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I am hungry. Let’s go shopping. Let’s buy chicken. (I am sort of vegetarian, but let’s keep it simple.) At local store X, chicken is $1.50 per lb. Next door, at local store Y, it is 1.58 per lb. About a mile away, local store Z is selling it for $1.48 per lb. All things being equal, that is to say, chicken is chicken, I suspect most of us would go to store Z.Why don’t we try something different. Not everyone eats chicken…at least not daily or even once a week. I have a lot of money and I am going to do something interesting. Why not sell food insurance. Tell you what, for a family of 4, I will charge $1,500 per month. (For arguments sake, let’s say a family of 4 spends $1,000 per month on food.) Additionally, you will use your insurance at the store, unless you buy particular items or more of a particular item than your insurance plan allows, then you have to pay a deductible.As my insurance business grows along with the monopoly on food it has created, the price of chicken is now $24.00 per lb.As you enter the store to buy less food than you could prior to my food insurance industry, you can see me in front of the store making extra money at a three card Monte table…or maybe a shell game…kind of a metaphor for what this is all about.Are you beginning to get the idea? Yes, the analogy is off the wall, but so is the medical insurance business.I am not going to go into the entire history of health insurance but I will touch on some points along the time line. At the beginning of the 20th century, with the industrial revolution in full swing, what we now know as workman’s compensation insurance began in 1910 when states began enacting laws to protect workers. Initially, an injured worker would see his own physician and the bill would be covered by the workers compensation fund. Subsequently, some companies hired their own physicians to provide care. Both of these models would evolve over time into models that we see today.Interestingly, even prior to this, since around the time of the civil war, some employers took a portion of their employees pay to put into a sickness fund that would be used to pay employees something during times they did not work due to illness. However, for the most part, absent workman’s compensation paid visits, the majority of physician and hospital visits were paid out of pocket by the patient.One must also take into consideration the fact that medicine as we know it today had quite a revolution since the first colonists came to America. At that time, all American physicians were trained in Europe. There were no CT scans, MRIs, blood work, or antibiotics. Jenner’s work on smallpox would not come until the end of the 19th century.During the 1700s a sophisticated diagnosis might be based upon the patient’s predominant humor. Blood letting was a popular treatment of the time. The “physician” doing the procedure might likely be your barber. The medicines of the day were predominantly botanical. Surgery as we no it today was non-existent.Interestingly, while the age of enlightenment would bring science or what we today call evidence based medicine into being. American physicians kept many of the traditional non-evidence based procedures in their armamentarium. Today, a patient going into cardiac arrest brings to mind the image of a crash cart, defibrillator, and CPR. Back in the 1700s a shortage of such equipment necessitated the use of other means. So, what did they do. The answer lies in a common expression uttered by an individual who believes he is being duped or lied to. Have you ever said, so in so is “blowing smoke.” For those that do not know the full expression, it is, “he is blowing smoke up my ass, or more properly put in doctor speak, rectum. Ever wonder where the expression came from? You guessed it. A method of revival was to give a rectal smoke enema. It started in 1774 in London by two doctors, William Hawes and Thom­as Cogan who administered the procedure at a cost of 4 guineas, about $756 in today’s dollars. (To be sure, the unconscious patient’s wallet would be examined to see if it contained a Blue Cross/Blue Shield card, or American Express.)In America both before and after the revolution, doctors could be paid in cash and if they could not afford the bill, they would likely pay in goods. At this juncture, an important point needs to be made. In the 1700s and 1800s, most notably in Europe, physicians in particular, and surgeons were highly respected members of society despite the fact that in reality, there was very little they could do for many of the common afflictions of mankind. While they may have been highly respected, what they were not was what we would call wealthy by today’s standards. One did not enter into medicine to become wealthy.We should look at this further by noting changes in language. The traditional definition of a profession is that it is a “calling.” It is something one does not for monetary gain or social status, but rather for the benefit of mankind. Historically, there were only three professions, the clergy, law, and medicine…nothing else. Physicians in the 1700s and 1800s were financially in what today we would call the middle class. One did not undertake medical training in the hope of attaining great wealth.Unfortunately, the concept of medicine as a calling has been lost. Approaching medicine as a personal calling is not a requirement for entrance into medical school although, perhaps it should be because in my opinion the practice of medicine requires a certain selflessness that I think is necessary to be a good physician. Of importance with respect to healthcare finance this plays an important role in understanding the economics of physician salaries today and differences in how the different specialties are compensated. If all physicians have answered a calling, then they would be paid equally. however, they are not as will be discussed subsequently.Getting back to the history of insurance, the depression hit hospitals very hard. Justin Kimble, an administrator at Baylor Hospital devised a plan that would pay hospitals and can be considered a forerunner of Blue Cross. He enrolled 1250 Dallas, TX teachers in to the plan. For 50 cents a month they would be provided 21 days of hospital care. The AMA was opposed to this so only the hospital and not the physicians were covered. In 1932 in Sacramento a plan was created not for one hospital but for all of those in a particular community. These plans were all non-profit. This geographic specification remains today in the Blues. It should be noted, especially because it is the crux of my position, the states did not view these plans as insurance. The looked at them as pre-paid plans. However, in 1933, the NY state insurance commissioner deemed these plans as insurance. His reasoning was that these plans were collecting money for services to be rendered in the future. In a sense, he likened them to life or casualty insurance both of which are paid out at a future time. As will be subsequently discussed I beleive this was a mistake that has had serious consequences in terms of its impact causing the healthcare problems we have tody.In 1939, the California Physicians Service developed what would become Blue Shield. It was an indemnity plan which paid the patient for each event. The patient would be responsible for paying the physician bill. Commercial insurance was another matter. The companies that provided Life, Casualty, and other insurance could not see how health could be insured. Once a patient obtained the insurance, there was no disincentive to be sick. This was resolved by only offering hospital coverage. An admission to a hospital could only be done after a physician determined the patient was ill. However, they did offer coverage for the surgeon because surgery was considered a discrete event. As will be discussed, I think this reasoning was also unsound.Around this time, prepaid plans for physician services would also develop. Physicians were against this because at the time they used a sliding scale with wealthy patients paying more. It was thought that the plans by ending the sliding scale would reduce physician profits because the wealthy were defraying the cost of the poor. However, the plans continued.We must keep in mind that up until the 60s and 79s, the majority of people had no insurance coverage for visits to their primacy care doctor. With the sliding scale, people were able to pay for a simple visit. You paid for your laundry, your food, a hair cut, a manicure. A doctor’s visit was just another expense. Let’s look at this more closely. In 1954 how much do you think a physician office visit cost. Before I tell you, a brake job was about 25 dollars. As for the office visit, around $3.50. A house call, many of you won’t remember them but yes, the doctor used to come to your home. How much….a dollar more…about $4.50. The point being this was an expense that could easily be paid out of pocket for most people. The fact that this was possible has an impact upon a potential remedy to one facet of healthcare costs, primary care and some other specialist office visits.Private Health Insurance grew rapidly in the 40s and 5os. for a number of reasons. World War II brought with it wage and price controls decreasing discretionary spending. The second reason was expansion of organized labor. The Taft Hartley Act of 1947 made health insurance a condition of employment. The US government stuck its nose where it did not belong. Taft Hartley then was an important milestone in the creation of the healthcare mess. The third reason is that the US tax code did not specify whether employee sponsored health insurance was taxable. In 1943 the IRS issued a ruling stating that employee sponsored health care was not taxable.There were also not as many insurance companies to drive a wedge between the provider of a service and the customer that interferes with supply and demand which drives prices in a free market.Physicians, (read surgeons) worried that hospital insurance would get into the physician business, created one for themselves that eventually became what we know as Blue Shield.Ever look at a physician bill? Your primary care physician might bill $100 for what amounts to a 30 minute visit. However, any medical specialty or surgical bill for a procedure will be much more. The reason is that since surgeons created insurance for themselves they were smart. Since people were not going to pay out of pocket, why not jack up the fees. The rest is history. This is why cognitive physicians, the ones who are supposed to help you stay well get paid less for their time than those who do procedures.One time I sustained a laceration to my finger. It was not a big deal. However, when I went to the ED, they wanted me to see a plastic surgeon. I thought it was a bit of over kill. Though trained in Internal Medicine, I had done enough Family Medicine and was very comfortable sewing up lacerations. However, I could not sew up my own finger. (I could teach you to do it.. it really is not hard!)I go to the plastic surgeon and he injects me with lidocaine and sews it up in a couple of minutes. Sometime later when I saw the explanation of benefits I hit the roof. The physician used a couple of different computerized procedural codes (CPT codes) to bill for the injection of lidocaine as well for sewing up the laceration. I used to charge $50 to $75 for doing the same procedure. He charge over $2,000. That is right…over $2,000.I called him up. At first I was polite. He became very defensive. His justification was simply that insurance was paying for it anyway. I wrote to BC & BS who at that time was my insurance company. I accused him of price gouging. What happened? Absolutely nothing! Was I surprised…no. The reason is that by that time in my career I understood what was going on. The company had no incentive to do something for the simple reason that the more physicians charge, the more they can charge for their premiums.Get rid of insurance. Make medical service competitive like any other service. We should stop hospitals from cost shifting, charging $25 for a band aid to pay for other services. Ever wonder what the real cost is for performing an MRI? I don’t know. Just look under the third shell. Maybe the answer is there.Note:Since writing this I have seen comments suggesting a one payer system. There was a time I thought that might be the way to go. However, there are several problems with that. Insurance companies are supposed to spread risk. If you move 5 blocks from where you live, your car insurance may go up. Why? They analyze many factors including how many accidents take place in a particular zip code. So, just moving a few blocks could make a difference. Hopefully, everyone will not have an accident! However, don’t worry, it does not much matter because if more people have accidents the company will increase premiums. It is said that the average profit is 4 to 5 percent. Whatever it is, they are in business and not running a charity!With respect to auto or any other insurance, actuarial analysis allows them to constantly monitor their exposure. This allows them to make what adjustments are necessary to insure they make a profit. So, how can one use this same model with respect to medicine. Think of all the people you know. Are there any of them who have never been ill, have a chronic illness or never required medical care?Pose the same question to yourself but stratify by age. As we get older, eventually, the likelihood that you are going to get something is sadly all too great. That this is true is a subject of another conversation. It has been said that 25% of Medicare outlays are for people during the last years of their lives. How far we go to preserve life and when to quit is also a topic for another conversation.However, no matter. Do you see where I am going with this. How can risk be spread when the risk that you will eventually be sick and have to use the healthcare industry is 100%. Its kind of like my concept of food insurance. There is no way around the requirement for food and unfortunately, as things are, medical care is a necessity.So, we are really not talking about the spread of risk. (Sure, not everyone will have their appendix taken out. That my happen to your buddy John. However, he will recover in time to visit you when you have your hernia repair. Some people may require less than others by virtue of good genetics, avoiding life style choices that lead to illness, and being educated about their health. However, just about everyone has something. Medical care is a service that all of us require at one time or another.The question than becomes how to pay for that service. Or is it? Why does it cost more to go to a doctor than to get a haircut? (I am playing the devils advocate here…a sore spot.) I remember working for a physician when I finished my residency in the early 90s. At that time he had signed up for a number of HMO panels. I suspect most of you don’t know how that works. Well, here is the deal. I will make up an example. Insurance company X gives you 1000 patients broken up into 400 men, 500 women, and 100 children. For each man, you get $6 per month, for each woman, $7 per month, and for each child, $8 per month. (I am making up the numbers…but they are different for men, women and children.) So, if my arithmetic is still good, that is $6,700 per month.For that amount, he has to take care of all those patients both at the office and in the hospital. Certain tests done at the office were also covered. If he referred too many patients to specialists, lab work, imaging, or modalities such at PT, he could be penalized and lose money. So, the incentive when Mrs. Smith calls about her 5 year old’s sore throat, to let the nurse handle it over the phone. The physician also has a disincentive to refer patients. This as opposed to fee for service medicine where the physician gets paid when the patient comes in. When Mrs. Smith calls about her son in this situation, the nurse tells her to bring him in. The doctor will order a strep test for which he can charge the patient.Now, the guy I worked for was a real doctor. To his determent, he did not care or think about money so he referred patients to specialists or for whatever tests he thought they needed. I remember one day after a phone call from one of his insurance companies, his face turned red, he screamed the name of the company with an epithet, and smacked his hand on the table. They called him to tell him that he had referred so much that essentially he would get less money that month.I was 100 K in student loan debt and making $40 bucks an hour in a DC suburb. I remember the early and mid-90s as we heard about these “kids” making a fortune on these things called PCs and something called the Internet. That doctor would shake his head thinking how hard he had worked and is still working busting his chops while these “kids” were making a fortune doing what? I am sure you get the idea. I have to be honest and say that whatever thoughts I had that my financial life would be easier after finishing my residency were quickly dashed by the reality of what medicine had already become and where it was going.Additionally, I wanted to work on my own. I remember wanting to start my own practice. The banks (well, the people in the banks) laughed at me. Physician practices were already having financial problems. To make matters worse, I, as did a number of colleagues who were similarly afflicted had a particular problem. We really loved medicine. We loved talking to our patients. We were terrible or perhaps we did not care about the fact that medicine is a business. One of my friends, a cardiologist, he had the same extrovert nature as I do and would spend a considerable amount of time with patients just talking to them. His wife, the office manager, a good choice because she had a vested interest in things running correctly, was constantly on him to move on.The things is, I think we were doing what we should be doing. You really have to get to know your patients, what they do for a living, their hobbies, their relationships…the whole nine yards. People are not automobiles. There is a psychological component which must be addressed. I do believe that our emotions and thoughts have a very significant impact on our health. Besides, how else to you get to learn about all the different things people do especially in and around a vibrant area such as the Nation’s Capital.This brings me to this. At one time, prior to what I call the egalitarian, inflationary pressure that everyone should be paid as much as the other guy, the Oxford Dictionary listed only three professions: the clergy, law, and medicine. That was it. You could not be a professional disk jokey or a professional sanitation worker (garbage man.) The definition of a profession is that it is a “calling,” something that people do because, perish the thought, they really like and want to help people. One might say you have to be a little bit nuts…perhaps in a good way.Prior to our moderns era, physicians were well respected but they were no rich or wealthy. This brings me full circle to my question. Should physicians be paid as much as they are. Should they be paid more? Should they be paid less? Sometimes I thought I would have been happier had I been independently wealthy and could practice medicine as a full time hobby! It may sound crazy but it isn’t. Certainly if we could remove the financial burden of medical education that would be a start.A guy I knew investigated Medicare fraud at one time. There was and probably still is lots of it. That is only one of the problems getting the government further involved in this mess. I sometimes wonder if there was a way to simply provide free care for everyone. Perhaps physicians should be paid while their patients are well and not paid when they get sick and shift the entire paradigm to prevention. I apologize if you feel I have led you on to think I have an answer because I don’t. I do know the present system is broken and The Affordable Care Act is not even a band aid.I do suggest that with the ability to access information that we have, that people take as much responsibility for their health as they can. Medical information is growing exponentially. The more people know the better they can make informed decisions about their health.

The cowboy of western lore didn’t exist as depicted in films and TV shows. By and large a herder of cattle held just about the worst job there was. The labor, though skilled, was hard and frequently dangerous; the pay was lousy; working conditions severe. It was a job often taken by the most down-and-out, just a hair better than being a ditch-digger or town waddie, mucking out saloons, moving an outhouse over a new glory hole, or shoveling out a stable.After the Civil War, numerous men migrated west seeking their fortune. If they lacked the means, skills, or wherewithal to establish a homestead or start a business of any kind, they often drifted into herding or “cowboying” to make their way. The term “cowboy” wasn’t much used; and if it was, it was rendered in print as “cow boy,” referring to the idea that on the smaller ranches youngsters were often put in charge of the smaller herds, even when they were driven to markets in Galveston or elsewhere along the Gulf Coast, or to New Orleans. As the larger ranches developed, though, regular hands were hired on to manage the larger and more cumbersome herds. They were sometimes called “drovers,” “riders,” “cowhands,” or “cow punchers,” or eventually “cowboys,” a term that was actually made popular by Buffalo Bill in his Congress of Rough Riders and Wild West Show in the 1870s and forward. Buck Taylor is credited with being the first cowboy, so-called and so billed by Cody. Thus was born the more romantic image that became iconic.The work offered a cowboy was usually of three types. Temporary hands or day-workers would be hired on during the spring months to round up stray cattle and unbranded calves and bring them to a central location for branding and castration. Fall roundups were also done in various locations on larger ranches, some of which encompassed hundreds of miles of open prairie and grassland, with rivers, woodlands, mountains, breaks and badlands taken in. Early in the period, the cattle were effectively wild and had to be herded together. Unbranded calves were cut out for branding, young bulls were castrated, and they were then driven to market overland. Later, they were more domesticated, hybrids such as Herefords, and would be driven to railheads or centralized market locations for shipment. The process was still the same. Roundup work lasted only a few weeks, but it tended to pay decently (by the standard of the time) and offered “found,” which was “chuck” or food and a place to sleep, often. The proffered diet was simple, usually beans and bacon, biscuits or cornbread, stew or chili, and occasionally beef that might be taken from a slaughtered animal, although this wasn’t all that common. “Green” or freshly butchered meat from grass-fed cattle tended to be tough, stringy, and required severe cooking to make palatable. More often pork or chicken, wild game of various sorts would be the main fare if there was fresh meat at all. The second kind of work was the “drive,” which was a herding proposition and could take anywhere from weeks to months to drive a gathered and branded herd from a ranch to a market, eventually a railroad head in Kansas or Nebraska, or later to large ranching operations in Wyoming and Montana. From the railheads, then were loaded for shipment to the slaughter houses in St. Louis and Chicago. Cowboys hired on for the trail drive and would work to round up the cattle designated for market, brand and cut them, drive them from the point of origin to the shipping site, and then receive their pay, which they would often blow through in the saloons, casinos, and cat-houses of the small towns that served the railroads (Dodge, Abilene, Fort Hays, Wichita, etc.). Then they were released from employment and either made their way back home or drifted off elsewhere. The third type of work evolved later in the period, with permanent herders being hired on to work on a large ranching operations. They would reside in a bunk house, work for a single ranching enterprise, riding fence (once fences were established), wintering in line shacks strategically located so they could monitor the herds, assist any heifer who calved early in the season, and protect the cattle from bears, wolves, coyotes, large cats, and, of course, cattle thieves who predated on untended herds. In the spring, these same men worked the round-ups, moving herds from one pasture to another or to local railheads for shipment, and doing whatever laborious chores were associated with work around a large ranching enterprise. These chores could range from carpentry to even plumbing. These were regarded as “plum” jobs, as they paid regularly, if not well, provided regular meals and shelter, and offered a man the possibility of advancement in life if he was frugal and stayed healthy. (There was certainly no “health plan.” A cowboy who fell ill or was injured was simply let go. Troublemakers weren’t tolerated, and any cowboy who married generally left the work.)Although many cowboys owned their own saddles and basic tack (bridles, blankets, etc.) most didn’t own their own horses. Ranchers provided a remuda of mounts for their use. Often a cowboy might ride several horses in the course of a day’s work, although they tended to have their favorites selected from the remuda as time went forward. (Horses routinely need more rest, water, and fodder than Hollywood or TV would suggest.) They did not routinely carry side-arms, although these might be issued by a rancher if the need warranted. Indians and rustlers were not infrequent threats on a long trail drive. Many had access to carbine rifles or more often shotguns that they could carry with them to defend against predatory animals or venomous reptiles. Around the turn of the century, Thompson Sub-Machineguns were marketed to ranchers for defense against rustling, although few actually used them. Most cowboys could not afford to buy and maintain their own firearms. A quality revolver or rifle could cost as much as a month’s pay, and ammunition was dear. Those who did have weapons and wore them regularly were usually not well regarded; it’s very hard to hit any target from horseback, in the first place, and a holstered pistol is not a comfortable accessory to wear while riding a horse or working cattle in a roundup. Most cowboys were very good with lariats and ropes (there is a difference), and they often owned their own, which they also had to maintain, no small task in itself. Lariats were rawhide made, woven tight, stiff and tough. Roping was a primary skill that they absolutely had to master. Some were issued bullwhips, as well, if they were herding particularly wild cattle, and they became adept at using the whips from the saddle.On the whole, cowboys were largely poor white or black or Mexican-Americans. Indeed Spanish then Mexican vaqueros were responsible for many of the techniques of working cattle and contributed a great deal to the clothing, tack, and other accoutrements that are associated with cowboy imagery. Even the ten-gallon hate of western movie fame is adapted from the Mexican sombrero, and the western saddle developed from the Spanish design. Other items such as large-rowled spurs, saddle fenders, latigos, and certain types of bits were other additions from vaquero culture. Cowboys were often ignorant, illiterate, lacking in any kind of social skills or refinement. Many were criminals escaping a dubious past. Sometimes, they were mentally challenged individuals who had limited abilities. Very few had family ties locally; often they had no social connections whatsoever and drifted from job to job without permanent addresses. Many manumitted slaves, fleeing the Jim Crow South migrated into this work after the Civil War, and many of these established their own ranches and farms, eventually; some took up other enterprises, most especially swine farming, dairy farming, and other agrarian enterprises, including tenant farming and share-cropping, as alternatives to the nomadic cowboy life. Hispanic cowboys were more common in the southern districts of the country, of course, but they tended to be more skilled and better trained in bovine husbandry than many migrants from the eastern or southern climes. On the whole, though, about three out of five American cowboys of the period was an African American. As a general rule, their pay was the same as anyone else’s, although it was so low that it truly was hardly a significant distinction. There is almost no reliable information about segregation among trail drovers or round-up workers; however, black and Hispanic cowboys working permanently on a ranch, generally bunked and took their meals separately from whites.Cowboy clothing and accouterments were often rustic, crude and varied widely in style and type. They did favor large-brimmed headgear—as mentioned, the famed “ten-gallon” hat, made of felt, although it’s not unusual to see photographs of working cowboys wearing derbies, caps, plug hats, or other forms of headwear common to the period; Hispanic cowboys, as noted, often wore large sombreros, and in southernmost climes, straw hats were not unknown—leather or corduroy trousers, later denim, lace-up, knee high boots, as a rule (pull on, high-top “cowboy boots” were known but were not often well-regarded, as they tended to wear out fast and were uncomfortable to walk in. Cowboys did a lot more work on foot than most people imagine.), chaps of varying styles, cotton, gingham, or muslin shirts, a denim or fleece-lined jumper in cold weather, an oil-skin slicker to ward off rain, and a bandanna or kerchief that was large enough to cover the face and protect against dust and dirt, as well as to wrap around the back of the neck to ward off sunburn. More prosperous cowboys sometimes had a waistcoat or vest, frock coat, at least one collar and cravat to wear should the occasion call for it.As the century closed, cowboy life improved somewhat. There was a famous strike in 1883, wherein a group of twenty-four cowboys demanded better wages and working conditions, recognizing that “corporate ranching” was making huge profits off their underpaid laborers. As many as three-hundred Texas cowboys pledged to join the walk-out that affected between five and seven large ranching operations, and the strikers threatened all kinds of violence if the owners didn’t relent. In the end, there was no violence, most of those who threatened to walk out deserted the strike, and the owners made a small gesture of better wages to defuse the whole thing. (The event is celebrated in Elmer Kelton’s landmark novel, The Day the Cowboys Quit.)After the turn of the century, the cattle drives were over. The problems of Texas Fever, which had prevented wild Texas longhorns from being easily marketed and shipped without lengthy quarantine periods and delayed the introduction of blooded cattle to the state for decades) had been solved (discovering in the 1890s that the disease was caused by ticks and that a dipping process would end it.), the ranges were all fenced and established by then, and railroad access had obviated the need for cross-country drives. Cowboy work became more regular, with part-time, temporary workers often hired during ranch round-ups and permanent staffs of herders being hired and housed on individual ranches. Salaries continued to be low; the work continued to be hard and dangerous; and the job appealed, really, to the lowest common denominator of the available labor force, men who usually could ride and rope and handle animals but who had no other abilities or education.There were some exceptions to all of this. Teddy Blue Abbott became one of the more famous and literate and almost poetic cowboys of the era. And there were some, like Charles Goodnight or Oliver Loving or John Chisum or Daniel Waggoner or Burk Burnett, who established their own ranches and became both social and political forces in their communities or regions. Some ranches such as the 6666 or the XIT or the Matador or certainly the King Ranch became almost legendary in their size and financial success. The cattle business was the most important enterprise on the southern plains and also in Montana and Wyoming for half a century. Cattlemen wielded huge political power and influence in state and territorial legislatures, often maintaining their own police force and establishing control over grazing land and water rights. Once hybrid cattle were introduced (Hereford being among the first.) and the wild Texas Longhorn was more or less marketed to near extinction (At one point only about two dozen were left.), the breeding and raising of high beef-producing animals fed on corn rather than grass to increase fat content in rendered beef became a priority, and the value of even a single animal went up.There are still cowboys working on America’s ranches. These days, they more often rely on pickups, helicopters, and even motorcycles and ATVs rather than horses as their primary tools for herding. Most are better educated and more socially aware than were the nineteenth century refugees from the East and South and Mexico. Many have embraced the image of the cowboy as created by Hollywood and TV as their own, galvanized their own superstitions and traditions, and certainly the clothing and tack markets for cowboy styles have been adopted as authentic. But the era of the Old West Cowboy was truly a brief one, lasting less than fifty years, and no one at the time admired them as noble “knights of the plains “ or any such nonsense as was propagated by dime novelists and pulp fiction writers. They were low-echelon skilled laborers, men who commanded very little respect in their communities, and whose work, although essential to the beef industry, was not admired, even by the most romantic.

Most police informants are "working off a beef" with the police. Confidential Informants are known as CIs. These people need to work hard to get evidence that someone else is a bigger crook than they are. That being said the police must not give absolute credence to the word of any informant without corroborating evidence. The corroborating evidence may include audio, video, surveillance or combination of these.The police must do thorough background checks on the informants to determine many things about their past. This includes arrest records and contacts with other law enforcement agencies to determine if the informant has ever provided confidential information to the police in the past. Also whether or not the information was investigated and found to be accurate and truthful. The informants must sign an agreement regarding their conduct and confidentiality of the relationship with police.Once a police informant has lied to the police or ever committed perjury his snitching days are over. A prosecutor will not allow an informant to testify knowing he/she is a liar.Most CIs provide information for the police to gather information that leads to the issuance of a search warrant. If criminal evidence is seized as a result of that search warrant the informant rarely ever has to appear in court.It is different when an informant is a material or percipient witness to a crime. In those cases the informant may be compelled to testify.A majority of informants are developed during investigations. They can be cultivated and sometimes be useful to law enforcement for many years. The hardest part about them is keeping them from participating in crimes. Some people just can't seem to change old habits. Other informants, and I've personally managed quite a few, are valuable tools for decades. They just need to follow the rules established by law enforcement to protect their confidentiality, from being arrested or physical injured.Sometimes police target someone to be an informant. Usually this person is a member of an organization and he has been determined to be a weak link by the agency conducting the investigation. In exchange for leniency by prosecutors the informant will become a "friend of the police" to further the investigation.Other police informants are known as mercenary informants. They were (probably still are) criminals that have a knack for meeting the kind of people that the police need to investigate. They might even help police recruit other informants.There are some things about CIs that people rarely think about. Informants are considered an employee of the agency they are assisting. It is important that the police protect them from injury as they may collect worker's compensation benefits from injuries received in the course of employment. Whether or not they are being paid for services. That's why it it so important that the police and CIs abide by the rules of conduct established at the beginning of the relationship.Those of us with experience know that we ought not to supply informants with too much information about how we conduct our investigations. Many times today's informant is tommorows target of another investigation. Informants are a necessary tool for law enforcement. Many crimes would go unsolved without them. But we can't excuse their criminal behavior, especially if they continue to commit crimes after they have begun working for the police.Most often police are viewed as skeptics. There is nothing wrong with that especially when we are dealing with information provided by a police informant. A good cop will use that information as a piece of his puzzle, in his investigation, and corroborate the CI's information for accuracy and truthfulness.Lastly, police need be be wary of CIs. Especially informants of the opposite sex. I've seen how manipulative and convincing ex-convicts are and their smooth talking abilities. Well informants are cons as well. Maybe not convicts - yet. The rules of conduct between the police and informants are well established in the agreement. There is no reason for a law enforcement officer to fraternize with a CI when off-duty. It is sad to see an otherwise good cop loose his or her job for falling into a relationship with an informant. I always told my rookie investigators that snitches do one - they snitch. If they see a cop do something wrong expect them to tell someone else at some time when it may benefit the CI.