Why Are American Physicians Paid So Much?

This was the topic of Matt Yglesias last week, with rather strong words about the idea that the US physicians have a pretty strong cartel on the market (cartels of providers keep incomes higher than they would be in less concentrated markets).  Then Kevin Drum joined in with a point about international comparisons:

What that bar graph shows is the number of practicing physicians per 1000 people in each country.  The blue bar is the OECD average, the red bar is Murka.  So the United States has fewer physicians per capita than the average of the richer countries in this world.  But the United States also has much higher physician incomes than most OECD countries!  A puzzle, if you happen to believe in the free-market-fairies, because high incomes in that reality mean that the markets are trying to lure in more physicians, that there is a need for more physicians.

But note this:  The above situation is not a recent one.  US physicians have been earning a lot more (in relative terms, such as when compared with other professions requiring roughly similar basic talents and years of training) than physicians in other countries for decades.  Yet that "signal" (we desperately need more doctors, screams the market) is not translated into more doctors being trained, or at least not being trained in the numbers one would predict if one was wearing the free-markets fairy-hat.

The answer to that paradox is, sadly, the one Yglesias proposes:  Certain institutions have a lot of market power in the US medical markets, and that includes the medical schools and various physician organizations.

On the other hand, the physician labor markets are not free markets in any other country, either, partly, because quite a few countries determine the number of physicians through government controlled funding processes but also because one of the basic requirement for a competitive market:  free entry and exit of providers, cannot hold (and must not hold) when it comes to physicians,

What I mean by the latter is that physicians are carefully screened and selected through often-vigorous competition for available medical school places and then further screened by licensing requirements.

The reason for the importance of this screening and training process is that there is no way consumers of health care can easily, cheaply and quickly determine whether someone is well-qualified as a medical provider without such signals as framed degree certificates or letters after the person's name.  If we really allowed an unregulated and chaotic so-called "free market" to operate in health care markets, I could set up a cosmetic surgery business in my basement.  You don't want that, because of the consumers' inability to judge provider quality.

Why that is especially crucial in health care (rather than in, say, the florist industry) is that the consequences of using a low-quality provider can easily include death or permanent disability.

Got it?  The physician markets are not truly competitive but regulated by either the physicians themselves or by governments or both, because unregulated entry to those markets is a serious health hazard.  In the United States the gatekeepers are the medical schools and various state-level physician associations.  A sizable chunk of all this is self-regulation.

Self-regulation makes some sense, because the lack of quality information means that bad physicians in the barrel infect all the physicians.  Thus, the physician organizations have an interest in controlling the "bad apples."  But the physician organizations also have the human interest of not ratting on their own colleagues and the more general interest of all trade unions:  To keep the average earnings of the existing membership high.

One way to guarantee the latter is by making entry harder and harder, both because that lets existing physicians have less competition and because the new entrants then look better-and-better, what with passing tougher screening.  That improvement, given the consumers' difficulty of discerning individual physicians' quality, serves to improve the markets for all practicing physicians.

Weird, isn't it?

My point is not to argue that the high US physician earnings are somehow undeserved.  The basic economic theory on how earnings are determined isn't about that, in any case, but about trying to understand how (and if) the demand for a particular kind of labor and the supply of a particular kind of labor come together and determine the average earnings of a profession.  When the markets cannot be competitive, the analysis must look at what is actually happening.  Calling for the free-market fairies to fix the problem is just plain silly, because the physician markets cannot be unregulated.

But once something IS regulated, and especially when it is self-regulated, the interests of the existing workers tend not to support increasing the competition.

So if I had to make one guess about the reasons why the United States in this source (covering data between 2005 and 2012)  had only 24.2 physicians per 10,000 people, while Australia had 38.5, France 33.8, Germany 36.9 and Switzerland 40.8,  I would point out the greater market power of US medical schools and physician organizations*.

What about the other arguments usually advanced to explain the higher earnings of US physicians?  Most of the arguments which are not comparing the US to other nations point out the high costs of getting a medical degree.  And those, indeed, are high.  Especially high when we also think about the fact that medical schools are highly subsidized by the government (via Medicare funding a lot of the teaching hospitals, for example), and those subsidies are not paid back by the student loans.

The problem with that argument is not that medical student loans aren't high or that those wouldn't need to be paid back from incomes which are sufficient for that plus a proper standard of living.  The problem is that those loans cannot explain the high incomes** all through the physicians' working lives:

 Orthopedic surgeons again topped the list as the highest earners, with a mean income of $405,000, followed by cardiologists ($357,000) and radiologists ($349,000).
The lowest-earning specialists were similar to those in Medscape's survey report from last year: internists ($185,000), diabetes physicians/endocrinologists ($178,000), family physicians ($175,000), and pediatricians ($173,000). HIV/infectious disease physicians ($170,000) dropped to the lowest-earning position, which was previously occupied by pediatricians.***

The second argument justifying physicians' high incomes has to do with the long hours physicians work in the US.  But that argument is tied to the small numbers of physicians per population.  If there were more physicians the average working day would be shorter.   It's a chicken-and-egg problem, but essentially something which could be changed without endangering patient welfare, say.  Indeed, one could argue that extremely long work-shifts endanger patient welfare more.

Then there's the argument that has to do with what one deserves.  I have already talked about how the market-determined earnings may not have much to do with what we truly deserve or not, but the more detailed argument has to do with the difficult and exhausting type of work physicians do and the  life-or-death power the work involves.  Those are also arguments which in themselves are not incorrect.  But as the same arguments would apply to physicians working in any other country, they cannot explain the international differences.

Finally, the idea that the quality of physicians might be better in the US because of tougher control of the various intake numbers is worth thinking about.  This may well be true, though it's hard to construct studies of that kind (because of the nebulous aspect of the whole concept).  But note that if the number of physicians is to be kept small because of that quality argument, we are then right back in the problem of long working hours for physicians, and, more importantly, the lack of access to physician care by many who have a medical need for it.  Alternative solutions exist for those who worry about lowering quality with increased intakes of new students in medical schools, say.  Those include using more other medical workers to carry out various routine tasks, allowing task-licenses for paramedics who get additional training in a narrowly defined medical field, and in general re-defining tasks in ways which make the few physicians go further.  Doing this would not, however, change the fact that physicians would face more competition and this would probably lower their average incomes.

It's worth pointing out that physicians are paid well (in relative terms) in all those OECD countries, and nobody is trying to change that.  The crucial question is how to make the American system more responsive to the health care needs of its people, and in that context looking at the various cartels in health care is necessary.  The physicians are not the only medical profession or industry with market power.  Just think of the pharmaceutical industry or the hospital industry.

Added later:
I want to stress, once again, the fact that salaries based on markets or other practices of similar sort are NOT the measure of the value of someone's labor in some ethical or moral sense.  Otherwise we would argue that hospice workers taking care of the dying are only worth the minimum wages which they often receive.  Neither does any of the above mean that individual physicians participate in the cartel-keeping or that they choose the profession for the high earnings or that they wouldn't deserve their earnings in the moral sense.  The question is simply to answer the question why American physicians are better paid than physicians in other comparable countries.


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*Sure, the data may not be strictly comparable, and, sure, Canada has even fewer doctors per 10,000 inhabitants (20.7).  But some of the countries with almost as low physician/population ratios as the US either regulate physician numbers centrally for financial reasons or allow other medical professionals do more of the tasks which are here defined to be done by the physicians only.

Note that all the Nordic countries have more physicians per population than the US.  Even Armenia and Egypt do.  Even the UK with its "socialized" health care system has more physicians per capita.

**Female physicians earn less than male physicians, on average, though the earnings gap is getting slightly smaller (30% overall now, 17% in primary care).  The reasons for the wage gap are probably partly the same as in any occupation (women's greater responsibilities for children and household chores which translates to lower hours at paid labor, societal steering or personal preferences which lead women to "choose" somewhat lower-paying specialties etc.). but an additional reason in medicine is the fact that women are fairly recent entrants (in large numbers) in the field, so we are comparing an average man and an average woman in an occupation where the average man is quite a bit older and thus has the income advantages experience provides.

***Whether the earnings differences in that quote are truly reflecting relative scarcity etc. is another question on which a long post is desired.  For instance, the relative ratio of specialists to general practitioners seems not be declining (but rather growing) in most countries.  Yet health care planners have for years complained about too many traditional-type specialists and not enough general practitioners and gerontologists.  Indeed, Herodotus mentioned that about medicine in ancient Egypt:

The practice of medicine is very specialized among them. Each physician treats just one disease. The country is full of physicians, some treat the eye, some the teeth, some of what belongs to the abdomen, and others internal diseases.

The Grandma Rapper

This is a 76-year old Finnish rapper*.  She raps about calling your grandma or visiting her because your grandma made your dad or mum and she will kick the bucket soon, and, besides, you might enjoy the visit, too. 

The language she uses is the slang of the young.  She also has a sentence or two about the contempt towards old people, and suggests adopting a grandma from the neighborhood if your not lucky enough to still have one.

All that goes for grandpas, naturally, and any person in the community who is isolated and lonely.



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*She could be older than that as I got the age from an interview in 2012.

I Need Chocolate. On The Internet and Social Media

In the last few days I have drowned in information overload.  The Twitter is the worst culprit in that, because most every tweet is on a different topic and so many of those tweets wake up my inner critic who starts yelling that the data needs checking and a long post needs to be written on that topic or otherwise the world will turn upside down.

The only cure:  Chocolate truffles.  And possibly dogs (not to eat, of course, but to play with).

More generally, I was just struck by the manipulation the social media outlets employ to keep our eyeballs glued to the relevant screens.  The way Twitter shows retweets and follower numbers, the way you can't get rid of those numbers (though in Tweetdeck you can), those e-mails which tell you that you have tweets out there, those other e-mails which suggest more people you should follow.

And the "likes" on Facebook and even on Disqus.  I've heard that in some places teenagers on Facebook collect "followers." including people they have never met and know nothing about, because there is this measure of how adored one is and that measure needs to be worked to make it higher.  Some of that gathering instinct can result in teenagers posting stuff they should not be posting.  Even dangerous stuff.

Now I should have realized that any business tries to make consumers buy more, spend more time in its stores and on its webpages, but it never quite occurred to me to what extent the social media manipulates us.

After that rant, let me also note that easy access to all  information (and misinformation)  is wonderful and social media has many useful roles to play. 

Let Us Celebrate Achievements, For A Change

Contents of first three links:  Essentialist and religious arguments about women's most suitable roles.

Sometimes this "work" I do is incredibly hurtful*, anger-causing, and frustrating.  What is most tiresome of all is the fact that the same jaded arguments crop up, again and again, pretending to be brand new and exciting and very troothy**.  It doesn't matter how many times some tiny goddess on some isolated blog has responded to them, tugged at the hem, cut out a seam or two, pointed out that the emperor might be just a teeny-weeny bit naked.  It doesn't matter at all.  Just be prepared to do it again.

It's very much like doing the dishes again and again,  by hand, except that there are piranhas under the soap bubbles and you have bare hands.  The minute you finish drying them (with your bleeding paws), the sink is filled up again.

That's pretty good.  I stuffed into two paragraphs two female metaphors and began the whole thing with the generally-accepted greater emotionality of women.  Though naturally getting attacked a lot might make all sorts of people a bit emotional or angry.

So let's talk about something worth celebrating.  For instance, the first four young women who passed marine infantry training.  I love the photo at the link, because it is a happy one. (Added later:  Only three graduated because the fourth one was injured.)

Or consider the newly unveiled restored Vatican frescoes which some argue show female priests.  Then, of course, others argue that the women in the frescoes are not priests at all.  Still:

More controversially, the catacombs feature two scenes said by proponents of the women's ordination movement to show female priests: one in the ochre Greek chapel features a group of women celebrating a banquet, said to be the banquet of the eucharist. Another fresco in a richly decorated burial chamber features a woman, dressed in a dalmatic – a cassock-like robe – with her hands up in the position used by priests for public worship.
The Association of Roman Catholic Women Priests, which includes women who have been excommunicated by the Vatican for participating in purported ordination ceremonies, holds the images up as evidence that there were female priests in the early Christian church.
But Fabrizio Bisconti, the superintendent of the Vatican's sacred archaeology commission, said such a reading of the frescoes was pure "fable, a legend".
Even though the catacombs' official guide says there is "a clear reference to the banquet of the holy eucharist" in the fresco, Bisconti said the scene of the banquet wasn't a eucharistic banquet but a funeral banquet. He said that even though women were present, they weren't celebrating mass.
Bisconti said the other fresco of the woman with her hands up in prayer was just that – a woman praying. "These are readings of the past that are a bit sensationalistic but aren't trustworthy," he said.

How interesting that readings of the past in something like evolutionary psychology are not held to the same rigorous standards.

Or how about this YouTube video?  Given that the ability in three-dimensional mental rotation is the new secular equivalent of St. Peter's key to the gates of heaven, it looks like a very good idea to give young girls more practice in it.  Boys get that practice in their games, girls not so much.






Gloria Steinem received the Presidential Medal of Freedom yesterday:

The first time journalist, organizer, and Ms. magazine co-founder Gloria Steinem graced the podium at the National Press Club, it was as the first woman ever invited to do so. However many points one might give the club’s members for having chosen the country’s most famous feminist for that honor, some must be subtracted for their having handed her what was then the standard thank you gift to Press Club speakers: a man’s tie.
When Steinem took the podium on Monday, it was to mark her impending receipt of a far more welcome piece of neckwear: the Presidential Medal of Freedom, to be bestowed on her by President Barack Obama at the White House Wednesday. “There is no president in history from whose hand I would be more honored to receive this medal,” she said.
“I’d be crazy,” Steinem told the Press Club audience, “if I didn’t understand that this was a medal for the entire women’s movement. It belongs to Shirley Chisholm and Bella Abzug and Patsy Mink.”
She noted that President Lyndon B. Johnson declined to give Planned Parenthood founder Margaret Sanger the medal because, Steinem said, “he feared reprisal from the Catholic church.”

She stated in her speech:

You know, people often ask me, at this age, who am I passing the torch to? And I always say, first of all, that I’m not giving up my torch, thank you very much,” she said to appreciative laughter from the audience. “But also, I’m using my torch to light other people’s torches. Because the idea that there’s one torch-passer is part of the bonkers hierarchical idea—and if we each have a torch, there’s a lot more light.”

And a lot more to light with the torches, I guess.
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*Well, not hurtful for me, anymore, because I have read all those arguments so many times.  But the situation itself is hurtful, because it is seldom reversed.  We do not often discuss what might be wrong with men's brains.

But we do discuss how women's brainz might stop them from all sorts of stuff and how that naturally  limits their lives in various fascinating ways, even when debating the whole issue is extremely premature, given the existing levels of genetic evidence (and the whole current research into epigenetics, how genes are turned on or off by the "environment" etc).  This discussion is expected to be polite, calm and collected by all participants, both those whose brainz are discussed and those whose brainz are not  discussed.  Any show of emotionality just proves that women are too emotional.  But not to show any emotionality (on my part, say), doesn't prove the opposite.

So the setup is rigged and that is what is hurtful about it.  When there is an article with one of the few reversals, men in the comments tend to get very, well, emotional.  And I don't blame them.

**No good word for the usual setup which is to tell a story either about the divine will or about something which is argued to have happened in the distant past but which cannot be witnessed, verified or falsified today, as "truth." 

ALEC on the Affordable Care Act. Or The Guy Behind The Curtain.

The UK Guardian reports on how Republican "model bills" are created, this time applied to the Affordable Care Act (ACA):

With Obamacare still in crisis from its botched technical rollout, the signature reform of the Obama presidency faces threats from state-based politicians who have devised a strategy to scupper the federal health insurance exchanges.
The move is the latest in a sustained effort by conservative states, mainly in the south and midwest, to resist key elements of the changes that are designed to extend healthcare to millions of uninsured Americans.
The idea for the new attack is the brainchild of the American Legislative Exchange Council (Alec), a group that acts as a dating agency for Republican state legislators and big corporations, bringing them together to frame rightwing legislative agendas in the form of “model bills”.
A new Alec proposal, approved by its annual meeting in Chicago in August and published as a model bill for adoption by state assemblies across the nation, would scupper the federal health insurance exchanges set up under Obamacare. The Health Care Freedom Act, as Alec calls its model bill, threatens to strip health insurers of their licenses to do new business on the federal exchanges should they accept any subsidies under the system.
Alec justifies the measure as a way to protect local employers from the “employer mandate” – the provision in Obama's act that penalises employers with more than 50 workers who do not offer any or sufficient healthcare cover for their employees. However, health insurance experts say that were the model bill to be taken up widely by Republican-held states, it would seriously disrupt the federal exchanges, and in turn put the whole health reforms in peril.

I love those euphemisms.  "The Health Care Freedom Act" indeed.  Perhaps it should be titled the Freedom From Health Care Act?

Let's go back to the reasons for the ACA:  Over forty million Americans without health insurance (with consequences ranging from preventable deaths to the fact that someone must pay for the care the uninsured receive, i.e., subsidies for care), the great difficulty of finding affordable insurance for anyone with pre-existing conditions (which with age is a large percentage of us all), the patchwork nature of the whole system and rapidly rising health care costs.

These are the problems.  And many of these problems will sneak right back in with the kinds of proposals that ALEC drafts.

I was for a single-payer system and still am, and my reason has to do with the inherent problems in markets for most health care services (lack of informed customers, great levels of  uncertainty, lots of supply-side collusion, very price-inelastic demand combined by the need for third-party payment systems, considerable external benefits not captured by markets etc etc).  A single-payer system is not without flaws but it's better than the market-based alternatives, especially the kind of imaginary free market alternatives the conservatives desire.  Those will not work because of the characteristics of health insurance and most types of health care.

Instead of fixing that patchwork quilt of American health insurance, ACA just covered the whole frayed mess by another layer of muslin.  But it is better than nothing, especially in fixing the problem of the uninsured.  And yes, even with the really deplorable launch problems the ACA sites have experienced, because the proper view to how things are going to work is a long-run view.

ALEC would like the old system back, thankyouverymuch.  I would like something more logical and reasonable.  I won't get it, but I hope ALEC won't get what it wants, either.

Vagina News

First:  The voters in Albuquerque, New Mexico:

defeated a proposal on Tuesday that would have outlawed most late-term abortions in New Mexico's largest city in the first test of such a measure on a municipal ballot in the United States.
The measure, which would have barred doctors within city limits from performing abortions after 20 weeks of pregnancy, unless a mother's life was in danger, was rejected 55 percent to 45 percent.

....

The proposed 20-week cutoff on abortions in the Albuquerque measure allowed for few of the exemptions permitted in most late-term abortion bans enacted in other states in recent years. It contained no exceptions for victims of rape or incest, and would have waived the ban only to save a mother's life or if continuing her pregnancy risked "substantial and irreversible physical impairment of a major bodily function."

Abortions after 20 weeks of pregnancy are rare. I believe that the attacks on this group of abortions is because if people who are carrying a fetus likely to die in the womb or live only a short time after birth can be forced to continue the pregnancy, how are we going to justify some general right to reproductive choice?

On the whole, this refusal of the Albuquerque voters to go along with that is a good thing.

Second, the Supremes have turned down an appeal to block the Texas law which requires all physicians who perform abortions to have hospital admitting rights within 30 miles of the clinic.  The decision went down along ideological lines.  The practical goal and effect of the law is to make abortion unavailable in lots of places in that state.  Charlie Pierce writes on the SCOTUS decision:

For all of this, of course, we can thank Justice Anthony Kennedy, for nobody is more comfortable on this issue in the alternate universe than is the court's weathervane. It was Kennedy who wrote the majority decision in Gonzales v. Carhart in which he memorably sought to spare the delicate flower of American womanhood from the trauma of exercising its constitutional right to one specific kind of abortion procedure that he, Anthony Kennedy, found to be icky. He then found that his personal concern for the delicate flower of American womanhood was not an "undie burden" on the women who needed the procedure that he found to be icky. His conscience was not an "undue burden" on them. The "undue burden" standard comes to us from the earlier Casey decision which carved a loophole in Roe v. Wade through which you can sail the Nimitz. Now the majority of the court has determined that a law specifically designed to ban all abortions de facto in the state of Texas does not place an "undue burden" on women in Texas who want to obtain one.

Pierce believes that Roe (the Supreme Court decision on which the right to abortions is based) is doomed.  I both agree and disagree.  The current court (with its Republican majority) could easily kill Roe, no doubt about that.  But whether it will choose to do so depends on strategic thinking.  If abortions were made essentially illegal in this country, what would the single-issue forced-birth voters do who now vote for the Republican candidates?  Some of them might turn their whole effort towards getting birth control banned, what with its power of emancipating women, but most might stop to be very interested in politics.  I'm not sure if Republicans want that outcome.

Third, these news from the UK (a week ago) are not really about the vaginas but the vulvas.  But  still important for understanding the lives of vagina-carriers:

British gynaecologists warned on Friday that increasing numbers of teenage girls and women are undergoing genital cosmetic surgery, driven in part by unrealistic images of how they should look based on pornography. 

...  

“The misapprehension arises from the prominence of just one type of ‘neat’ genital appearance, the type to be found prominently depicted in pornography,” said Thomas Baldwin, a philosopher who sits on RCOG’s ethics committee.

...

In a new paper, the committee expresses particular concern that teenage girls are undergoing unnecessary surgery, which is often anatomically similar to female genital mutilation — a crime in Britain.
There is very little data about the long-term risks of labiaplasty, particularly the effect it has on sensitivity and sexual function.
As a result, the committee recommends that genital cosmetic surgery not be carried out on girls under the age of 18, until their external genitalia are fully formed.
“The younger a girl begins her labiaplasty trajectory, the higher the number of operations over her lifetime and the greater the risk of scarring and sensitivity loss,” warned the British Society for Paediatric and Adolescent Gynaecology.

It is hard to see any other cause for a five-fold increase in genital cosmetic surgery over a period of ten years than the impact of wide-spread pornography consumption on sexual expectations.  That is troubling, and I cannot help wondering if pornography isn't also contributing to the Othering of girls and women*, especially if early consumption of pornography takes the place of both sex education and the learning of dating rules.
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*Stories like this one or this one.  Or this new one.

Mystery humans spiced up ancients’ rampant sex lives

That is the title of a Nature post about a story which is really about the sub-headline below that above one:

Genome analysis suggests interbreeding between modern humans, Neanderthals, Denisovans and a mysterious archaic population.

Here's where the current clickbaitiness ends up hurting, I think.  The headline is sexsexsex so that people would read the story.  And I get that.

But aren't we going to go away subconsciously thinking that the ancients had spicy and rampant sex lives?  Like at least over thousands of years and if we count any act of intercourse by any ancient as somehow part of giant sex rampage?  Wow, those boyz-n-galz shure got some booty!

A trifling point, you might think.  But then I have found that old cartoons about the stone age (the stay-in-cave-housewife and the man who drags her by her hair) still have an impact on how some people think of the past.  We might want to be careful about those kinds of headlines, at least in places like Nature.

Note, also, that those "mystery humans" are not included among the ancients in the headline.  But they must have been ancients, too.  Indeed, they might be the ancestors of at least some of us.

I don't know how much this matters.  Probably a lot less than the practice of publicizing new studies which are not available for scrutiny and which have not been even accepted by a peer-reviewed journal for eventual publication.  Some of those studies never get published, because of flaws in the research.  But their message remains in the cyberspace.

Sexual Assault in the Military: The Washington Times Take

You should read the op-ed by Mackubin Thomas Owens, a Marine infantry veteran of Vietnam, on the topic first.  If you don't care to give the Washington Times (a heavily subsidized right-wing paper) more clicks, the gist of his argument is this:

If women are strong enough for some combat roles, how come are they frail weaklings when it comes to sexual assaults?  And why are we trying to emasculate our fighting men?  And why are we trying to objectify our fighting women?

The answer:  FEMINAZIS.

Hmm.  I don't think the Times will offer me a writing gig any time soon, though I'm both clear and concise. 

What's fun about Owens' piece is how many of the assumptions he uses are disguised in an interesting way. 

For instance, as Media Matters for America points out, more than half of those who reported having been subject to unwanted sexual contact in one study of the military were men.  The percentage of men who report that is much smaller than the percentage of women who report that, because there are many more men than women in the military.  But the point Owens makes disappear is that unwanted sexual contact is not just a problem for women in the military.

Then there's the whole language of anger, aimed at people who believe in gender-equality, the insinuation that concern about sexual assault in the military is just so that we can get our gelding shears out of the pink handbags earlier and turn the military into a group interested in false eyelashes and group hugs and countless other horrors.  I'm pretty sure that this language comes from Mr. Owens' own mind, not from actual people.  But it is a language picked on purpose and its goal is to make sexual assault look like a non-existent problem and perhaps even a victim!

Most importantly, the false dualism Owens sets up between women as strong enough for some combat roles and then frail flowers which need to be protected from sexual assault (which Owens says doesn't happen anyway and if it happens, it is just courting behavior) deserves to be dissected:

First, note that being attacked by a comrade-in-arms is  different from being attacked by an enemy.  There are certain steps one takes in the latter situation and soldiers are trained to take those steps.  But if your assaulter is, say, your military superior?  Are you supposed to throw him/her over your shoulder and then stomp on his/her throat?*  Get him or her in a stranglehold?  What are you supposed to do?

My point is that even a brawny and very fit soldier might have difficulty reacting to such an assault in some way which would later be deemed "correct."  To exert only the minimal amount of physical restraint required is tricky to determine, and, once again, if the assault comes from your superior, most likely a very bad plan to begin with.  Even if the person inflicting unwanted sexual contact on you is not a superior, can you later prove that your physical response wasn't all that happened?  Perhaps you are the one who will be punished.

That's why Owens' dualism is false.  The reason I talk about only physical responses is that those are what Owens really talks about.  If women are not strong enough to repel a rapist, say, why should they be in any combat roles?
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*I'm using martial arts ideas here, though I fully understand that most soldiers don't have that kind of training.  The training in itself wouldn't help, however, because of the problems I discuss in applying it in real-world situations.


 

On Women, Spaghetti and Vacuum Cleaners

Those three concepts are interlinked by one abstinence preacher.  Abstinence preachers are invited to local schools in lots of places in this country, and they can get federal funds for that work.  While they promote abstinence, they also promote traditional sex roles and gender stereotypes:  God created boys to lead, girls should not talk so much, boys are thinkers, girls are emotional and so on and so on.

This Mother Jones article on few of the abstinence preachers is utterly and wonderfully hilarious.  For example:

Donahue is a speaker for the Colorado-based Center for Relationship Education, an abstinence-only education program that works with students in 42 states and has received millions in federal funds. In 2006, Donohue caused controversy at Natrona County High School, a public school in Casper, Wyoming, when she gave a religious-themed abstinence presentation. According to the Casper Star-Tribune, she asked students, "Do you get closer to your God or do you get farther away when you have sex?" (The answer she wanted: "Farther away.") She also said that boys are "wired" to like math, science, and numbers, and girls are wired to be more feelings-oriented. She held up a bag of noodles to indicate that girls "are like spaghetti, with their feelings about parts of their lives entangled," according to the Star-Tribune. (She told the paper: "The outpouring and the positive was so much greater than this one kid's complaint.") In a training video posted by the Denver Westword in 2011, Donahue tells students that if a guy gets sperm anywhere near a girl's vagina, it will turn into a "little Hoover vacuum" and she will become pregnant. (No. Vaginas don't vacuum sperm off the couch.) In another 2011 video, she says, "the boys want to love and respect these girls, and the girls won't let them. The girls are backing up the booty, the girls are being assertive, these girls are emasculating these boys." She continues to conduct sex-ed training programs for teachers on public Title V funds and is holding one this month in Greeley, Colorado.

Bolds are mine.  These messages may be brought to schools courtesy of tax payers!

The other preachers talk quite a bit about the need for girls and young women to cover up, which reminds me of some other preachers of other religions.

Then there are all the factual inaccuracies or lies.  What intrigues me most is the paradox of demanding that girls abstain from sex  but also let the boys be the leaders, for doing otherwise emasculates the boys.  How do you manage to refuse sex if your leader wants you to have it?  Especially as you are supposed to shut up and bat your eyelids admiringly instead of saying anything.

The government is to blame here, for letting these preachers among our young people and for paying them lots of money. 

Wal-Mart Workers Asked to Give Food Aid To Other Wal-Mart Workers

Via Lawyers, Guns and Money:

A Cleveland Wal-Mart store is holding a food drive — for its own employees.
“Please donate food items so associates in need can enjoy Thanksgiving dinner,” reads a sign accompanied by several plastic bins.
The Cleveland Plain Dealer first reported on the food drive, which has sparked outrage in the area.

So delicious!  The idea is that the workers should care about each other, especially the ones who make even less than they do.  But I think the idea is to take off the pressure from Wal-Mart to actually pay living wages to its workers.  It may or not matter to you that the Walton family which owns over fifty percent of the Wal-Mart company is the richest family in the world. 

All this reminds me of the important question about who it is who is subsidized when a company pays its workers so little that a full-time worker can qualify for food stamps and other federal programs. 

Evolutionary Psychology as the Justification for Real-World Misogyny

Here we go!  One of those misogyny sites you don't want to visit without a hazmat suit gives us a list of principles their members believe in.

The list is straight out of the ass of the worst kind of Evolutionary Psychology (EP)*, the kind Satosi Kanazawa practices, the kind which is mostly focused on justifying various kinds of stereotypes about men and women and the most archaic gender roles as biologically innate (even when those roles keep changing).  That the work uses neither genetics nor any data from prehistory (when we supposedly were hard-wired, immutably) and is therefore a bunch of JustSo stories doesn't stop it from being used to justify an unequal and oppressive world view as scientific.

Thus, the list from that site I will not link to (it's a hate site) gives us a very crude (normative?) version of the arguments in much of EP:

A woman's value is mainly determined by her fertility and beauty.  A man's value is mainly determined by his resources, intellect, and character.

Translation:  The guy who wrote this values people on those terms.

Note how men get to be judged  by their  intellect and character, women not so much.  But that's because the view of the world on that site is one where women are commodities, men are human actors.  But even the narrowest commodified definition of how women's values are defined doesn't give women with lots of children the greatest respect among women in reality.  Those would be the most fertile women, in terms of output.

Here's a set of three further principles from the site.  Taken together, they are a word soup with poop dumplings in it.

 Men will opt out of monogamy and reproduction if there are no incentives to engage in them.

Women are sluts if they sleep around but men are not.  This fact is due to the biological differences between men and women.

Elimination of traditional gender roles and the promotion of unlimited mating choice in women unleashes their promiscuity and other negative behavior that block family formation.

Men are naturally polygamous, goes the first statement in that set of three, except that, very oddly, and in complete contradiction to almost all EP, men here are not interested in reproduction!  How does that work, in practice?

Men need to be bribed into monogamous marriage, because they are inherently promiscuous.  But women are not naturally polygamous, goes the second statement, because of somethingsomethingbiological.

Then the third statement upends the second statement.  If eliminating "traditional"** gender roles unleashes promiscuity in women,  women were always biologically as likely to sleep around as men.  Remember that these beliefs are based on everything being fixed once, a long time ago.  Everything that is biological, in any case.  So whether you call women sluts and men not-sluts has nothing to do with this so-called biological argument.

The second contradiction in that set of three is between the idea that men don't want to form families, to begin with, what with wishing to pollinate one flower after another, but that it's unleashing women's promiscuity which blocks family formation.  And again:  Men will opt out of reproduction without incentives?  Really?

My apologies for writing about a hate site (mostly full of rage at stuff like women not getting pregnant enough).  But the way EP is employed, and by what types of people it is employed is worth pointing out.  In short, EP offers a scientific-seeming crutch which is used to whitewash existing misogynistic beliefs. 
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*I call the kind of subset of evolutionary psychology which people like Satosi Kanazawa practice Evolutionary Psychology, with capital letters.  The work in that field usually begins with some stereotypes about men and women (almost always negative stereotypes about women, by the way) and then tries to prove that the stereotype is well and alive today and then argues that this proves its evolutionary origins. Much of the work in this field pays little attention to alternative explanations.
**What they mean is Victorian gender roles, pretty much.

The Impossible Dream in the United States: An Annual Paid Vacation

One required by law.  American workers have no idea how it would change their lives for the better.  Think of a month off when the children are out of school, too, a month off without extra money worries or the fear that you will lose your job because other worker-ants work harder and take less time off. 

Think of what a month off each year could do to your bonding with your children, your health, your ability to learn, your ability to have a family in terms different than glancing at your children when they are already asleep.  Think of how much less angry and aggressive people would be if they could trust on that time of recuperation and it wouldn't mean that everything is lost in the rat-race.

The lack of such paid legally required vacations in the US is an atrocity, in my not-so-humble view.  The lack is also invisible, and when it is discussed it is discussed from the angle of the employers:  How can we compete with other countries who are even more exploitative than we are?  Never mind that the European countries mostly do offer paid vacations for their workers (and even paid maternity leaves, gulp!) and that the countries which do not offer such leaves may also not care about safety rules or the protection of the environment, thus engaging in unfair competition.

Paid federally required vacations are an impossible dream in this country, because there are no worker-side organizations that can push such issues.  The American right has effectively killed the unions.  Or put in different terms, the employer side is well organized (even represented by the US government in international trade talks) but the employee side is not allowed to organize.

Paid vacations are an impossible dream, because the reality is that American workers are losing the benefits they used to have, so going for new benefits is a pipe-dream.  The forty-hour-work-week is pretty negotiable, today, and in any such negotiations the firms have the upper hand: 

"You don't like to keep working overtime?  Well, lots of worker-ants out there desperately seeking an anthill to join." 

Indeed, firms have so many desperate people to pick from that some refuse to even consider those who are already unemployed.  Paid vacations, Echidne demands?  She is a joke.

In my view, all this is extreme capitalism.  Few things remain to keep it under the kind of control it needs.  Socialism and communism as alternative economic models are dead or very sick. Globalization has removed many of the old restraining controls on capitalism, leading it towards the lowest shared denominator (which allows countries without social safety networks or without environmental protection to set the going prices).  Nation states are becoming too weak to fight the multinational corporations, unless they are already cooperating with them and thus share their goals, and I don't see any multinational workers' organizations of similar power to the power of the multinational firms.

The American workers are well-schooled, on the whole, expecting nothing but the fiercest and most primitive competition for the available slots.  What those slots offer is much less than they should offer, and the current political process is busily trying to kill the last spots of unionized labor in this country (teachers).

This is a pendulum post, if you wish.  The pendulum in this country has swung so much against the interests of the ordinary working people that the quality of life has decreased for even those who count themselves among the middle classes. 

This situation does not automatically get better.  It requires organizing in order to get the kind of counterveiling power that is needed, and it requires massive cooperation in that process.  The atomized view of Americans works against that and so does the American odd idea that we are all but one step from joining the billionaires, and I fully appreciate the difficulty of the task.  But the Democratic Party is no longer standing for the ordinary working people (because of the way money buys votes in the American system), and someone else must do the necessary work.