Tuesday, November 15, 2022

Should prescribing Zolpidem/Ambien be moved mostly to the realm of psychiatrists?

I have come to believe that prescribing Zolpidem/Ambien ought to be reallocated mostly to the realm of psychiatrists -- because psychiatrists have the training -- and the inclination -- to do the necessary work up and careful follow up -- and primary doctors, more and more clearly in my hearing, definitely do not.

The clear trend in the "physical illness” medical field – I hear about it over and over – is of medical doctors zapping long running prescriptions for Zolpidem without so much as a five minute, intelligent discussion about how much the withdrawal of their sleeping crutch may upset and or even upend patients' whole ways of life.

Logically, one would think that interruption of a long running, successful treatment for a seriously debilitating “condition" (we don’t use the word “illness" here) should necessitate a careful work up and follow up.

It is not like there seems available any routine Zolpidem substitute, like switching from antibiotic to antibiotic.  Therein lies the patients’ dreaded rub.  Candidate substitutes all seem to introduce serious (yucky feeling) drug hangovers for maybe the first half of patients waking hours.  Alternately, patients can spend all their waking hours in a sleep deprived haze (w/o drug).

I mostly need help getting my last two hours of sleep.  I take a 3-4mg dose cut from a Zolpidem tablet after the first five hours and wake up 2 hours later bright eyed and bushy tailed – zero, ZERO, drug hang over.

Five minutes after I wake up I feel perfectly fit to drive a car.  Logistically perfect.  Doctors will fret that the “hypnotic” is still in your blood stream even if you cannot sense anything like that – causing you to make mistakes even if you feel perfect.

After trying one Zolpidem “substitute" (Mirtazapine) I made one major driving error and had to concentrate hard to avoid two others -- two days after I downed it!  But, intellectually I had no problem knowing I was doing some things very wrong.  Ditto, if I drive on five hours sleep -- I am definitely aware that I am a bit short on patience and judgment.  12 years on Zolpidem; I have never received any “intellectual” message that I am driving incorrectly because of the drug.

So a close look at me, anyway, would seem to obviate extra driving accident concerns.

Even if Zolpidem doubled my accident risk – on the road or slipping and breaking my knee in the kitchen – I prefer that to enduring a drug hangover half the day (from a “substitute”) or to living in a sleep deprived daze all day – every day of my life in my case.  I know; I recently did four miserable months alternating between all day sleepiness and half day gradually shedding the feeling of being hit by a truck.  That half day was what I lived for.  

My OTC “substitute” was Diphenhydramine (Benadryl) – recently reported to bestow the maximum risk of developing dementia.

But, this is the caliber of workup and follow up detail that psychiatrists are primed to ferret out.

Memory loss?  Zolpidem doesn’t make you forget anything you have learned already – or anything new about how things work together.  Less than 1% of users have clinically significant memory loss (whatever that means).

Somebody should do a study of 1000 insomnia patients who have been bumped off Zolpidem (most, probably without discussion) – and 1000 who had their dose halved (probably from 10mg to 5 mg) – to see how deep an effect this may have had on their lives, up close and personal.

But, this is the caliber of follow up that psychiatrists are primed for.  (Did I say that already?)

In one internet conversation, a patient was panicking.  He had previously been out of work for three years because he couldn’t sleep.  Now, after a year and a half on Zolpidem, his doctor was leaving and he was afraid he couldn’t get his prescription renewed (I've been there).  Do you think his doctors realized that they were denying him everything else in his life – job, ability to raise a family, pay for entertainment – to make him safer from slipping and breaking his knee in the kitchen?  Did they think all that through?

I have seen one chart (link below) that shows annual Zolpidem prescriptions have dropped from 45 million to 10 million from 2012 to 2020.  Does that mean that 35 million Americans are now walking around in drug hangovers for hours, or in a sleep deprived hazes all day – in insomnia periods?  Could that be?  (The chart is at the end of a blog post mostly on another topic.)

I am nothing if not grandiose.  I envision the day when everyone can go down a checklist that identifies whether or not they likely have what is known as insomnia – and 50 or 60 million patients are taking Zolpidem.

Sunday, October 9, 2022

Zolpidem users: a debilitating surprise awaits at 65

I took Zolpidem (a.k.a., Ambien) for 12 years. Last spring my doctor cut off my prescription without discussion. Around the same time my brother's doctor cut his prescription from 10mg to 5mg without discussion. At same time a fellow employee of my brother had her prescription cut off – without discussion also, I believe. Same time frame, I was refused a prescription for Zolpidem by an online nurse practitioner.

I cannot imagine a sufferer of, say, migraine headaches being treated in such a neglectful way -- in such an unscientific way -- to be left without treatment for a seriously debilitating condition (insomnia) without even a sit-down discussion.

What’s apparently scaring the doctors off is stats building up about accidents (at home and on the road) for the elderly – reported memory problems (for the great majority, including me nothing especially severe) and reports of strange behaviors (e.g., sleep driving) on Zolpidem. Doctors seem to jump away from these daunting side effects with an almost Pavlovian response – without ever considering that for insomnia there is no other sleep aid that does not have a half or all day after drug cloud to live with.

I DON’T WANT TO BE PROTECTED FROM FALLS IN THE KITCHEN AT THE EXPENSE OF LIVING MY LIFE IN SOME KIND OF HANGOVER MIASMA. That’s the issue our doctors somehow seem to miss wholeheartedly with UNIQUELY hangover free Zolpidem.

I speculate that is because – what I call the physical doctors; as opposed to the psychiatric practitioners -- can't measure insomnia; can't weigh it, can't take its temperature, can't sew it up, wouldn’t know where to sew it back – insomnia doesn’t really exist for them.

IOW, nobody’s knocking to ask them to open their motivational door – not nobody home; nobody even knocking – on a deep motivational level. So they don’t even get around to the purely scientific level that they are so deeply trained on.

There are 38 million Americans on Zolpidem – 85% of all sleep aid prescriptions. Are we going to take all of them off their most practical (no hanging on-hangover) and effective sleep aid just when they need it most? For my part I am going to seek a prescription from a psychiatrist. I am very optimistic. I think that with a doctor for whom insomnia is a tangible, palpable, corporeal thing – the argument against being consigned to a life in the miasma to protect against falls in the kitchen – or just losing sleep every night -- will be very compelling.

Notes: I can cut a 10mg tablet in three parts – and take one whatever time of night I can’t sleep. Only had five hours sleep? Take one piece: 25-45-50: 25 minutes to act-45 minute blank brain (unless I want to think about something)-50 minutes to waking, bright eyed and bushy tailed.

If I drive without taking the drug (after five hours sleep) I can feel less concentration and patience. No such lack of clarity if I take the drug as little as two hours earlier. If I were making druggie “mistakes” I would intellectually know it.

Note: My time-fitting (4 hours sleep to go) nights, OTC substitute -- Diphenhydramine: https://healthunlocked.com/redirect?url=https%3A%2F%2Fwww.medicalnewstoday.com%2Farticles%2F288546%23Taking-anticholinergics-for-more-than-3-years-linked-to-higher-dementia-risk

I also wake up from Diphenhydramine feeling like I’ve been hit by a truck. Great.

Friday, July 1, 2022

Insubstantial Due Process -- what Roe never said

 “One of the most curious things about Roe is that, behind its own verbal smokescreen, the substantive judgment on which it rests is nowhere to be found.”  (HLR, Vol 87: 1, p 7 – Laurence Tribe)

Roe enshrined bodily privacy in constitutional theory -- seemingly no one takes exception to that today.  Roe went on to proclaim it takes a "compelling state interest" for a law to override fundamental privacy.

Then Roe fudged.

“One reads this passage several times before becoming convinced that nothing has been inadvertently omitted.”

‘ … the compelling" point is at viability. This is so because the fetus then presumably has the capability of meaningful life outside the mother's womb. State regulation  … after viability thus has both logical and biological justifications.’  

“Truly, this mistakes a 'definition for a syllogism' and offers no reason at all for what the Court has held."  (Ibid. p 4 -- quoting John Hart Ely, YLJ 1973 April; 82: p 924)

The Roe majority took upon itself what would correctly be be seen as a legislative job -- matching the compelling interest standard to the stages of prenatal development -- as opposed to interpreting words of law.  There being no consensus on the worth or rights of fetuses "deeply rooted in this Nation’s history and tradition" -- the Roe majority found itself out in substantive-sorting land all by its lonesome.

But instead of coming back with a substantive delineation of prenatal life (v. privacy) -- Roe served up a fiat trimester policy that gave prochoice nearly everything it wanted.

Roe disguised its baked-in substantive holdings on fetuses by not articulating any one in any part.
What will any future Supreme Court be able to say once medical technology enables extracting a fetus temporarily from the womb and then returning it to complete its gestation -- when the cosmic question is legal personhood in the womb?

Coming soon?!

Thursday, February 17, 2022

Putin's nostalgia for a past that never was

Putin — and many Russians I suppose — long for the days when Russia was considered a great power.  Some great power.   An all time crackpot economic system — an all time oversized police state (never forget J.S. Stalin at its worst) — and what little economic surplus they could eke out (compared to modern countries) wildly squandered on a military that looked ready for a Mars attack.

180 armored divisions — 1st category, 75% active, 25% reserve, ready in a week, 2nd category, 50%/50%, ready in a month, 3rd category, 25%/75%, ready in three months.  Components of 90 tank divisions (compared to central NATO's 30 armored, fully mobilized), active, ready to go any time (!) — could actually man 50,000 tanks in the field.  Almost 10,000 jet fighters, 300 plus submarines (mostly conventional).

All out of the pitiful economic base.

Visions of communist Russia's military behemoth (more like a gigantic Arab army in quality) must be what feeds the historic mirage of “the great power” in Vladimir's mind.  Forgetting the backwards, creaky foundation of that force, he remembers only its crazily over expanded muscle — in his autocratic ignorance.

Sunday, January 16, 2022

An 800 pound guerrilla (USRA*) can liberate Afghanistan

Liberate twenty million Afghan women from house arrest and all Afghan adults and children from the threat of catastrophic starvation ...

… possibly without taking a single Allied casualty.

The Taliban military – if you want to call it that – does not possess a single tank, no more than a few  abandoned Russian artillery barrels nor one attack helicopter.    From the military prowess standpoint the Taliban clocks in as no better than a national crime gang.  Their most powerful weapons are automatic personal weapons and shoulder fired rockets.

Taliban non popular support: David Brooks said on PBS News Hour: “ ... one of the good things that has happened in the Middle East over the last several years is that people have taken a look at the Taliban, and they hate it. A survey of 11 countries, Muslim countries, only 13 percent of positive views about the Taliban.”  I’m guessing back in Afghan home that might come in at more like 5 percent.
 * * * * * *

The thing is this: if our military moved back in there – with the promise to leave their so-called military alone as long as they leave ours alone – the Afghan government couldn't do much of anything about it.  If they picked a fight with any regular army, they'd be smashed.  They would have no incentive to militarily oppose our landings – as long as we did not land in downtown Kabul.

If we can move 120,000 refugees out in two weeks, without planning, we can move 100,000 soldiers and aviators back in in a similar time frame.  Say we take Bagram airbase back.  Their fighters would be free to leave – they may take their weapons with them.

Once, having set up a few bases the Taliban cannot attack without 100% casualties, we could get down to the business of deploying the “second government" – the knows-what-it's-doing, competent (and well funded) government.  First priority, distribute the necessities of life (likely with international NGO and UN org help).  What could the would-be Afghan military do but look on in envy?

Next comes popular revolt? – in stages?  The women especially – having been introduced to what I call “Zoom World”; and now demanding the same advantages, everyone everywhere else enjoys – were the first out of the box protesting the return of Taliban oppression and will now have their nerve reinforced.

40,000,000 Afghans v. 100,000 very unpopular weirdos -- 40 to 1 modernizing population v. crackpot police state.  100,000 Allied troops just hanging around v. 100, 000 can’t-do-anything-about-us-hanging-around hated screwballs. Sprinkling 50 M-1 tanks around symbolically – no real use – could further depress and frustrate Taliban leadership. Sounds like an untenable social mixture for them – unstable politically to say the least – encouraging upheaval?

Think about this the next time the media finds time to notice the bloated stomachs and prominent rib cages of Afghan children.  Where does an 800 pound guerilla sit?  Anywhere it wants to.
(*United States Regular Army)

Monday, November 15, 2021

What to teach about slavery, Jim Crow and (so-called) inequality?

 Most Americans of 1789 might as well have been living in 789 as far as their ability to do anything about slavery -- for most of recorded civilization the glue holding societies together on dry land was the horse.  The rail road and the telegraph and 360,000 dead Union soldiers (appox. one in five military age males killed or severely wounded!)  -- and post-industrial America brought an end to that.

Came Jim Crow -- and waves of new Americans.  Paddy and Giuseppe and Chan had their own problems.  TV and MLK and LBJ were needed to finally put an end to that.

Came so-called "inequality" (to most Americans this word sounds like a race problem from the 50s). When I explained our labor market to my late brother John, he came back with, "Martin Luther King got his people on the up escalator, just in time for it to start going down for everybody."

At last, put all races on the same economic level:

Saturday, October 23, 2021

Who did COVID victims catch the virus from?

 Most all COVID patients in hospitals or on ventilators were put there by someone or someones who had not been vaccinated.

Given that police officers are forced in their jobs to go into below average sanitary situations -- taking whatever they pick up with them into other less than optimum sanitary conditions -- could that make any police force into a"super-spreader force", if not vaccinated?  Nothing snarky intended.
Risk of taking the vaccine -- exact numbers unnecessary:
Let's just say half our population (cradle to grave) have gotten the vaccine -- 165 million -- at least one dose.  How many died from those needles?  Not even 100 died?  Be a gigantic story, if they did!
Let's just say one-quarter of our population -- 80 million -- has been exposed to the virus to the point where their immune system reacted.  700,000+ died.
Best odds?
Those who wait for "more research" to judge the vaccine by will likely out wait the pandemic by the time their curiosity is satisfied -- will essentially wait for every epidemic to pass by before they ever get vaccinated.  Smart.

Saturday, October 9, 2021

"Dark City" labor market

Imagine a world where buying consumer goods takes place only on Mon-Tue-Wed-Thur-Fri — and — cashing pay checks done only on Sat-Sun.  (I just viewed Dark City, so I am in the mood for such a model.)

Typical employers like Target and Walgreens average 12.5% labor costs — outliers WalMart and fast food have 7% and 25% labor costs.  Say, in one-single Mon-thru-Fri week, lower 40% pay employees double wages on average -- up 50% at fast food, up 2 1/2 X at Walmart.

Consumer prices for goods produced by lower income workers have to rise about 12.5% across the board — demand falls 12.5% for lower pay produced goods …

on that particular Mon-thru-Fri.

Sat comes; lower cost workers pick up their doubled pay — for producing possibly fewer goods — Mon-thru-Fri haven’t dawned yet.

Mon comes; lower pay workers take the extra money squeezed from consumers to market to purchase goods and services — probably proportionately more on goods produced by lower wage workers.  Demand for lower pay produced goods rises more than 12.5%.

Put this eight-grade, market math to work for everybody whose labor the consumer might agree is worth more:

Monday, October 4, 2021

Joe Manchin's phoney trillion dollar trilogy.

 $5.4 trillion over six months -- compares to $3.5 trillion over ten years -- how? 

Even if we were leaving the bill for our grand kids -- GDP $20 trillion a year today -- 50% more population -- 50% more per capita income -- $45 trillion econ output 40 years from now (two generations).  Meantime $3.5 trillion sinks to $1 trillion with inflation.  Just saying.

Can't pay for Social Security today, Joe?  Trust Fund depleting?  Wanna build another Trust Fund for future?  Trust Funds make a lot of sense: you raise taxes decades earlier when the economy is less productive and the nation is less populous.  Then, you keep taxes lower in the future when we are more productive and more over crowded.  Smart.

Friday, October 1, 2021

South Vietnam won the war – at first

(1)  If we believe Richard Sorely’s 1999 book, A Better War, by mid-1972, the poor bedraggled South Vietnamese villagers, with about half the obsolescent American weapons they could have used, had so reduced their poor bedraggled Viet Cong counterparts that an American ambassador could travel the countryside without escort.

(2)  This in turn made it impossible for Northern main forces to conceal their caches of food, medicine and ammunition delivered down the Ho Chi Minh trail– their main force soldiers were eating grass.  

(3)  Which in turn prodded North Vietnam to send every last soldier it had left at home – 200,000 – down south in an old fashioned conventional tank and artillery assault in a desperate attempt to relieve -- thrown back with 50% casualties.

The defending infantry were exclusively Vietnamese -- aided by American logistical, air and intelligence support.

Three years later North Vietnam blitzed its way through South Vietnam in three months.  With three more years to shape up, the South should have been even more ready.  What happened?  No American logistical, air, intelligence and financial support.  

We had taken our bat and ball and gone home.  After losing 60,000 American lives and spending hundreds of billions of dollars we wouldn’t even give South Vietnam the money to finish the job …

… craziest thing I’ve seen in my life.

Cannot fault Southern spirit:
“On the road to Saigon at Xuan Loc, an ordinary South Vietnamese unit, the 18th Division, fought battle-hardened North Vietnamese regulars backed by tanks, trucks, and artillery to a standstill for two full weeks. Not only did those South Vietnamese soldiers take heavy casualties, with more than a third of their men killed or wounded, but they held their positions through those long days of “meat-grinder” combat until the enemy had to circle around them to reach the capital.”

According to Frank Snepp’s 1977 book, Decent Interval, we had someone on the North Vietnamese politburo and they had voted to throw in the towel (not sure the timeline here) – but when they in time caught on that the South was rationing artillery rounds, etc., they decided to start up again – with the well known result.

The decision year.  In 1965, our knees were still knocking over two little countries almost taking over the world 20 years earlier.  Now, the two biggest countries in the world were (very vocally) coming to get us (“We will bury you”).  It may look 10 X more dangerous than it should when it’s coming at you, but at that time but we were plenty scared (think Korea).

Sunday, September 26, 2021

How to handle flying Mt. Everest -- Att: Bruce Willis ;-)

 If you explode a fission device in the closed end of a 10 foot long cardboard tube, in about 20 nanoseconds the entire blast should have exited the open end.

Kosta Tsipis weapons tutorial: Bulletin of the Atomic Scientists, early 80s: 99% of the energy of fission explosion is released in the last 8 nanoseconds.  Photons, which are the main output of the device travel 10 feet in 10 nanoseconds.  Hence, about 20 nanoseconds.

Richard Rhodes' 1995 book Dark Sun, on first page behind first set of photos: diagram illustrating the successive stages of a thermonuclear explosion.  The force of the fission blast at one end reflects off the walls down to the opposite end where it compresses another plutonium device to critical mass.  Trapped between two fission explosions, tritium-deuterium atoms are heated fusion temperature -- whence they release left over protons from the t-d fusion into helium.

This fusion reaction would peter out to less than a kiloton -- if the whole device were not wrapped in reactor grade uranium which explodes upon being bombarded with the left over protons -- which latter reaction feeds back and forth, back and forth until the process plays itself out.

The idea is that cardboard or steel sides of a fission device cannot move 186,000 miles a second to get out of the way of a nuclear explosion.  You could contain a nuclear explosion for several nanoseconds by wrapping it in toilet paper.
 * * * * * *

While watching the movie Armageddon it occurred to me that the NASA characters might be able to rely upon the cardboard tube model to nudge the asteroid away (not one the size of Texas or course [!]; just the standard dinosaur wipe out-6 mile wide model).

If a fission bomb embedded down a hole can release 99% of its energy without breaking up the asteroid the next question would be how much thrust will the fission exhaust alone create since it is not blowing out much of the asteroid mass.  Multiply how much of matter in the bomb will be turned to energy and by the speed of light, squared; and that will give us our thrust -- I guess.

Now, we just have to find somebody who knows what they are doing to answer that -- or tell us that the whole idea is bulloks.  ???  :-O

Noto bene: cannot use a hydrogen bomb for this purpose because the back and forth fusion/fission process is self contained -- and will get around to taking out part of the asteroid.

Sunday, August 29, 2021

50% of Afghans horrified by Taliban -- not counting males

 20 years gave "Zoom world" plenty of time to touch base in Afghanistan -- time to touch that deepest cord of innate behavior: equal social status -- which translates to having the same freedoms (e.g., democracy) as the rest of the world.

David Brooks: "A survey of 11 countries, Muslim countries, only 13% have positive views about the Taliban."  (PBS NewsHour, Fri, 8/27)

50% of Afghans are horrified by the Taliban -- not counting males.

David Brooks again: " ... and so at a time when liberal democracy is beginning to have a little momentum and theocracy is taking some blows ... "

Could we be snatching defeat from the jaws of victory in front of the entire thug theocracy world?

(See also: Adam Tooze, Don’t Abandon Afghanistan’s Economy Too, http://click1.crm.foreignpolicy.com/chtccnzmzhcftttgfghnqfkzsdfnnkmgqgtmdqlgmtcld_dhcrjdsjftmhgtsddgg.html?a=35816&b=Editors+Picks+OC&c=35816 )

(See also: Mona Tajali, “Hear Our Cries”: What Terrifies an Afghan Women’s Rights Activist, https://www.thenation.com/article/world/interview-afghanistan-womens-rights/ )


Thursday, May 6, 2021

Take American labor -- and America -- off the road to serfdom

The PRO Act would add some teeth to the toothless NLRA ($50,000-100,000 fines for retaliating against union organizers) and pull some teeth from Taft-Hartley (take down right-to-work laws).  Does anybody expect this would magically triple union density from today’s 6.5% in private (non-gov) economy to 20% — even while 50% want to join a union?  When private union density was 20%, McDonald’s, Target, Walgreen’s and Walmart were not unionized.  We want them all unionized this time around, don’t we?

Half the Prime delivery drivers whose opinion I seek about federally mandated, regularly scheduled union elections (cert/recert/decert) at every private workplace have no idea in the world what I am talking about.  I guess they are from the other 50%.  They are intelligent; it seems they live in a time and place that has largely forgotten what a labor union even looks like.

The 50% who remember would kill for regularly scheduled cert/recert/decert elections.  

Only the promise of mandated cert/recert/decert elections could claw back enough Obama/Trump voters to safely swamp any Republican efforts to steal the coming elections (by putting the dominant political party in charge of counting votes for instance: the real road to serfdom).  

New York Times numbers guru Nate Cohn:
“But pinning Mrs. Clinton’s loss on low black turnout would probably be a mistake. Mr. Obama would have easily won both his elections with this level of black turnout and support. (He would have won Michigan, Ohio and Wisconsin each time even if Detroit, Cleveland and Milwaukee had been severed from their states and cast adrift into the Great Lakes.)”

The PRO Act is not going to start an Obama/Trump voter stampede for Republican Party exits. But, federally obliged, labor union election cycles are just what today’s democracy deprived American workers would recognize they overwhelmingly need.
 * * * * * * * * * * * *

[cut-and-paste from: Which Side Are You on?: Trying to Be for Labor When It's Flat on Its Back by Thomas Geoghegan]
First, [Taft-Hartley] ended organizing on the grand, 1930s scale. It outlawed mass picketing, secondary strikes of neutral employers, sit downs: in short, everything [Congress of Industrial Organizations founder John L.] Lewis did in the 1930s.
And Taft-Hartley led to the “union-busting” that started in the late 1960s and continues today. It started when a new “profession” of labor consultants began to convince employers that they could violate the Wagner Act, fire workers at will, fire them deliberately for exercising their legal rights, and nothing would happen. The Wagner Act had never had any real sanctions.  …   So why hadn’t employers been violating the Wagner Act all along? Well, at first, in the 1930s and 1940s, they tried, and they got riots in the streets: mass picketing, secondary strikes, etc. But after Taft-Hartley, unions couldn’t retaliate like this, or they would end up with penalty fines and jail sentences.


Thursday, February 25, 2021

Higher min wage makes more (low wage) jobs? -- Cert/recert/decert as "you like"

 For states that already have $12.50 minimum wages, waiting out four years to reach a $15 federal minimum wage won't soften job impact – because not much to soften.  A 20% pay raise for a firm with typical 10%-15% labor costs could add about 2.5% to products prices (20% X 12.5%).  
For $7.25 minimum wage states, doubling pay to $15 could force firms with 25% labor costs (e.g., fast food), to jump prices 25%.  But even if that incurred 25% jobs losses, employees as a group would be only too happy to be 50% ahead in pay overall (200% X .75).

If lower 40 percentile wage earners (all who below $15 an hour) sell less stuff to the upper 60%, but for more money overall, their accordingly greater spending will in effect employ more jobholders than before – while the 60% will in effect employ fewer jobholders.  
http://fortune.com/2015/04/13/who-makes-15-per-hour/  (2015, pay wall)
 * * * * * *   

We have to go back seven decades to find a federal minimum wage that is albeit a dollar higher than today’s minimum: $8.35 in 1950 (inflation adjusted)!

We would have to go almost as far back – to the 50s and 60s -- to find a level of labor union density that could wring (as in extract) fair share for employees out of the labor (consumer) market.  

Meanwhile blue collar workers are running for the Democratic Party exits at a pace threatening to remake Republican demographics look more like Democratic demographics of the 50s and 60s.  Blue collar voters switching to Republican, last ten years: White 45% to 57%, Hispanic 23% to 30%, Black 5% to 9%.
(Meet the Press, Data Download – 2/21/21, 39:07 to 41:14)

A healthy rich country labor market being so far in their (our) rear view mirrors that nobody even guesses (remembers) what’s critically missing anymore -- unions!  Build back every bit as much labor union density as we “feel like" as quick as “we like":

A union is a business.  You should be able to open any union business you “feel like" as easily as any other business: just apply for a license for most businesses; just vote in regularly scheduled cert/recert/decert elections in all private workplaces for union businesses.

Better act in a hurry to restore these folks' sense of their own power over their own existences -- before the next would be American Mussolini turns out to be less of a buffoonish fool (who nevertheless got 74 million votes).