Florida Early Voting Fiasco: Voters Wait For Hours At Polls As Rick Scott Refuses To Budge

11/04/2012

Florida Early Voting
Huffpost

Florida Gov. Rick Scott (R) has refused to extend the state's early voting hours, despite long lines at the polls.

WASHINGTON -- Once again, Florida and its problems at the polls are at the center of an election.

Early voting is supposed to make it easier for people to carry out their constitutional right. Tuesdays are notoriously inconvenient to take off work, so many states have given voters the option of turning out on weekends or other weekdays in the run-up to Election Day.

But in Florida this year, it has been a nightmare for voters, who have faced record wait times, long lines in the sun and a Republican governor, Rick Scott, who has refused to budge and extend early voting hours.

"People are getting out to vote. That's what's very good," said Scott.

People are getting out to vote -- but many of them are having to wait in line for three or four hours to do so. One contributor to DailyKos claimed it took 9 hours to vote. In Miami-Dade on Saturday, people who had gotten in line by 7:00 p.m. were allowed to vote; the last person wasn't checked in until 1 a.m., meaning it took some individuals six hours to cast a ballot.

"We're looking at an election meltdown that is eerily similar to 2000, minus the hanging chads," said Dan Smith, a political science professor at the University of Florida.

Miami-Dade attempted to deal with the problem on Sunday by allowing voters to cast absentee ballots in person between 1:00 and 5:00 p.m. However, after just two hours, the Miami-Dade elections department shut down the location after too many people showed up. People outside the locked doors were reportedly screaming, "We want to vote!"

"They didn't have the infrastructure," filmmaker Lucas Leyva, who was among those turned away, told The Huffington Post's Janie Campbell. "We read the press release and everything that went out this morning, promising we'd be able to get absentee ballots and vote. We got here and there was a line of hundreds of people all being told the same thing, that that wasn't true anymore. You could drop off [a ballot], but they could not issue one."

And if getting turned away from the polls weren't enough of an indignity, some of those 180 people ended up getting their cars towed from the parking lot across the street, according to a Miami Herald reporter.

On Twitter, former Republican governor Charlie Crist -- who is now an independent -- responded to news of the office's closing, writing on Twitter, "Let the people vote!"

“We had the best of intentions to provide this service today,” said department spokeswoman Christina White. “We just can’t accommodate it to the degree that we would like to.”

About 30 minutes later, a Miami Herald reporter tweeted that the Miami-Dade location was reopening its doors.

Palm Beach, Pinellas, Orange, Leon and Hillsborough Counties also opened up in-person absentee voting on Sunday.

President Barack Obama's campaign and some of its supporters were attempting to keep people's spirits up -- and discourage them from abandoning the lines -- by bringing in food, water and even local musicians and DJs as entertainment.

North Miami Mayor Andre Pierre brought 400 slices of pizza to voters in line at 10:30 p.m. on Saturday night at the city's public library, according to an Obama official.

While many Democrats viewed it as a victory when a few offices opened absentee balloting on Sunday, the process is not the same as early voting -- and could result in more individuals not having their votes counted.

"Absentee ballots have a much higher rejection rate for minorities and young people, if you look at the Aug. 14 primary," said Smith.

A major reason there are so many problems at the polls is that last year, Florida's GOP-controlled legislature shortened the number of early voting days from 14 to eight, meaning all early voters are trying to cast their ballots in a shorter window. Previously, Floridians were allowed to vote on the Sunday before Election Day -- a day that typically had high traffic.

But losing that final Sunday isn't the only problem. Smith said that he and Dartmouth professor Michael Herron found that in 2008, voters 65 or older were much more likely to cast ballots in the first five days of early voting than members of other age groups, alleviating some of the pressure at the polls in the remaining days. Those extra days, however, are gone this year, leading to a compression that the system has been unable to handle.

Scott has refused to extend early voting hours, essentially arguing that there is no problem, despite calls from Democrats, independent groups and even a Republican elections supervisor. He is arguing that he can extend early voting hours only when there is a true emergency -- like a natural disaster -- that warrants it.

"I'm focused on making sure that we have fair, honest elections," said Scott. "One thing to know, these early voting days and on Election Day, if you're there by the time the polls close, you get to vote."

Scott has some of the lowest approval ratings of any governor in the nation. In recent Quinnipiac poll, just 39 percent of Floridians said they approved of the job he is doing. Scott, unlike many other GOP governors, has not hit the campaign trail much on behalf of Mitt Romney.

As Florida Democrats have pointed out, the state's previous two Republican governors -- Jeb Bush and Crist -- both extended the hours. A spokesman for Bush didn't return a request for comment.

A judge extended the hours in Orange County after the state Democratic Party sued for more time. The location was closed for several hours on Saturday when everyone was evacuated due to a suspicious package.

Democrats are traditionally more likely to vote early, which is why many in the party have ascribed political motives to Scott's restriction of the process. According to a report in the Miami Herald on Saturday, Democrats were leading Republicans "by about 187,000 early in-person ballots cast" as of that morning.

On Election Day, there will be fewer polling precincts this year than in 2008 -- due to redistricting and budget constraints -- meaning traffic on Tuesday could also be a problem.

Florida is expected to be tight in this election. According to HuffPost Pollster's average of polls in the race, Romney is now leading Obama in the state by less than one percentage point.

Avoid feast and famine in housing

Nov 04, 2012

Better to have stable supply of new homes every year than try to predict property cycle
 
By Han Fook Kwang
 

When I bought my first property, I didn't know I would still be living in it 27 years later. I had bought it soon after getting married after a year of house-hunting.

I don't remember it as being an eventful year for property then and I don't recall being particularly anxious about whether we were buying it at the right time in the property cycle. We needed a place to call home, we liked what we found and the price was within our budget.

As it turned out, it was not a bad buy. The house has appreciated in value about 10 times since, which works out to an increase of about 9 per cent every year compounded over 27 years. I can't think of anything I have bought or owned which has risen as much in value or as rapidly.

As an individual, this must count as a good thing and a source of some satisfaction. In fact, my experience is not untypical of many in my generation and I would think those who bought around the time I did would have seen similar appreciation in values, some more, others perhaps less, depending on location.

Singaporeans have generally felt good about how property prices have moved over the years, barring the occasional dips in every economic cycle.

Until quite recently, that is.

There has been a discernible shift in public attitude towards ever-rising property prices over the last few years and it is important to understand why this is taking place and what can be done about it.

For a flavour of the negative views being expressed, here is a recent sampling from the Internet:

• Low property prices favour citizens as they help everyone have a roof over their head. High property prices favour only developers and rich people as they can make super normal profits and collect rent instead of working hard and creating value.
• The Australian government takes care of citizens and imposes strict restrictions on property purchases by foreigners, for example, when they leave, they have to sell, when they sell, they have to sell only to locals, etc. Why doesn't the Singapore Government take effective steps and also contribute to raising property prices?
• The property owners of today are only raiding the future earnings of the next generation. How? Well, all these gains in property prices must come from somewhere. It will come mostly from the next generation. But this will net the wealthy much more as they own many more and higher-value properties.

These online comments are in response to recent news that some executive condominium units had been sold for more than $1 million. As with many Net postings, they are often not logically argued and are laced with an extra dose of negativism. But the sentiments they represent are real and shared by an increasing number of people here.

Indeed, rising property prices were an issue at the general election last year. In response, the Government introduced several measures, mostly increasing the supply in both the public and private housing markets.

Prices, however, have yet to come down.

According to the latest data reported last week, private home prices rose by 0.6 per cent in the third quarter, while the Housing Board resale price index climbed 1.3 per cent.

This public sourness over property prices is a relatively recent phenomenon given the history of rising prices here, which has been generally welcomed by the public.

It shows there is a point beyond which resentment sets in, even if the majority see the value of their homes going up.

They worry whether their children will be able to afford these prices in the future, and whether they themselves will be able to upgrade.

Worse, they perceive it as largely favouring one class of people over another.

It used to be said that property prices cannot rise by too much, otherwise who would be able to afford them? In other words, prices cannot run too far ahead of income levels.

This link between prices and incomes is, however, broken when the market is open to foreigners whose salaries have no connection to those of Singaporeans.

When rich Chinese, Indians, Indonesians and Malaysians account for a significant number of the purchases here, prices can run away from the local population's ability to pay.

The Government's recent measure to make it more expensive for foreigners to buy property through the additional stamp duty was aimed at cooling the market.

But the Government has never made clear if this will be a permanent feature of its policy on foreign purchases and the extent it will allow them to influence prices.

There is clearly a tension between wanting Singapore to be a global city attractive to foreigners (which includes how open it is to them buying homes here), and preserving the link between home prices and Singaporeans' income levels.

Getting this balance right is critical to having a successful property policy which is politically acceptable.

How much should the Government protect local buyers from the purchasing power of foreigners?

This is an especially important issue with so much surplus money flowing round the world after so many rounds of loose monetary policies, with central banks printing money to stimulate their domestic economies.

Should Singapore go the way of Australia, for example, and force foreigners to sell property back only to citizens?

[So foreigners can buy property but they can only sell back to locals, so when they make an offer, they have to take into account the constraints of the local demand. So if they are here for the short term, they would rent. Only if they are here for the long term should they buy, and even then there is the chance that they would lose on the buy and sell. It would in fact curb speculation. This should be more targeted and be limited to HDB, HUDC, EC, and DBSS flats.]

One word of caution though about the Government's ability to get the property market right. Its track record of trying to match supply to demand has in fact been patchy.

In the early 2000s, it was saddled with a record surplus of 25,000 unsold HDB flats when it overbuilt and demand collapsed following the Asian financial crisis in 1997.

[This is a bigger problem than just having too many flats. Depreciation, and need to maintain "ghost towns" were not happy problems to have. When the flats were finally sold, the lease was considerably shorter than 99-years.]

And the sizzling market of the last two to three years in both the public and private sectors was clearly the result of it underestimating demand, which rebounded after the slump of the 2008 financial crisis.

Governments, and not just in Singapore, are often behind the curve when trying to read the market.

This being the case, the better approach is to aim for a stable supply of new homes every year and to not try to predict too closely the ups and downs of the property cycle.

There is a steady underlying demand for homes from new households being formed every year, and even when it falls because of an economic downturn, the pent-up demand will likely return in subsequent years.

Better to aim for a predictable and transparent policy on how many homes to build so as to avoid a feast-and-famine situation.

Fortunately, public housing is available for the large majority of Singaporeans in a market that is largely protected from foreign funds.

These estates today enjoy some of the best facilities - markets, hawker centres, MRT stations, bus interchanges, sports stadiums and shopping malls, and most have been upgraded to high standards.

Because of the convenience of having these facilities nearby, Singaporeans are prepared to pay relatively high prices in the resale market for these flats.

We take this for granted but it could have turned out completely differently, with few takers, had they become urban slums.

And because the resale market is open to all Singaporeans regardless of income levels, the prices these flats command reflect their true market worth.

But there is one tweak to this market which may be needed to make sure it remains affordable to Singaporeans.

At present, permanent residents are allowed to buy resale HDB flats - this door was opened to them in 1989, presumably to make the country more attractive for PRs.

But it might have inadvertently caused prices to move up and, more critically, weakened the link between local wages and resale prices.

The PR numbers are in fact not insignificant - it was reported last year that they accounted for 20 per cent of all resale transactions in 2010.

That's one fifth of all sales, enough to move prices significantly.

Making the HDB market - both for new and resale flats - exclusively for citizens is the best safeguard for the future to ensure that public housing prices will always remain within reach of the majority of Singaporeans.

[The other problem in the resale market is the Cash Over Valuation (COV) the cash component over and above the official valuation of the flat. There is no cap on the COV. Perhaps COV of up to 10% of the valuation of the flat can be allowed without any restrictions. However beyond 10%, every dollar of COV will be taxed as "Windfall" tax, or even considered part of income tax of the seller.

Beyond 20% of valuation, every dollar paid by the buyer must be matched with a dollar of tax to the govt to be paid by the Buyer. i.e. 100% tax.

So if a flat is valued at $400,000, the seller may ask and receive up to $40,000 as COV tax free.

If the COV is $45,000, the seller will be taxed on the $5000.

If the COV is $100,000, the first $40,000 will still be tax-free, but the seller will have to include $60,000 as part of his income tax. The buyer in addition to the COV of $100,000 will also be required to pay the govt $20,000 for a total of $120,000.

This effectively puts a loose "cap" of 20% of the valuation for COV, as beyond 20%, the buyer has to pay 100% tax.]

Flip side of parental pressure

Nov 04, 2012

Singaporean parents push their kids hard, but more are letting them go with what they are happiest doing
 
By Ignatius Low
 

I was sitting in a food court the other day eating my prawn noodles when I heard what I have come to recognise as "the sound of PSLE".

Sometimes it's the sound of a mother with despair in her voice, wondering why her child seems to have suddenly stopped absorbing anything into her head a couple of weeks before the exam.

Other times, it's the sound of office colleagues madly reeling off cut-off scores for top secondary schools like they were seasoned sports commentators.

That day, however, it was the sound of a father talking intensely to his 12-year-old daughter - his deep booming voice resonating within the half-empty eating area.

The girl's mother and older sister were also looking intently at her as Daddy gave a long lecture. The young girl was the only one of the four eating, looking up at everyone as she balefully slurped her noodles.

We are into the period after PSLE now. The kids have done the exams and everyone is waiting for the results, so this particular conversation seemed to be some sort of scenario planning, an analysis of "what ifs".

I wasn't sitting close enough to hear everything that was being said, but I caught bits of it.

In a slightly hectoring tone, Daddy - a seemingly high-powered grey-haired man of about 50 - laid out the options in a no-nonsense way, like he was addressing a boardroom full of company directors.

These are the best Integrated Programme (IP) schools, but some are very competitive, he said. If you go to one of the top schools, we will have to get you extra help, maybe tuition in certain subjects.

But there is also the International Baccalaureate (IB) programme, he added. That is prestigious as well but it is tough in a different sort of way. If you choose that, we will need to get you another type of help, a different type of tuition, and so on.

At one point, the girl raised her head and mumbled something about "Sota" (The School of the Arts). Daddy didn't seem very keen, but explained the pros and cons anyway, trying his best to sound neutral. At the end of it all, he announced that he really had to get back to the office (it was 2.20pm after all).

I was ready to write him off as yet another overly kiasu parent, but then he turned to his daughter, kissed her on the forehead and said quite tenderly: "Anyway, dear, you go and think about it carefully and let us know what you decide, okay?"

The girl nodded. He then kissed his wife on the lips (how rare!) and trundled off.

I don't know why but that little incident stuck in my mind, particularly during this period of intense discussion about school admissions and the role of the PSLE.

It reminded me that however awful or unreasonable some Singapore parents' behaviour might seem - the horrible stress they put on their kids and themselves, the fierce complaints they have about the system - the bottom line is that they really do love their kids and just want to do right by them.

It also reminded me of the time I did the exam in 1984.

I remember there being less stress. My parents did not take leave to help me through the exam period. There were just lots of bottles of Brands Essence of Chicken to gulp down in the morning.

There also wasn't that much discussion in the house about my preferences after the PSLE. I remember there was an admissions form on which my parents had to indicate six choices of secondary schools. Being from St Michael's Primary, first choice was naturally the affiliated St Joseph's Institution.

My parents and I filled up the other five places without much fuss. We simply picked five schools that were near to our HDB flat, which was in Holland Drive at the time.

Then, a few weeks later, the results came in. I don't remember feeling particularly nervous and my parents didn't seem nervous either.

When we opened up the slip, we saw that my score had qualified me for the Special Assistance Plan (SAP), which was a new elite scheme that emphasised the study of Chinese. The decision over where to go after that was straightforward.

Special stream is better than Express, so you should go for Special, my parents reasoned. We are Catholic - and among the SAP schools, Catholic High is better than Maris Stella - so you will go to Catholic High.

That was how a Peranakan boy who spoke only English and Malay at home ended up utterly terrified and lost in a roomful of Mandarin-speaking teachers and classmates on the first day of school.

My parents couldn't have picked a worse fit for someone like me. I don't quite know how I survived, but I did.

Comparing the two PSLE stories that are 28 years apart, I wonder whether things are better now for kids, or worse.

Back in the 1980s, there was less stress partly because there were far fewer options on the table.

And without the sort of incessant discussion over the pros and cons of these options that you now get online, there was less of a fear that one's choice might not be optimal.

But there was also an unhealthy preference for whatever was the best option on the table - whether it was a triple Science combination or a degree in medicine or law.

Today, the reverse seems true.

There seems to be much more stress around the PSLE and the school admissions process. People take special leave, read up on way too much useless information and go to great lengths to game the system and give their kids the widest possible number of options.

But having done that, a softer side of the Singapore parent emerges, just like that father in the VivoCity food court.

Instead of insisting on the best option on the table, I find more and more parents listening and going with whatever their kids are happiest doing.

Maybe it is a symptom of a maturing and more financially secure society starting to put more value on the non-material aspects of life.

Perhaps it is simply that the generation that is now in their forties doesn't want their kids to have the same regrets they have: choices gone wrong or preferences left unspoken.

I guess it would be too much to ask for the best of both worlds.

Clarity needed on fate of frozen embryos

Nov 03, 2012
 
By andy ho senior writer
 

IN A recent case here, a woman sued her former husband for custody of their young daughter as well as 12 frozen embryos they had made.

The Family Court awarded "sole custody of the embryos" to her so she could decide unilaterally the future of the embryos and/or any children born thereof and he was not to interfere. The woman then thawed the frozen embryos and had them interred in a niche.

Embryos are created by couples who go to a fertility clinic to try for a baby by in-vitro fertilisation (IVF). His sperm is used to fertilise her eggs and the embryos that result from this will be implanted into her womb.

Since harvesting eggs from a woman to make embryos puts her body through lots of very dangerous drugs, various surgical procedures, several tests and a great deal of stress, usually each cycle aims to harvest more eggs than needed. Embryos are then created using all of them and excess embryos are frozen. Once frozen, embryos can be thawed out when needed at any time in the foreseeable future. At that point, their cells start dividing and they can be implanted into the mother's womb to develop into a foetus, at the right time of the woman's menstrual cycle.

The Health Ministry's rules do not permit the use of embryos to treat infertility if they have been frozen for over 10 years. After 10 years, they may be used for research if the progenitors agree.

Not all frozen embryos are ultimately used if IVF completes the family for the couple concerned, or if the couple gives up on the very taxing IVF journey of trying for a baby, or if divorce occurs.

Who gets the embryos then? Currently, there is no law regulating IVF nor any that spells out the legal position on frozen embryos. There are only practice guidelines that are enforced as part of the ministry's licensing and accreditation requirements for IVF centres to operate here. The guidelines require that no couple may access IVF services without pre-agreeing on how to dispose of their frozen embryos in case of separation, divorce or death. Couples must state their preferences when signing the informed consent form to secure IVF services.

The ministry requires IVF centres to "seek written instructions from every couple whose gametes/embryos are to be stored" before IVF is ever begun concerning how they want their gametes (sperms/eggs) or embryos to be disposed of "in the event of separation... premature death or divorce... or incapacitation".

Yet, having such a written agreement within the informed consent form does not stop a divorcing spouse from contesting it. In such a situation, the judge must then consider if it reflects the intentions of both parties when it was signed.

This is because the infertile couple is often desperate and willing to do almost anything to get a baby, so signing a consent form is the least of their worries. Given the stress of trying for a baby, they are not likely to have carefully weighed who gets what, including embryos, if they ever divorce.

At the time of signing, they are working with, not against, each other. Thus such an agreement is unlikely to reflect their true interests at divorce.

[And buyers of property are desperate and willing to pay any price for a flat or a home. It is likely that any agreement as to price and Cash Over Valuation does not reflect the true market value of the property, let alone the interest of the buyer. Does that mean that a court should decide if paying above the market price (valuation price) of a property properly reflects the true intent of the buyer or if they have been irrationally influenced by their desperation? If Stress and Desperation are a defence against Caveat Emptor and grounds for invalidating legal agreements, we would be a legal and contractual limbo.]

Of course, prenuptial agreements are signed (in jurisdictions where they are legal) when people are very much in love, yet are enforced at divorce. But even if prenuptials specify child custody at divorce, courts are not bound by it as they will decide such matters in the child's best interests instead.

More fundamentally, you can argue that it is coercive to require couples to sign off on disposing of embryos as a precondition for IVF treatment. Couples who want IVF do not really have a choice not to agree on disposing of embryos. So it may be an invalid contract.

[So? When I bought my flat I had no choice but to agree to pay S&C charges, comply with minimum occupancy rules, sub-tenancy rules, and when I sell the flat, rules about the eligibility of potential buyers. Does that make my sale and purchase agreement for my flat invalid?]

Instead of relying on past agreements therefore, the court will have to make its own decision on distributing embryos equitably at divorce. Some may argue that the right by default should go to the woman, in the same way that any decision to abort a pregnancy is her exclusive right by virtue of a woman's right to privacy and bodily integrity. However, such rights may not kick in until implantation occurs and a foetus develops.

If both parties are indifferent about the embryos, no legal issue arises. But if both want the embryos, then the woman should arguably get more since, compared with sperm donation, she had to bear considerable physical risks and psychological stress to have her eggs harvested to make them.

What if one party wants possession of the embryos for implantation - the woman so she can get pregnant herself, say, or the husband in case his new wife (if any) needs them - but the other party objects? Or if one party wants to donate them anonymously to other infertile couples but the other party objects?

Then, the issue of "coerced parenthood" emerges. Since an embryo contains DNA from both man and woman, making a baby from it against either party's wish enforces genetic parenthood on the reluctant party. This would violate one's freedom of personal choice to decide if and when to become a parent.

In such cases, the court could award the embryos to the party who wants them - in return for a consideration perhaps - but also condition on them contracting for the other party to be legally accorded non-parental status. (This would be the inverse of adoption, which basically establishes parental status by contract.)

[Brilliant! Wonderful suggestions! So why can't these terms and conditions be put in the agreement prior to IVF treatment? The whole point of legal agreements is to avoid the HIGH cost of court cases and court judgements which even in efficient Singapore has a time factor.]

Finally, what if one party wants to donate the embryos for research or simply to be thawed out and destroyed while the other objects? Then the embryos could be frozen indefinitely if one party will pay for storage costs. But if that party stops paying, the numbers of abandoned embryos could rise over time.

At any rate, the court might have to grapple with some imponderables such as when life begins as well as the religious convictions of both parties, if any.

[No it doesn't. Life begins at birth (or whatever the law says currently) or abortions will have to be outlawed.]

Things would be clearer if the courts had statutory guidance about ownership and parentage of frozen embryos. Thus, Parliament should consider such a law.

[The issue raised in this article is a valid question. However, I cannot help but be discomfited by the direction Dr Ho seems to be suggesting here as well as his previous article on Advance Medical Directive (AMD). In his previous article, Dr Ho makes the observation that an AMD is an imposition of pre-commitment by his past self on his present and future self and suggests that that is in principle wrong. Here he suggests that a contract or agreement a couple pre-IVF makes is coerced and so invalid, and that pre-agreements are unreliable.

His points are valid, but his proposal to set aside all agreements is rather extreme. There may be some cases were the parties to the agreement may have entered into the agreement in the less than competent state of mind and the agreement should be set aside. But these are to be decided on a case by case basis if there are prima facie evidence for such a claim.

The other issues he raised are all valid issues that couples and IVF clinic should discuss and put into the agreement prior to IVF treatment.

And couples have a choice. Agree to the deposition of the products of IVF before the start, or walk away from the IVF procedure.]

In effect he is arguing that these agreement or contracts are invalid.]

When market values rule society

Oct 26, 2012
 
By Willie Cheng For The Straits Times
 

FORTY years ago, Mr S. Rajaratnam, one of modern Singapore's founding fathers, warned against the "moneytheism" trend of the day. Singaporeans, he said, should not become "a people who know the price of everything and the value of nothing".

Some would say that his concern is still relevant today, if not more so.

If Mr Rajaratnam were alive today, he might remark on the extent to which we have placed a price tag on everything in sight:

• Having a baby. Each baby born can result in a cash bonus of between $4,000 and $6,000, plus matching contributions to the child's savings account of up to $12,000.
• Citizenship. Singapore citizenship can be accelerated for wealthy and talented foreigners. For example, an entrepreneur with a proven three-year business track record and an investment of at least $2.5 million can apply for immediate permanent residency with citizenship after two years.
• Sports wins and losses. Singapore athletes stand to receive cash awards of between $5,000 and $1 million for winning medals at international events such as the Asian Games and Olympics. Conversely, the S-League will fine the last two football teams $30,000 and $50,000 for finishing at the bottom of the table.
• Right to own a car. Certificates of Entitlement (COEs) to own a motor vehicle for 10 years are auctioned twice a month. The most recent winning bids for COEs for cars ranged between $71,000 and $87,000.
• Queue places. Those who can afford it can get around the first-come-first-served system of long queues for the latest gadgets, property launches, et cetera, by paying others to queue for them. Some attractions such as Universal Studios have "express queues" which have shorter waiting lines for higher-priced tickets.

The number of monetised items adds up when you start listing the various kinds of financial inducements (fees, levies, penalties and rewards) that government agencies, private companies and even social sector organisations have created to influence the behaviour of citizens, employers, employees, customers, suppliers, volunteers, and donors. In other words, just about anyone.

The triumph of the market

MONETISATION is, however, only part of a broader trend of marketisation in which the principles, practices and values of the free market system are being adopted in what traditionally were non- market areas.

A core market principle, for example, is competition. Thus, we now have competition in public health care (health-care clusters), education (school rankings, then banding), public transport (multiple bus and rail operators) and even the social sector (sales pitches for grants and other contests).

Marketisation is most evident in the public sector in two instances. The first is when functions which typically could be provided by the state (for example, kidney dialysis and special needs education) are devolved to non-state players. The second is when state-run enterprises such as telecommunication, utilities, airlines and national lottery are divested to the private sector in the way Singapore has done over the last two decades.

Marketisation is also increasingly evident in the social sector.

We have the rising trend of social enterprises (hybrid organisations with business and social missions), impact investing (investing in social enterprises and inclusive businesses) and venture philanthropy (applying venture capital approaches to philanthropy).

There is no doubt we operate in a market economy, and there are merits in the market, including efficiency. But should all aspects of society be subjected to the market? This, in fact, is the subject of a recent book by Professor Michael Sandel of Harvard University.

Prof Sandel believes that, over the last three decades, we have "drifted from having a market economy to being a market society". He defines a market society as "a place where everything is up for sale (and) where market values govern every sphere of life".

The morality of markets

BUT then, just what is wrong with markets and putting up everything for sale? After all, the conventional wisdom is that the market is the most efficient way to allocate scarce resources?

Prof Sandel points out two moral concerns of markets: inequality and corruption.

The first concern rests on the unfairness and inequalities that arise when all types of goods are commodified and money becomes the necessary, sometimes the only, means to obtain these items.

He argues that when money can buy more and more - including political influence, improved health care and better education - then, having money matters more and more. The consequence is that the poor will be systematically disadvantaged and marginalised in the new market places.

For example, in an education system where outside tuition is expected by teachers and where lessons are delivered through computers, those from poor families without the means and time to afford tuition or home computers will be disadvantaged.

Increasing inequality will lead to a divided society. When we have separate, shorter lines for those who can afford them, the affluent and those of lesser means will live increasingly separate lives. The class-mixing institutions and public spaces that forge a sense of common experience and shared citizenship are eroded. The result is a more materialistic class-based society.

Prof Sandel's second concern is the corruption of social values when market norms displace valuable non-market behaviour.

Contrary to what some economists maintain, he argues that markets are not morally neutral. Turning certain goods into commodities can corrupt the very value of those goods. For example, when parents and schools give monetary rewards for academic results or good character, children may see learning or good behaviour as a service that demands remuneration, rather than something that is intrinsically valuable.

Prof Sandel believes that policymakers will discourage altruistic social values if they leave everything to market forces. The moral imperative for doing "the right thing" will be lost. For example, if carbon trading is implemented, a country or company may feel entitled to pollute the atmosphere with more carbon once it purchases the pollution permit.

Singapore: market society?

THE financial success of our market society is without question. Whether measured in gross domestic product per capita, proportion of millionaires, or any of the slew of economic-related key performance indicators, Singapore is usually among the top, if not at the very top.

But are we also - using the terminology of the market - paying too high a price for this success?

Income inequality has risen, while social mobility has declined over the years. We have the dubious distinction of having one of the biggest gaps between the rich and poor whether measured by the Gini coefficient, or by the ratio of income between top and bottom deciles. Thus, there have been calls for, and a policy shift towards, "inclusive" growth to better focus on more equitable distribution of income and levelling up of lower-income workers.

The devaluation of social values is harder to measure. Certainly, the recent emergence of the Nimby (not-in-my-backyard) syndrome, our vaunted kiasu trait and the long-held Singaporean aspiration towards the 5Cs (cash, car, credit card, condominium and country club) are more aligned with the market values of self-interest, survival of the fittest and utilitarianism.

The recent debate on the disparity of monetary rewards for Paralympians versus Olympians shows our obsession with the economic aspects of life as opposed to, in this case, valuing the innate character building and community bonding aspects of sports.

There is a silver lining in the cloud though.

First, the world at large is pushing back against the forces of excessive capitalism. The increasing support for the sustainability agenda, higher forms of corporate social responsibility and impact investing are manifestations of the emergence of a more compassionate form of capitalism.

And Singapore is taking notice. Pockets of the economy and society are moving in that direction.

While our volunteerism and philanthropy rates lag significantly behind the West, they are, nevertheless, rising.

A recent OCBC Bank survey showed that a new set of 5Cs is emerging: control, confidence, community, career and "can-do".

There is increasing talk of a national happiness index, not just GDP, as a measure of progress. In the first citizens' dialogue of Our Singapore Conversation, many expressed a desire to be No. 1 in happiness. (Yes, by wanting to be No. 1, we remain stubbornly competitive - a market trait.)

Reversals of marketisation- based policies have begun. The recent educational reforms include the removal of banding for secondary schools, and for schools and examinations not to be run on the basis that students will have tuition. In explaining the changes, Education Minister Heng Swee Keat said: "Extreme meritocracy and competition can lead to a winner-take-all society, with the winners thinking little of others."

We should ask ourselves where markets do and do not belong. We should ask where market-based approaches and values are not suitable from a national and social standpoint.

We should ask hard questions like whether natural monopolies (such as mass public transport and telecoms infrastructure), or merit goods (such as pre-school education and preventive health care) or morally hazardous activities (such as gambling) should be owned and managed by the state instead of being run by private operators, most of which are focused on profit maximisation.

We should ask harder questions like whether market-driven values such as "individual responsibility" need to be tempered, in this case, in favour of those who do not have the resources to exercise the individual responsibility. This will lean towards greater welfare for the lower-income.

Yes, we have gone far down the road of market-based thinking as the default in solving everyday problems. Like the proverbial frog in a pot of water that slowly warms up to boiling point, we have allowed market forms and norms to progressively creep up on us over the last few decades.

But it is not too late to stop ourselves from completely selling our collective soul to the market.


The writer is a former managing partner at management and technology consulting firm Accenture. After a career in the market economy, he now sits on the boards of several commercial and non-profit organisations, and is the author of Doing Good Well.

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Who decides on care when a patient is dying?

Nov 01, 2012

Eye on Singapore

When it comes to end-of-life decisions, existing rules stress patient autonomy - but family members often insist on a role. What's a doctor to do?

By Andy Ho Senior Writer


TWO local studies show that doctors here tend to defer to the family in end-of-life scenarios. But the law and practice regulations see decision-making authority as being vested only in the adult patient of sound mind, not the family.

This sometimes places doctors in difficult situations. By contrast, Hong Kong and China have laws that allow for the family's role in medical decision-making. It may be time to see if Singapore's laws need similar updating.

Family members' role in health-care decisions is in fact already entrenched in health financing. Singaporeans may use their own individual Medisave funds - and those of their immediate family members (up to 10 accounts) - to pay for hospitalisation, day surgery and certain outpatient treatments.

That Medisave funds may be transferred within one's family implies it is official policy that responsibility for long-term care rests primarily with individuals and their families, not the state.

But when it comes to treatment options, Singapore's laws and practice guidelines for decision-making stress patient autonomy, not familial decision-making, so long as the patient is an adult who has not lost mental capacity.

Family decisions come in when the patient has lost mental capacity. But even in such cases, a just-published National University of Singapore (NUS) survey of 147 health-care professionals in a local cancer centre reports that 60 per cent of them said they would defer to families in end-of-life care - even when family decisions went against preferences previously expressed by the patient while still competent.

So "collusion between family members and... health-care professionals is evident".

In a 2011 study where 78 doctors here were interviewed by four NUS dons for the Lien Foundation, the "frequent scenario of collective family decisions and doctor-family collusion" was noted too.

It reported that doctors dreaded family requests to withhold the diagnosis from dying patients since they were legally obliged "to give full and frank disclosure to their patients", there being no "default legal authority" for families to decide for adult patients.

But "the Singapore family favours collective decision-making, (rendering) the principle of patient autonomy hard to apply", it surmised.

What the law says

A SLEW of Singapore laws and regulations highlight the principle of personal autonomy for end-of-life decision-making.

First, it is implicitly recognised in two statutes, namely, the Advance Medical Directive Act and also the Mental Capacity Act, according to NUS law professor Tracey Evans Chan who was involved in the Lien study.

Second, patient autonomy is upheld in case law. Prof Chan noted a case In re LP (2006) where the High Court "seemed to recognise the primacy of patient self-determination" in regard to consent for treatment. In 2005, Madam LP, who had diabetic gangrene, was urged to have her right leg amputated, which she refused, insisting that her limbs be saved at all cost. The infection in her gangrenous parts spread into her blood system and she became comatose.

As her only known relative was a 16-year-old son, Mount Alvernia Hospital doctors petitioned the courts to authorise various amputations needed to save her life.

The court ruled that the adult patient "was entitled to give or withhold consent to any medical treatment and doctors are obliged to respect that person's decision", adding: "No one else, however close by reason of kinship or friendship, was legally entitled to make that decision for the patient"; and, specifically: "The best interests of the family are not to be confused with the best interests of the patient."

If the patient is incompetent, the court ruled, a third party may apply to the courts to have a person appointed to act in her best interests. However, if time was of the essence, the court had jurisdiction to authorise attending doctors to decide in the patient's best interest, medically speaking.

Eventually, the doctors thus authorised by the court amputated both her legs below the knees in order to save her life.

So, by statutory and case law, the decision-making matrix on medical options puts the competent patient first; followed by the courts if the patient becomes incompetent. The family is not included.

Finally, in the National Medical Ethics Committee guidelines, patient autonomy is explicitly highlighted as follows: "The primary ethical principle in advance care planning is respect for the individual's autonomy (so) family members and loved ones (are to be made to) understand the individual's wishes". The guidelines advise that "family involvement is usually inevitable (so) sufficient time should be provided for discussions between individuals and their family members to acknowledge and respect the goals, values and wishes the individual chooses".

That is, whatever the family may want, doctors are to always and eventually regard the patient as having the final say.

Family members' roles

YET as studies show, doctors here break this very rule in deferring to families who override the patient's expressed wishes.

In other words, supremacy of patient autonomy is assumed in the law and practice regulations, where the family has actually no legal standing. But local medical practice suggests doctors and family members are making decisions that do not always accord with this principle.

Other societies have adapted their laws to recognise the family's role in these scenarios. For example, the Hong Kong Hospital Authority 2002 guidelines on life-sustaining treatment for the incompetent elderly explicitly require that "the health-care team should work towards a consensus with the family".

In a 2004 study, City University of Hong Kong ethicist Chan Ho-Mun found empirically that end-of-life decision-making in the city saw family involvement so taken for granted that there was the "presumption that patient consent is not (even) required for disclosure of (his) information to the family".

This family-oriented model of decision-making is all the more accentuated in China where a 1982 law permits consent for treatment to be given by either the competent patient or his family.

Under a 1994 law, a family member's signature suffices if the patient is incompetent.

Finally, a 1998 law permits the family to give consent for a patient to participate in research involving experimental treatments.

Thus, China and Hong Kong laws affirm the family's authority for its members. By contrast, it is an anomaly that the law and regulations here put patient autonomy at the centre of medical decisions, when family members, in practice, are crucial partners, and doctors end up deferring to them instead.

The Lien report wondered "whether our current laws should be reviewed" to take into account this reality.

A review could allow for but also prescribe limits to family involvement. Also, practice guidelines for dying patients could be tweaked to strike a balance between the avowed theory of patient autonomy and the actual practice of active family involvement in decisions.

Doctor-family engagement on end-of-life decisions for patients needs to be legitimised, with suitable safeguards.

[So the question in my mind is, should we be "true" to our culture and involve the family in such end of life decisions, or should we respect the principle of the primacy of the patient's expressed decision.

China is used perhaps as the ultimate example of our cultural touchstone for our familial values which seems to suggest that the family's interest is similar to the patient's interest at best, and  a casual disdain for the patient's rights or wishes at worst.

Certainly harking to China for answers to ethical questions seems surreal if not outright insane. Using China's practice to bolster one's argument is probably the weakest link the argument, yet it has certainly cultural, dogmatic, and emotional cachet with the Singapore audience (75% Chinese), and may have been included for that reason. In other words it is a subtle appeal to affinity for the motherland rather than a dispassionate and rationale argument.

The first question is whether the wishes of the patient is the primary ethical consideration. The author has tried to make a case for it in this previous article. The problem is families do not know best. The court noted that the interest of the family may not be aligned to the interest of the patient.

The second problem is that the argument for a family-centric decision-making for end-of-life issue is ass-backwards. The argument seems to go, "well, doctors today do the illegal thing of asking families what they want and carry out the families' wishes when the patient is incompetent or comatose, so we might as well make it legal."

As a rational argument, that fails logic.

As a principled argument, it is a spectacular failure.

Dr Ho needs to first address the ethical principle issues. He tries to do so in the first article, by arguing that an Advance Medical Directive (AMD) is a pre-commitment by his "past self" that prescribes the freedom of his present or future self. It is therefore an infringement of the rights of his present or future self. There is a simple solution to this; don't make an AMD.

But for those who wish to make an AMD while in full control of their mental faculties, why argue against their right to do so?]

'Storm-troopers' do NY proud

Nov 01, 2012
ON THE SCENE

Sandy fails to thwart spirits of resourceful residents

By hoe pei shan for the straits times


NEW YORK - As he stepped into a tiny cafe with a queue stretching out its front door, a man yelled into his iPhone.

"I've found power and food," he said, clearly excited. "We can charge our phones here."

It could have been a scene out of some poorly written movie about a less developed country. But this happened just across the street from the iconic Grand Central Station, right smack in the heart of trendsetting New York City.

This was a man whose downtown Manhattan neighbourhood had gone pitch dark only hours earlier when super storm Sandy triggered an explosion in a power command centre and caused a blackout in half a million households in the city's five boroughs.

But New Yorkers did not sit around mourning the loss of wi-fi in dark rooms, or cursing inept city officials.

The ones I saw emerging in the aftermath of possibly the most devastating storm ever to hit the north-eastern United States had packed their laptops, phones, even coffee machines, and set out through whipping winds and flooded streets in search of spots in the city that still had power.

They were determined to regain some semblance of normalcy in a world blown completely upside down on Monday night.

However, much of the city was still shut down on Tuesday, and there was an unfamiliar peacefulness.

Schools, the New York Stock Exchange and Broadway's famed theatres remained closed for the second straight day, claiming more than a few historic firsts. Restless tourists milled around Times Square, unsure where to go, or if they should venture anywhere else.

The storm and ensuing floods had also all but ruined the city's extensive public transport network. Only limited subway train services are expected to resume today. Sandy triggered the worst disaster in the history of the Metropolitan Transit Authority, according to its chairman Joseph Lhota.

That left me to make my way around town on foot as I attempted to cure a mild case of cabin fever from having been cooped up with three roommates in our cramped one-bedroom apartment while riding out the storm.

Manhattan, where I live, was one of the hardest hit areas - the storm claimed some 22 lives here. Surveying the area, I realised the storm had spun New York into a tale of two cities - the half that had largely escaped unscathed and the half that had lost electricity, water and even homes.

The city's power grid system meant there were distinct borders to these two halves. Along 39th Street, on the east side of Manhattan, it was possible to walk the line between so-called "civilisation", where restaurants could still provide cooked food and homes were lit - and on the other side, utter darkness.

As I walked to the financial district where Wall Street had turned into a river the night before, the city I have called home for five years was barely recognisable. Stores, apartments and cafes were empty.

Nothing worked - not the street lamps nor traffic lights. Yet the typically reckless New York drivers were slowing down for, and even giving way, to pedestrians as night fell and it was every man for himself in the dark.

Back along 39th Street, some people huddled around a pillar outside a building, trading storm stories in the light drizzle.

Suddenly it became clear what had brought them there; they had a dozen electronic devices plugged into the pillar. Two strangers who had been uprooted from their homes had brought power strips, or extension blocks, with them. When they found a working wall outlet, they offered to share their power strips with others.

The helping hands did not stop there either. Those whose showers still ran and fridges still worked opened their homes to others in need of a wash and food, posting invitations on their Facebook pages.

It was almost as if the storm had washed away some of New York City's least likeable traits - its cut-throat, business-like manner, over-confident stride, and centre-of-the-universe solitude.

Indeed, Sandy had forced one of the world's brassiest, fastest- paced metropolises to slow down and humbly embrace life with a united resilience.