South Dakota Politics

Carbon Restrictions Mean Lights Out in Britain

Any serious attempt to dramatically cut carbon emissions is going to mean draconian cuts in living standards. Maybe the one is really called for, though I am skeptical; but those pushing cap & trade and similar kinds of legislation in Europe haven't been open about the other.

Or at least not until now. This from The London Telegraph:

Demand for power from homes and businesses will exceed supply from the national grid within eight years, according to official figures.

The shortage of supplies will hit the equivalent of many as 16 million families for at least one hour during the year, it is forecast.

The admission that Britain will face power-cuts is contained in a document that accompanied the Government's Low Carbon Transition Plan, which was launched in July.

Ed Miliband, the Energy and Climate Change Secretary, outlined the plan amid much fanfare.

Britain has an Energy and Climate Change Secretary?

The looming problem in Britain is caused by the scheduled closure by 2015 of nine oil and coal-fired power plants. They are the victim of an EU directive designed to cut pollution.

In addition, four existing nuclear power plants are set to be shut, adding to the need for new sources of energy.

Labour failed for several years to commit to a new generation of nuclear power stations. Several reviews and rows with the green lobby delayed any definitive statement on the issue.

So Britain is going to close some perfectly good oil and coal-fired power plants, maybe keep open some nuclear plants that are supposed to be decommissioned, but can't seem to get around to building new nuclear plants. The only good news here for the Brits is this:

Greg Clark, the shadow climate and energy change secretary… pointed out that the scale of the blackouts could in fact be three times worse than the Government predictions. He said some of the modelling used was "optimistic" as it assumes little or no change in electricity demand up until to 2020. It also assumes a rapid increase in wind farm capacity. There is also the assumption that existing nuclear power stations will be granted extensions to their "lifetimes".

That's good news if the bit about a rapid increase in wind farm capacity means that there won't in fact be such a rapid increase. Wind power doesn't curb pollution and it doesn't provide a net gain in power. So if they can't manage to increase wind power like they plan because, basically, they are lousy and doing anything they plan to do, that's unexpected good news, no?

So maybe there is hope than it looks like. But that's true only if the government responds to the present situation with the same incompetence that got it there in the first place.

Gordon Brown Admits Role in Terrorist Release

From the London Times:

Gordon Brown was dragged into the centre of the row over the early release of the Lockerbie bomber last night after it emerged that a key decision that could have paved the way for the terrorist to serve his sentence in Libya was approved by Downing Street.

A source close to Jack Straw told The Times that the move to include Abdul Baset Ali al-Megrahi in a prisoner transfer agreement in 2007 was a government decision and was not made at the sole discretion of the Justice Secretary. "It wasn't just Jack who decided this. It was a Government decision. Jack did not act unilaterally."

The row over the early release of the Lockerbie bomber ten days ago shows no sign of abating after the Ministry of Justice indicated yesterday that the decision to include al-Megrahi in a prisoner transfer agreement had been made with the possibility of trade deals with Libya in mind.

British Justice Secretary Jack Straw is sounding a bit like Harry Reid. From the London Telegraph:

Mr Straw said Britain forced Libya to give up its nuclear weapons programme in 2003, and "obviously, they had to have something for that."

"But the suggestion that at any stage there was some kind of backdoor deal done over Mr Megrahi's transfer because of trade is simply untrue," he continued.

"All this, however, is academic as Mr Megrahi was not released under the PTA treaty but quite separately by the Scottish Executive on compassionate grounds."

So Mr. Megrahi's release had nothing to do with trade negotiations between Britain and Libya? It was a "quite separate" event? Well, not exactly.

In a letter to [Scots Justice Minister Kenny] MacAskill, written in December 2007and leaked on Sunday, Mr Straw said: "The wider negotiations with the Libyans are reaching a critical stage and, in view of the overwhelming interests for the United Kingdom, I have agreed that in this instance the (PTA) should be in the standard form and not mention any individual."

Six weeks after the PTA was agreed, Libya ratified a £15billion oil and gas exploration deal with BP.

One wonders how much longer Gordon Brown can treat water. His government appears to be corrupt and incompetent beyond repair.

Vicki and the Vacancy

According to Susan Ferrechio of The Washington Examiner, there is bipartisan support for Vicki Kennedy to take over Ted Kennedy's office. Indeed, says Ferrechio, some think she would be "perfect for the job." Ferrechio quotes Orrin Hatch as saying that Kennedy is a "brilliant lawyer" and "a solid individual." She also quotes Chris Dodd as saying that if Kennedy wants the position, he will back her up. There are only two problems with this picture.

1. Kennedy has stated that she does not want the position
2. It's not legal for her to take it.
   

But not to worry! The Democrats mean to solve both of these problems.The Massachusetts state legislature is getting ready to debate a bill that would give Democratic Gov. Deval Patrick the authority to appoint an interim senator to fill the seat until a special election is held." And the democrats have been pushing for Kennedy to take fill that position. She is, after all, according to John R. Bohrer of the Huffington Post, 'the only logical choice." Plus, Obama needs her vote and that certainly justifies changing the rules!

So whether or not Kennedy wants the position, and whether or not the voters want her to have it, she may very well be pushed into it.

Dr. Blanchard mentioned the possibility of this sort of dirty politicking in an earlier post. He said this:

Elections are contests, and when you change the rules in mid-game to favor one contestant, that's cheating. I am guessing that Kennedy won't get his rule change. Just right now, Massachusetts Democrats don't want to give the voters another reason to be irritated.

Maybe the Massachusetts Democrats are not as wise as he thought. Hatch is certainly not as wise as I thought.

Democrats in Disarray 2

The sad state of the President Obama's healthcare reform project is illustrated neatly by two stories about Senate Majority Leader Harry Reid. First from the Politico:

Senate Majority Leader Harry Reid said Friday that he was not bound by a controversial deal negotiated between the White House and pharmaceutical companies, telling thousands of Nevada voters on a conference call that "I have not agreed with anybody to do that."

The drug industry told the White House this summer that it would cut future drug costs by $80 billion in exchange for assurances that any health care legislation would prevent the government from negotiating for lower drug prices. As a result of the deal, the industry is bankrolling an ad campaign touting Barack Obama's health care overhaul.

Now this is clearly a case of strategic disarray. President Obama brought the pharmacy industry on board the healthcare reform ambulance by promising them that under any plan the government wouldn't use its clout to bargain down drug prices. You can think what you want about that compromise, and about whether the President would have kept this word. But Reid disavowing the deal now means that Congressional Democrats and the President can't make a united effort on the legislation.

A second indication of disarray is Senator Reid's equivocation regarding the "public option." From Steven Benin at the Washington Monthly:

"I've told people, whoever will listen, that I am in favor of the public option," Reid said in answer to a participant who asked why he hasn't been more vocal on his position. "We're working now to try to come up with a program that would allow that to take place." Reid said a public option is essential to provide competition to private insurance companies that enjoy an exemption from federal anti-trust laws.

He added that "a lot of people misunderstand" the public option as "some government run program… But there are many ways we can do it," he said. "One would be to have an entity like Medicare. I really don't favor that. I think what we should have is a private entity that has direction from the federal government."

Okay, so Reid is in favor of "a public option," but he doesn't want it to be really public, exactly, like Medicare. As Benin points out, a Medicare-like program is sort of the whole point of a public option. Reid seems to want an option that is privately run but controlled by the Government. That was Ms. Clinton's big idea. But "seems" is the operative word in that sentence. No one can guess what Reid really means, and I am guessing he can't either.

Both of these quotes come from a single conference call by Reid. If the Senate Majority leader is throwing two wrenches at the same time into the gears of the healthcare reform machinery, I think that probably means it isn't going anywhere. Why this much disarray?

One reason, of course, is that Reid is himself in big trouble. If things don't change by November of next year, a second Democratic Party leader will be defeated for reelection. That speaks to the weak foundations of Obama's ambition. But the bigger problem is that the President simply hasn't met the challenge he faced. He hasn't proposed a coherent solution to problems that the American healthcare system faces. The problem with this round of healthcare reform legislation isn't the lipstick, it's the pig.

Welcome Badlands Blue

A former student of mine and all around great guy, Travis Dahle, has resurrected Badlands Blue.  If you want to know what intelligent and (I dare to say) well-trained political thinkers on the regional left really think, this is a good place to go.  I like to think that SDP is right more often than Badlands Blue, but by gosh they have a prettier banner.  Welcome BB.net. 

Scot’s Rot this side the pond

The liberation of Abdel Baset Ali al-Megrahi seems to have a lot of guilty parties behind it. Andrew C. McCarthy at National Review Online shows how wide the stink extends, but puts some blame squarely on the Obama Administration.

The release of the Lockerbie terrorist was said to be on humanitarian grounds, because Megrahi is said to be terminally ill. The action, though, was totally discretionary on Scotland's part and could have been stopped by Britain. The Obama administration did nothing meaningful to stop it from happening. Perhaps the White House and the State Department were too embarrassed to try. In June, when they made arrangements with Bermuda's prime-minister to transfer four of the Uighur detainees (trained jihadists) from Guantanamo Bay to the tiny island, they cut the British government out of the secret negotiations — even though Britain, aside from being our closest ally, is responsible for the foreign policy and national security of Bermuda, its protectorate.

McCarthy's connection between the Bermuda fiasco (embarrassing enough on its own) is plausible but no more than that.

A more stinging barb comes from Ron Liddle, writing in The (British) Spectator:

The problem with this story is that it is difficult for ordinary people with an averagely developed moral sense to discern upon whom we should turn our guns first. I've been mulling this over for a while and decided it should probably be that third party, the Americans, for that familiar stench of hypocrisy now emanating from Washington DC. One by one, American politicians have lined up to condemn Britain for having released the man convicted of having blown up Pan Am Flight 103 in the skies above the Scottish town of Lockerbie in 1988. Some two thirds of the passengers were American citizens. The director of the FBI, Robert Mueller, called the decision to release the cancer-bedevilled al-Megrahi a 'mockery of justice'. Both Hillary Clinton and Barack Obama stuck the boot in too, calling the release 'totally inappropriate'.

What, exactly, is the hypocrisy of which Liddle speaks?

Well sure, perhaps. But at least al-Megrahi was convicted and served a portion of his sentence. In the single year before the Lockerbie bombing the IRA murdered 20 people, mainly civilians, and maimed thousands of others — 11 dead and many more injured in one single atrocity in Enniskillen in November 1987. That campaign of terror, waged against British citizens for more than 30 years, was bankrolled by donations from the USA — and in those 30 years not a single terrorist was extradited from the US to face charges here, despite our repeated requests. Both federal and local US courts refused extradition requests almost as policy, while the funding of the IRA continued without interruption and was still raking in the money even after 9/11, when the Americans suddenly decided that they ought to start proscribing certain terrorist groups. The IRA was not, for some time, one of the groups so proscribed.

Now I will admit that this business is one of those things to which I have should have paid attention, but didn't. I knew of course that the IRA has long been bankrolled from New York, Chicago, and Los Angeles, among other Irish American enclaves. I love Irish music and have attended a number of Celtic music fairs. At one I remember thumbing through literature at a Sinn Fein (pronounced Shin Fain) booth. Sinn Fein is the legal wing of the IRA. I have always regarded that as a scandal, but one can keep track of only so many scandals.

The fact that the U.S. has never extradited a single Irish cutthroat to Britain strikes me as a scandal on the top shelf. I know nothing about it. How many requests for extradition are we talking about? What terrorists have we shielded from British justice and what crimes did they commit?

If Liddle is right, and I don't doubt that he is, there is a lot of Scots Rot right here. The Ulster Catholics may have good reason to complain, but that does nothing to save the reputation of the IRA and its many murderous splinter groups. These are twenty four karat terrorists. We have no excuse for protecting them. It discredits everything we think we mean when we take a stand against terror.

Rangeling up Some Cash

The Wall Street Journal says that Charlie Rangel has “won the personal lottery.” Rangel, Chairman of the Ways and Means committee, is now being investigated for failing to report up to $780,000 in income and assets.  Those who defend Rangel claim that this was an accident. But Larry Kudlow wants to know how it is possible that someone does not know he has a $500,000 checking account.  I'd like to know too!

It is, of course, possible that Rangel made a mistake (or rather, several mistakes). But even if that is all he did, his actions have serious implications for the healthcare debate. The Democrats and their supporters have been trying to convince skeptical voters that the government ought to be trusted with running America’s healthcare system.  Some have asserted that the only problem with governmental authority has been that Republicans have had it. The Rangel case proves conclusively that neither of these things is true.

If Rangel made this sort of colossal mistake accidentally, he is incompetent.  Rangel should be able to understand these things. He is a lawyer, who the Democrats have put in charge of one of the most powerful positions in congress. Was this wise? Not at all. And this is not the first time the Democrats have put someone tainted by financial improprieties in charge of critical financial decisions.  No one has yet forgotten Timothy Geithner.

There is, of course, also the possibility that this was not a mistake. If Rangel purposely failed to report his income and assets, then he clearly believes in one law for the governors and another for the governed. Can we trust someone with that sort of view to make the best decisions for us? It would be hard to argue that we can.

Something Rots Among the Scots

It's one thing to argue that we shouldn't torture terrorists. It's rather another thing to let one go to a hero's welcome. In case anyone missed it, Kenny MacAskill, Justice Minister for Scotland, ordered the "compassionate release" of Abdel Baset Ali al-Megrahi. Al-Megrahi was one of the persons responsible for the bombing Pan Am 103, which came down on Lockerbie. Two hundred and seventy people died, including eleven on the ground.

Al-Megrahi was apparently suffering from prostate cancer, and was said to have had less than three months to live. That three months is apparently key under Scottish "prison guidance," allowing but not requiring MacAskill to grant the murderer's request. MacAskill claims that he had a deal with the Libyans, who promised not to receive al-Megrahi with a hero's welcome. Well, guess what: they lied. The cutthroat returned home to cheering crowds.

Whatever one may think about the treatment of detainees, I am guessing that most Americans, and most folks in England, Ireland, Scotland, and Wales, for that matter, would think that a Scottish prison was a comfortable enough place for a mass murderer to die. I certainly do. Such a person should never be released, for any reason. To think otherwise is to be softheaded about what terrorism means.

It gets better. The release aroused outrage in England. There is strong suspicion that this was part of a secret deal that won big oil contracts for England. Now it turns out that the release was suspect on its face.

One of Scotland's most respected legal figures has bitterly attacked Kenny MacAskill, the Justice Minister, for his decision to visit the convicted Lockerbie bomber in prison. From the London Times:

Lord Fraser of Carmyllie, who as Lord Advocate was responsible for drawing up the indictment in 1991 against Abdul Baset Ali al-Megrahi and his co-accused, described Mr MacAskill's decision to go to Greenock Prison on August 5 as "absurd".

He would have done better, Lord Fraser argues, to go to America and explain the release to us. But apparently some hobnobbing with the hoodlum was more in order.

It gets better still. Apparently the report detailing Mr. al-Megrahi's medical condition was suspect.

It emerged that the prognosis that Abdel Baset Ali al-Megrahi had a life expectancy of only three months or less was supported by an unnamed doctor who had no expertise in terminal prostate cancer.

For all we know this guy has years left to be fêted. No doubt he will pose for a new Libyan postage stamp. The stink seems to go far enough that it looks to be a further blow to Gordon Brown's government, which is already about as popular as the Swine Flu. Good thing if so.  They have sat too long for any good that they have been doing.

This is very bad. To allow al-Megrahi to go back home to political glory (before being awarded his virgins), grants him a very visible moral victory. It demonstrates a weakness in the West that is very encouraging to our enemies. Terrorists 270, Scotland 0.

Trusting the Government

In this post, Cory over at the Madville times takes aim at Senator Thune and his claims that Americans don't trust the government. Here's some of what he has to say:

But Cory says the problem is Republicans, not government. The government can be trusted he says, if it is made up of Democrats (or, at least, that seems to me to be what he's saying).

All of these arguments strengthen Thune's claim. Even if Cory's comments are fair, and the Republicans alone are to blame for everything from terror to health care crises, leaving health care in the hands of the government might be a very bad idea. For now, Democrats control congress and the presidency. But will they always?

Probably not. This means that, while the Democrats might vote to implement this bill, Republicans may run the system later. Republicans would almost certainly fill many if not all of the appointed positions created by the plan. That's bad news if Cory is right. It's worse if he's not and I don't think he is. While Republicans do deserve much of the blame for the unbridled spending during Bush's terms in office, they are not the only culprits. Indeed, the Democrats stood right alongside them. Bush was president for two terms, but Republicans only controlled congress for one, and, indeed, many Democrats were behind some of the most expensive programs congress implemented.

As far as Bush "not preventing the worst terrorist attack on American soil in history", I'm not sure whether or not Cory is right. If we did prevent a worse attack, it didn't happen, so it would be hard to know. But blaming President Bush for his "failure" to prevent a type of attack that had never before occurred in America and took millions by surprise is, I think, a little unfair, particularly when Democrats complain about the military taking any sort of preemptive measure.

I do not blame Bill Clinton for failing to prevent the Oklahoma City bombing, which was the most significant attack on American soil until September 11th. However, if one is to blame, so is the other and appointing Democrats will not solve the problem. As for Corry's complaint that Bush did not "maintain good relations with foreign allies," Obama has snubbed our closest ally at least twice. So electing Democrats might not be the best solution to that problem either. Time will tell how Obama responds to the other problems Cory lists.

In the mean time, I think Thune is right. It is hard to trust the government when, no matter which side controls it, it has proven itself untrustworthy.

 

Tortured Logic

I find it difficult to believe that Attorney General Eric Holder would have launched an investigation into CIA interrogations of terrorists if the debate over healthcare reform were going better. He certainly didn't do it because he is scrupulous about enforcing the law. As Andrew C. McCarthy points out, Deputy AG in the Clinton Administration, Holder acted to protect VP Al Gore from prosecution when Gore had obviously violated U.S. criminal law.

Moreover the issue has previously been vetted by the Justice Department, and one prosecution has taken place. President Obama clearly (and wisely) wanted to avoid opening up this issue, and has tried several times to close it down.

But just right now he desperately wants to change the subject from the mess of his legislative agenda, and he just as desperately needs to shore up his support on the left. The left wants nothing more than to see Dick Cheney in leg irons, so maybe throwing them this bone makes sense.

That said, I can't see how this plays out to the Administration's benefit, or to Cheney and Bush's disadvantage. It is possible, though by no means certain, that the enhanced interrogation techniques in question broke the law. But like the guy who gets a speeding ticket when rushing an injured orphan to the hospital, not all breaches of law damage a person's reputation. If this prosecution goes forward, what are the people going to make of it?

Let's consider what kind of torture we are talking about.

Holder rests his decision on a five-year-old report by the CIA's inspector general that was declassified on Monday. The most alarming details revealed by the report involve Abd al-Rahim al-Nashiri, the al-Qaeda chieftain said to have directed the October 2000 U.S.S. Cole bombing that killed 17 members of the U.S. Navy. The report alleges that a gun was brandished during Nashiri's interrogation and that a power drill was held near him and occasionally turned on and off. Moreover, it is claimed that, on more than one occasion, shots were fired in adjoining rooms in a manner suggestive of the possibility that the CIA was executing uncooperative detainees.

I'll leave the legal definitions to the lawyers, but that does look like torture to me. It also looks like torture done by people who were trying very hard to get the information they wanted while avoiding any lasting physical or mental injuries to the captured terrorists. Maybe that doesn't excuse the practices, but I just don't think that most folks will see the CIA interrogators as ruthless villains.

More likely they will seem them as people who were trying very hard to make sure than no more Americans had to leap out the windows of burning buildings. And while the writers at The Nation may see the above paragraph as evidence of Bush brutality and lawlessness, I suspect most people will think that the terrorists were treated at least as well as they deserved.

And then there is the question of outcomes. Did the rare instances of torture result in effective intelligence? Did waterboarding or shooting a gun in the next room have the result that more Americans weren't blown out of their socks? It looks like there is a case for that.

I still think it very unlikely that we are going to prosecute our secret agents for trying to prevent another terrorist attack. I am sure President Obama would not want us to ask this question: would he authorize such means if he concluded that such was the best way to prevent a future attack? The President has said that the real question is whether we could have obtained the vital information in another way. But that is surely not the real question. The real question is, given the circumstances of the moment, are we willing and able to do what is necessary to keep the unthinkable from happening.

I think that President Obama would do whatever he might think was necessary to prevent another attack from taking place, just as President Bush did. If Americans come to think otherwise, his healthcare blues will be the least of his troubles. But if he were forced to be explicit about this it would open up a rift between him and his activist base. Attorney General Holders action makes such a moment more likely.

Edward Kennedy Passes

From CNN:

Massachusetts Sen. Edward Kennedy, the patriarch of the first family of Democratic politics, died late Tuesday at his home in Hyannis Port, Massachusetts, after a lengthy battle with brain cancer. He was 77.

I saw Ted Kennedy once, when I was sitting in the Senate Chamber gallery.  I was listening to the conversation below when the speaker announced that Senator Kennedy was to speak.  All around me the tourists suddenly took interest and leaned to see the man.  That is what fame looks like. 

Deficits & Constraints

Last February I posted on the Administration's unbelievable budget numbers. I argued that the numbers coming out of the White House were, well, not to be believed. In fairness to the President, I pointed out that this was an almost universal characteristic of White House projections in any presidency.

I was right, of course. From the Wall Street Journal:

In their traditional summertime budget review, administration officials acknowledged that they relied on overly optimistic assumptions about the economy when they forecast in March that Obama's budget plans would generate deficits of $7.1 trillion over the next 10 years. After factoring in the severity of the recession and the prospect of a more sluggish recovery, the White House concluded that the budget outlook is significantly worse.

I say "of course" above not because I claim any special accuracy, but because the Administration's earlier projections were so obviously fraudulent. Obama's team is now projecting about $9 trillion in deficit spending over ten years. It is possible that economic growth will surprise everyone, and if that happens then the real numbers will be lower. It is difficult to conceive of growth that would not leave us running unprecedentedly large deficits over the next decade. If growth turns out to be more sluggish than the Administration expects, the deficits will be much larger. I predict that, short of seriously responsible reform (and fairies), we will be seeing at least ten trillion added to the federal debt over the next ten years.

Also earlier this year I was a guest on Dakota Midday with Paul Guggenheimer and retired SDSU political scientist Bob Burns, two thoughtful friends of mine. The question of healthcare reform came up, and both Paul and Bob thought it was high time for it. I had the bad grace to point out that nearly a trillion to bail out the banking system and were about to spend as much on a stimulus package. I think I pointed out (I certainly should have) that Social Security and Medicare were both about to go into the red. For decades these programs have been subsidizing general Federal spending. That is over. From now on they will suck revenue from the budget.

Another way we have been covering the deficit is by selling it to China. They got ownership of future American growth, and we got lots of cheap textiles. But that only worked so long as they believed in future growth. Right now they are looking at the balance sheet, and making a lot of skeptical body noise.

In light of all this, it seems to me that the debate over healthcare legislation and that over the now silent issue of cap and trade legislation (the two key items of President Obama's agenda) have taken place in a bubble. Washington has run completely out of our money. There is not money enough to pay for current obligations, let alone an expansion of the healthcare insurance system.

As for cap and trade, are we really going to adopt legislation that intentionally retards economic growth for the sake of largely abstract environmental ideals? No. I think it very unlikely that any cap and trade legislation will actually pass the Senate.

Maybe it's time to come out of the bubble and smell the sulfur.

Ted’s Last Shenanigan

I am genuinely sorry that Senator Ted Kennedy is suffering. I have never been an admirer, but I have never wished him personal misfortune. Whatever you think of his policies, he has cut a great figure in American politics. It is a shame, then, that what may be his last public act is shameful. From the Wall Street Journal:

Senator Ted Kennedy, who is gravely ill with brain cancer, has sent a letter to Massachusetts lawmakers requesting a change in the state law that determines how his Senate seat would be filled if it became vacant before his eighth full term ends in 2012. Current law mandates that a special election be held at least 145 days after the seat becomes available. Mr. Kennedy is concerned that such a delay could leave his fellow Democrats in the Senate one vote short of a filibuster-proof majority for months while a special election takes place.

The journal points out that the present system for filling a senate vacancy is a result of a previous change that Kennedy himself is responsible for.

What Mr. Kennedy doesn't volunteer is that he orchestrated the 2004 succession law revision that now requires a special election, and for similarly partisan reasons. John Kerry, the other Senator from the state, was running for President in 2004, and Mr. Kennedy wanted the law changed so the Republican Governor at the time, Mitt Romney, could not name Mr. Kerry's replacement.

Kennedy managed to take the power to appoint a Senate successor away from the Governor when Mitt Romney held that office and it looked like John Kerry might vacate his seat for the White House. Now that the Governor is a Democrat and Kennedy cannot hold on long enough to vote for healthcare reform, he wants to change it back. This is a blatant case of manipulating the election procedures to ensure a partisan outcome. That's dirty politics by anyone's standards.

It may be too blatant for the Mass. Legislature. The Boston Globe reports that state leaders are cool to Kennedy's proposal.

It is assumed that Kennedy's motives are all about healthcare reform. He is apparently unable to play any role in the process at this point. If he vacates his seat, that will be one less vote in the Senate and so no filibuster proof majority for the Democrats.

But there may be another reason why Kennedy wants the change. In a special election, a Republican might actually win. There is a gubernatorial election next year, and current polls show incumbent Governor Deval Patrick is facing a tight race. One poll shows moderate Republican Christy Mihos leading by five points. To be clear, I don't know what is going to happen in November of 2010. But off year elections tend to be bad for the party that owns the White House, and current trends suggest the possibility of Republican blowout. It would add insult to injury if healthcare reform failed due to Kennedy's absence and the seat he has held so long inherited by the GOP.

Still, that doesn't make his shenanigan look any better. Elections are contests, and when you change the rules in mid-game to favor one contestant, that's cheating. I am guessing that Kennedy won't get his rule change. Just right now, Massachusetts Democrats don't want to give the voters another reason to be irritated.

Health Care Conundrum

 Democrats think that healthcare reform is in trouble because the Obama Administration has been strategically inept and the Republicans are playing dirty. Republicans think the reform effort is in trouble because the American people are rejecting it. Both sides are right.

There is no doubt that the reform effort is in big trouble. Support for the plan varies among polls, but pretty much every pollster agrees that support for Congressional plans has fallen dramatically. But the bigger indication of trouble is the collapse of support for Democrats in general and the President in particular and the corresponding rebound for Republicans. Here is a chart from Rasmussen:

This chart tracks the "Presidential Approval Index," which compares those who strongly approve of the job the President is doing with those who strongly disapprove. As the chart shows, Obama went from a very favorable index to a very unfavorable one, a dramatic reversal of fortunes in a pretty short time.

Meanwhile, Republican candidates are leading in two important gubernatorial races to be decided this fall: Virginia and New Jersey. New Jersey for heaven's sake! Current polls show that Senate leader Harry Reid is in danger in his home state. Of course, all this may reverse by next year, but right now the Democrats are deep in the poop. We don't need to ask whether healthcare reform is the problem because we have seen all this before.

Have some critics of healthcare reform been playing dirty? Yes. The "death panel" argument being pushed by Sarah Palin goes way beyond any evidence in the various plans. But such strategies rarely have much effect. Most would not take this sort of thing seriously unless they were already angry and anxious and looking for reasons to oppose the plan.

The Administration has to take most of the blame, as many Democrats realize. Peter Nicholas, Washington correspondent for the Los Angeles Times, has this:

Democratic strategists say the Obama administration's evolving, abstract arguments for healthcare reform are backfiring and contributing to a decline in public support for the legislation.

The strategists, many of whom saw healthcare reform fail in the Clinton administration, contend that President Obama has advanced too many rationales for his plan, leaving people confused.

That's a very nice way of saying that the Administration can't get its story straight. Why it been so difficult for President Obama and his team to present a coherent and consistent case for reform? Another bit from Rasmussen provides a clue.

Without the public option, just 50% of Democrats support the legislation. That's down from 69% support measured a week ago. But here the enthusiasm gap is especially strong. A week ago, polling found that 44% of Democrats Strongly favored the reform plan. Without the public option, just 12% of Democrats Strongly support it.

There would be a lot of serious obstacles facing any reform effort. To have a chance of success, one might begin by asking what are the problems with the current system, how can they be solved, and how can the solutions be sold to the public? For the core of the Democratic Party, the first two steps were hardly necessary. They know that the real problem is the lack of a single payer system, and that such a system is obviously the solution. That is where decades of passion direct them.

Unfortunately for them, that passion is not widely shared. The public might be willing to accept a public option, or even single payer, if it promised to deliver enough benefits at a reasonable cost; but they have no emotional attachment to the idea and many are frankly suspicious of it to begin with. The result of this is a disconnect between the arguments the Administration employed to sell its proposals, and the goal to which their base is passionately attached. That explains the meandering rationales for reform.

The Administration has squandered an enormous reserve of political capital in a very short time. Maybe a dramatic economic rebound in on the horizon, one big enough to restore public confidence in the Democratic Party. But it seems silly to have put themselves in a position where they have to hope for that.

Tom Daschle & Tragedy

I have not engaged in the recent fisticuffs over Tom Daschle as I was out of the loop when most of it occurred, and I am all about the future. I will say a few words about our illustrious former Senator. I have met Tom Daschle on several occasions, and have had the pleasure of speaking with him. On such occasions, when the microphones were turned off, I found him to be unusually candid and very clear headed about the current political situation.

Senator Daschle is a man of considerable intelligence and talents and obvious political ambitions that did not end with his Senate career. Unfortunately for Tom, somewhere along the way he got into a habit of undermining himself. The man who once ran a commercial bragging about driving his old car to work in D.C. bought a lifestyles of the rich and famous house in Virginia, which I think was his undoing in his last Senate campaign. He undermined himself by carelessness about taxes while he prepared to play a big role in healthcare reform, and lost the chance to serve as healthcare czar. And now that the President has tapped him for an unofficial role as advisor on healthcare, no doubt in the hope that Daschle can help push a package through the Senate, he is again undermined by a conflict of interest created by his role as very well paid lobbyist. This is a tragic hero waiting for his Sophocles, or Arthur Miller.

I don't think Daschle will be of much help to the President in any case. When he appeared in Aberdeen recently, as I understand it, he answered only questions submitted in advance. No doubt he was wary of "organized" protestors showing up, but if you want to connect with real people and try to enlist their support, that's just something you have to put up with. Senator Daschle was apparently afraid to engage in an unscripted discussion with the people of a town he once called home.

The Fat Lady Clears Her Throat

Sometimes in a restaurant, when I am hungry and waiting for a meal to arrive, I get up a go to the bathroom. Not because I really need to go, but because I think that the food will be there when I get back. Sometimes I go on vacation with a similar expectation: things will be better when I get back. A year ago I got back from several days of hiking in Theodore Roosevelt National Park to discover that John McCain had chosen Sarah Palin as his running mate. It doesn't always work.

This time may be different. Yellowstone is almost a news-free zone. When I did get some information, I learned that the Obama Administration was saying that "the public option" might not be part of the healthcare package, and that it would be part of the package. And then I read this, at The Politico:

A day after House Speaker Nancy Pelosi said that health reform won't get through the House without a public option, House Majority Leader Steny Hoyer said Friday that the public option may have to go in order to get a bill passed.

Well, as my Irish ancestors liked to say, "it tis' and it tisn't." When they say that sort of thing, you can be pretty sure that it tisn't. When I left for the last outpost of civilization (the last place one can buy whiskey) I had no confidence in the Democrat's reform project so coming back to signs of deepening disarray among Democrats is comforting.

The problem for the Democrats seems to be this: a substantial portion of the House coalition won't support any healthcare plan that doesn't include the public option, and another substantial portion (the Blue Dogs) won't support any proposal that involves big increases in deficit spending. So far no one has figured out how to square that circle, so that means no plan can pass.

Meanwhile, the President's approval ratings continue to decline, especially when it comes to confidence about his handling of the healthcare issue. Americans are increasingly convinced that healthcare reform will mean higher prices and fewer choices for them. Oh, and the Rasmussen poll has the generic Congressional vote favoring Republicans by five points. That is huuuuge. Republicans always do better in actual elections than the generic polls predict. They rarely lead Democrats. Right now that means the Republicans have recovered in a big way. Only a few weeks ago the outlook for next year's election favored Democrats. Now The Hill reports that 2010 looks like an uphill battle for the Donkeys.

Of course a lot of things may change before next year's November. The Press may declare that the recovery is under way (it will). That can't hurt their beloved. But it might not be enough. President Obama has focused all the public attention on the healthcare issue. He has made a mess of it. He has promised that all Americans can be covered with health insurance, that this will help balance the budget and be revenue neutral (a contradiction involving an implausible claim), that no one will have to give up their present coverage (another implausible claim) or face reduced options, and that no one will have to pay more in taxes (except the very rich). Any idiot can see that this doesn't add up. And when you figure out that there is something he isn't telling you, you can be sure it's bad.

As my friend and frequent interlocutor A.I. says, the fat lady hasn't sung yet for health care reform. But she is certainly clearing her throat.

Yellowstone

Just left Yellowstone National Park after about a week of hiking.  It is surely one of the greatest parks in the world.  I don't think I have ever heard more languages in one place than in the Mammoth Hot Springs Hotel lobby: French, German, Japanese, Hebrew, Arabic, Spanish, and reasonably good English.  Oh, and a lot of E. European languages.  Here are a couple of pics. 

A beaver  marmot cleverly poses for us. 

Here is the most magnificent waterfall I have ever seen, in the "Grand Canyon" of Yellowstone.  [At least I hope it was a waterfall, and no one will add a comment informing me it was a flume or something.]  For the life of me I can't imagine why they never gave these falls a name of their own. 

Not bad, that.  With any luck I'll be blogging on politics again tomorrow night, but if you look closely at the picture above you will just see Obama's healthcare reform about to go over the falls.

UPDATE:  The critter above is apparently a marmot.  It's the first one I have seen, and I have never seen a beaver except in the water.  I am here to learn. 

In Yellowstone I saw lots of bison (not buffalo, I have been informed by the ranger from Hell), three coyote, a bunch of prong horns, a herd of elk, and a grizzly bear from a considerable distance (which is the best way to see one). 

But the real prize came on the next to last night.  Returning to Mammoth from the direction of Norris, we saw three cars parked on the left side of the road.  That is usually a sign that some folks have found a loan bison to admire.  When we slowed down to look we saw nothing at first.  Then we saw them: two wolves, about twenty yards from the road.  A big black wolf was digging furiously and occasionally he leaped into the air and came down in a pounce.  I am guessing he was trying to snag some rodent.  A slightly smaller gray colored wolf, I am guessing his mate, meandered around the black one.  The pair were just across a shallow creek. 

I have had the pleasure of a long morning watching wolves through spotting scopes in the Lamar valley.  That was two years ago.  I was with some other faculty and students, and the Yellowstone Association was giving us a week long class in National Park politics.  If you search back in this blog, you will find some pictures from that trip.  We were watching a couple of baby sitter wolves taking care of the cubs while the pack was out hunting.  It was great.  But those wolves were a long way away. 

The wolves I saw this week were close enough I could see their ears.  This was magnificent!  I love wolves.  I am very happy they have returned to Yellowstone.  But then, I am not a rancher.  Here is one last picture, this one of prong horns  kangaroos.  I am pretty sure they are prong horns kangaroos, and not marmots. 

 

Actually, I did find a picture of the wolves.  Here it is:

Daschle in Aberdeen

Tonight, a lot of people are talking about has-been Brett Favre joining the Vikings, but since I'm not much of a football fan (hockey and Indycar are another story), I thought I'd blog about my favorite has-been instead. He was in town today, after all.

Tom Daschle has been part of my world since I was small. He used to come to my elementary school every so often, along with other politicians to shake hands and answer questions. I remember what a thrill it was to be able to ask such important men anything at all. Back then, the questions weren't prescreened - or, at least, not at my school.

Today was different. Every question taken had to be submitted ahead of time. Many who had legitimate questions went home without answers and without satisfaction. I suppose Daschle was sent to try to convince skeptical South Dakotans that Obama's plan was worthwhile. I can understand why. Nothing is more convincing than a prescreened townhall meeting, run by a man you voted out of office.

Except maybe a prescreened townhall meeting run by a man who has proven his lack of sympathy for the elderly and ailing. I still remember when, in 2001, Joe Biden pointed out that Strom Thurmond- then 98- was ill. Biden wanted to pair his vote with Thurmond's, so that Thurmond could go home. Daschle wouldn't allow it.

Here's Fox's account.

One other interesting thing about Daschle's appearance is that UnitedHealth has paid Daschle more than $5000 for his advice. While some have alleged that all of the townhall protesters have been paid off by insurance companies, there is more evidence to show that Daschle has taken money from them. And it's hard to believe someone sincerely has a problem with the insurance agencies when he takes money from them.

Democracy in America

By July 20^th, the Washington Post had reported that the approval rating of Obama’s healthcare plan had dropped below 50%. In spite of this, the Democrats pressed on. Arlen Specter and Kathleen Sebelius continued to preach the benefits of the plan, even after being loudly booed and screamed at by their constituents.

 Those who argued against the plan were accused of being fearmongers, Nazis or anti-patriots by Obama’s supporters, including congressional Democrats like Nancy Pelosi and Blanche Lincoln. To me the situation was beginning to look a little hopeless.  What did protests matter? The Democrats controlled both houses of congress (with a 60-vote majority) and the presidency. I supposed they could  and would pass any bill they wanted to, whether or not they had the support of the people.

But  today, the Democrats surprised me by doing the last thing I would have expected them to do. They listened to the people.  The headline I woke up to today read “White House Appears Ready to drop `public option.’” Here is its first line:

Bowing to Republican pressure and an uneasy public, President Barack Obama's administration signaled Sunday it is ready to abandon the idea of giving Americans the option of government-run insurance as part of a new health care system.

If the Democrats truly mean to follow the will of the public, then they will deserve credit for listening when doing so is optional. They will have proven themselves, at least this instance, to be true democrats. 

If, however, Obama and his supporters are giving up, not because they care about the will of the people, but because they cannot get enough support from their own party, then Obama and his supporters have much to be ashamed of. Meanwhile, the Democrats who have stood up for their constituents in spite of political pressure ought to be applauded.

Obama. Naked. With Unicorns.

I have no idea what to make of this, but for my parting shot as I leave for a little R&R, here is something completely different.

An artist has done a set of paintings of Obama, and sometimes Ms. Obama, naked, with unicorns. The unicorns seem to have their appendage coming out of an Obama logo.

There is a set of these online. Some of them, including the first, are grotesque. Most are just plain weird. But this one, for obvious reasons, is quite funny. I invite my loyal readers to put on their art critic hats and do a little hermeneutic investigation. I can't wait to see what you come up with. Hat tip to my old grad school buddy Steve Hayward for this post on No Left Turns.

Who’s Her Daddy?

Okay, enough with all this healthcare trivia. Let's turn to something really important, like John Edwards and Rielle Hunter's baby girl. Howard Kurtz has the goods.

I'm not betting against the National Enquirer.

If the supermarket tabloid says there's medical evidence that John Edwards fathered the baby he denies is his, I assume it's true.

After all, the Enquirer not only broke the Rielle Hunter story, it's been right every step of the way.

Who, you might ask, really cares at this point? Edwards is washed up politically, and most people assumed the 18-month-old girl is probably his kid.

But it seems to me that the man who put himself forth for last year's Democratic presidential nomination -- and who could have been vice president if Sen. John F. Kerry had won Ohio in 2004 -- has now lied twice. First he denied the affair with his former campaign videographer. Then he acknowledged it in a "Nightline" interview but said the baby wasn't his.

There are a lot of sex scandals bedeviling both parties and arising in a lot of different parts of the country. As Kurtz notes, this one is rather special. Edwards came within a few counties of being a heartbeat away from the Oval Office. He is a major league scoundrel, and a shameless liar.

He had an affair with Rielle Hunter while his wife was being treated for cancer. He lied about it publically and lied again about being the father of Hunter's child. But best of all, in my view, he briefly persuaded a loyal if somewhat confused campaign aid, one Andrew Young, to falsely claim paternity. Edwards is a piece of work.

But the real scandal here is that we learned about this only through the dogged journalism of the National Enquirer. Now I like to think of myself as an inquiring mind that wants to know, as the Enquirer's slogan used to go. I don't think I ever purchased as issue, but I have always surveyed the cover as I piled bundles of celery and boxes of Raisin Brand onto the supermarket conveyer belts. It's nice to know when a four year old girl gives birth to a two-headed Elvis clone. Occasionally I have even picked it up and turned to an article. Once I learned that 12 U.S. Senators were space aliens. I correctly predicted eleven of them in advance.

Were it not for the Enquirer, we might never have known just how utterly appalling Edwards really is. You might have thought that the New York Times would be interested. After all, in February of the last election year, the Times ran a major article hinting at an affair between John McCain and a lobbyist. The article consisted entirely of innuendo, unsupported by a single piece of evidence. Surely the hint of scandal in the Edwards camp, first reported by the Enquirer in October, 2007, was beneath the Times' exacting standards.

The NYTs and the rest of the mainstream press circled the wagons around Edwards. As long as he was remotely credible as nominee, he enjoyed protection. Fortunately the inquiring minds at the Enquirer kept at it, and now we learn that Edwards is about to confess paternity. Edwards is toast. But this episode should be deeply embarrassing to the American Press.

Taking a Break

I'll be mostly out of WiFi range for about a week.  I may post if I get the chance, but I probably won't be able to respond to comments.  Miranda will have to pick up the slack. 

U.S. Healthcare Better than Europe 2

My last post drew a couple of responses that are worthy of addressing in a separate post. FS has this:

Ken Blanchard, you would do well to actually back check where the statistics you cited come from. When they are comparing "Europe" and "the US" in that Lancet Oncology Study, they are including such places as Slovenia, The Czech Republic, and Poland in "Europe" and excluding wealthier countries like Portugal and France. Also the US oncology data they use for this study only covers a small fraction of the total US population.

We can only go with what we have, but here is an interesting bit from WebMD about another study:

July 16, 2008 -- Where you live plays a role in cancer survival, according to a new study that shows the U.S., Japan, and France recorded the highest survival rates among 31 nations for four types of cancer. Algeria had the lowest survival rates for all four cancers.

"This is the first direct comparison of so many countries as far as I am aware," says Michel Coleman, MD, a professor of epidemiology and vital statistics at the London School of Hygiene and Tropical Medicine and the study's lead author.

Coleman and colleagues drew on data from nearly 2 million cancer patients, ages 15 to 99, whose medical information was entered into 101 population-based cancer registries in 31 countries. The patients had been diagnosed with one of four cancers: breast, colon, rectum, or prostate cancers during the years 1990-1994. They were followed up to 1999, with the researchers comparing five-year survival rates.

The highest survival rates were found in the U.S. for breast and prostate cancer, in Japan for colon and rectal cancers in men, and in France for colon and rectal cancers in women, Coleman's team reports.

So the U.S. is second to none when it comes to surviving breast and prostate cancer, the second and third most commonly diagnosed cancers. Maybe our lead over Europe in the most common cancer, colorectal, is entirely due to those dreadfully lax Slovenes and Poles. But in this study, at least, we were competing with France and Japan.

And here is a summary of the Lancet Oncology study from MedScape Today:

Survival was significantly higher in the United States for all solid tumors, except testicular, stomach, and soft-tissue cancer, the authors report. The greatest differences were seen in the major cancer sites: colon and rectum (56.2% in Europe vs 65.5% in the United States), breast (79.0% vs 90.1%), and prostate cancer (77.5% vs 99.3%), and this "probably represents differences in the timeliness of diagnosis," they comment. That in turn stems from the more intensive screening for cancer carried out in the United States, where a reported 70% of women aged 50 to 70 years have undergone a mammogram in the past 2 years, one-third of people have had sigmoidoscopy or colonoscopy in the past 5 years, and more than 80% of men aged 65 years or more have had a prostate-specific antigen (PSA) test. In fact, it is this PSA testing that probably accounts for the very high survival from prostate cancer seen in the United States, the authors comment.

Now it may be that Iceland has a better record, or that the Lancet study doesn't cover all cancers. And again, there are those Czechs, Slovenes, and Poles. But it is absurd to argue that Americans are getting worse healthcare than in Europe. We are clearly getting the best treatment available.

Both FS and my buddy Ken seem to think that a lot of Americans are not getting adequate healthcare treatment. That may be true, but if it were, wouldn't we have some reliable numbers? To be sure, cancers can go undiagnosed and untreated, but deaths have a way of showing up on statistics. If millions or even thousands die from cancers that were not treated because of a lack of insurance, surely someone would be able to produce those numbers. And just as surely, the President would be using them. We constantly hear that 47 million Americans lack health insurance. Imagine if the President could say this:

Every year ten thousand Americans die from prostate cancer because they could not afford health insurance.

Wouldn't he be saying that? He ain't, because it ain't true. Ken has this:

So it is not that we have broken healthcare, as much as we have a broken healthcare system. That is why the WHO ranks the US system 35th in the world and life expectancy as 27th in the world, behind virtually all advanced nations. This, despite our costs measured as %GDP as high as #2 in the world (behind only Marshall Islands).

That ranking of the US healthcare system as 35^th is absurd, as the information above show. Does anybody really think they have a better chance in Saudi Arabia? That life expectancy is low in the US compared to other advanced nations is true. But a lot of things that affect that statistic are not amendable to health care, like obesity, smoking, accident and crime rates. There is no evidence that the life expectancy deficit in the US is more than marginally related to factors that are amendable to healthcare reform.

Our healthcare system is not in crisis, nor is it broken. It does have at least two problems: too many people uninsured and too rapid a growth in costs. I think that the constant attempts to paint the system as broken and in crisis make it harder to address those problems.

U.S. Healthcare Better than Europe

Atul Gawande may be emerging as the anti-Czar of American healthcare reform. I wonder if he drives his old automobile to work every day. Gawande makes the case, as I describe in my last post, that a model of healthcare reform that delivers better care at a lower cost is already well established in the U.S.

He describes this model in a piece he co-authors in the New York Times. He and his coauthors scoured the country for "hospital referral regions" that provided cheaper care on average, according to Medicare costs, but ranked higher than average in quality outcomes. What is the secret?

He doesn't lay it out nearly so well in this short article as in the New Yorker piece, but basically it is this: the medical communities in the 306 models of success that they identified got together (or the clinic administrators laid down the law) and they decided to focus on quality outcomes. Wow. Who'da thunk that could work? It certainly seems to.

This is hardly a secret, but it's hardly what we have been arguing about either. The President's defenders have argued that a lot of the elements in the Gawande model of reform are in the various Democratic plans. Maybe. But the debate so far has focused almost solely on the "public option," with one side greatly fearing it and the other side deeply desiring it. Both the fear and the desire may be all out of proportion. The result seems to be favoring the fearful, as public confidence in the Democrat's proposals has been steadily eroding, along with the President's approval ratings.

Gawande et. al. make a very bold claim for their model:

If the rest of America could achieve the performances of regions like these, our health care cost crisis would be over. Their quality scores are well above average. Yet they spend more than $1,500 (16 percent) less per Medicare patient than the national average and have a slower real annual growth rate (3 percent versus 3.5 percent nationwide).

That would be great if it were true. It may be true, though it is not substantiated in the article. But it is important to recognize that the U.S. system as a whole already delivers healthcare outcomes that are as good and sometimes much better than do state-heavy, European systems.

Samuel H. Preston and Jessica Y. Ho authored a study, published by the University of Pennsylvania's Population Studies Center, that compared five year survival rates for the most deadly diseases in the U.S. with rates in Europe and other developed countries. Here is the beginning of their summary:

We have demonstrated that mortality reductions from prostate cancer and breast cancer have been exceptionally rapid in the United States relative to a set of peer countries. We have argued that these unusually rapid declines are attributable to wider screening and more aggressive treatment of these diseases in the US. It appears that the US medical care system has worked effectively to reduce mortality from these important causes of death.

This conclusion is consistent with other evidence that we have reviewed on the performance of the US health care system: screening for other cancers also appears unusually extensive; 5-year survival rates from all of the major cancers are very favorable; survival rates following heart attack and stroke are also favorable (although one-year survival rates following stroke are not above average); the proportion of people with elevated blood pressure or cholesterol levels who are receiving medication is well above European standards.

The comparison of cancer survival rates in the U.S. and Europe are astounding. Here is a chart

5-year survival rate (%)		United States	Europe
Prostate Cancer		99.3	77.5
Skin melanoma		92.3	86.1
Breast		90.1	79.0
Corpus uteri		82.3	78.0
Non-Hodgkin lymphoma		62.0	54.6
Stomach		25.0	24.9
Lung		15.7	10.9
All malignancies	(men)	66.3	47.3
All malignancies	(women)	62.9	55.8

 

This is not a system "in crisis," at least with regard to healthcare outcomes. Persons in the U.S. are more likely to be tested and more likely to be effectively treated for a range of deadly cancers than similar persons in Europe.

I have little doubt that the U.S. system can be made more cost-effective by the kind of reforms that Gawande et. al. advocate. We may be able to improve outcomes across the board. But the "public option" and "single-payer" debates have nothing to do with it. One of the reasons that the Democrats have, for the second time, lost public confidence on this question is that they have steadfastly ignored what most Americans can tell for themselves: that the American system is delivering very good healthcare.

One of the reasons that American healthcare is so good is that it relies on self-organizing systems. The models Gawande et. al. produce are locally generated, by people who know the conditions they are dealing with. They are not mandated from the top. Maybe the top can give the system as a whole a push to follow the best models. But trying to replace the system with another, modeled on Europe, is not warranted by the facts.

The Real Healthcare Villains: Damned Doctors!

Cherished interlocutor FascistSocialist, whom I will charitably refer to as FS, has been working very hard to keep me honest. Don't think I don't appreciate it! I especially appreciate his recommendation of a piece in the New Yorker, by Atul Gawande. It is a very good article.

Gawande focuses on McAllen, Texas, which he says is the most expensive city for Medicare in the country. The amount spent per enrollee is twice the national average, and three times (I think he says this) the average in El Paso. What gives?

The answer is that doctors in McAllen have come to think of their medical practice not as a service but as a revenue stream. They order tests and treatments that have no reasonable connection to better health outcomes in order to fund all their other investments. So, though medical care in "the Square Dance Capital of the World" is much more expensive, the people of McAllen do not benefit.

Is this what is driving up American healthcare costs? Gawande's piece is an excellent example of investigative journalism, but it isn't a study in any sense, even of McAllen. To know for sure whether Gawande is right, a much more rigorous examination of the facts would be necessary. I say this not to discredit the piece. I think it is dead spot on. I say it only to point out that generalizing to the larger healthcare system is certainly suggested but not yet warranted. We can't know from this how pervasive the problems in McAllen are in the country at large.

The problem with McAllen is not an unfamiliar one to anybody who has followed the larger healthcare debate. American doctors are generally paid on a fee for service basis, meaning that more services mean more money even if they don't do any good. The best healthcare institutions, like the Mayo Clinic, focus on outcomes instead of services provided. This results in better and more cost-effective care.

So maybe the question to ask is whether the Mayo Clinic model could be made universal in the system at large. Are any of the healthcare proposals before Congress actually doing that? Gawande doesn't provide much hope.

We began talking about the various proposals being touted in Washington to fix the cost problem. I asked him whether expanding public-insurance programs like Medicare and shrinking the role of insurance companies would do the trick in McAllen.

"I don't have a problem with it," he said. "But it won't make a difference." In McAllen, government payers already predominate—not many people have jobs with private insurance.

How about doing the opposite and increasing the role of big insurance companies?

"What good would that do?" Dyke asked.

The third class of health-cost proposals, I explained, would push people to use medical savings accounts and hold high-deductible insurance policies: "They'd have more of their own money on the line, and that'd drive them to bargain with you and other surgeons, right?"

He gave me a quizzical look. We tried to imagine the scenario.

The problem is not basic institutions, but medical culture. Fixing culture by reforming institutions goes back to the ancient Greeks, but it is a very difficult business. Gawande gives us some clues:

McAllen and other cities like it have to be weaned away from their untenably fragmented, quantity-driven systems of health care, step by step. And that will mean rewarding doctors and hospitals if they band together to form Grand Junction-like accountable-care organizations, in which doctors collaborate to increase prevention and the quality of care, while discouraging overtreatment, undertreatment, and sheer profiteering.

Under one approach, insurers—whether public or private—would allow clinicians who formed such organizations and met quality goals to keep half the savings they generate. Government could also shift regulatory burdens, and even malpractice liability, from the doctors to the organization. Other, sterner, approaches would penalize those who don't form these organizations.

This is pretty good, but it's thinking on the fly. Gawande doesn't really know how to turn the American system into a bunch of Mayo Clinics. But if he is right, then the President and Congress are wrong. Insurance companies are not the villains, Doctors are. And insurance is not the solution, whether public or private.

Dramatic improvements and savings will take at least a decade. But a choice must be made. Whom do we want in charge of managing the full complexity of medical care? We can turn to insurers (whether public or private), which have proved repeatedly that they can't do it. Or we can turn to the local medical communities, which have proved that they can. But we have to choose someone—because, in much of the country, no one is in charge. And the result is the most wasteful and the least sustainable health-care system in the world.

I like the idea of salvation by medical communities. Barack Obama and Barney Frank won't like it. They think the whole point of healthcare reform is to get single payer. Thanks for recommending this article, FS. I agree with pretty much everything it says. It won't make any difference.

And even if it did, it won't solve the larger fiscal problems facing the future of healthcare.  We have been told for decades that we can have something for nothing if only we weed out waste and fraud from this or that system.  It never works out that way.  Systems changes involve costs of their own, and more efficient systems generate more demand.  Still, Gawande points toward a much more honest and effective medical culture.  That's no small achievement. 

Julie & Julia

I like food movies. Eat, Drink, Man, Woman, and Babette's Feast (or Babettes gæstebud, for the delicious original title), are probably my favorites. Julie & Julia is a brilliant movie, and the DVD will sit well next to the above.

The movie weaves together two autobiographical works: My Life in France, by Julia Child, and Julie & Julia, by Julie Powell. Julia Child deserves secular canonization, if such is available. In a series of monumental best sellers, she brought the idea of cooking as an art to millions of American households. I was fed, for my first twenty years or so, from a Southern tradition that treated vegetables like detainees: boil 'em until they confess. Not that my mother was a bad cook. She was a fine cook in that tradition. But I just can't convince her that the yellow stuff in the water after you have boiled a half dozen ears of corn into submission is what the corn used to taste like.

It didn't hurt that Child had a very unusual voice. The Julia half of the movie begins with Ms. Child arriving in France, and tells the story of how, against ridiculous opposition, she learned the art of French cooking and was eventually responsible for the most successful cookbook in the history of that genre.

The Julie Powell story is much less weighty, very contemporary, and a lot of fun. Powell, I gather from the movie, was a frustrated civil servant in New York. In the days after 9/11 she decided to cook all the recipes in Julia Child's Mastering the Art of French Cooking, and to blog about it. The blog became a hit, was featured in the New York Times, and the rest is a book and a movie.

I understand that all the food in the film is real food. More importantly, all the actors are real. Meryl Streep's Julia Child is so astonishingly convincing that I forgot, several times during the movie, that I wasn't watching the real Julia Child. Streep, of course, is the great master of voices. I used to watch Julia Child on TV back in grad school, and Streep does a better Julia Child than Julia Child. She also looked the part.

Very nearly as good was Stanley Tucci as Paul Child. What a wonderful, wonderful gift this man is. To judge by the photos in My Life in France, he looks the part. He also starred in an earlier food movie, The Big Night. Paul Child was a diplomat and amateur photographer. He and Julia McWilliams met when they worked for American Intelligence (OSS) in WWII. These folks had a big life. Tucci does a superb job of portraying a man who is in love with his wife.

I haven't yet read the books, but I gather that the Julie part of the movie required a lot of sanitizing. She was very fond of the "F" word in her blog, and it didn't take me more than a few minutes to find a lot of specimens in the text. I gather she had a very low opinion of the Administration that she worked for. That gets left out. The only politics in the film involve the McCarthy era, and we all know what we are supposed to think about that so no stress is involved.

This is a very good movie. I predict great things at the Oscars.

 

Healthcare, Cost Control, & Hidden Agendas

My favorite economist, Robert Samuelson, is my favorite economist because he confirms what I usually think. He is also bold and direct in a way most pundits aren't. He has this post today:

One of the bewildering ironies of the health care debate is that President Obama claims to be attacking the status quo when he's actually embracing it. Ever since Congress created Medicare and Medicaid in 1965, health politics has followed a simple logic: Expand benefits and talk about controlling costs. That's the status quo, and Obama faithfully adheres to it. While denouncing skyrocketing health spending, he would increase it by extending government health insurance to millions more Americans.

Now this strikes me as historically impeccable and pretty obvious when it comes to the present situation. Medicare is or is about to become insolvent. If the House plan or something like it passes, we will extend Medicare-like coverage to a lot more people. I don't see who that doesn't mean a much great fiscal burden on the system.

But Jonathan Cohn was irritated enough by this that he put aside blogging about Sarah Palin. That's real sacrifice. He thinks that the Obama plan would cut costs, and tells us lots of ways that would happen. One of them is the creation of healthcare "exchanges".

These "exchanges" would likely attract tens of millions of people, mostly those who now don't have insurance or buy it on their own. Once in the exchanges, people would do exactly what Samuelson says he wants: They'd shop for plans, with incentives heavily favoring those plans that offer high quality at low cost.

Hurray! Competition and incentives. Cohn doesn't mention that all insurance would have to be sold in these "exchanges" which would be controlled by the Fed. No new policies could be sold outside the "exchanges." More on that later.

Well, can we really believe that the Obama Administration is really committed to cutting costs and promoting competition in the healthcare industry? No. A pretty good indication of this is fellow short person Robert Reich's scathing column at Salon:

I'm a strong supporter of universal health insurance, and a fan of the Obama administration. But I'm appalled by the deal the White House has made with the pharmaceutical industry's lobbying arm to buy their support.

Last week, after being reported in the Los Angeles Times, the White House confirmed it has promised Big Pharma that any healthcare legislation will bar the government from using its huge purchasing power to negotiate lower drug prices. That's basically the same deal George W. Bush struck in getting the Medicare drug benefit, and it's proven a bonanza for the drug industry. A continuation will be an even larger bonanza, given all the boomers who will be enrolling in Medicare over the next decade.

Reich is no conservative or even moderate. He is a lefty in good standing. When Obama irritates him, something is up.

Now I should issue a disclaimer here. My father, who personally defeated the Japanese in the Second World War (don't let that influence your opinion) spent his working life as a salesman for Merck. So I like the pharmaceutical industry. It paid for my chemistry set and my Firebird. Both of 'em blew up. But maybe neutralizing one of the advantages of a large government hand in healthcare isn't exactly a cost-cutting measure.

Why did the Administration make this deal? You might say because they had to. But if they really wanted healthcare reform because they want to cut costs and save the economy, isn't that self-defeating?

In fact what they really want is socialized medicine, i.e., single-payer, i.e., Canadian style healthcare. I actually think there are some reasons for going in that direction. But I would only advocate such a reform if it was a reasonable means to good ends. I think Obama comes out of a culture in which single-payer is viewed as good in itself. Any deal with any pharmaceutical devil is okay so long as it gets you socialism, at least at the threshold of every clinic.

Michael Barone backs me up on this. If healthcare reform fails, as I suspect it will, then the cause is this: instead of trying to solve the problems America faces, the Administration tried to satisfy its deepest desires.

Sunny Sunstein

I have conceded that it is possible that Ezekiel Emanuel only favors young people over the elderly in end-of-life situations. I have also acknowleged that it is possible that even if Emanuel does favor the youth in other situations, he might not bring that view to the table while advising Obama. And I admit that Obama might not even listen listen to him if he did.

It is also possible that Obama might ignore the advice of Cass Sunstein, his regulatory Czar. According to The Wall Street Journal, Sunstein is a friend of Obama's from his faculty days at the University of Chicago law school. According to Obama, says the journal, "the job will be crucial as the new administration overhauls financial-services regulations, attempts to pass universal health care and tries to forge a new approach to controlling emissions of greenhouse gases."

Clearly, then, Obama means for Sunstein to have a role in his health care plan.So what does Sunstein have to say about health?

Well, in 2003 he had already decided that that the government should favor young people over the elderly.

Here's Sunstein:

In protecting safety, health, and the environment, government has increasingly relied on cost-benefit analysis. In undertaking cost-benefit analysis, the government has monetized risks of death through the idea of "value of a statistical life" (VSL), currently assessed at about $6.1 million. Many analysts, however, have suggested that the government should rely instead on the "value of a statistical life year" (VSLY), in a way that would likely result in significantly lower benefits calculations for elderly people, and significantly higher benefits calculations for children. I urge that the government should indeed focus on life-years rather than lives. A program that saves young people produces more welfare than one that saves old people.

And then Sunstein echoes Emanuel, justifying favoring the youth by saying that every old person was young once, and most young people will be old.

It is possible, I suppose, that Obama knows nothing about Sunstein's views. It is also possible that he does not agree with them. But the fact that he appointed two men with the same rationalization for discriminating against the elderly  to positions related to health is interesting. And because Sunstein is a friend of Obama's, it seems likely that Obama knows something about his views. If not, why appoint him?

Throw’n Out Bodies Just t’Cut Down on the Drag?

Critics of the Town Hall Protesters like to accuse them of being ill-informed. They complain about socialized medicine, but they're all on Medicare! Never mind that it's no contradiction to want to keep a paycheck coming but also think that further government expansion might be a bad idea.

But it is clear, to me and to the editors of the Washington Post, that the White House has been just as guilty of peddling disinformation with less excuse.

[I]t is disappointing, to say the least, to see Ms. Pelosi and other Democrats revert to round-up-the-usual-suspects demagoguery. President Obama has been more restrained but hardly more accurate; in a news conference last month, he inaccurately complained about insurers making "record profits, right now." In fact, among U.S. industries generally and other parts of the health sector in particular, insurers are not particularly profitable. The latest Fortune 500 ranking of most profitable industries has pharmaceuticals third, medical products and equipment fourth, and health insurers down at No. 35. Drugmakers reported a 19.3 percent profit margin; insurers, 2.2 percent.

More fundamentally, the Obama administration is peddling health reform as an everybody-wins scenario in which no one, except perhaps the wealthiest of the wealthy, has to sacrifice anything. We recognize that selling dessert is easier than selling spinach, especially when the other side is falsely claiming that your food is poisonous. But if health reform passes and starts bringing down costs, it is going to pinch some patients who have become accustomed to getting every test or procedure they want. At that point, Mr. Obama might wish he had done a little more to prepare people for the changes.

The President has a somewhat larger staff than your average Town Haller. He has no excuse for not knowing the truth.

The Post is right about the basic problem, but isn't being very explicit itself. What is it about healthcare reform that is so unpalatable? Another piece in the WaPo by Charles Lane zeroes in on Sec. 1233

which would pay doctors to give Medicare patients end-of-life counseling every five years -- or sooner if the patient gets a terminal diagnosis.

Lane notes that, contrary to some conservative propaganda, there is nothing sinister about this. But why, then, do the Democrats not want to talk about 1233?

Perhaps because, at least as I read it, Section 1233 is not totally innocuous… Section 1233, however, addresses compassionate goals in disconcerting proximity to fiscal ones. Supporters protest that they're just trying to facilitate choice -- even if patients opt for expensive life-prolonging care. I think they protest too much: If it's all about obviating suffering, emotional or physical, what's it doing in a measure to "bend the curve" on health-care costs?

Though not mandatory, as some on the right have claimed, the consultations envisioned in Section 1233 aren't quite "purely voluntary," as Rep. Sander M. Levin (D-Mich.) asserts. To me, "purely voluntary" means "not unless the patient requests one." Section 1233, however, lets doctors initiate the chat and gives them an incentive -- money -- to do so. Indeed, that's an incentive to insist.

Patients may refuse without penalty, but many will bow to white-coated authority. Once they're in the meeting, the bill does permit "formulation" of a plug-pulling order right then and there. So when Rep. Earl Blumenauer (D-Ore.) denies that Section 1233 would "place senior citizens in situations where they feel pressured to sign end-of-life directives that they would not otherwise sign," I don't think he's being realistic.

So as Lane explains it, Section 1233 provides incentives for Doctors to provide patients with "end-of-life counseling." Doctors may initiate the counseling, and if a patient agrees a decision to end care can be signed right then and there. If counseling patients about end of life decisions is part of the process of "bending the cost curve" down the road, well…

The problem is that government, a party interested in reducing overall costs, will be recruiting doctors to make a case. Paul Krugman thinks that private insurance is bad because the insurance agent has an incentive not to pay for your treatment. But surely a government trying to get control over costs has an incentive not to pay for a lot of folks' treatment and one way of reducing payments is to get more of them to go more gently and more importantly earlier into that good night.

Now something like this may be unavoidable. An aging population and the growth of medical technology are what is driving up total healthcare costs. Anyone who does not know this is ignorant about the issue. Both public and private insurance may have to simply refuse to pay for treatments that would extend the life of an elderly person several years into the future. I am not passing judgment on that, I am just noting that it may be a fact. See Peter Singer's piece on this, in the New York Times (hat tip to FS). 

But you can understand why Obama doesn't want to talk about it. According to the WaPo, not exactly a Republican rag, the President isn't being candid about healthcare reform. So let's not pretend it's just Town Hall mobs who get the story wrong.

Flat Birthers

Vociferous contributor to this blog's forums, FascistSocialist (I really should ask him about that penname) responds to my last post on the turbulent town hall meetings, with these results from a Daily KOS poll:

Do you believe that Barack Obama was born in the United States of America or not?
77% Yes/11% No
Dems: 93 / 4
Reps: 42 / 28
inds: 83 / 8

This was relevant to my criticism of Paul Krugman who made the connections between the town hall protesters and the Birthers, and accused the former of racist motives. My criticism stands, as Krugman's piece was all innuendo.

As to the numbers, KOS is a very partisan outfit (not that there's anything wrong with that), so I'd like to see these results confirmed by Pew or someone. FS's other link (of the two that he accused me of not reading) directed my attention ultimately to a poll that didn't seem to be about the birther issue at all but about the appropriateness of press coverage of this and other issues. Nonetheless, I expect that the numbers are probably about right and I acknowledge that that is embarrassing.

Birthers, for anyone who doesn't know, are people who believe that Barack Obama was not really born in Hawaii but in Kenya, and is therefore ineligible for the office of the Presidency. This is a manifestly silly idea for a couple of reasons. One is that there is no reason to believe it other than a desire to believe anything that might discredit the President. Another is that Obama is in fact President. Only proof that he was part of a conspiracy to conceal the truth would matter, and that, only if the House chose to impeach him for it.

So it is indeed embarrassing that more than a quarter of Republicans cling to this nonsense. I would be more embarrassed if I did not know that Democrats tend to be as much or more goofy on different questions.

When asked in a Rasmussen poll whether George W. Bush knew in advance about the 9/11 attacks, seven out of ten Republicans said no. Democrats almost broke even.

Dems No 39%/Yes 35%.

Now I humbly submit that this is worse than the birther thing. 9/11 conspiracy theories require much greater leaps in logic. Also it is rather worse, I think, to accuse someone of willfully letting thousands of people die for political purposes than to accuse someone of being born in Kenya.

The birther theory and the 9/11 conspiracy theories are embarrassing to Americans. We are prone to believe in wild conspiracy theories. A lot of us still believe, against all evidence, that JFK was murdered by Lyndon Johnson, or the CIA, or Castro, or John Dillinger, or maybe the Pope and the Jews.

At any rate, it is illegitimate to tar the town hall protesters with guilt by association, especially when the association is all innuendo. It is worse to accuse them of racism on the basis of no evidence whatsoever. These people are doing what nearly everyone says Americans should do: they get involved and they question authority. The Left used to say it liked that sort of thing. It doesn't like it at all when the shoe is on the other foot.

Why Worry?

Some have accused me of “fear mongering” for questioning the way Obama’s healthcare plan redefines the relationship between the government and its citizens. I thought the accusation seemed a little bit out of proportion, until I realized that Obama himself had put out the following message on my.barackobama.com:

There are those who profit from the status quo, or see this debate as a political game, and they will stop at nothing to block reform. They are filling the airwaves and the internet with outrageous falsehoods to scare people into opposing change. And some people, not surprisingly, are getting pretty nervous. So we've got to get out there, fight lies with truth, and set the record straight.

How dare anyone oppose change on the airwaves or the internet? It’s preposterous that someone might not see what a grand scheme Obama has cooked up!

The writers on Obama’s blog have encouraged web surfers to e-mail them if they notice any suspect information about ObamaCare in their e-mail or on the web. Here’s one quote directly from the blog:

There is a lot of disinformation about health insurance reform out there, spanning from control of personal finances to end of life care.  These rumors often travel just below the surface via chain emails or through casual conversation.  Since we can’t keep track of all of them here at the White House, we’re asking for your help. If you get an email or see something on the web about health insurance reform that seems fishy, send it to [email protected].

What do the Obama bloggers hope to accomplish? Suppose they find misinformation about Obamacare on someone’s blog. Then what? Will they ask the author to change his blog? Will they post counterarguments on their own blog? It is unlikely that the same base will read them. And the idea of the government asking people to tattle-tale on dissenters is disturbing. Had Bush requested such a thing, Democrats would have been up in arms – and rightly so. But because this is Obama’s plan, Democrats are lining up to help.

If questioning Obama’s view of governmental power makes me a fear monger, then I am in interesting company. I am joined not only by my conservative friends, but by notable liberals as well.

Journalist Helen Thomas is known for her liberal bias. She was one of President Bush’s strongest critics. Yet, even she is unhappy with what she sees as Obama’s abuse of power. Not one to keep silent, she accused Obama of trying to control the press. Indeed, she says, it is a “pattern” for him.

Finally, she says that no other administration has tried to exert this level of control over the press - not even Nixon. The transcript of the exchange can be found here.

The C-SPAN Footage is here.

I note that Thomas does support Obama’s healthcare plan. But when a supportive liberal like Thomas notices something is wrong, you’d think it would make others think.

Democracy and Discontent

In my first year of grad school, Ronald Reagan made an appearance on the campus of the Claremont Colleges. He was running for President. The night before his arrival campaign elves cleared a parking lot just off the Quad where Reagan was to speak, for his helicopter to land on. Then they built a long wooden ramp, with high walls on both sides, for Reagan to walk from the landing area to the podium. I arrived early and got a position just in front of the stage. A lot of sandalistas showed up at the same time and lined up along the wooden walkway. I don't know what they had planned, but I am guessing shaking hands with the former Governor of California was part of it.

And then the Helicopters landed. Reagan and his entourage didn't use the walk way, he went around by the street. The walk way wasn't intended for Reagan. It was intended to pull the adolescents away from the main action, which it did. I like to think of it as the little kids table. Anyway I got to hear a fine speech by a man whose organization had demonstrated that they were smarter than at least some of their enemies.

All during the speech, the sandalistas did everything they could to shout and sing Reagan down. They were too far from the main stage to have any real effect, though Reagan pointed out that they really couldn't sing all that well. God, but I loved that man.

Well, when people protested President Bush or the war in Iraq, that was always Democracy in action. But right now the shoe is on the other foot. Congressional Democrats are going back home to town hall meetings, and finding crowds that are loud and very grumpy. Here's how Errol Louis puts it:

From coast to coast, as members of Congress try to engage their constituents on the important matter of health care reform, many of them - mostly Democrats - are being shouted down by howling mobs.

Suddenly protesters aren't the people at all, they're mobs. Worse still, they are organized! By organizers! That's not genuine democracy, is it?

Well, the press wasn't so interested in who was organizing the anti-war rallies when Dubya was still in town. I was interested, and I posted on it. A key organizer of the big anti-war rallies in D.C. and elsewhere was an outfit called International Answer (Act Now to Stop War & End Racism). This was a front for the Worker's World Party, and outfit that supported the Soviet Invasion of Hungary, and is very fond of North Korea. I thought that was worthy of pointing out, but I also made it clear that it didn't all discredit the motives of the many participants. I wrote this in my 2005 post:

I am not suggesting anything about the thousands who attended the rally.  They were no doubt a very mixed bag.  I am certainly not suggesting that anyone who opposes the war is in any way tainted by the decidedly nasty history of International Answer.  As I have said repeatedly, there are many honest and intelligent people on both sides of the question.

Well, Paul Krugman writing in the New York Times has something to say about these mobs. He is surprisingly honest on one point:

While the organizers are as crass as they come, I haven't seen any evidence that the people disrupting those town halls are Florida-style rent-a-mobs. For the most part, the protesters appear to be genuinely angry. The question is, what are they angry about?

Well, might it be that they are angry because they disagree with the Democratic agenda on healthcare, and think it bad for them and bad for the country? Here Krugman's fairness drops off.

The driving force behind the town hall mobs is probably the same cultural and racial anxiety that's behind the "birther" movement, which denies Mr. Obama's citizenship. Senator Dick Durbin has suggested that the birthers and the health care protesters are one and the same; we don't know how many of the protesters are birthers, but it wouldn't be surprising if it's a substantial fraction.

And cynical political operators are exploiting that anxiety to further the economic interests of their backers.

Does this sound familiar? It should: it's a strategy that has played a central role in American politics ever since Richard Nixon realized that he could advance Republican fortunes by appealing to the racial fears of working-class whites.

Well, that's sets it straight. We don't know how many of the "town hall mobs" (see how quickly protesters become mobs when they are protesting your favorite policies) are birthers (people who question whether Obama was really born in the U.S.). But that's no reason not to employ a little innuendo. And on the basis of no evidence whatsoever, Krugman brands the protesters as racists. Krugman is a weasel.

I think it is bad form to shout people down, and the town hall protesters should acquire some decorum. But it's worse form to imagine that everyone who disagrees with you must be doing so because of some deficiency of character. That turns conflict into contempt, and that is what Krugman is about.

Some Rules for Commenters

I love each and all of my commenters, and I value your participation.  I think this blog has attracted a lot of folks who are intelligent, reasonable, and interested in conversation about the issues we raise.  I have very few rules, and most of them I develop on the fly.  But here are a couple:

Attach your comments to relevant posts.  Don't comment on a previous thread in a new one, unless the topic is the same.  If you have a comment on a post where it obviously does not belong, copy your work and post it in a more appropriate place.  I will give you some time, but I will remove irrelevant comments from the various threads. 

Make sure that your post is a genuine comment and not a pre-packaged statement.  I have had to remove a few Martin Luther style parchments from the blog. 

Also: I try to respond to as many comments as I can, but this blog is a hobby and I have a real job.  If I don't respond to a comment, it doesn't mean I am ducking your incisive it or that I judged your comment unworthy of response.  It might just mean that I had to mow the lawn. 

Gruesome Practices of Ancient Americans

Modern social science has long been in love with the idea of a virtuous past. Margret Mead's Samoan fantasy of a culture without adolescent angst or any form of sexual oppression stands out. Similarly, early studies of Chimpanzees presented us with a perfectly peaceful relative, who did nothing all day but eat and have sex. Think of it as a spa species. These scientific fantasies had their counterparts in, and frequently gave rise to, similar sexy dreams in popular culture. Herman Melville may be famous for Moby Dick, but he made his money on Typee, a semi-biographical novel that involved a couple of Americans and a lot of naked, brown women. And then there are the paintings of Gauguin.

All of this was nonsense, of course. Mead's Samoa was like everywhere else: fathers striving to protect their daughter's virginity and young men using their upper body strength to get what they wanted. Chimpanzees, meanwhile, have turned out to compare favorably only to certain dead Rap artists. Our nearest mammalian cousin is geared for war, and brutal in his politics.

Recent archeology has corrected a number of myths about the original Americans. It seems clear now that Native American civilizations were much more advanced and much more extensive than previously thought. It is also clear that they did not live in harmony with their environment, nor did their civilized life represent a model for modern civilization.

Andrew O'Hehir has a review at Salon of "Timothy Pauketat's cautious but mesmerizing new book, "Cahokia: Ancient America's Great City on the Mississippi." Cahokia was a great city in North America that thrived a little before Thomas Aquinas discovered Aristotle.

At its peak in the 12th century, this settlement along the Mississippi River bottomland of western Illinois, a few miles east of modern-day St. Louis, was probably larger than London, and held economic, cultural and religious sway over a vast swath of the American heartland. Featuring a man-made central plaza covering 50 acres and the third-largest pyramid in the New World (the 100-foot-tall "Monks Mound"), Cahokia was home to at least 20,000 people. If that doesn't sound impressive from a 21st-century perspective, consider that the next city on United States territory to attain that size would be Philadelphia, some 600 years later.

That's fascinating. Equally interesting and appalling is this:

Simultaneous burials of as many as 53 young women (quite possibly selected for their beauty) have been uncovered beneath Cahokia's mounds, and in some cases victims were evidently clubbed to death on the edge of a burial pit, and then fell into it. A few of them weren't dead yet when they went into the pit -- skeletons have been found with their phalanges, or finger bones, digging into the layer of sand beneath them.

That is more than remarkable. Throughout human history women have been considered a vital resource, and for obvious biological reasons: a few men can have about as many children as a lot of men, but reduce the number of women and you sacrifice some of your society's reproductive potential. Fifty-three young women is a real sacrifice.

And there is this description of a mound excavated in the late sixties:

This mound contained a high-status burial of two nearly identical male bodies, one of them wrapped in a beaded cape or cloak in the shape of a thunderbird, an ancient and mystical Native American symbol. Surrounding this "beaded burial" the diggers gradually uncovered more and more accompanying corpses, an apparent mixture of honorific burials and human sacrifices evidently related to the two important men. It appeared that 53 lower-status women were sacrificed specifically to be buried with the men -- perhaps a harem or a group of slaves from a nearby subject village, Pauketat thinks -- and that a group of 39 men and women had been executed on the spot, possibly a few years later. In all, more than 250 people were interred in and around Mound 72.

Another sacrificial site contained a lot of other good stuff.

Analyzing the strata of rotting gunk found therein, Pauketat concludes that there was probably an upside to Cahokia's appalling "mortuary rituals," which he suspects were officious public ceremonies  to honor the ruling family or to install a new king. The garbage dump reveals the remains of enormous Cahokian festivals, involving as many as 3,900 slaughtered deer, 7,900 earthenware pots, and vast amounts of pumpkins, corn, porridge, nuts and berries. There was enough food to feed all of Cahokia at once, and enough potent native tobacco -- a million charred seeds at a time -- to give the whole city a near-hallucinogenic nicotine buzz.

Civilization arose independently in the new world, evidence that the trajectory of human development was firmly pointed in that direction. I wonder why mass human sacrifice was so prevalent in Native American cultures. I note that the adolescence of human civilization was marked by despotism and bloodshed everywhere and always. It took a long time for us to mature, if indeed we have or ever will.

But I also note that this gruesome confirms, in an odd way, the natural human inclination to think in terms of justice and reciprocity. What were the ancient Cahokians trying to do, by slaughtering so many men and woman, and sacrificing so much bounty? Increase the aura of their upper class, to be sure. But they were also trying to bargain with the gods. In return for all this virgin blood, you big spirits need to make the crops grow and our enemies diminish. It is terrible to say so, but only a basically moral animal could think that way.

August is the Cruelest Month…for Healthcare Reform

In a few short months President Obama has turned public opinion from a solid majority in favor of healthcare reform into a divide public and perhaps a solid opposition. Americans who had a very dismal view of their own healthcare options suddenly seem very fond of them, according to one poll. We can quibble about which polls to believe and how much, but there is no doubt that confidence in reform has declined precipitously, along with confidence in the President and his party.

Why? Is it the Republicans, who haven't enough strength to block reform in either chamber? Is it the evil health insurance agencies (as Speaker Pelosi would have it), who, as the WSJ points out, have been very timid? Is it those pesky voters who show up at town hall meetings? Fellow short person Robert Reich says that Republicans won't defeat healthcare reform. He is surely right about that. If it goes down, it will be the Democrats and the people who done it in.

The main problem is that the reform effort so far has been a basket case. Let's look at what is in the basket.

The President has no plan. Nobody in these United States has a clear idea of what is being proposed. Never mind all the disinformation Republicans are supposedly generating. The President and Congressional Democrats keep saying contrary things about their own proposals. You get to keep your current plan, and you don't. Without a coherent proposal, it's hard for Democrats to go back home and defend the President.

The President can't decide what case to make for reform. Originally, it was all these poor people who were uninsured. Then it became a necessity to save the economy, the main argument up until very recently. Now it's a new one: health insurance security. These aren't necessarily exclusive, but the shifts in emphasis weaken the idea that reform is an imperative.

The President is making implausible promises. Can any healthcare package really extend health insurance and more treatments to a lot more people, put no limits anyone's choices, be not only revenue neutral but actually help bring down budget deficits, and all this without raising taxes for anyone making less than $250 grand a year? People are smart enough to see that the answer is no, and now that they are being forced to think about it, they figure that what goes and what stays might be very unpalatable.

The President isn't being honest about what he really wants. He wants a single payer, Canadian style healthcare system. He wants that because he is a liberal Democrat, and that is one of their congenital desires. It may be a good idea. But it is a means, and they see it as an end. It is clear that the President and a lot of powerful Democrats see the "public option" as only a way to get single payer down the road. But he won't say that in public now. He thinks that we won't buy it, and that the only way to get it is to sneak it in.

This is a another fine mess. It has eroded support for reform, and it is reviving the fortunes of the Republican Party. Two major state houses are in play this year, in Virginia and New Jersey. The Republican gubernatorial candidates lead in both by about 14 points. Short of a miracle, both state houses will go red.

In the generic Congressional polls, Rasmussen has the Republicans ahead by 5 points. Gallop has the Democrats ahead by 6. But this kind of poll, for whatever reasons, usually exaggerates the Democratic lead. Either way you cut it, this is a tremendous recovery for the GOP. I have no crystal ball. But just right now this looks like a disaster for the donkeys.

Selling out the Environment

Mr. Heidelberger at The Madville Times responds to my post by arguing that even though destroying vehicles probably does harm the environment, it's alright because it boosts the economy. Cory is beginning to sound a lot like a Republican!

He also submits that, eventually, most old cars will end up in a landfill. That may be true, but fewer cars would end up there if we used the cars we had until we couldn't anymore. The current plan is wasteful.

Furthermore, the money paid out is not free. It is money from our pockets.The move is also regressive. It favors the haves over the have-nots. Those who can afford to scrap their clunkers might be getting a good deal - but what about those who don't have a clunker to sell?

Cash for Clunkers

When I heard about Obama's Cash for Clunkers plan, something struck me as not quite right. In order to get the cash incentive, I noted, car buyers had to let their older vehicles be destroyed. That didn't seem particularly "green" to me, and, as it turned out, I wasn't the only one who questioned the plan's environmental benefits.In this article, Fox News quotes Gwen Ottinger of the Chemical Heritage Foundation's Center for Contemporary History and Policy as saying the following:

It takes energy to shred and recycle metals; plastic components often cannot be recycled and end up as landfill cover; and the engine fluids, refrigerants and other chemicals essential to operating products end up as hazardous wastes.

The plan, then, may not be as green as some would like to think. Does that matter?

Dr. Who and British Science Fiction

The BBC-Wales series, Dr. Who, may be the most successful revivalist effort in the history of science fiction. That may not be true financially (what, in what universe, can compete with Star Trek?), but it is surely true in artistic terms. The original series, which ran from 1963 to 1989, was a lot of fun. I will always fondly remember Tom Baker's Doctor. But it was largely an adolescent business, with ridiculously low production values. The new series, was a little better in presentation, though it continued some of the babes in wonderland costumes and sets from the old one. But the new series excelled in writing and acting.

Christopher Eccleston was the first Doctor in the 2005 revival. He was very good, and I missed him when he dematerialized. But David Tennant was simply masterful, and we will not see his like again. I remember one scene where he was trying to peacefully reconcile the British Government with one more gaggle of Alien Invaders. Giving a Captain Kirk like speech, he sudden stops in the middle of his rhetoric and says: "no, wait a minute, that was the Lion King." That was good.

I just finished watching one of Tennant's last performances as The Doctor. "Planet of the Dead" was rocking good sci fi, and had all the charms of the reborn series. But I couldn't help comparing it to the Torchwood miniseries that I recently posted on. In the past I usually judged Torchwood to be good, but at best a diminished spin-off of the Dr. Who franchise. But Children of Earth blew away anything achieved on Dr. Who.

The Doctor is a great invention. He gives us a very appealing character, unlimited by time, space, or mortality. His compassion and forgiveness are preternaturally large, if not quite unbounded. But most of all, he has the charm of competence. No matter what is going on, he always figures out what to do about it. In the recent show, he tells his ally, a beautiful, aristocratic jewel thief, that "the worse it gets, the more I love it." Well, if you have all the time in the universe at your disposal, what else will get your TARDIS moving?

Another Doctor is coming. We can only hope. I note that BBC Wales is based in the city of Cardiff.

How Government Works: Weather Alerts

 This evening I was watching a recorded news cast when the U.S. Government took over my TV. The recording went away and I got a dangerous weather alert. Now, contrary to the little joke above, this is the kind of thing government is for. Everyone needs to know when a tornado, or the Huns, or Godzilla is coming. It is a bit distressing to notice that the U.S. Government's Emergency Alert Service does it so very badly.

The Weather Alert consisted of a visual and an audio message. The visual one was a black screen with white dot matrix letters, cutting edge technology in the 1980s. Maybe someone has research that says this is the right way to post the message. But I am very sure that a key strategy in visual communication is to make certain that the information you most want to communicate stands out in the message.

There are only two things I really need from a weather alert: what is happening (severe storm) and whether or not I am in its path. The first piece of information was contained in the message, but it was buried in a lot of other information that was worse than useless. I did not need to know who was issuing the alert (The National Weather Service) or what office the alert was coming from (Aberdeen). Knowing when the alert expired might be helpful, but why in heaven's name did I need to know the exact time the alert was issued? It was not particularly useful to know today's date, since storms are a lot more about now than they are about August. I certainly did not need the additional numbers and codes attached that might be meaningful to someone (though I wouldn't put money on that) but are inscrutable to pretty much everyone who might actually need the warning.

As for the second piece of information, Brown County was indeed mentioned in the message. But I had to scan down several lines of garbage text to find it. Nothing made it stand out. It was also, for every practical purpose, wrong. I was not in the storm's path at all, though people in other parts of Brown County were. Now you might think that a warning that is overly broad is better than one that is too narrow, but you'd probably be wrong. Too narrow and some people who need a warning don't get it. Too broad, and people quickly learn that a severe thunderstorm warning doesn't necessarily or even usually involve a severe thunderstorm. In that case they lose interest. What I really needed were the words Storm Warning and a map of where the storm was and where it was going. But apparently the National Weather Service has not figured how to do what the Weather Channel has been doing for years.

The Audio Message was even worse. It went on for what felt like forever telling me, in a slow but nonetheless almost unintelligible computer generated voice, all sorts of things that were of no use to me at all. The word radar adds a sense of urgency to the message, but do I really need to know it was Doppler radar? The annoying voice and warning sound took ridiculously long to go through and it was repeated three times.

In short, both the visual and audio portions of the warning left out the most important piece of information, were designed to communicate that information in the most inefficient way possible, and did everyone one might think of to encourage listeners to walk away from the set. This is how the U.S. Government designs a public warning system. These are the folks that some of my good friends think ought to take control of the American healthcare system.

Banning Tony the Tiger?

Mark Steyn (who I think is always worth a read) points out a problem with Obamacare. According to him, "reforming" healthcare is the first step in redefining the roles of the government and its citizens, so that the government can regulate all human affairs as it sees fit. Steyn warns that this will lead to considerably less freedom. In Britain, he points out, one bill tried to ban Tony the Tiger from daytime television, because of his bad influence on children. Another bill, he says, would have allowed citizens to fly only a certain number of miles before being charged eco-surtaxes. 

I think this ties in well  with the current discussion on this blog regarding taxes on soft drinks. It might be easy to accept new taxes on soft drinks, but if we do, might it not pave the way for the taxation of other things? Are we willing to have every choice we make subject to monetary punishment? Or are we only willing to be punished for some of our choices? Where do we draw the line?

I understand that this is a slippery slope argument. Still, if it can happen in Britain, it can happen here.

Recalibration

A.I. and Denature took me to task recently for making a poorly supported argument. They were right. I should have calibrated my words differently. 

Today, I did penance by reading through every relevant Emanuel article I could find. I have to admit that there is a lot to admire about the man.  He directs physicians to take the time to listen to their patients’ concerns and he recognizes the problems of excessive bureaucracy in medicine. Furthermore, he does seem concerned with putting an end to euthanasia.

Nevertheless, I think that there is, as P. Chirry points out, still cause to be wary.  Emanuel wrote his Lancet article in January of this year. In it, he showed a preference for allowing younger people to live at the expense of the elderly.

A.I. also points out that Emanuel only specified that he favored this kind of preference in one set of circumstances. He says that we cannot assume that Emanuel would apply this kind of thinking to Obama’s current health policy. He is right, but neither can we assume that he will not.

It is true that values sometimes change. However, since Emanuel’s article was written so recently, I find it unlikely that he would suddenly change his mind or suddenly decide that the elderly were as valuable to society as the young. It is possible that Emanuel only finds younger people more fit for care than older people in end-of-life situations – but that is often when healthcare is most critical. Obama may, as A.I. points out, ignore advice from Emanuel. But he is likely to take it, or he would not have chosen Emanuel as an adviser.

There is other thing that I find disturbing regarding Emanuel.

While researching, I came across his book, The Ends of Human Life: Medical Ethics in a Liberal Polity. In one chapter, he says that it would not be right for a physician to decide that an elderly person did not deserve care, because that would be a “personal quality of life decision. “ However, if society deems that an individual can no longer benefit society, he says, that is another matter. He then goes on to discuss what he thinks society’s criteria in deciding these things should be.  Anyone who has access to the book can have a look at pages 73 and 74. That chapter disturbs me a little bit.

Still, I haven't yet read the whole book, so I may, again, be taking things out of context. But it is something worth scrutinizing.

Miranda Boosts SDP's Numbers!

My wisdom in inviting Miranda Flint to join SDP has been quickly confirmed.  Here is a chart of our traffic for the last thirty days:

Miranda's first post was on July 30th.  The next three days saw a dramatic increase in page views.  That's a stimulus package I can believe in.  It was a very good idea to bring her aboard.  I just have to wonder why she needs me. 

Old People Got No Reason Either

 

One of the most memorable campaign ads of the 2002 election was the ad the Democrats ran against Bush's plan to privatize Social Security. The ad showed a cartoon Bush pushing a cartoon elderly lady off a cliff. For those of you who enjoy reminiscing, here it is: http://a1979.g.akamai.net/7/1979/8082/v00001/democratic1.download.akamai.com/8082/flash/bush.swf

Today, these Democrats are silent. Yet, one of the current president's top health advisers has a plan that is a little bit like shoving granny off a cliff. That adviser is Ezekiel Emanuel, Rahm Emanuel's brother and head of the Department of Bioethics at the National Institute of health. Emanuel recently authored an article in The Lancet, entitled, "Principles for Allocation of Scarce Medical Interventions." In it, he says the following:

We recommend an alternative system—the complete lives system—which prioritises younger people who have not yet lived a complete life, and also incorporates prognosis, save the most lives, lottery, and instrumental value principles.

Emanuel notes that having a "first-come, first-served" plan is not the best, because it "favours wealthy, powerful and connected" people. He also notes that having a system that focuses only on treating having a system that focuses only on treating the youth first is bad, because it gives an, "Undesirable priority to infants over adolescents and young adults." The rest of the article can be found here. http://www.ncpa.org/pdfs/PIIS0140673609601379.pdf

So, don't worry, Dr. Blanchard. Team Obama is ready to tackle old people too (and maybe a few infants, besides).

Torchwood and Moral Philosophy

I have been a big fan of the BBC series Dr. Who and its spinoff, Torchwood. "Torchwood", by the way, is an anagram of "Doctor Who." The main character in Torchwood, Captain Jack Harkness (John Barrowman) is immortal. Shoot him, and he coughs back to life a few minutes later. Blow him to bits, and one of the bits will grow back into a new Captain Jack. As one might expect, immortality turns out to be more curse than blessing. Harkness is doomed to love mortals, have babies, and watch everything and everyone he loves die and leave him alone. That's a romantic hero on stilts.

Torchwood is a branch of the English government (which seems to excel in creating branches) created by Queen Victoria to deal with extraterrestrial threats. Jack Harkness leads Torchwood 3, based in the town of Cardiff. The first two seasons were quite good science fiction. The general context of the show is that the universe is crawling with aliens, many of them capable of interstellar travel, and most of them nasty as they want to be. Now is the time that earthlings are beginning to recognize their presence and interference.

I have just finished watching the third season, a five episode miniseries called Children of Earth. It was superb. I don't think I have seen anything in science fiction that was as morally sophisticated as these five episodes. As it happens, I was teaching philosophy and got to the section on ethics just as I was viewing the show. The major themes of modern moral philosophy were woven into the show in a blunt but nonetheless artful way. If it weren't so long, I'd have my students watch it.

I won't spoil anything here, but the plot involves an alien species that wants a lot of human children for, well, not so pleasant purposes. It lays out theme of corruption and sacrifice about as well as they can be in fiction. This is high art so far as film is concerned. If you like science fiction at all, and you like thinking, character, and drama, don't miss Children of Earth.