil.
It was then realized that Turkish Prime Minister Tayyip Erdogan and his Foreign Minister Ahmet Davutoglu had stabbed Western-Arab Syrian policy in the back and moved over to help prop Assad up at the very moment his regime was on the point of buckling under international after-shocks from the systematic massacres of his own people.
That day, Erdogan’s betrayal was confirmed when Davutoglu announced over Turkish NTV: “We have never advised either the Syrian National Council or the Syrian administration to conduct an armed fight, and we will never do so.” He added: “The Syrian people will be the driving force that eventually topples the Syrian regime. Assad will leave as a result of the people’s will.”

This was precisely the view voiced this week by Russian President Vladimir Putin, when he spoke out against violent rebellion, military intervention and sanctions to topple the Syrian ruler.
For the time being, the pro-Assad Moscow-Tehran front, bolstered now by Ankara, has got the better of Western and Arab policies for Syria.  Ayatollah Ali Khamenei, Bashar Assad and Hassan Nasrallah have drawn encouragement for advancing to their next step: to confront the United States and Israel with another accomplished fact, the deployment of Scuds aimed at Israel from Lebanon.
Failing to curtail their transfer across the Syrian-Lebanese border in compliance with its 2010 ultimatum will seriously shake Israel’s deterrent capabilities and undercut its military credibility against its enemies, including Iran.
If on the other hand, the Obama administration again holds Israel back from military action, this time to destroy the long-range Scuds, Bashar Assad, Hizballah and Tehran will be awarded a winning hand – and not only in Syria.   

Obama’s BRILLIANT Economic Plan

Well…I’m not exactly sure WHAT to say. I am STUNNED by the depth and breadth of Obama’s knowledge of economics.

Finally, yesterday, he made a clear and concise statement regarding his plan to fix the economy.

Oh, it’s late in coming but, better late than never…Right?

Obama was in Minnesota, speaking to liberal voters who, naturally, hang on his every utterance, and he substantially cleared up his, up to now, foggy approach to the nation’s struggling economy.

It seems to me that I MIGHT have to take back every bad thing I have said regarding his economic prowess over the years for truly, we are in the presence of greatness.

Here is what he said, word for word.

“I assume there are some folks here who could use $3,000 a year. Let’s get that done right now.  That means they’re — you know, if you got $3,000 a year extra, that helps you pay down your credit cards. That helps you go out and buy some things that your family needs. Which is good for business. Maybe somebody will be replacing some thingamajigs for their furnace. They’ve been putting that off. but they got that extra money, they might just go out there and buy that thing.”

If people would just heed Obama’s sage and well researched advice and buy…”THINGAMAJIGS”… for their furnaces, why, everything would be just skippy.

“Thingamajigs.”

He said “THINGAMAJIGS.”

The $3000.00 to which he refers would come from the Mortgage Refinancing initiative he sent to congress which, if you remember, he championed in his last State of the Union Address.

Well, at least we hope it was the last one.

Anyway…

According to Obama, the program would be paid for by…ummm…“a small fee on the largest financial institutions will ensure that it won’t add to the deficit.”

HELLO SOCIALISM!!!!

This is yet another attempt by Obama to redistribute the wealth. In this case, he would soak banks because they have more than their fair share of money and give it to those who he feels have less than their fair share of money.

Such a program would increase the risk of government backed loans and, as this is going nowhere fast in congress because only the hardest core socialists there can see it as workable or prudent, don’t expect to get a check for $3000.00 any time soon.

That of course means that people will have to find some other way to buy…”THINGAMAJIGS”…other than with somebody elses money.

Because we’re heading into summer, one could easily believe that any furnace in dire need of a…”THINGAMAJIG”…probably got one installed last…winter.

Personally, I think buying a couple of DOOHICKIES or a WHATJAMACALLIT or two would spur the economy more than a furnace…”THINGAMAJIG.”

Just to be clear, before I proceed, BUSH was the one liberals always called an idiot and OBAMA the genius.

Now, had George W. Bush told us to buy…”THINGAMAJIGS”…HE would be up there with Einstein.

Obama and his liberal minions are currently trying to portray Romney as unqualified for the office of president based on his years at Bain Capital. That of course would be rendered null and void as an argument if Romney would come out and advocate the purchase of “WIZBANGS.”

Clearly, being a community organizer is the highest qualification achievable in seeking the oval office while being a former Governor and a Captain of Capitalism is, well, just silly.

Over the last 3 years, Obama has spent BILLIONS of tax dollars on solar DEALIES and wind WIDGETS but, alas, to no avail, THOSE companies just keep going bankrupt. Furnace…”THINGAMAJIGS”…though…now that just has to be the winner. Doesn’t it?

The problem is that almost ALL the affordable furnace…”THINGAMAJIGS”…are made in China where Job Czar, Jeff Immelt, moved the GE…”THINGAMAJIG”…division. Those actually made here, like award winning green energy light bulbs, cost 20 times as much.

While there ARE a few WHATZIT and THINGY plants operating in the U.S. they have been laying off workers left and right due to high corporate tax rates and excessive, unsustainable union pension entitlements.

DOOFUDDIES?

Could DOOFUDDIES pull our economy out of the blue funk?

No. Sadly DOOFUDDIES can NOT be the answer as DOOFUDDIES require fossil fuels to run them and the EPA would surely regulate them out of existence. There WAS a DOOFUDDY plant that was proposed to be built out in the TOOLIES but, after 16 years of studies it was determined the location was the ONLY habitat in the world for suitable for the 2 democrats with a NOBAMA bumper sticker on their un-bailed-out FORD EXCURSION who live there in their PAID FOR home some 353 miles from the nearest polling place.

They can NOT be disturbed.

So much for DOOFUDDIES.

Even as Obamacare seems likely to be struck down by the Supreme Court, it’s not at all hard to picture…

A 2000 page bill which would have to be passed to find out what’s in it, forcing upon a suspicious public a…”THINGAMAJIG”…mandate requiring us all to buy one for our furnace whether or not we want one. Oh, we’ll be told that if we like the…”THINGAMAJIG”…we currently have…We can keep it but…We all know better…Don’t we?

This will all, eventually, foist a 31 year old Georgetown Law Coed into the mix, before a specially convened congressional committee to demand…Free furnace filters…as a part of the package because the cost of being…in heat….is too great to bear.

There will be wrangling between ideologies…Those who stand with furnaces and those on the other side of the aisle…The air conditioner crowd. One’s gender selected offspring will of course be allowed to stay on their gay married parents utility bill until they are 26 and no preexisting conditions, like, poor insulation will prevent one from buying a…”THINGAMAJIG.”

Whether or not this works, whether or not it turns our economy around, one thing is clear…

It’s not every day you hear a DINGLEBERRY tell you to buy a…”THINGAMAJIG”…but yesterday…

One did.

No Anti-Obama Jews Wanted in These Synagogues

Inside the synagogue, U.S. Ambassador to the United Nations Susan Rice, who mindlessly called Israeli settlements obstacles to peace, was going to speak.  Outside B’nai Torah, in Boca Raton, Florida, members were anxiously pointing out Alan Bergstein, writer and pro-Israel activist, to the reinforced law enforcement detail. Bergstein and other anti-Obama Jews were denied entrance and told by law enforcement to leave the property.

How far and how shamelessly some in the Jewish community have sunk in their embrace of Obama is ineradicably seen in this action. A Jew being denied entrance to a synagogue brings to mind Germany in the 1930s. This is a poignant and symbolic imagery written in infamy, an image that one would think Jews would avoid at nearly all costs. But this Jewish congregation gave it not a second thought.

What would Bergstein and the others have done? Would they have detonated suicide bombs? Created a physically threatening disturbance? Of course not!  They would most likely have asked Rice some difficult questions. They could have pointed out that Rice and Obama adviser Samantha Power have a long history of being anti-Israel. Power, in fact, advocated using American troops to create a Palestinian state that would be forged with American firepower pointed at Israelis. The anti-Obama Jews might  have noted  that Obama has been so pro-Palestinian that he carved out positions on limiting the expansion of Jerusalem that exceed the demands of both Palestinian President Mahmoud Abbas and Yasser Arafat.

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Days later, just down the road in Miami, in another Jewish congregation, Temple Israel, a conflict was stirring over the planned speech of Democratic National Committee Chair Debbie Wasserman Schultz, one of Obama’s strongest and most vocal supporters. Schultz’s speech, which was clearly partisan electioneering on behalf of Obama for the Jewish vote in Florida, was met with objections from synagogue members who did not believe that being Jewish was synonymous with being Democrat.  Moreover, religious institutions are tax exempt and are not supposed to be forums for clearly partisan activity, even though all denominations breach this behavior in excess and both partisan camps are represented in the breach.

Stanley Tate, an eighty-five-year-old Republican activist, was denied time to offer a rebuttal to Schultz.  A six-decade-long member and strong financial supporter of the congregation, Tate resigned. Soon the synagogue found that it had “security” issues and cancelled Schultz’s appearance, giving one pause to consider that, perhaps, Bergstein was seen on his way to Temple Israel armed to the teeth with difficult questions.

The people who instituted these events call themselves liberals and Jewish. In fact, Temple Israel prides itself on itsagenda geared to social change. But these people are neither liberal nor Jewish in any real meaning of the terms. Liberalism is supposed to be open to the broad challenge of ideas, the clash of positions, in a stirring environment ensconced by the free market place of ideas.Liberals traditionally extol process as much as outcome.  It is not only necessary to do what is right.  For traditional liberals, it is also necessary to do what is right the right way.

Judaism at its essence is a religion open to debate and interpretation. A page of Talmud is surrounded by different commentaries, but even commentary is not limited to what is written on the page. The reader of Talmud can pursue his own interpretation.

The American Jewish community has no chief rabbi. Jews have no pope. I sat once in synagogue as the rabbi delivered a stirring “drosh” (sermon), when suddenly he was interrupted by one of the congregants, who unabashedly said the rabbi misinterpreted the meaning of the biblical text. The rabbi, accepting this interruption, then went into great detail about the root meaning of the terms to which he was referring.  The congregant observed that the rabbi was correct only if the terms originated in Hebrew, but what the rabbi missed was that the terms were Aramaic in origin and consequently their meaning was different, a meaning the congregant went on to explain as the rabbi patiently listened.

Could this exchange take place at either B’nai Torah or Temple Israel? Could such diversity of perspective be tolerated?  I think not, for these people are not true liberals. Nor can they be considered Jews by any longstanding philosophical tradition.

They are not people of the book, but people who are the philosophical heirs to the leftist New Jewish Agenda. These are people who seem to confuse Tikkun Olam, saving the world, with every harebrained leftist social policy that is evaluated by philosophical intention rather than empirical outcome. These are people who are all too quick to follow the New Jewish Agenda in its embrace of the Palestinian narrative.

It is not surprising the B’nai Torah’s rabbi, David Steinhardt, is a supporter of CAIR’s fight against anti-Sharia laws, in keeping with the Obama administration’s position on the issue.  And while B’nai Torah claims to be pro-Israel, Congressman Allen West (R, FL), a strong supporter of Israel, would no more be able to speak to B’nai Torah than Alan Bergstein could get through the door to ask Susan Rice a demanding question.

Jacob L. Talmon, who wrote seminal works on totalitarianism, noted that there is a collective mindset (which originates with Jean Jacques Rousseau) that sees democracy as only meaningful if the individual’s interest is aligned with the collective interest.  Talmon coined the term “totalitarian democracy” to define this concept.  Totalitarian democracy as an idea is the progenitor of Stalinism and the excesses of the French Revolution.  It is an idea that is embodied in the statism of the Obama administration.  Totalitarian democracy is seen in the New Jewish Agenda, which perceives collectivism as the solution to social problems. There is no room in this philosophy for an individual who stands at variance with the collective.  Just as there is no room in these synagogues for those who do not agree that the collective will of the majority should define and limit the political interests of the individual.

That is the lesson of what happened in Florida. That is increasingly the lesson of this administration.

Abraham H. Miller is an emeritus professor of political science and a former head of the Intelligence Studies Section of the International Studies Association.

The reign of the fantasists Caroline Glick »

Defense Minister Ehud Barak has done it again. Speaking on Wednesday at the Institute for National Security Studies in Tel Aviv, Barak warned that if Israel can't cut a deal with the Palestinians soon, it should consider surrendering Judea and Samaria in exchange for nothing.

Even the diehard leftists in the media had a hard time swallowing his words. After all, when Barak was premier, he oversaw Israel's unilateral surrender of south Lebanon in 2000. Barak promised that by giving Hezbollah south Lebanon, Israel would force the Iranian proxy army to disarm and behave like a Western political party.

Whoopsie.

Then of course, there is the Gaza precedent.

Ignoring the lesson of Lebanon, Barak's successor Ariel Sharon reenacted his unilateral surrender policy in Gaza in 2005. Like Barak, Sharon promised that once Gaza was cleared of all Jewish presence, it would magically transform itself into a Middle Eastern version of Singapore.

Whoopsie.

Both Barak and Sharon promised that their unilateral surrender policies would do more than merely transform Hezbollah and Hamas into liberal democrats. They said that by cutting and running, Israel would earn the love of the international community, and winning the love of the likes of Washington and Brussels, they said, was the most urgent item on Israel's agenda.

Apparently Barak was referring to the same imperative when on Wednesday he said that Israel needs to act fast because, "We are on borrowed time. We will reach a wall, and we'll pay the price."

So yes, Hezbollah has taken over not just south Lebanon, but all of Lebanon. And true, there is no one in the Palestinian Authority today who is willing to accept the continued existence of Israel in any borders. But that just means we need the West to love us even more. And the only way to get the West to love us is by imperiling our very existence by handing our heartland over to people who wish to destroy our country.

Given the high value Barak and his comrades place on winning the love of the West, it is worth considering what motivates the West - or more to the point, the US, which leads the Western world.

Unfortunately, the situation is not pretty. US President Barack Obama's policies are just as irrational as the ones that Barak is urging Israel to implement in order to win Obama's support. And Obama's rationales for adopting these policies are just as divorced from reality as Barak's are.

The place where this irrationality is displayed most prominently today is in Obama's policy regarding Iran. As Michael Singh rightly noted on Wednesday in the New York Daily News, under Obama, US policy towards Iran is based on the view "that at the root of the Iran nuclear crisis is US-Iran conflict, and that the root cause of that conflict is mistrust."

THIS VIEW is pure fantasy. No Iranian leader has ever given the US any reason to believe that this is the case. To the contrary, every Iranian leader since the 1979 Islamic Revolution has made clear that the regime is dedicated to the destruction of the US and Israel.

The Iranians do not wish to destroy the US and Israel because they distrust them. The likes of Ayatollah Khomeini, Ayatollah Khamenei, President Ahmadinejad and all of their comrades wish to destroy Israel and the US because they hate us. They hate us because as they see it, both nations represent forces that are antithetical to their revolution's goal of Islamic world domination.

Rather than accept this fundamental, but unpleasant truth, Obama and his advisors base their policy of engaging Iran on fairy tales about nonexistent fatwas that purportedly ruled out the development of nuclear weapons. As Vice Premier Moshe Ya'alon put it delicately this week, the Iranians are "laughing all the way to a bomb."

Ya'alon explained, "During talks with world powers, the Iranians have managed to enrich 750 kilograms of uranium to 3.5 percent, and 36 kilograms of uranium to 20 percent."

And while the Iranians were enriching all that uranium, according to satellite imagery published on Wednesday by the Institute for Science and International Affairs, they were destroying buildings at the Parchin nuclear site.

The buildings in question were suspected of being used to conduct high explosive tests pertinent to the development of nuclear weapons.

And yet, despite Iran's obvious bad faith, and despite the fact that the much-touted sanctions against Iran have done nothing to slow the pace of its sprint to the nuclear finish line, the Obama administration insists on clinging to the fantasy that it can convince the Iranians that they can trust the US and therefore convince them to give up their nuclear weapons program.

Lacking any substantive means of defending this Tinkerbell-fairy-dust policy towards the most pressing threat to international security today, the only thing the Obama administration can tell increasingly distressed Israeli leaders is that we should trust them. They know what they are doing.

Allowing Iran to go nuclear isn't the only price Obama has been willing to pay to fulfill his fantasy of solving Iran's conflict with the US by building trust. He is also willing to destroy any chance of Syria becoming a responsible actor on the international stage.

Obama's willingness to sit on his thumbs for 14 months as Syrian President Bashar Assad has killed as many as 15,000 of his countrymen owes in part to Obama's desire to win the trust of the ayatollahs in Tehran. Since Assad is Iran's client, any US move to overthrow him would weaken Iran. And since as far as Obama is concerned Iran doesn't have anything against the US, but simply suffers from a chronic lack of trust in Washington, it would be wrong to harm Tehran's interests by overthrowing the ayatollahs' Syrian lackey.

Obama's Syria policy is not only a product of his fantasy-based policy towards Iran. It is also a consequence of his fantasy-based policy towards Turkey. Rather than intervene early in the conflict and support pro-Western forces in Syria as an alternative to Assad's tyranny, Obama outsourced the organization of the Syrian opposition to Turkey's Islamic Prime Minister Recip Erdogan.

In Obama's fantasy world, Erdogan is a great ally of the US. The fact that Erdogan has redefined Turkey away from the West and towards Tehran and the Muslim Brotherhood; rendered incoherent NATO's strategic mission; ended Turkey's strategic alliance with Israel; used advanced US arms to kill Kurdish civilians, and threatens war in the eastern Mediterranean over natural gas deposits that do not belong to him is irrelevant. All that matters is the fantasy that Erdogan is America's friend. And since Obama embraces this fantasy, he subcontracted the formation of the Turkish opposition to Erdogan.

Lo and behold, the opposition Erdogan established was dominated by the Muslim Brotherhood. And now, according to a report by Jacques Neriah from the Jerusalem Center for Public Affairs, the Syrian opposition is dominated not only by the Muslim Brotherhood, but increasingly by al-Qaida. So whereas a year ago the US had an opportunity to build and shepherd into power a multiethnic, pro-Western Syrian opposition, in the throes of his fantasies about Iran and Turkey, Obama squandered the opportunity. As a result, today we are faced with the grim reality that the world might be safer leaving Assad alone than intervening to overthrow him.

THIS BRINGS us back to Barak, and the Israeli establishment that cannot rid itself of the notion that we need to give away the store to the Palestinians to win the support of the "international community," that is, to win Obama's support. But towards the Palestinians as well, Obama has embraced fantasy over reality. This week the State Department had the bureaucratic equivalent of an apoplectic fit when it learned that US Sen. Mark Kirk inserted an amendment into the State Department funding bill that will require the department to provide Congress with two pieces of information: the number of Palestinians physically displaced from their homes in what became Israel in 1948, and the number of their descendants administered by the United Nations Relief Works Agency, UNRWA.

The Palestinians claim that there are some five million refugees. They demand that Israel allow all of them to immigrate to its territory as part of a peace deal. UNRWA and the Palestinians claim that not only are the Palestinians who left Israel in 1948 to be considered refugees, their descendants are also to be considered refugees.

Estimates place the number of Palestinians alive today who were physically displaced from Israel at 30,000.

All Kirk wants is the information. And for his effort to bring some facts into the discourse about the Palestinian conflict with Israel, the State Department came down on him like a wall of bricks. In a letter to the Senate Foreign Relations Committee, Deputy Secretary of State Thomas Nides wrote that Kirk's "proposed amendment would be viewed around the world as the United States acting to prejudge and determine the outcome of this sensitive issue."

As far as the State Department is concerned, until the Palestinians and Israel reach an agreement, the US must keep faith with the international community by supporting a policy regarding Palestinian refugees that is both factually absurd and deeply hostile to Israel.

This policy is in perfect alignment with the US policy on Jerusalem. In late March we learned that in the interests of not prejudging the outcome of nonexistent negotiations between Israel and the Palestinians over eastern Jerusalem, the US refuses to recognize Israeli sovereignty not only over eastern Jerusalem, but over any part of Jerusalem. The fact that Jerusalem is Israel's capital is of no interest. The fact that US law requires the US government to recognize that Jerusalem is Israel's capital and to locate the US Embassy in Jerusalem is irrelevant. To appease the international community, the US won't even recognize Israeli sovereignty over western Jerusalem.

So according to Barak and his associates, to prevent Israel's isolation by securing US support, Israel ought to ignore the lessons of the Lebanon withdrawal, the phony peace process with the PLO, and the withdrawal from Gaza and move full speed ahead with policies that will make it impossible to defend the country.

As for the US, to win the support of Europe, Iran and Turkey, Obama has adopted policies that enable Iran to become a nuclear power, make Assad the most attractive leader in Syria, empower the most anti-American forces in Turkey and pressure Israel to renounce its right and ability to defend itself.

Standing alone never looked so good.