Monday, February 28, 2011


It's like waking up on another planet (maybe one in which there's oxygen but only, say, about 10%; and, you know, weird plants and animals with ten legs and seven eyes, yeah, and you're not sure how you got there and maybe there's no way to get back unless it's a dream but it's not but it could have been something you ate) when hearing Mahmoud Ahmadinejad condemn Moammar Khaddafi (pick your spelling, who cares) for shooting at his own people. Really, he did. I don't think the word "hypocrisy" even applies to something like that, any more than "damp" applies to the ocean.

I must say, though, that I felt a little bit of astral projection when I heard that John Boehner was on a golf-gig in Florida, after having condemned President Obama for distracting us from the people's work, during the most impactful budget debate in all of history, on this planet. Because, remember, he's the one that famously said this, about President Clinton. Not long before Clinton balanced the budget over the no-votes of every Republican, leading to the surpluses which Bush turned into unprecedented deficits, leading us to where we are now.

I couldn't care less who plays golf, or when. But he's the one that threw down the marker.

Boehner's no Ahmadinejad. There are matters of degree, of course. But there's still something nearly incomprehensible about people who are so easily able to do the very things they criticize in others, without even a suggestion of irony. I won't claim that it's only tyrants and Republicans who do it. But in them there's a certain ease, a facility, comfort, that speaks of a special kind of mind...

Sunday, February 27, 2011

My Point, Exactly

Here's an interview with a researcher, about the decline in the teaching of evolution. Some important points therefrom:

We see two distinct issues here. The first is that students are being cheated out of a sound science education. All nations are increasingly confronted with important policy choices that are informed by science: Should we mandate vaccines for all school children? Should we take costly steps to reduce carbon emissions? How can we most effectively reduce the incidence of chronic diseases? For ordinary citizens to play a meaningful role in democracies tackling these issues, they need to be excellent critical thinkers concerning science. They should not blindly accept scientific findings, whether they come from academia, government or industry. But neither should they believe that scientific debates are simply clashes of opinion and values. A healthy appreciation of the nature of science, the persuasiveness of replication, and respect for the necessary expertise is also essential. When teachers tell their students that they can have their own opinions about the validity of evolutionary biology, they are sending a dangerous message to our future citizens.

On the other hand, the failure to integrate evolution into the general biology class represents a missed opportunity to turn students on to science....

... Evolutionary biology — taught well and thoroughly — offers a great opportunity to convey the nature of science to young people. This is an opportunity most school children are denied.

And it addresses the main problem, that of faith and the closing of the mind:

We estimate that no more than 30 percent of Americans belong to faith traditions that emphasize a strict and literal reading of the Bible that may lead adherents to see a potential conflict between their faith and the findings of evolutionary biology. The contradictions are rooted in beliefs about the antiquity of the earth, Adam and Eve, and the idea that all current animals descend from those on Noah’s ark. ... Nevertheless, these ideas have diffused into the larger population and are held by others whose own pastors, priests and rabbis see no inherent contradiction between scripture and science. I think there are opportunities for those associated with these other faith traditions to better articulate how faith accommodates modern science, and vice verse. ....

... More broadly, many people of faith are drawn to the study of evolution to explore God’s work, and find a spiritual connection in their study of nature. This perspective was common in the 19th and early 20th centuries, but is not often enough articulated in current debates about evolution. Maybe that is because nobody has yet stated it more eloquently than Darwin himself:

There is grandeur in this view of life, with its several powers, having been originally breathed into a few forms or into one; and that, whilst this planet has gone cycling on according to the fixed law of gravity, from so simple a beginning endless forms most beautiful and most wonderful have been, and are being, evolved.

As our worldly problems become more complex and threatening, the response, sadly -- in the US, anyway -- has been to resort to simplicity and ignorance. As it suffuses into our education system, already lacking in much, the future is steadily being pulled away from us. The need of some to ignore reality is translating into the inability of everyone to evaluate data, to be skeptical, to have a rational -- a scientific -- way to address information.

The results are obvious: we're turning away from difficult solutions toward magic. And with increasing frequency we're electing prestidigitators, not leaders, at the very time we need them the most.

Saturday, February 26, 2011


I know I have some lawyers who are readers here, and at least one judge. So maybe they can provide enlightenment. I have a problem with President Obama's recent stance on DOMA.

Admittedly no legal scholar, I've always thought the law was unconstitutional, and I was very disappointed in Clinton for signing it. Constitutional or not, it was and is, clearly, discriminatory, religious-based, unfounded, hurtful, senseless, useless, and who-knows what else. So I'm with the president when he says it's wrong; the sooner it's off the books the happier I'll be.

But I find myself agreeing with those on the right who are saying he's wrong in his approach. I don't go as far as Mister Screw-around-on-'em-while-they're-dying-and-divorce-'em-before-they're-dead, but as long as the law is the law, he's bound to defend it, isn't he? For him to have said he believes it's unconstitutional and therefore he'll no longer enforce it, isn't within his powers. As I see it.

I'd much preferred it, had he said that, given financial constraints throughout the government, and the important issues facing the Justice Department, he's ordered a prioritizing of efforts, and defense of DOMA is at the bottom of the list. We'll get to it when we've taken care of all the other more pressing issues like terrorism and corruption, and if we don't run out of money to spend on it.

Meanwhile, he could urge Congress to rescind it, or whatever the proper terminology is. The effect would have been the same. The suggestion of executive overreach would be absent.

Or am I wrong?

[Addendum, 8:30 pm: Here's an illuminating article. I was wrong.]

Friday, February 25, 2011

Party People

As has been pointed out in a recent comment thread here, there are some similarities between the pro-union rallies in Wisconsin, and teabagger rallies everywhere. This morning I read an interesting take on the idea. It isn't very long, so here's the whole thing:
There’s something about the union demonstrations in Madison, and the excitement it has caused on the left, that reminds me of the Tea Party. I think I’ve figured it out what it is. The advent of the labor movement is at the heart of the left’s sacred creation myth. The sense on the left that unions are under siege gives them something to fight for with a bracing sense of historically-rooted identity and moral authority. Similarly, the sense on the right that America’s foundational values are under siege gave the Tea Party something to fight for with a bracing sense of historically-rooted identity and moral authority. Of course, the Tea Party has about as much to do with the values of the American founding as John Adams has to do with Raytheon, and public-sector unionism has about as much to do with preventing worker exploitation as Eugene Debs has to do with unfireable $100,000 a year public-school teachers. But it’s nice to have a team, and a noble lineage, and to get out there and really give the bastards who are stealing our country hell.

(No less split along partisan lines, the comments there are generally much more enlightened than those that disagree here. But the author is smarter, and more and better read than me.)

I don't disagree that, in many ways, including enthusiasm across the spectrum and hyperbole at the fringes, from a distance the crowds are similar. But as I said in response to a recent comment, I also think there's a very basic and fundamental difference: on one side, the fears and complaints are mostly made of thin air, deceptively packaged and produced by the very people the protesters would (or should) find most repellant; on the other, what they are saying is demonstrably true, and their rights, their freedoms, if you will, are, in fact, being threatened.

Naturally, I claim the factual high ground here. Given evidence, I might be open to learning the truth is nearer to the middle, if still significantly to the left of the mean.

Teabaggers claim they want their country back, cry that "they're taking away our freedoms," call Obama a Nazi, a socialist, a communist, a Muslim, a foreigner. I've never heard any of them -- and many have been asked -- which freedoms have been removed or even threatened, except in some feverish and sweaty waking dream. Nor has any made a case (plenty of claims, of course, but no case) that the president does Nazi stuff. Painting on a mustache does not make it reich. Sure, there are deficits, and that's something about which to be alarmed. Real enough. But their understanding of the differences between those that preceded and those that followed Obama's election is entirely absent; and their so-called solutions are nonsensical and have always made things worse. Nor are deficits the coherent center of their complaints.

On the other hand, the unions in Wisconsin are demonstrably under attack. Not even conservatives deny that it's about trying to bust them. And whereas there are legitimate arguments to be made on either side of the right of government workers to strike, there's no doubt that what's at stake isn't some imaginary fever dream: it's the explicit end of their rights to collective bargaining. Agree with the concept or not, that's a freedom, and it's on its way to being taken away. And it's their central point.

Further, I can't think of a teabagger equivalent to the fact that the Wisconsin union members agreed to all the give-backs requested by the governor. They did so without striking or shutting down anything. All they want is to retain future bargaining rights. That's not imaginary. And it's nothing like the sort of no-compromise, all-for-us, nothing-for-you stance of teabaggers.

So, yeah. The vision of pro-union demonstrations is energizing to many liberals, and is a welcome pushback against the cynical, heartless, and ineffective budgetary plans of the teabagger Congress. It's just as bracing, I guess, to be in a lefty crowd as a righty one. And whereas I'm sure people can point to excessive rhetoric and signage, to the same sort of over-the-top vitriol that has characterized teabagger rallies and which comes from the mouths of RWS™ round the clock, it doesn't change the essential difference: the people in Wisconsin are in fact being fundamentally threatened in ways that affect their livelihoods; teabaggers are afraid of monsters under their beds and homosexuals in them.

Thursday, February 24, 2011

Making Sense In Tough Times

To Make Us Dumber

In its quest to blind its already deaf and dumb audience, Fox "news" adds to its disinformation campaign a "calculator" that purports to show individuals their "share" of the cost of health care reform. Unsurprisingly, it's complete bullsh*t.
For all these reasons, Fox's calculator can't be taken seriously. Its calculations are basically nonsense, and I hope that it dies a quiet death before its numbers are widely repeated without any context. There are many valid reasons to oppose (or support) the health care reform that passed last March, and it's important that we continue to have that debate without resorting to nonsensical numbers.

Gee. The article calls for serious debate, based on serious inquiry.

That'll be the day. Teabaggers will see to that.

Wednesday, February 23, 2011

What Passes For Logic

John Boehner's response to the news that the Obama administration has decided not to continue defending DOMA: we should be focusing on jobs. So, let's see: not wasting time on something is... not focusing on jobs? Help me understand. Anyone?

And it's divisive. Not doing something is divisive. In ways that non-stop attention to abortion, Planned Parenthood, instead of jobs isn't?

This is not an intelligent man, a serious man. Even when he speaks through his spokesperson, this is not an intelligent man.

Thanks, teabaggers.

Think Or Swim

Asked why he refused to call out Republicans who, in depressingly large numbers, still believe Barack Obama is not a US citizen, John Boehner said, "It's not my job to tell people what to think." I find that amusing in a clarifying sort of way.

Isn't that what all politicians do, all the time? Tell us what to think? Aren't they pretty much wholly committed to convincing people that their ideas (applying the term generously) are worth adopting? The Speaker of the House, third in line for the presidency, isn't in the business of being a thought leader? On health care, deficits, war, and Planned Parenthood?

Of late, for reasons even more unfathomable than Beckian theories on communists and Egypt, there's been an attempt (I'd say it's out of embarrassment, but I don't think the term applies to the RWS™ or R leaders or teabaggers) to toss off those birther numbers as some sort of left-wing conspiracy. Connecting dots visible only on the inside of their skulls, such people as Debra Saunders (and the occasional commenter here) claim the problem is that liberals are "flogging" the story to make conservatives look "like rubes." Creative. It's not that these people are rubes (a refreshingly archaic term) for believing Barack Obama was born in Kenya; it's that liberals keep pointing it out.

I'm still processing...

What makes that proposition particularly laughable is where we started, with John Boner simpering in his seat, coyly refusing to influence thinking on the matter, perish the thought. If, as Ms Saunders claims, birtherism is somehow a liberal plot, why doesn't the titular head of political Republicans do everything he can to shoot it down? Might it just be that he calculates such foolish flames help stoke the fires of resentment and hatred that got him his shiny new office? What are RWS™ about, if not that?

Birtherism -- its evolution and hyping and relentless promotion by the RWS™ and Fox "news" -- does, however, help me understand another and much more opaque mystery: if a majority of potential Republican voters choose to believe, against definitive and unquestionable proof, that our president is foreign-born, it shouldn't be surprising that they also accept the mythologizing about and reject the failures of Ronald Reagan, to believe he was our greatest president ever.

Now that is testimony to the power of the right-wing propaganda and disinformation media coalition. That's strange we can believe in.

Tuesday, February 22, 2011


I remember when Colonel Qaddafi (unusual, isn't it, for a despot to assign himself such a lowly military rank -- plus there are more ways to spell his name than there are for Hannukah) disavowed nukes after we invaded Iraq. It was touted as powerful proof of the power of power: we scared him into submission with the toughness of our tough-guy toughness. Bush was right, so it was said.

Now, when peaceful revolution has occurred in Egypt, suddenly that's the incarnation of evil, fueled by a coalition of communists, Islamists, American leftists, and Barack Obama's henchmen (or is it controllers?); a precursor to some chick named Sharia moving into your neighbor's basement. Many of the RWS™ slammed our president for not supporting Mubarak.

Meanwhile, back in Libya, feather in the neocon cap, our fraidy-cowed pal Muammar is raking protesters with automatic weapons and shooting at them from planes, while calling out America "the superpower." Will the Rushannitysantoroglennists voice their approval of that, too?

What's a patriot to think?

How Does Wiscon Sin, Boys?*

My first experience with a union rep was in a swamp. I'd been working to build a major sewer system through the boondocks: my summer construction job in college. The man had slogged out there to tell me that I had to join the union or quit working. Since I'd spent most of the summer there already (and all of the previous one), and the amount I'd have had to pay was more than I'd earn in the remaining couple of weeks, I quit.

Years later, there was a movement among some employees of my clinic -- which had had about thirty-five docs when I joined, was then up to around two hundred, and is now at over three hundred docs with more than twelve-hundred employees, I think -- to unionize. It didn't succeed; recently, the clinic was named as one of Fortune's top one-hundred companies to work for in the US. (I think it has less to do with whether or not it's unionized than with the fact that it's still owned and operated by the docs themselves, who care about employees in ways not all big corporations do. I'm very proud of the place, and of my contributions to it.)

I'm not a reflexive supporter of unions in all things.

In Wisconsin, though, I think if the unions are successfully busted, it'll be the beginning of the end of any remaining pretense of democracy in the US. Teabagger naivete notwithstanding, it's becoming increasingly clear that the strings of power in the US are being pulled by the super-wealthy. In fact, it's because of teabagger naivete: in their gullible blindness, they've let themselves be manipulated into thinking they're a people's movement, when the exact opposite is true. I've said it before. Paul Krugman's latest opinion piece, not unexpectedly, says it much better:

.... Wisconsin is indeed facing a budget crunch, although its difficulties are less severe than those facing many other states. Revenue has fallen in the face of a weak economy, while stimulus funds, which helped close the gap in 2009 and 2010, have faded away.

In this situation, it makes sense to call for shared sacrifice, including monetary concessions from state workers. And union leaders have signaled that they are, in fact, willing to make such concessions.

But Mr. Walker isn’t interested in making a deal. Partly that’s because he doesn’t want to share the sacrifice: even as he proclaims that Wisconsin faces a terrible fiscal crisis, he has been pushing through tax cuts that make the deficit worse. Mainly, however, he has made it clear that rather than bargaining with workers, he wants to end workers’ ability to bargain. ...

... it’s not about the budget; it’s about the power.

In principle, every American citizen has an equal say in our political process. In practice, of course, some of us are more equal than others. Billionaires can field armies of lobbyists; they can finance think tanks that put the desired spin on policy issues; they can funnel cash to politicians with sympathetic views (as the Koch brothers did in the case of Mr. Walker). [Bloggers note: the Koch brothers are the main money behind teabaggers, as well.] ...

... Given this reality, it’s important to have institutions that can act as counterweights to the power of big money. And unions are among the most important of these institutions.

You don’t have to love unions, you don’t have to believe that their policy positions are always right, to recognize that they’re among the few influential players in our political system representing the interests of middle- and working-class Americans, as opposed to the wealthy. ...

.... There’s a bitter irony here. The fiscal crisis in Wisconsin, as in other states, was largely caused by the increasing power of America’s oligarchy. After all, it was superwealthy players, not the general public, who pushed for financial deregulation and thereby set the stage for the economic crisis of 2008-9, a crisis whose aftermath is the main reason for the current budget crunch. And now the political right is trying to exploit that very crisis, using it to remove one of the few remaining checks on oligarchic influence.

So will the attack on unions succeed? I don’t know. But anyone who cares about retaining government of the people by the people should hope that it doesn’t.

Predictably, teabaggers have showed up in Wisconsin right on cue, unknowingly (one would hope) doing the bidding of those who would complete the coup against their own power. And every time I allow myself the glimmer of hope that they'll wake up to see how they've been used, I get another comment here from the Jersey shores that convinces me I'm wrong. There's no getting through to these people.

Never have so many been so deceived by so few, so easily, into doing so much so clearly against their own interests.

* A reference to this, for the culturally deprived.

Monday, February 21, 2011

Making A List

Here are some of the programs so far defunded by House Republicans:

They did, however, vote to continue sponsoring NASCAR cars. So there's that. And tax loopholes for oil companies.

Need it be said that Planned Parenthood is about much more than abortion services? Need it be pointed out that pollution is bad for us, even if it costs money to deal with it? That deregulating finance is what, in large measure, got us where we were a mere two years ago?

Next day, they did more:
    • Voted to strip funding from just about every EPA project, including air quality, emissions, and water pollution monitoring.
    • Defunded NOAA
    • Stripped funds to administer the Affordable Care Act.
    • Eliminated funds for the Intergovernmental Panel on Climate Change
    • Continued $53 billion in oil subsidies
    • Tried to eliminate Davis-Bacon rules for government projects (that failed)
    • Stripped federal workers of their salaries in positions within agencies targeted for defunding

The thing is that these cuts (which are admittedly not likely to become law) would hurt the most vulnerable people, pander to corporations, and do practically nothing to reduce the deficit. They're symbolism. Which is exactly the point.

In these cuts we can see what the teabagger wing of conservatism is all about: short-term (as in their personal lifetimes) savings for themselves at the expense of everyone else. And of the future. In order to prevent themselves from ever paying more in taxes, they're happy -- eager!! -- to ignore the needs of the country. They call it fiscal responsibility. It's not. It's pure selfishness, rationalized by a heavy dose of willful ignorance, wrapped in an entirely unserious concern about some imaginary future that doesn't exist. These measures completely ignore the hard stuff, the real factors pushing the deficits. It's sandbagging the teabaggers, who, looking for any reason to believe, allow themselves to be played for fools.

Nothing gets the selfish to hop on board like the promise of tax cuts. No one -- not even me -- likes paying them; some, however, recognize the need. It's easy to find wasteful spending in any government program. To those wishing to rationalize taking their money and running from responsibility, it's nice to be able to point to such things. But they're beside the point.

The first person seriously to address Medicare waste was Barack Obama, and, nearly unbelievably, it's been shouted down ever since (despite the fact that it reduces the deficit) by the very people who claim they want fiscal responsibility. It's like Sarah Palin decrying Michelle Obama's push for breast feeding after previously declaring, during her half-ass term governorship, that the government has a stake in promoting it. Anything for politics, hey?

The left isn't scott-free, of course. The mere mention of addressing entitlements sends them into a frenzy. But surely there are ways to do it (Obama already did) that don't affect those who need them the most while getting those who can afford it to pay a little more. And until defense cuts and tax hikes are on the table (credit to teabaggers on the F-35 engine, although they merely did what presidents and defense secretaries have been calling for; and it's a diddly drop in a big bucket), we'll never get anywhere.

Teabaggers are willing to do harm to the present needy and the future everyone in order to die with their pockets full. It takes a special kind of blindness to justify that: in their budget proposals, the lack of seriousness is there to be seen, for anyone interested in looking.

Sunday, February 20, 2011

Science Education

Don't let the accent lead you astray: this is Ken Ham, the guy who, with the approval of governors, would destroy education in the US. He already is, with his Creation Museum. The Ark is coming next, floating in on hot tea. Legislatures are lining up to make this sort of "teaching" part of public school curriculum.

Hallelujah, say the teabaggers.

See ya' in the rear-view mirror, say China and India and Japan. Not to mention all of Europe.

Saturday, February 19, 2011


If it's too hard to read, a bigger version is here.

Let's imagine a revised version ten years hence, if teabaggers have their way. And let's hope it'll only be imagined.

One thing that's clearly exceptional about the US: the number of people who think saying it's exceptional suffices, and substitutes for making it and maintaining it that way.

Friday, February 18, 2011

Fracture Lines

This is from an interesting article, titled "Shibboleths." It begins with the fact that a majority of potential Republican voters believe Barack Obama is not a US citizen:

...birtherism is a shibboleth, that is, an affirmation that marks the speaker as a member of their community or tribe. (The original shibboleth was a password chosen by the Gileadites because their Ephraimite enemies could not say “Sh”.) Asserting a belief that would be too absurd to countenance for anyone outside a given tribal/ideological group makes for a good political shibboleth.

It’s clear, as Dave Weigel points out, that beliefs of this kind are a marker for partisanship, as witness the high correlation between stated birtherist beliefs and approval of Palin. But that doesn’t necessarily mean that the statement isn’t actually believed. ...

... we can distinguish numerous different belief states that go along with birtherist answers to opinion poll questions. There are lots of nuances, but most are combinations of the following

  • A conspiracy-theoretic view of the world in which liberal elites (a term encompassing Democrats, unions, schoolteachers, scientists, academics and many others) are plotting to undermine the American way of life and replace it with some unspecified, but awful alternative. In this case, answers to these questions reflect actual beliefs
  • Partisanship as suggested by Weigel in which Republicans choose to give the most negative answer possible about Obama as an affirmation of tribal identity.
  • Doublethink in which people are aware that in some mundane sense Obama was born in Hawaii, but also believe that Republican ideology is true and implies the birtherist answer
  • Conformism, in which people know the truth but give the culturally preferred answer, or choose some evasive form of words, as with John Boehner recently.

Does all this hurt or help the Republicans? In short-run electoral terms, I think it helps. A base of loyal supporters who, for one or other of the reasons mentioned above, are immune to factual evidence has to help win elections. (emphasis mine, as it's the whole Rovian point.) There are, however, two big costs

  • First, people have noticed that Republicans have a problem with reality. That perception, which undermines the rationale for all sorts of thinking about policy, will take a while to sink in, but it will also be hard to erase once it is generally accepted. In the long run, this has to turn off a fair number of Republican-leaning independents and any remaining Republicans with a capacity for embarrassment.
  • Double-think is very difficult, and people will start to act on the basis of their beliefs. If those beliefs are ludicrously false, trouble is likely to follow.

It's among the most puzzling phenomena with which I wrestle daily: the fact that acceptance or rejection of undeniable facts should fall so sharply along party lines. Deniers of anthropogenic climate change, rejectors of evolution, believers in Obama's foreign birth -- they're all Republicans. I get that hating Obama is politics as usual; but birtherism simply has no explanation in reality as understood by those living in, well, reality.

I've said it before: I think it's no accident that there is a strong religious undercurrent that flows through the separation between Ds and Rs. Which is not to say that Ds aren't religious: many are; maybe even most (I'm sure there are polls out there). But, from what I observe, there are very few biblical literalists on that side of the breech. Few who would force their beliefs on others, and substitute them for public education. The sort of religious certainty that demands rejection of the observable resides, it seems, essentially exclusively on the other side.

So it comes back to neurophysiology, as it always seems to: our brains simply work differently. Unfortunately, there's no vive la difference there, no "it takes all kinds," no tangoing by twos. When the gears of a major political party are turned by those who actively and proudly reject reality, it does few of us any good. Oh, John Boehner sheds happy tears, Michele Bachmann thinks her shit don't smell. But for those of us whose eyes are open and able to look from side to side, there's trouble coming, as the above author said; and it's heading here fast and hard.

I've expressed the unlikely hope that at some time before it's too late, people will realize that teabaggers have long since passed through the departure gate from reality. It's why I continue to write. The article posits that it could happen, too. It's a question of how many critical thinkers there are out there, unheard from; and how willing they are to employ their brains, when so many have already chosen not to and seem happy as clams at high tide. When the tide is out.

Thursday, February 17, 2011

Cry, The Beloved Country

Referring to the teabagger-inspired House R budget, John Boehner was asked (and Dana Milbank writes about it):

"Do you have any sort of estimate on how many jobs will be lost through this?" Pacifica Radio's Leigh Ann Caldwell inquired at a news conference just before the House began its debate on the cuts.

Boehner stood firm in his polished tassel loafers. "Since President Obama has taken office the federal government has added 200,000 new federal jobs, and if some of those jobs are lost in this, so be it," he said.

"Do you have any estimate of how many will?" Caldwell pressed. "And won't that negatively impact the economy?"

"I do not," Boehner replied, moving to the next questioner.

Well, Mr. Speaker, I do. I checked with budget expert Scott Lilly of the Center for American Progress, and, using the usual multipliers, he calculated that the cuts - a net of $59 billion in the last half of fiscal 2011 - would lead to the loss of 650,000 government jobs, and the indirect loss of 325,000 more jobs as fewer government workers travel and buy things. That's nearly 1 million jobs - possibly enough to tip the economy back into recession.

So be it?

It's a dilemma: what to wish for?

A cockeyed optimist, I keep thinking that once people understand the devastation that would be brought upon us were the current crop of Republicans to have their way, it'd be the end of them and we'd get back to trying to make sense. So there's a part of me that says, screw it: let them catch the car they're chasing and see what they do when they have it. Let voters have the opportunity to say, gee, I didn't know that would happen.

But I also know that if they actually get their way it's likely we'd never recover. We have once, sort of, barely. I can't imagine how it could happen again. The next time will be different: instead of starting with a strong economy and budget surplus, we'd be kicking ourselves while we're still down. Hard.

Here's the sort of thinking, from a conservative, that is so far beyond teabaggers as to be in another universe:

Conservatism could once be described as a three-cornered stool: social, economic and national security conservatives.

Today though it’s more relevant to think of conservatism as an attempt to draw a line connecting four points:

1) No tax increase
2) No defense cuts
3) No Medicare cuts
4) Rapid move to a balanced budget.

Obviously it’s impossible to meet all four of those commitments. It would be difficult enough to combine #4 with even two of the first three...

... Much of the 2012 GOP presidential nomination will attempt to send signals as to which commitments each candidate will sacrifice. Since so much of this signaling is non-verbal, it will be hard to pin down who truly is committed to which. ...

... You can play this game at home too – and it may tell you a lot about the kind of conservative you really are.

In the spirit of full disclosure, here’s how I’d square the quadrangle.

I don’t think we should be moving rapidly to budget balance. The time for budget austerity begins when unemployment drops below 7%, not before.

I don’t think we can cut defense spending before we have successfully concluded commitments in Iraq and Afghanistan. And generally I favor the Herb Stein approach to budgeting: First you decide how much it costs to maintain America’s global supremacy. Everything else comes after that.

I affirmatively want to see Medicare squeezed. The American health system is wasteful, wasteful, wasteful.

I am prepared to accept tax increases provided they fall on consumption and pollution rather than work, saving and investment. A carbon tax yes, a VAT if need be, but no increases in personal or corporate income taxes or capital gains taxes. On the other hand, the 15% tax rate on corporate dividends seems to me a laughably unjustifiable giveaway, even though I personally benefit from it.

With the exception VAT, which I think is much more regressive than income tax, there's much in it that makes sense to me.

The problem is, it's clear that teabaggers and those that love them simply don't have the ability to visualize. If the idea of consequences had any meaning to most of them, if they were inclined to think things through, they'd be on the other side of the argument. Except, of course, for the "so be it" faction: those that couldn't care less what happens to the country toward which they make exclusive claims of patriotism, as long as they have theirs and don't have to spend any of it in taxes.

Given the inability of most teabaggers to think sequentially, and given that the rest of them don't care, trying to point things out in advance is futility. And yet, to wish they'd get their way as a sort of final and undeniable proof of their simplistic solipsism would be a dark perversion of the Make-a-Wish Foundation: the last thing we do before we die.

Wednesday, February 16, 2011

Food For Thought

I liked President Obama's words at his press conference more than I like what I understand to be his budget. At this point, having not read the whole thing, what I know is what I've read in various commentaries. My conclusion is like the line in the Woody Allen movie: the food is terrible and the portions are too small.

The first problem is that I'm still persuaded by economists I respect that this is the wrong time in the recovery to be cutting spending. Stiglitz, Krugman, Reich and others say pretty much the same thing. And it would seem that history backs them up, as the Depression was followed by recession when FDR moved too soon in that direction. So I understand.

The next is that a budget claiming to address deficits but which ignores defense spending and entitlement reform is hard to take seriously, at least as advertised. During the press conference, on the other hand, Obama said what I believe; namely, that any cuts must be assessed in terms of harm they'd do both to the needy and to the recovery. He also indicated the top-end Bush tax cuts aren't sustainable, but, having agreed to extension, they're not addressed in the budget. Maybe he figures anything is better than the scald and burn of teabaggers.

I think he knows what constitutes the right things and the right time, so I'm disappointed that he seems to have punted on both. Maybe he's concluded that he'll never get anything he proposes, and his only option will be the veto pen if the teabag budget is as crazy and dangerous as it threatens to be. But I think he'd be in the stronger longer position were he to state and defend, clearly and simply, what needs to be done, and when, straight up, no towing of the cow; and let the Rs make their case for why he's wrong. They claim he is, continuously and loudly. They have yet to propose workable alternatives.

In the long run, whether we can solve our fiscal problems will depend, I think, on how pervasive is teabaggerism. It gets all the attention and it certainly has plenty of votes. But are the sane ones completely and forever outnumbered? Rush Limbaugh has once again claimed that the people in the White House literally hate America. Only a few conservatives recoil from such talk. Nearly half of Republicans believe Obama is not a US citizen. Of those, 83% love Sarah Palin.

So, who has the budget ball? The crazy paranoid haters seem to be the ones for now. The only way out is for people to speak up; and that ought to start with the president. It wouldn't hurt, either, if there were more Rs willing to say this, and fewer going with crap like this.

We need smarter Republicans and a bolder president. The former, clearly, isn't going to happen, at least before it's too late; the latter, I'm pretty sure, is still possible, and it's our only hope. He has the intelligence and the knowledge. He just needs to trust himself -- and, more importantly, US -- a little more.

Tuesday, February 15, 2011


And thus spake the icon of the teabaggers, with purpose, comprehension, and incisive clarity, simultaneously bringing into focus for us all the path best taken in Egypt, and solidifying her status as the next to assume the mantle of leadership.

How fortunate that such a leader has arrived on the scene in these momentous times, and how propitious that we have teabaggers to have discovered and promoted her brilliance. Without them, I might have entirely missed it.

Monday, February 14, 2011


A study of spending under President Obama:

The math isn’t particularly complicated. So far, the Obama administration has pushed for six major, immediate spending increases that aren’t offset elsewhere in the budget: the American Reinvestment and Recovery Act (aka “the stimulus package”), which had a 2009-10 price tag of $340 billion, according to the nonpartisan Congressional Budget Office; the GM/Chrysler bailout and other portions of the Troubled Asset Relief Program, which have largely been paid back ($25 billion); unemployment-insurance extensions ($67 billion); COBRA extensions ($9 billion); Cash for Clunkers ($3 billion); and loans to automakers for energy-efficiency improvements ($8 billion). That’s $452 billion. Factor in $296 billion in stimulus funds that have yet to be spent and $136 billion in refundable tax credits that passed in December as part of Congress’ bipartisan tax compromise, and you wind up with $884 billion on the spending side of the equation...

And here's the concluding paragraph:

.... during an accounting argument, it’s useful to have real, live numbers to battle over. On the rare occasion Republicans do allude to real stats, they tend to shout about the growing short-term deficit, a problem that has a lot more to do with declining recession-era tax revenues and increasing safety-net outlays than anything Obama has done, or not done. Instead, Republicans should be referring to the amount the president has decided to spend so far: $884 billion. They can say it’s too much, and that a thriftier approach would’ve been better for the country. Democrats can reply that rescuing the U.S. economy from a second Great Depression for less than the price of the wars in Iraq and Afghanistan was a relative bargain. Both sides, meanwhile, can debate the wisdom of cutting more than $900 billion in taxes while spending is going up. At least they’ll be arguing about facts, not fantasies.

Precisely. That's exactly the sort of discussions we (by "we" I mean teabaggers and our politicians, and the talking heads) should be having. Fair questions, tough ones, based on reality. Will they wake up and do so, before it's too late?

Saturday, February 12, 2011

A Good Speech, And Simple

And the most important words, in such times, were these:

This is the power of human dignity, and it can never be denied. Egyptians have inspired us, and they've done so by putting the lie to the idea that justice is best gained through violence. For in Egypt it was the moral force of nonviolence, not terrorism, not mindless killing, but nonviolence, moral force that bent the arc of history toward justice once more.

Perhaps, too, the message to the Egyptian military will be heard in other despotic places:
We saw a military that would not fire bullets at the people they were sworn to protect.
We can hope those who would give support to terrorists, because they felt they had no other option, will have heard it all, that they, too, might change history.

Friday, February 11, 2011

High-Speed Railing

Our president would like to see high-speed rail move forward in this country. Not only would it provide countless construction jobs in all parts of the country for several years, and many that would continue for as long as the tracks remain, it would decrease our energy use and greenhouse gas production. (Here's what we're missing.) Republicans consider that "insanity."

What would they do instead?

More cuts in spending on the most needy: hungry kids, sick moms. Law enforcement. Research. Education. Amtrak, of course (it's communism.) And how much does their we're-in-it-separately vision cut the deficit? Barely at all.

As things now stand, the budget deficit will be $1.500 trillion for this fiscal year. If the GOP has their way, it will be $1.477 trillion. That's a cut of merely 1.5% . Despite everything the GOP is going after, our budget deficit will be 98.5% of what it would have been otherwise -- virtually unchanged. In other words, the only thing they didn't slash was the budget deficit.
Why? Well, in part it's smoke and mirrors:

The proposed cuts are not always as big as they seem, because they are reductions from President Obama's never-enacted budget proposal for this year.

So, having campaigned on jobs jobs jobs, Congressional Rs have yet to propose a single bill that addresses that. Instead, it's showy cuts that hurt the vulnerable while in actuality being the anti-Suttons: going where the money ain't. And, really, this stuff is just the afterthought anyway: their relentless focus is on abortion. They're so concerned for life that they would allow hospitals to let pregnant women die. You know, out of conscience.

How can you even argue with people who think like that?

Who knows? Maybe the teabaggers were in on the scam. Maybe the Koch brothers paid for their rallies on the condition that baggers play along: make it seem to be about jobs while the real agenda was the Rovian one: hooking the "values" voters and deceiving all the rest.

Some "values." Cutting loose the most vulnerable, the least among us, in order never to raise taxes. On the Koch brothers. And, while we're at it, letting them die.

These are the same folks that call us a "Christian nation."

Missing Doc You Meant

As if there's not enough to worry about in the political realm, I came across this article about my chosen profession, general surgery. (I'm pretty sure you can't read it without a password, at least at Medscape. It's by a David W Page, MD, FACS, and originally appeared in The Southern Medical Journal, South Med J. 2010;103(12):1232-1234). While it's not really anything I didn't know, it crystalizes what will surely be an increasingly severe problem. The following is from the part titled "The Consequences of Inexperience":

... it is crucial to reassess the challenges, cognitive and technical, that face our trainees as they enter private practice. To reach a level of basic competency in performing most laparoscopic operations–not to become a master surgeon–the learning curve (number of cases versus complications) requires between 30 and 50 cases or repetitions. For laparoscopic hernia repair, the number is closer to 100 to 200 cases. Laparoscopic groin hernia operations are true ergonomic and technical challenges. Despite this fact, most graduating residents do ten or fewer casesduring their training. These trainees are, by definition, not competent to perform laparoscopic hernia repairs but do them in practice.

During the most frequently performed laparoscopic operation (cholecystectomy), the incidence of common bile duct injury continues to fall as far out as with the surgeon's experience of 200 cases. Graduating residents do about 84 cases in their five years of training. Bell et al conclude, "Even for more commonly performed procedures, the numbers of repetitions are not very robust, stressing the need to determine objectively whether residents are actually achieving basic competency in these operations."

In a related presidential address entitled, "Why Jonny Cannot Operate," the same Richard H. Bell, MD, stated that chief residents in surgery spend between 1148 and 2753 hours performing the essential 121 and other operations. This is only 6 to 14% of the resident's total working time during a five-year training program. ... Clearly, surgical residents are not exposed to an adequate number of cases nor do they practice enough to achieve minimum competence in a wide range of surgical procedures...

How we train surgeons remains part of the problem. In 2007, a survey revealed that there is a wide disconnect between what teaching surgeons felt residents needed to do to prepare for a case and what the residents felt was proper preparation...

... the system remains weighted with inertia. All of which leaves one to react with little surprise to the fact that 13% of today's general and vascular surgery patients develop complications and 2% die postoperatively.

I can't vouch for those last numbers, and they're way higher than I saw in my practice, or in those of surgeons around me. WAY higher. But from my several friends in academic surgery, the trend toward less and less rigorous experience in a training program is inarguably true.

Rightly or wrongly -- depending on whether you were one of my patients, or are a current student or trainee -- when I learned to be a surgeon (the process never stops; but I refer to residency here), there were no limits on hours spent at work other than the number of hours in a day, days in a week, weeks in a month. Nor was there much in the way of touchy-feely, unless you count the occasional rap on the knuckles with a surgical clamp. Techniques of surgery were, in some sense, the least of it: pounded in hourly, daily, at conferences, on rounds, in the operating room was the sense of personal responsibility, of commitment. Doing everything necessary to be able to make a proper judgment, being held accountable for anything less than perfection, taking care of what needed doing no matter if you (theoretically) had the night off or not. In my several years of training, it was far less than half of nights that I spent at home. Many were the rotations in which I got out of the hospital only every other weekend and no weekdays at all. In my final year, as Chief Resident on the trauma service, I didn't go home for two straight months.

I'll leave it to others to argue whether such training -- the way it was since William Halsted picked up a knife and until only a handful of years ago -- was inhuman, brutal, dangerous, or necessary. Whatever else is true, I came out of it with the ability to operate safely, to know when to operate, when not, which operation to do, and which not. Perhaps more important, I had a sense of commitment -- probably based on an unrealistic sense of my own importance and indispensability in the care of my patients -- that had me making rounds several times a day, day on, day off. As Mr Miyagi would say.

I don't blame the trend entirely on reduced training hours. I recognize there's more to know every year, and that assimilating what's known and what's coming down the pike is increasingly impossible. Sub-specialization is the inevitable consequence both of receiving less initial training and of the desire to limit what one does, in order to become and remain expert, and to de-stress one's life. But I loved being a general surgeon, able to provide a wide range of care, to be for some their "family surgeon." To be, as we liked to imagine in training, "an internist who can operate."

Those days are surely on their way to being irrevocably gone, and given the fact that we're never going back to the kind of training I had, I think it's best: we'll have some surgeons capable of doing a few things well, leaving much of the post-op care to someone else, and that's all we can hope for. The article also refers to the decreasing numbers of people choosing to become surgeons, and, as reimbursement continues to decline and various annoying paper requirements continue to increase, I don't see that changing, either.

The author includes mention of the problem of burnout -- which I experienced -- and ends with a few suggestions for changing training. To me, they ring pretty hollow, in part because the list assumes mostly laparoscopic procedures (which lend themselves to recording and reviewing), and because, given the time constraints, I don't see much of any of it happening in a meaningful way. Too, it seems to ignore the idea of being a physician along with being a surgeon. Unimportant? I don't think I know anymore.

Bell has suggested seven recommendations to improve surgical education:

  1. Insure that the trainee has undergone both cognitive and skills training (simulation) with the procedure before going to the operating room.
  2. Have the resident assessed (using validated metrics) before going to the operating room (OR) so the faculty surgeon will know the resident possesses a basal level of ability.
  3. Rehearse the operation on a simulator and discuss with the faculty member where major intra-operative decisions need to be made before going to the OR.
  4. After the operation, debrief with the faculty member and review areas of accomplishment and parts of the operation that need more work.
  5. Grade the trainee's performance and file the report in the resident's portfolio.
  6. Have the resident review a video of the case and practice in the skills lab those maneuvers proven to be difficult for the trainee.
  7. Keep a national database of resident experience for the purpose of research and norm-setting.

Near the conclusion is this uplifting view of the future:
These and other related issues conspire to make quality surgical care problematic for Americans in the future. Without change, we will almost certainly witness the disheartening 1990 prophesy by Griffen and Schwartz who stated, "Eventually, our society will be "served" by a medical community that is less talented and definitely less interested in providing medical services in the tradition of its predecessors."

In that spirit, here's my personal plan, as I view my potential patienthood: don't get surgically sick. And if you do, aided as necessary by decent pain medication and gin, and if all else fails, by a hose to the tailpipe of your car, let nature take its course.

If you're a teabagger, think of the money you'll remove from government spending, just like you want. (I'll avoid any sort of cheap reference to the gene-pool.)

And with that, I'm off to the OR to assist in a cancer operation. Have a healthy day.

Thursday, February 10, 2011

"News" Flash

Stipulating that it's based on an unnamed source, I nevertheless find this article credible and unsurprising. Credible because the site is always factual, if partisan; unsurprising because it states what's obvious to everyone except the Foxobeckified:

Asked what most viewers and observers of Fox News would be surprised to learn about the controversial cable channel, a former insider from the world of Rupert Murdoch was quick with a response: “I don’t think people would believe it’s as concocted as it is; that stuff is just made up.”

Indeed, a former Fox News employee who recently agreed to talk with Media Mattersconfirmed what critics have been saying for years about Murdoch’s cable channel. Namely, that Fox News is run as a purely partisan operation, virtually every news story is actively spun by the staff, its primary goal is to prop up Republicans and knock down Democrats, and that staffers at Fox News routinely operate without the slightest regard for fairness or fact checking.

“It is their M.O. to undermine the administration and to undermine Democrats,” says the source. “They’re a propaganda outfit but they call themselves news.”

And that’s the word from inside Fox News. ...

... The real story, and the real danger posed by the cable outlet, is that over time Fox News stopped simply leaning to the right and instead became an open and active political player, sort of one-part character assassin and one-part propagandist, depending on which party was in power. And that the operation thrives on fabrications and falsehoods. ...

... "anything—anything--that was a news story you had to understand what the spin should be on it. If it was a big enough story it was explained to you in the morning [editorial] meeting. If it wasn’t explained, it was up to you to know the conservative take on it. There’s a conservative take on every story no matter what it is. So you either get told what it is or you better intuitively know what it is.”...

... “And then two, three, five years into that it was, we’re taking the Bush line on things, which was different than the GOP. We were a Stalin-esque mouthpiece. It was just what Bush says goes on our channel. And by that point it was just totally dangerous. Hopefully most people understand how dangerous it is for a media outfit to be a straight, unfiltered mouthpiece for an unchecked president.”...

... The source continues: “I don’t think people understand that it’s an organization that’s built and functions by intimidation and bullying, and its goal is to prop up and support Republicans and the GOP and to knock down Democrats. People tend think that stuff that’s on TV is real, especially under the guise of news. You’d think that people would wise up, but they don’t.”...

... The former insider admits to being perplexed in late 2009 when the Obama White House called out Murdoch’s operation as not being a legitimate new source, only to have major Beltway media players rush to the aid of Fox News and admonish the White House for daring to criticize the cable channel.

“That blew me away,” says the source, who stresses the White House’s critique of Fox News “happens to be true.”

This is the point in the conversation when the aggrieved predictably begins to shout, "They want to take away my first amendment rights. Patriot that I am, I'm standing up for free speech." In other words, I have a right to say whatever I want, but you have no right to point out my bullshit. Sarah and gunsights. Sharon and second amendment remedies. Glenn Beck and pretty much everything. Fox "Whateveritis."

Fox "news" has a right to say whatever they want. The rest of us have not only the right but the duty to point out how dishonest and destructive it is. If comments from within the teacups on this blog are any indicator, however, the information will be rejected like a mismatched kidney.

Which is hardly a news flash.


The new chair of the House Committee on the Environment marginally believes, with eyes lowered and face turned away, that there's global warming going on, but doesn't think human activity has anything to do with it. Well, I guess it's better than nothing. He can read thermometers.

So all we need to do is convince him of what 97% of scientists in the field say. Which, admittedly, is no walk on exposed shale, given the teabagger propensity to recoil at the very mention of science, like Lestat from a crucifix. In educating (another recoil word) the guy, maybe we should start with ocean acidification: the numbers are there, it's pretty straightforward, doesn't require much in the way of deductive or inductive reasoning -- no ice cores, only a pretty rudimentary knowledge of chemistry. Dissolve CO2 in water, get carbonic acid. Not hard, makes sense. Observe what happens to the calcium in coral reefs as the water becomes more acidic. Then tell us where that CO2 is coming from.

But, heck, it's only fish, right? I mean, who cares about the ocean? Too salty to drink, that's for sure. Or coral. CORAL? What's that all about?

Okay, then let's ask the congressman how he explains the above graph, in which he evidently sort-of slightly kinda believes, and the rise in which -- whaddya know -- coincides with the arrival of the industrial revolution. If he's gonna discount all of science, and given that he's pretty literally in charge of our future, ought he not be expected to produce some alternate explanation? Some way to justify not doing a damn thing about it? (Note to Mr Upton Down: sun spots have already been eliminated.)

No good can come of this. We've handed enormous power to people who lack the most basic rudiments of common sense, let alone the ability to think with any part of their bodies residing in a location above their waistbands. It's not good enough simply not to believe. Not in the halls of Congress. You wanna ignore something that science says has cataclysmic potential, you gotta say why. You gotta learn about the science and tell us why it's wrong. "I don't believe it" might not kill us when it's about evolution (other than the fact that brainwashing kids will make us a nation of dunces that can't compete with anyone on anything). Take to your churches and disbelieve till the cows come home. Or drown. But "I don't believe it" WILL kill us when it comes to climate change, if the scientists are right. So you owe us a lot more, Congressman. Put your mouth where your money is.

Wednesday, February 9, 2011

Acting Down

I find it interesting that the House failed to renew the Patriot Act. It's a little tricky, because they actually had a majority in favor, but since the R leadership chose some method or other, it required two-thirds. But let's just consider the fact of its "rejection."

Washington • The House on Tuesday failed to extend the life of three surveillance tools that are key to the nation’s post-Sept. 11 anti-terror law, a slipup for the new Republican leadership that miscalculated the level of opposition. ...

... The Republicans, who took over the House last month, lost 26 of their own members, adding to the 122 Democrats who voted against it. Supporters say the three measures are vital to preventing another terrorist attack, but critics say they infringe on civil liberties. They appealed to the antipathy that newer and more conservative Republicans hold for big government invasions of individual privacy....

.... Rep. Dennis Kucinich, D-Ohio, said Republican supporters of the tea party movement should show their opposition to big government by joining Democrats in opposing the measure.

“How about the Patriot Act, which has the broadest reach and the deepest reach of government to our daily lives?” he asked.

I've always thought that true conservatives would have recoiled at the Act when it was first proposed. What greater example of big-brotherism could there be; what anathema is it to those who distrust government power, who believe in small government? When, I wondered, would they change their tune? When there was a Democrat as president? What about a black one? Not that that would ever happen.

Leaving the snark aside -- and admitting I don't have the names and affiliations of the Rs who said "no" -- I must say it does impress me that there were some Rs who voted nay, and that the obvious conjunction of liberal civil libertarians and conservative big-government worriers finally became apparent. One can only speculate on the extent to which the R-noes came there from a black place.

None of which is to opine about the merits of the act per se. I think the government needs effective tools to intercept messages from and otherwise track bad guys. I was among those, however, who thought it could be done legally -- as opposed to the way President Cheney chose: no oversight at all, no restrictions whatso. It's an argument that was made only at the edges back then, as any attempts to keep our leaders within the law were shouted down as treasonous by the RWS™.

Interesting how things have changed, to the extent that they actually have (which is not much, in that it'll no doubt come up again in a manner that allows majority vote. But it does make for a nice, if short-lived, headline.)

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