Guest post: Nostalgia and the small-town GP (by Skylanda)

In the era of rapid change in the medical field, not more than a few days go by before another major news outlet produces a heartfelt ode to the dying breed of the small-town family GP. Hard-working, ever-suffering, delivering babies from their mothers and the elderly from the bonds of the earth, this backbone of America is as vaunted as a Norman Rockwell painting and – sometimes – only slightly less fictional.

Take the New York Times last month on this imminent extinction:

Dr. Sroka’s fate is emblematic of a transformation in American medicine. He once provided for nearly all of his patients’ medical needs — stitching up the injured, directing care for the hospitalized and keeping vigil for the dying. But doctors like him are increasingly being replaced by teams of rotating doctors and nurses who do not know their patients nearly as well. A centuries-old intimacy between doctor and patient is being lost…

Aside from the bizarrely reverential allusion to the mythical centuries of family-doc intimacy (given that this is historically a rather recent arrangement, and neatly overlooking a rich amalgam of barber-surgeons, midwives, and other messy players in the not-so-remote history of medicine), the article and discussion hash over the usual suspects – and the usual ups and downs – in the transition from the one-man solo practitioner to group and hospital practices with specialist care, hospitalist coverage for inpatient services, and less personalized services. Over-capitalization, too much technology, falling reimbursement, the push to require basic technologies like electronic medical records, and the like all make requisite appearances. But missing in this idyllic picture of times a’passing is two key concepts that no one mentions in these greener-pasture revues.

One is that the America’s doctors are changing, but so is America. We are no longer a nation of small-town doctors who care for their neighbors from cradle to grave, but that may be disproportionately a product of the fact that we are no longer a nation of stationary agrarian townships. I may not have the same GP that birthed me, but that is largely because I have called four states and two continents home since I turned eighteen years old. Even a move across a major urban metropolis may be geographically far enough to justify changing to more convenient medical provider. Increasing mobility is even more pronounced in the class of folks that graduate medical school; doctors have the same pressures of spouses’ job transfers, sick parents back home, better offers elsewhere, and all the other quirks of life that make their patients pick up and move every few years.

Even more pronounced – but less overtly discussed – is the reliance of the traditional GP on strait-jacket gender roles that read like a primer out of frontier America. Many small-town GPs of yesteryear (including the one profiled above) relied on the assumed labor of wives who played secretary, billing specialist, nurse, medical assistant, phlebotomist, lab tech, and office manager. Clearly this arrangement could benefit a couple mutually, pulling in a lifestyle that neither individual could arrange alone, but it fails in the face of any independent career notions from the female half of the couple, and fundamentally relies on the good will of the male half to provide for the financial good – a notoriously insecure place for women to find themselves. On top of that, in an era of decreasing revenues, a stark note in the NYT article is the pink-collaring of the jobs that do not remain in the family: the subject of that story hired half a dozen part-timers with no health benefits themselves to cover the work load that the wife could not cover.

But the gendering of old-time GPs is not limited to their own families. These old-timey GPs of such esteemed nostalgia are almost invariably male, and they are usually the only provider for miles around. They talk fondly of stitching up little Bobby after hours with his Little League mishap, and of being at the bedside of old Miss Jackson as she succumbed to her third heart attack, but these are politically neutral conditions. The most vulnerable populations do not always do well with a solo male – often older – GP who knows everyone in town: teens seeking birth control, pregnant girls and women seeking difficult options, gay kids needing honest information about risks, victims of molestation by the local power brokers. That is not to say that any given small-town GP is incapable of entirely appropriate behavior toward all of the above (indeed, I have known many who are) – but the intimidation factor alone may pose an untenable barrier for the most vulnerable population as much as the familiarity factor may help.

An assumption runs through both articles and comments that everyone would of course want such a small town GP, but I disagree: when I have something personal on my mind, I don’t want familiarity – I want anonymity, and I want choice (factors which – besides low cost – help explain why Planned Parenthood is such a wildly popular option among teenagers, even those who have established providers elsewhere). A larger portion of Americans are now the product of an extraordinarily cosmopolitan culture, and there is equal legitimacy between those who long for the intimate markers of small-town life and those who prefer the anonymity that an urbane lifestyle can provide. A universal desire for the small-town GP is a dangerous presumption at best, leading to models of care that harken back to times that many of us would prefer not to return to.

As with most nostalgia for perfection in times that never existed as we want to believe they did, the glossing over of these imperfections turns a notably rightward bent. Women didn’t need their own careers, because managing their husband’s office should be satisfying (and secure) enough. Girls don’t need to worry about feeling intimidated about asking a white-haired gentleman for birth control pills because, gosh, they shouldn’t be having sex. These questions do not arise in the hang-wringing over the loss of the small-town GP because if they were acknowledged, that would give into the admission that this idyllic world of small-town America was not perfect, if indeed it ever existed.

There is no fundamental evil in the small-town GP model; indeed, in the name of diversity, it deserves its place among small group practices, community health clinics, and behemoth hospital corporations in the pantheon of choice. It just does not deserve to be held up as the only model that serves, or serves universally best.

Cross-posted from my recently re-located and re-launched blog, now found at America, Love It or Heal It.

We Are Becomming a Nation of Nasty Boy Assholes [Anthony McCarthy]

Hemant Mehta, the owner of the dishonestly named "The Friendly Atheist" blog, has taken it upon himself to publicize the second "Draw Muhammad Day". I wrote a post last year in which I critisized Dan Savage for his part in the first one, it looks like the self-appointed rationalists among us are bent on continuing it for kicks and rallying the aging adolescents who comprise their customer base. The first commenting at Hemant's asserts that Muhammad, as historical a figure as exists, is "a NON-EXISTENT ENTITY". Then the Bright boy goes on to call Muslims "retarded". With few exceptions, that's the level of what passes as discussion on those kinds of blogs.

I'm not going to go through the arguments against taking useless, provocative actions that are known to be useful in rallying violent reactions within Muslim countries. The readers of this blog don't need to have ground level arguments for rational conduct repeated every time. Leave it as said that there's way too much rallying of irresponsible people around the world, it's far too easy for people to gain some perverse kind of status for themselves by doing that.

Thinking about Hemant's post, found through its promotion by another blogger who apparently believes himself to be a figure of mature rationalism, I'm struck by how the internet has enhanced the profile of nasty boy assholism in the general culture. Risking sparking deadly violence among Muslims over the cancellation of an episode of South Park, a really bad, really stupid cartoon dedicated to the basest of 12-year-old boy meanness and stupidity, I really don't know what else to call it but assholism in civil libertarian costume. That it's the self-appointed defenders of rationalism, science and Western civilization who are the ones continuing it is an ironic non sequitur that should really be remarked upon by someone.

Identifying this kind of stuff with boys is entirely justified, though there are some girls involved with it. NOTE: I will not honor anyone who behaves that way with a term denoting adulthood. This kind of thing is just the kind of behavior and thinking that has been an increasing presence in our culture in the post-WWII period, a period of macho assertion unlike even that of the late 1800s which was minimally restrained by the dominant Victorian culture, at least in "mixed company". "Playboy" wasn't called "Playman," cowboy are "boy"s as are the characters in South Park. The celebration of irresponsible, juvenile behavior by males is richly manifested throughout popular culture and a lot of junk that passes as something higher than that, these days. It's easy, it requires no thinking, it is likely to get you a far larger audience than the more demanding effort to act and think like a responsible adult, so it is potentially a popularity and financial boon. In light of that, it's not surprising that many of the most popular blogs pander to the kind of audience that you can get that way.

As the anti-Clinton side of the 2008 election shows, nasty boy assholes are a danger to adult level politics. I was hoping that there would be a reaction to suppress it and tried to encourage that reaction. But the assholes are winning. Sexism is as ubiquitous as it was in 2008, if it is given a focal point for the boys to rally round, they will at the drop of a hat. Racism has certainly gained that kind of focus in Barack Obama since he won the election and the 2010 congress and legislatures are working to destroy all of the progress of the past two centuries. This is a serious problem, one of the most serious problems we have. Nasty boy culture approves of meanness, violence, hatred, bigotry and pointless, nihilistic vandalism. Draw Muhammad Day began with the cover of First Amendment protection. Coming fast on the deadly reaction to the Quran burning by Terry Jones HEAVILY CONDEMNED BY MANY OF THE SAME PEOPLE WHO SUPPORT DMD, promoting other stupid publicity stunts are all the more manifestations of assholism.

Also Note: The identification of civil liberties with this kind of thing really makes you wonder if the civil liberties establishment needs to be put in more responsible hands. Right now they're really acting like a bunch of jerks. I've never known anything good to come from the moral poses of jerks.

Albino Porcupine Eating an Acorn

This Says it Better Than I Can [Anthony McCarthy]

We finally find and kill that evil fuck, Bin Laden.

You gots to ask yourself then, why, on every single goddam talk show, news broadcast and web site, is everybody suddenly talking about waterboarding? It's like Command Central took over all the information feeds and began injecting the Thoughts for the Day into the national discourse.


This is how it ends.

Quintin Compson, Negatory (at Eschaton Blog)

And this:

But this is not why I think torture is wrong. Just because something benefits me doesn't mean it's morally right. Let us assume that the logic of torture were sound. What, then, if the only way to convince a terrorist to reveal the ticking bomb's location was not simply to waterboard him, or to tear off his fingernails, or to electrocute him. In this day and age, many bombers have no qualms about sacrificing their own lives, so even extreme torture might not induce them to might only validate their martyrdom complexes.

Maybe dragging in their children would work. And if a little torture might help, then a lot of torture might be better. Maybe if you force the terrorist to watch his children be brutally raped and murdered before his eyes, that would break his spirit and force him to tell you everything.

That doesn't make rape or murder ethical, any more than it makes torture ethical. Indeed, I'd argue that the willingness to do what's right even when it's hard is exactly the measure of a person's morality.

Joshua Rosenau: Thoughts from Kansas.

Our FREE PRESS is the sales vehicle for torture, and it isn't just on the Sunday Morning Chat Shows the promotion of torture has been a consistent theme in entertainment crime shows for most of the past twenty-thirty years. The complaint that juries are being corrupted by what they see on the popularity of crime shows featuring fictitiously omniscient forensics studs is taken seriously by the criminal justice system. The far longer promotion of the equally fictitious "ticking bomb" excuse for torturing people couldn't have less of an effect.

Our free press, our media, our establishment wants to abridge the Eighth Amendment ban on cruel punishment. They aren't only doing it to give their hack writers something to spice up their crappy scripts with. This is for a reason and there's nothing good about that. We will rue the day that we allowed torture to be made legal.

Friday Critters

In no particular order

The Three Revelations of Eric Cantor. Or Conservative Principles on Health Care

Reading a particularly revealing piece like this one makes my knees go weak and my eyes light up with delirious joy. To be offered a well-known politician's real views for the tearing-apart process! I am not worthy.

The well-known politician in this case is Eric Cantor, the Republican House Majority Leader from Virginia, and the views he reveals to us are from a talk he gave to the College of American Pathologists, which is a fun detail, given what increases the customer base of pathologists.

Anyway, here is Cantor's First Revelation:

House Majority Leader Eric Cantor (R-Va.) said Tuesday that private healthcare plans ration care for profit but that consumers should be free to buy whatever coverage they can afford rather than depend on government rationing.

Free to buy whatever care they can afford! That is beautifully put. He is very clear on what his concerns are when it comes to the idea that governments might ration care: That might stop some people from buying loads and loads of care, even if they could afford it. The poor naturally are free to buy no care at all under the current system, if they can't afford it. So that is all right.

But those poor billionaires! In Cantor's world they are the true victims of government rationing. In the world the rest of us live all so-called socialized health care systems have auxiliary private insurance plans for those who wish them, which means that billionaires are not affected, except to the extent that they must still pay taxes to fund the public system. Perhaps it is this which Cantor finds so distasteful?

Cantor also thinks that the amount of care the not-so-rich can afford to buy on their own is the correct amount. Government plans are too generous:

In remarks to the College of American Pathologists, Cantor warned that Democrats' healthcare reform law mandates benefits that are too generous and will bankrupt the country as the government ends up having to offer ever increasing subsidies. That can only lead to government rationing, he said.
"That doesn't mean those kinds of decisions aren't being made now by the private sector," Cantor added, "because they are."

Indeed. Those kinds of decisions are made by the private sector, and the yardstick for rationing is money. If you can pay for a procedure you are likely to get it, whatever the nature of the procedure and whatever the seriousness or non-seriousness of your condition.

If you cannot pay for a procedure in the private market-place you will not get it, whatever the seriousness or non-seriousness of your condition. It is the government that you will turn to, then, but Cantor doesn't like that at all. I think he prefers a world where the dying lie outside the gates of the rich. It's Biblical.

And it matches the odd mixture of aggressive capitalism and right-wing Christianity which has so tainted the Republican Party. As the quoted article mentions, competition in health care markets does not bring prices down and does not guarantee quality, for reasons which have to do with the fundamental economic problems in that particular marketplace (uncertainty and severe informational asymmetry). But Cantor and others like him believe in the gods of free markets to such an extent that his Second Revelation is this:

Cantor appeared to go further than Republicans have in the past by acknowledging that not all patients are certain to get optimal healthcare under a system of private insurance. 
"I think that the fundamental nature of our system of third-party payer is the problem," he said. Patients, he added, too often are left with "no decision about what they want and what they can afford."

He does suggest that the care patients get under private insurance is not optimal. But note that what he thinks would be optimal is a system with no insurance at all! Because that way it is your wallet which hurts when all those bills come in, not the wallets of insurance companies and plans.

He's not talking about the problems of denial of services or of cherry-picking in the market, nope. He's referring to the ideal conservative jungle-world where you pay for all your health care expenses out-of-pocket. That way you will examine every proposed service, decide if it is worth the fee and then calmly and rationally either buy or refuse to buy the proposed package. All this from your hospital bed or nursing-home wheelchair!

I must be fair here and acknowledge that Cantor probably isn't planning to ban health insurance. But what he refers to in the above quote is a traditional conservative economic argument: If only people had to directly pay for their own health care consumption they would be more careful about how much to spend!

And they would be. In the case of catastrophic illnesses they would have to choose between losing everything and getting the recommended treatment, even if that treatment bankrupts not only the patient but her or his whole family. Health care costs, by the way, are a common reason for bankruptcies in this country, even with health insurance. The situation without it would be devastating. But sure, people would mind their money like hawks. Or try to.

To recap, Cantor wants rationing to take place not by the government and not ultimately by the marketplace, either. It is the individual patient who is supposed to simply accept the fact that he or she can't afford medical care and choose the alternative. That way the rest of us don't have to pay taxes for the treatment of Others. It is invisible rationing until the dying arrive at the gates of the rich.

But Cantor is not so heartless as these quotes might have made him look, no. Because he gives us his Third Revelation:

Later, Cantor said Republicans want a safety net for people who can't afford care but that "we're not for everyone having the same outcome guaranteed."

They are not for everyone having the same outcome guaranteed. The safety net care should take place in industrial bunkers, with gray walls, bad cabbage-soup as the meal of the day, fewer medications, fewer health care professionals and cheaper care in general. Possibly even death panels?

I'm joking there. But the usual conservative description goes something like my previous paragraph. It never occurred to me that Cantor and others like him hold it as the proper way government-funded care should be: Second rate, intended for those who don't have enough money.

Note that suddenly Cantor IS all for government rationing, too. It's just that the rationing should only apply to the poor, not to Cantor. In his world the markets should ration care, those who can't afford it are quite free not to have any, but because we are charitable people they can get tax-funded care which will be rationed in quality if not in quantity.

Mother's Day (by res ipsa)

Just now, in the Chinese restaurant:

Cashier: Thanks, res. Happy Mother's Day! /hesitates Are you a mother?
Me: No. /smiles
Cashier: Oh! /makes sad face; strokes my hand

A few weeks ago, at a four-year-old's birthday party:

Adult partygoer: Hello, I'm So-and-So. My son Such-and-Such is the blonde one with the striped shirt and cake in his hair.
Me: Cute! Hi, I'm res. Birthday boy is my partner's Godchild.
Adult partygoer: Oh, are you the childless friends?
Me: I think I'll fix myself a drink.

Last year, Mother's Day, at the greenmarket:

Guy selling fish: Thanks. Happy Mother's Day. Are you a mother?
Me: No. /smiles
Guy selling fish: Well, don't worry. It takes no talent.
Woman next to me: What the hell do you mean, 'It takes no talent'? /commences rant
Me: /smiles, walks away

I think I know what the fishmonger meant, but whether or not conceiving, giving birth, and/or mothering takes talent is not my point.

What is the proper response in these situations? I don't have children. I wanted them, but I didn't have them. (Do I say that?) Once that made me sad, but now I am okay with it. (How about that?) There are children in my life. (Should I tell them about the three-month twins whose acquaintance I made about two weeks ago and whose pictures are now my screen saver?). I like children. I just didn't have them.

Maybe this is my first mistake, but I don't object to people assuming I have children and wishing me a "Happy Mother's Day". What I do object to is the assumption that I need my hand patted when someone asks me if I do, and I reply, "No". I smile for a reason when I say, "No" (to put the person asking the question at ease). Am I wrong to do so? It took some work to be okay with not having children, but I did accomplish that work. Should I start ranting? Or maybe I have this all backwards?

A Musical Interlude

On Medicaid, Cinderella and Pumpkin Politics

Ezra Klein writes about the vulnerability of Medicaid today:

There are two reasons Medicaid is more vulnerable than Medicare. The first is who it serves. Medicaid goes to two groups of people: the poor and the disabled. Most of the program’s enrollees are kids from poor families, though most of the program’s money is spent on the small fraction of beneficiaries who are disabled and/or elderly. These groups have one thing in common, however: They’re politically powerless.
The second is who pays. Medicare is a federal program. Medicaid is a state-federal match, and it kills states during recessions, as unlike the federal government, states can’t run deficits, and so they find themselves with increased costs because they have more people in need but decreased revenues. So there are a lot of governors — particularly GOP governors — straining under overstretched state budgets who’d like a way out of their fiscal crisis that doesn’t include raising taxes, and there are a lot of federal legislators who’d like to save money without having seniors mounting protest marches outside their office, and Medicaid begins to look like an answer to everyone’s problem.

Medicaid is the federal-cum-state health financing program for specified groups of the poor. (It's easy to confuse it with Medicare which is the federal health financing program for the elderly.) While attacking Medicare has been called the third rail in American politics (you get electrocuted because the elderly vote), attacking Medicaid has far fewer risks, and the reason, as Ezra states, is in the powerlessness of its recipients and the fact that they mostly don't vote.

It does look like Medicaid has been picked out as the Cinderella who will not go to the ball, after all, by both the Republicans and some Democrats. Something needs to be cut and the neediest among us are also the least likely to mount powerful opposition to such cuts. Both the Ryan proposal of replacing federal matching funds with block grants and the ironically named State Flexibility Act would make sure that the pumpkin stays a pumpkin and doesn't turn into a carriage.

But so would the federal spending caps proposed by Senators Bob Corker (R-Tenn.) and Claire McCaskill (D-Mo.):

More than half of the Senate's Democratic members have signed a letter to President Obama opposing Medicaid block grants as well as spending caps.

"Just like a block grant, a total spending cap fails to account for trends like the aging of the population and rising health care costs," the letter states. "It would require such unprecedented and draconian cuts to Medicaid over time that it would inevitably result in s block grant, spending caps or other radical changes to the Medicaid program."

How fascinating that states should have more flexibility (to kick people off Medicaid, mostly) but that the federal government should have less flexibility! It is pumpkin politics.

The only real hope of not cutting the state budgets by cutting off aid to the most vulnerable might lie in the fact that a quarter of Medicaid funding goes to the elderly, mostly because long-term nursing home stays are not covered by Medicare but by Medicaid, absent private funds for them. Many of these elderly recipients, if not most, were not poor to begin with. Nursing home care is expensive and once private funds are run down it is Medicaid which takes over.

Thus, the Medicaid cuts might mean that middle-class voters will wake up some day finding an extra very large bill for grandpa's nursing home care in their mailbox. Or grandma might be deposited on their front step because there are no longer funds to care for her.

That is the only fairy godmother (badmother?) that I can conjure to help Medicaid.

Fun Wonkery!

Watch Paul Ryan get tangled in his own shoelaces (metaphorically speaking) in this Racine Townhall meeting:





Ryan has previously opposed the individual mandate, but in fact his Mediscare proposal would have one because you have to pay the taxes for the later vouchers, whether you wish to do so or not! As the wonks at Think Progress tell us:

All this tells us is that the mandate isn’t some horribly coercive policy aimed at usurping individual freedoms. Rather, it is a mechanism by which government attempts to encourage more individuals to purchase coverage and expand the size of the health care risk pool, thus spreading the costs and risks of insurance across a larger population (and bringing down health care costs). It’s simply asking able individuals to take personal responsibility for their health care expenses and it’s something Republicans have supported in the past and (apparently) still favor.

Perhaps consistency is the hobgoblin of small minds, but inconsistency isn't necessarily some wonderful thing, either. And Ryan is inconsistent here, mostly because the vouchers in Medicare are intended as a preliminary step in its total eradication. The final dream is for all of us to work hard, win the game, and then go out there to study the details of all complicated health insurance policies offered in asymmetric markets with incomplete information and to easily pick the most suitable of them. Piece of cake.

No Taxpayer Funding For Abortion Act

This bill has passed in the House though president Obama has told that he would veto it.

Yet 235 Republicans and 16 Democrats voted for an act which would expand the scope of the Hyde amendment to private choices as well as make it permanent:

The truth of the matter is that H.R. 3 breaks sharply with longstanding federal abortion policy in ways that could significantly impact people's health insurance and set a precedent that jeopardizes federal funding for many faith-based organizations. Proponents of the legislation claim it will permanently codify the Hyde Amendment, which is renewed annually and prohibits federal funding of abortion services except in the case of rape, incest, or to protect the life of the mother. But H.R. 3 would also create financial penalties for individuals whose insurance plans cover abortion services (something the majority of insurance plans currently do, and have done without arousing controversy during pro-choice and pro-life Presidential administrations in the past). The bill would discontinue all tax subsidies to private health insurance plans that cover abortion, even if abortion coverage is entirely paid for by private funds, and it would impose tax penalties on those that pay for abortion coverage. In other words, it would create incentives for health insurers to not cover abortion services at all. Pro-life leaders who support this tax increase and departure from the status quo should say so.

Isn't the language of the extreme forced birthers fun, by the way? An example:

“Today we seek to end taxpayer complicity in abortion violence,” Smith said Wednesday at a Capitol news conference. “No taxpayer should be coerced to pay, subsidize or facilitate the dismemberment, chemical poisoning, starvation or suctioning to death of a child and the harming of a woman.”
The bill would do away with tax breaks for insurance providers that cover abortion and would permanently codify the Hyde Amendment, which prohibits taxpayer funding for abortions in all federal programs. The amendment is typically renewed annually by Congress.
Democrats and abortion rights advocates have contended that federal law already bans taxpayer money from directly paying for abortion services, and that H.R. 3 would amount to a tax increase on individuals and insurance providers that cover abortion.

Remember Chris Smith? He is the guy who tried to alter the definition of rape in the early drafts of this bill. He is extremely concerned about the rights of zygote-Americans. The rest of us? Not so much.

And how interesting that my taxes can be used for the actual killing of people abroad or that donations causes I regard as evil are tax deductible in many states.

Just So You Don't Feel Special (by res ipsa)

Now that it has a newly majority-Tory government, Canada has commenced war against its female citizens, too.

Trigger Warning. Shame. Fat Hatred. Etc. (by res ipsa)

Trigger Warning: domestic violence. Yesterday, I put up a post about Barbara Sheehan, who killed her husband after being battered by him for years and years. Then, last night, in a misguided and insomnia-addled attempt to clean up the punctuation, wound up deleting the post instead. I talked about the question, "Why did she stay with him?" and discussed that in this particular case, the man had all manner of weapons (two on him at any given moment) and told his wife that he'd use his police training to kill her and make sure her body was never found. I also offered an anecdote about a newly-married friend who stayed with a batterer for months because she was so ashamed of what she perceived as a series of terrible mistakes, from having "chosen badly" to feeling not smart, mature, and/or "woman" enough to have married in the first place. I noted that prosecutor in the Sheehan case was trying to shame and intimidate the victim, too ("the defendant has failed to cooperate").

Trigger Warning: fat hatred. Was also going to discuss this David Sirota piece about the "Fat Guy's Privilege" and why it needs to end (and not just because I'd rather stick needles in my eyes than have to listen to any more bullying, braying, and/or bellowing from Chris Christie).

More, hopefully, later. Right now, I have to work. Why does it always get in the way?

Using A Wife As A Human Shield!

Did you manage to read about Osama bin Laden using one of his wives as a human shield? The story began here:

"Here is Osama, living in a million-dollar compound, hiding behind women who were put in front of him as a shield," Brennan said. "It speaks to just how false his narrative has been over the years...he's putting other people out there" to wage jihad while he is secure in his luxury compound.

...

Brennan also identified bin Laden as the combatant who had used a woman as a human shield. She was the only woman who died in the operation, which also killed a courier for bin Laden, the courier's brother, and one of bin Laden's sons, Brennan said. Brennan later said it was his understanding that the woman was one of bin Laden's wives, but officials later said Brennan was mistaken -- his wife had only been injured in the attack.

So the woman used as a shield (if this happened) was not one of bin Laden's wives. But Jonathan Chait thought so when he wrote this analysis:

This morning I forgot to take out the trash, but if my wife is upset when she sees me tonight, I'm going to bring up this.

...

Let's see if "At least I didn't use you as a human shield" gets me off the hook.

More seriously, I wonder if this will help destroy whatever romantic allure bin Laden has left. I don't know very much about Muslim cultures, but it's hard to imagine there's any culture in which hiding behind your wife, or any woman, rather than fighting for yourself is not considered about as shameful and cowardly as it gets.

Hmm. Chait hits all the points in a particular gender relations plot.

The next round of possible information on the human shield topic:

President Obama's counterterror chief John Brennan also initially said that bin Laden used one of his wives as a human shield and the woman was killed in the gun battle. That has turned out to be incorrect and officials attributed the mistake to the confusion that usually accompanies a fast moving gun battle, or "the fog of war."

And also:

When the SEALs entered the room in which bin Laden was hiding, his wife charged them and was shot in the leg, Carney said. Bin Laden was then shot in the chest and head.

Wow. My head spins. We move from a wife being used as a human shield in the most reprehensibly anti-masculine way to a wife charging Navy Seals.

I am now eagerly awaiting Chait's new funny post, based on that latest information!

More seriously, as Chait might say, this reminds me about the way evo-psycho popularizations are spread over the world in a nanosecond whereas the later corrections are only known to those inside the ivory towers.

Liposuction, Fat and Body Shape

Gina Kolata writes about a liposuction study in the New York Times. This study is interesting because it matched the experimental group having surgery with a control group of otherwise similar women:

In the study, the researchers randomly assigned nonobese women to have liposuction on their protuberant thighs and lower abdomen or to refrain from having the procedure, serving as controls. As compensation, the women who were control subjects were told that when the study was over, after they learned the results, they could get liposuction if they still wanted it. For them, the price would also be reduced from the going rate.
The result, published in the latest issue of Obesity, was that fat came back after it was suctioned out. It took a year, but it all returned. But it did not reappear in the women’s thighs. Instead, Dr. Eckel said, “it was redistributed upstairs,” mostly in the upper abdomen, but also around the shoulders and triceps of the arms.

I am not going to write about the study itself or its meaning but about something slightly different.

Kolata mentions that more than half of the control group in the study still wanted the surgery after learning that the fat comes back though in different parts of the body. Yglesias writes about this, noting:

The psychology of medical care remains a bit murky.

I think he means the fact that a procedure found ineffective (in removing fat and keeping that fat away) was still desired by more than half of the women in the control group.

But if you read Kolata's description of the study carefully you will notice that the women in the study were not obese. They were what used to be called pear-shaped, with fat perhaps mostly lodged in their thighs and lower abdomen.

If a woman with that body-type wanted liposuction before the study, why wouldn't she want it after the study? She may well have welcomed more upper-body fat, considering that it reduces the pear-shapedness, and the abstract of the study does state that the areas where fat was liposuctioned stayed smaller.

Not all the women in the control group wanted to go on with the surgery after they learned the results. But those who did may not have acted in mysterious ways. If their desire was for a less pear-shaped body, then the surgery succeeded in achieving that.

----
Cartoon by Artful Asp

Joanna Russ, RIP

Joanna Russ, a feminist science fiction writer, died on April 29, 2011. She is best known for her novel The Female Man. Several feminists recommend her 1982 How To Suppress Women's Writing as a "reverse" guide for women and minorities.

I was never able to get through The Female Man. Mea culpa. It is time to try it again. For me Russ' most important work by far is We Who Are about To, followed by The Two of Them.

Neither of those books is thick. That is about the only light thing I can say about them. Yet they are important to read because Russ' complex (and pessimistic) views on gender are under-represented and because she is excellent at showing the larger connections, the ways in which gender hierarchies serve and support the societies which created them and the ways in which they do not. Neither her men nor her women are free to make their own lives but neither are they complete victims of the system. With a few exceptions, they see dimly, comprehend partially and struggle on, sometimes in the wrong direction.

Hers is a pessimistic eye. She doesn't shy away from the violence in human society, including in its gender relations, and she doesn't offer easy solutions to those. Yet the characters in her books have some agency. They have choices, though we might not regard those choices as very pleasant.

We Who Are About To is the better of the two books. It is better written and offers us not only a dystopian example of gender arrangements but also a dystopian example of what space travel might really mean, to counteract all those utopian examples where having a space ship means that one is a step closer to godhood than in our actual earthbound lives.

Trigger Warning: Female Journalists and Sexual Assault

Lara Logan's 60 Minutes interview is not going to get much attention because of bin Laden's death. But it should be discussed. The video of the interview, available here, deserves a strong trigger warning about detailed descriptions of sexual assault.

To put this heinous crime into a wider perspective: Female journalists face a heightened risk of sexual assault, especially when reporting from chaotic places and areas of warfare. Women journalists seldom talk about this risk, and the reason is an obvious one: The cure they would be advocated is worse than the disease, because the cure usually consists of urgings not to send women out to those types of assignments. Yet if a woman is a war reporter, how can she carry out her job if she is not going to be sent to war zones?

All journalists covering dangerous events face greater risks of death and violence, of course, and it is not clear to me that men wouldn't face the risk of sexual assault. But if the talk is about sexual assaults, the concern is about women.

Did you note something interesting about the way I wrote those paragraphs (other than my usual first-draft clumsiness)? Did you notice the passive tense that crept in? How I wrote about women "facing a heightened risk of sexual assault", as if "sexual assault" was something like a tornado? This way of writing is the common one on the topic. For example*:

Logan was attacked by a mob near Cairo's Tahrir Square on Feb. 11, the day that President Hosni Mubarak was finally driven from power. At the time, CBS News issued a statement saying that she "suffered a brutal and sustained sexual assault and beating before being saved by a group of women and an estimated 20 Egyptian soldiers." Her attack reverberated around the world and highlighted the dangers of sexual assault and harassment that women face while reporting.

With the exception of that active attacker, "the mob", the quoted paragraph turns things upside down. It is Logan who suffered a brutal attack, it is female reporters who face the dangers of sexual assault and harassment. The people doing the harassment become a simple mob and then fade away altogether.

This may sound trivial. But once we begin focusing on the victims of the assault and on how they affect their own odds of being attacked, we are well on the way towards solving the problem by focusing on the victims, too. That means limiting their abilities to live the lives they wish.

It also feeds into a wider problem. As Logan mentions in the video interview, street harassment of women by men is a way of life in Egypt, as it is in many countries of this world, and when it happens the blame is often placed on the women. They shouldn't go out alone or they shouldn't dress "provocatively."

If we focus our solutions only on the victims of sexual assault, who is it we are ultimately protecting here? And whose lives we are limiting?
---------
*The quoted article does continue with a (too-gruesome-to-quote) paragraph which puts the blame where it belongs.

On Osama bin Laden's Death

I heard about it last night in the president's speech and then watched people celebrating (USA! USA!) on television. The three vibrant young people I knew, one very well, who died in the World Trade Towers and were never found are still dead. The mother of one of them who died because of her son's death is still dead, too.

And so are all those Afghanis and all those Iraqis and all those members of American military forces who have died in the last ten years since 911. Many among them were not combatants. Justice was not done to them, though perhaps it was done to bin Laden, as Obama stated in television last night.

Was revenge done? And was it a revenge for the USA as those celebrants seem to argue or for the actual victims of 911? I understand revenge, I do. Had you offered me the chance to kill the creator of the 911 carnage a week or so later, after all those phone calls, all that searching and all that suffering I watched so closely...

But even then what I wanted was an international police operation, a court and proper sentencing. Criminals should not be made into warriors, crime should not be turned into war. That way come the martyrs for a cause and the chance to grow it. But we all know what actually took place.

What does the death of bin Laden mean? It has mythical meanings and those are different for the American people in general, for those who lost someone either in the 911 massacre or the wars following it, and those are also different for people in Pakistan or for members of Al Qaeda. Which myths will matter the most in the future shaping of events remains to be seen.

Bin Laden's death also has practical meanings. What those will be depends partly on the battle of the myths, but they also depend on who it is who in fact runs Al Qaeda if anyone does. Then there is the practical meaning of the fact that bin Laden lived in the suburbs of the capital of Pakistan a city halfway between Islamabad and Peshawar* and not in some tribal area in the hinterlands as we were told.

I'm not sure that justice was done. For that crime must be swiftly followed by proper court proceedings and the appropriate punishment. What we got instead was a religious fanatic playing cat and mouse against the most powerful military on earth. With ten years of success.
----
*Thanks for this correction go to N. in the comments.

Giving Scandal, John Paul II Was No Saint [Anthony McCarthy]

People who don't follow the Catholic Church would probably be shocked to find out that a lot of the people who reject the fast track to canonization for John Paul II are Catholics, some of the Catholic theologians and clergy, many of them observant Catholics. Most of the criticism focuses on his knowingly abetting the sexual abuse crisis as it was building and his cover up of it once the dam burst and the scandal of it was undeniable. In modern Catholic history, its chief rival as a scandal was the Vatican's activities in relation to the Nazis under Pius XII (and before when he was a Vatican diplomat), who is also being fast tracked for canonization under the incumbent Pope. I'd also point to his appalling indifference to the slaughter of peasants in Central America, especially, during the 1970s and 80s. In a lot of ways he acted more like a CIA asset than someone who should be held up as a great moral example, which is the reason that canonization is supposed to be important.

The National Catholic Reporter has given quite a bit of coverage to the opponents of the rush to canonization and the reasons for it, much of it from sisters and priests. That alone would shock a lot of people who don't know much about Catholic and Catholic culture. Here are a few samples:

Benedictine Sr. Joan Chittister said John Paul’s “attitude toward clerical sex abuse of children embodied the worst kind of clericalism.”

Said Chittister: “The least the church could do in respect for those who have already suffered insult at the hands of the church is to let the perspective of time decide whether or not canonization is in order.”

Anthony Padovano, a professor at Ramapo College in Mahwah, N.J., said the late pontiff’s use of power during his papacy set a bad example for “the kind of life you expect the people in the church to emulate.”

“The witness of John Paul II has been extremely disappointing,” said Padovano. “It should not be presented as a model for what a Christian is supposed to do.”

Fr. Charles Curran, professor of theology at Southern Methodist University in Dallas, said that although he had no objection to the news of the beatification, the church “would be a lot better off if we stopped canonizing popes, bishops, clergy and religious.”

Mercy Sr. Theresa Kane said other causes for canonization should have more priority -- particularly Salvadoran Archbishop Oscar Romero’s -- and called the late pope’s beatification “somewhat premature.”

Kenneth Woodward, author of Making Saints: How the Catholic Church Determines Who Becomes a Saint, Who Doesn’t, and Why, said the late pope had a “profound prayer life.”

Yet Woodward, a contributing editor for Newsweek, also bluntly said that John Paul “ruined the Catholic hierarchy” by making agreement on the issues of women’s ordination and a married priesthood a virtual requirement for episcopal elevation.

You might remember Sr. Kane from John Paul II's first visit to the United States for her address in which she called for sexual equality in all the ministries of the Catholic church to the Pope's stony glare. Needless to say, he did exactly the opposite, forbidding clergy from discussing women's equality, calling it a settled issue. I remember it because I'd been skeptical of him before that visit but by the end of it I knew he was bad news for anyone who wanted more equality.

Much has been made of the economic justice stand of the Vatican and, it's true, officially it is the foremost world institution that has been critical of market capitalism and capitalism, in general. You can only wish that they followed it up in ways that mattered. As John Paul II appointed bishops and cardinals they were generally far more friendly to exactly the same institutions and individuals that comprise the economic establishment that the last two Popes have spoken against.

Why this should matter to anyone except Catholics is that it does matter what direction the Catholic church takes. It has enormous influence over many influential people inside and outside of its membership. It has an enormous potential for doing things both bad and better. Its clergy exerts a strong influence on our politics, though less so now that the sexual abuse scandals have become known.

John Paul II infamously set up the fast track for canonization during his papacy, canonizing and declaring people "blessed" more people than all of the other popes combined. His canonization of some of them was a scandal in itself, Josemaria Escriva who started Opus Dei, which JPII turned into a spy agency in his war against the Jesuit order and liberals in general. A number of his fast track saints were canonized for political reasons, especially some of the Polish ones and Gianna Beretta Molla, who chose to die rather than have a hysterectomy and abortion to save her life (I'm not sure if it's still true but even the Catholic church allowed that kind of "indirect" abortion in cases when doing nothing would lead to a woman's death). It's led to some pretty bad potentials for scandal as the new prominence leads to a review of the lives and writings of those people.

With his papacy, John Paul II ended the period of reform set into motion by John XXIII and Paul VI. That reform was the reason that John Paul I took the names of his predecessors before his early death. John Paul II took the same name under false pretenses, his every action belied that tribute as he set up a dictatorial, scandal ridden clerical despotism, one which Catholics have been leaving at a rapid rate. Some of his and the present pope's critics say that it's part of the plan they made for a much smaller, much more clerically controlled Catholic church, killing the reforms of Vatican II and becoming a force of political and social reaction in the world. I don't see anything blessed in that.

Johannes Brahms

Op 44 Four Songs for Women's Chorus

Cambridge Singers

John Rutter conductor

I was looking for something for Walpurgisnacht but found these instead.

This Looks Right [Anthony McCarthy]

Matt Honan at Mother Jones Magazine, has made a very useful flow chart that explains how the corporate right manages to turn their lies into common received wisdom.

How to Make Your Lie Go Mainstream in 26 Easy Steps

Looking through it a few times, applying it to lies they've managed to make into a temporary substitute for the truth, it has explained just about every one I've come up with.

Everybody Knows That Men Marry Looks And Women Marry Money And Why.

Yes. Everybody knows that men marry women with good looks and that women marry men with resources, and that this is because of what took place in the area of evolutionary adaptations a long time ago somewhere on the African savanna!

I hate stuff like that, because what "everybody knows" is not based on any actual evidence of the prehistoric origins of hypergamy for women but not for men. In other words, women want to marry "up" in terms of resources because that provides for their future children best. What the guy looks like is immaterial and how old he is is also immaterial! As evidence people argue that Rush Limbaugh has had several wives and he is ugly as hell.

What made me irritated enough to write about this again were the comments to a David Sirota article about gender differences in how obesity is treated in the US. He argues that men get a pass when it comes to societal disapproval of fat.

Alas, the article itself stirs me less than comments like this (to be found attached to Sirota's piece)*:

The reason fat men don't matter is simple and goes to our biology, women have to be beautiful and men have to be rich.

Cassie is unrepentant about dating rich men. “Of course it is much better to sleep with men with lots of money,” said the 27-year-old lawyer from London.
“Any girl who tells you different is lying. Rich men are powerful and successful and confident and charismatic. They know what they want, and they go out and get it. That translates to being fantastic in bed.”
Cassie is living proof of the latest scientific discovery about human sexuality: that the number and frequency of a woman’s orgasms is directly related to her partner’s wealth.
Her explanation is simple. “Women don’t want to lie back and think of the gas bill,” she said. “It’s a lot more fun to have sex in the Ritz than the Swindon Travelodge. And to be ripping off Rigby & Peller underwear than M&S knickers.”
Wealthy men give women more orgasms.

The study that is referred to is something I have discussed on this blog. But note that firm statement at the beginning of the comment about it all having to do with biology! Women go for money, men go for looks, and that is how it is.

You can prove it by looking at the orgasmic frequencies of women married to poor and rich men in China under its current capitalist turmoil which leaves some people with nothing but stress and heaps others with all they wish, and then you can find an anecdote (a lawyer!) to prove a point about "women" and "men" in general.

Biology. Where does the idea that these particular mating habits are biological come from? From evolutionary psychology (ep), naturally. But the story told there doesn't actually bear closer scrutiny very well:

Suppose that those prehistoric women did want to mate with men who somehow had more resources, just as the evolutionary psychologists of a certain stripe assume that men wanted to mate with women who had more resources in terms of youth and high fertility. What would those male resources have consisted of? The tribes in the hypothetical area of evolutionary adaptation were presumably nomadic. What wealth do nomads have?

It seems to me that any resources in those hypothetical days would have been embodied ones, for both sexes. A woman might have been more interested in a man who could hunt well, was healthy, young and still strong, just as a man might have been more interested in a young and healthy woman. I see no clear advantage in mating with an older man under those conditions if the advantage is to be viewed through the eyes of maximizing the likelihood that one has children AND that those children grow into adulthood in order to have children themselves.

So my evo-psycho theory would be that in a nomadic society of the type ep commonly specifies women would look for young and fit men. That is not Rush Limbaugh, and that is not marrying money. Can the incentives to marry money be explained in other ways?

I can think of at least two very obvious explanations, though they are intertwined.

First, women have traditionally not had the same opportunities to amass wealth as men have. Childbearing and child-rearing have handicapped women in this particular competition, societal norms about women's proper place (at home) have exacerbated the problem and, lest we forget altogether, laws everywhere tended to make sure that daughters couldn't inherit as much as sons, guilds excluded women from most trades and married women lost control of any property they had (and any income they earned) for the duration of the marriage.

All this left only one common way for women to better their social position: marriage. There's no need to assume that the desire to marry "up" is in women's genes when historical explanations suffice.


And even though the laws no longer restrict women from amassing wealth, the societal norms about child-rearing still do, general societal norms and myths change slowly and it is still hard in many countries for women to acquire wealth except through marriage. As long as women are, on average, poorer than men we are going to observe more female hypergamy than male hypergamy.

The second explanation is in some sense the same as the first one, though it looks at the situation from a different angle. Return to that hypothetical area of evolutionary adaptations and put your ep glasses back on. The story we are usually told is that men in those days struggled hard to get resources so that they could attract those young nubile Barbie-lookalikes for some dating and mating. Forget about the tribes being nomadic and pretend that the men wore backpacks with goodies inside them.

Only the most successful men got access to the Barbies, and, presto!, we have all descended from those alpha males, the ones with the heaviest backpacks.

And from those fairly mindless gold-digger Barbies.

That's how the story is written in the most inane ep versions (the ones I abbreviate to EP), and it is intended to explain, among other things, why men are so much more energetic, ambitious and creative than us poor women.

You see, almost all women got to pass their genes on without any struggle (no, pregnancy wasn't hard in those days, and in fact children popped out of the vulvas already fertile and ready for another round of mating right away, so the fact that women didn't compete at all or evolve very much was of no great consequence). But only alpha males got to pass their genes on!

How the EP guyz know that it was the alpha males whose genes they now carry I do not know. No woman has ever had a bit of nookie on the side, for instance, and no woman has ever been adulterous or exhibited any other mate choice except that for the imagined alphas of EP. (Who am I kidding? Even chimpanzee females mate with anyone they can get hold of when in heat.)

But I digress. To return to the second explanation, the EP story wants to stress how men have an incentive to climb the societal ladders but women do not. What they don't appear to see is that women do exactly the same when they marry money, that women show rather strong tendencies towards the very same kind of societal climbing that presumably underlies the reason why women don't need to scale those ladders. It is just that women have been limited in the tools they can use in furthering their social ambitions.

Would women marry for resources in a world where men and women earn roughly equal amounts and where child-rearing responsibilities are equally shared? I doubt it.

If I had to guess between the rather caricatured motives: looks vs. resources, I'd pick the former by a large margin in such a world. Women would choose their partners on fairly similar grounds to those men use. But of course neither men nor women mostly marry for looks or money but for much more complicated and, well, human reasons: Shared values, shared interests, friendship and kindness.

There. That is the post I wrote, instead of the one I planned to write on Sirota's article. Maybe later.
----
*For a second example in the same vein:

This 70's feminist version of society is all wrong
Men are judged by success, women are judged by looks. It's as simple as that. No man ever slept with a woman because of the car she drove, but women do that all the time. This is of course all romantic notions aside, just basic lust and status. Men and women are equally shallow, just about different things. Men are shallow about boobs and waists, women are shallow about status/comfort/wealth/success.
So the reason fat successful men don't care if they're fat isn't because of chauvinist culture, it's because they can still attract women based on their success, and they don't *have* to be as physically attractive to be successful in attracting the opposite sex. There's no chauvinism, oppression, or brainwashing involved. It's just the basics of how men and women work.

There ya go.

Today's Action Alert

From Catholics for Choice:

Catholics for Choice is issuing the Catholics for Choice Matching Gift Challenge to support the women of DC and assist the DC Abortion Fund (DCAF) in its critical work. Women in the District of Columbia need your help—and we’re asking you to give now as generously as you can. By participating in this challenge, your gift will mean twice as much.

As Catholics, we are called upon to speak up and show our compassion for the poor. Our faith guides our commitment to social justice, including reproductive justice. CFC condemns using the reproductive health of low-income women in Washington, DC, as a bargaining chip to reach a budget agreement. When Congress chose to prohibit the DC government from distributing its own local funds to pay for poor women’s abortions it made an unconscionable decision.

You can donate here, but hurry, as there's only one day left of the gift-matching project.

Friday Music: Carola Standertskjöld

I recently learned about this Finnish singer of the 1960s, and right now I am hooked, both on her musical and her linguistic skills. Let's begin with the latter:

Carola was born into an upper class Swedish-speaking Finnish family. Here she sings in Swedish:





She spent her childhood in Switzerland where her diplomat father was stationed. Whether she learned French there I don't know, but her French sounds very good indeed:





Her father was later transferred to Spain. Carola singing in Spanish:





Her English isn't too bad, either. If you watch the silly video, please watch until the very end! It's worth it.





And her Finnish, too, is perfect:





She died of early onset Alzheimer's disease fairly young but as far as I can tell the fame she deserved was not going to be something she would have achieved by living longer.

The music industry has many similar cases, of talented singers not making it. Very sad.

To finish with, here Carola interprets a Finnish folk song. I'm not certain if the words are traditional, too, but they are worth translating*:

I walked the edge of fields with the young gentlemen,
yeah, yeah, and I walked the edge of fields,
yeah, yeah, and I walked the edge of fields.
Now I think I feel a kick in my belly
yeah, yeah, and a kick in my belly
yeah, yeah, and a kick in my belly.

Well, the gentlemen they tell stories and stories
yeah, yeah, stories and stories
yeah, yeah, stories and stories.
They look you in the eyes and praise you unctuously
yeah, yeah, and praise you unctuously
yeah, yeah, and praise you unctuously.

And how can a girl know every single trick
yeah, yeah, and every single trick
yeah, yeah, and every single trick.
But she is the one who must bear the consequences,
yeah, yeah, and bear the consequences
yeah, yeah, and bear the consequences.

Then winter arrived and snow covered the ground,
yeah, yeah, and covered the ground,
yeah, yeah, and covered the ground.
And the gentlemen no longer want to walk me home
yeah, yeah, and walk me home
yeah, yeah, and walk me home.

They now bow and scrape to other young women
yeah, yeah, to other young women
yeah, yeah, to other young women.
But me they pass by with a haughty mien
yeah, yeah, and a haughty mien
yeah, yeah, and a haughty mien.

I walked the edge of fields with the young gentlemen,
yeah, yeah, and I walked the edge of fields
yeah, yeah, and I walked the edge of fields.
Now I walk with my child the narrow road,
yeah, yeah, and the narrow road
yeah, yeah, and the narrow road.





-----
*A quick translation by me in which I took some liberties to give the flavor of the lyrics. I'm not sure if I got across that the "gentlemen" would be of a higher social class than the woman singing.

Santorum's Stupid Comments. Nothing Changes.

Here he goes, in his desperate and vanity-driven drive for presidency, once again:

Santorum, a father of seven and a former U.S. senator from Pennsylvania, said he wrestles with balancing time with his family and the campaign trail as he explores a presidential bid, but his passion for repealing the federal health care reform law is part of what fuels his political aspirations. "I look at how society with socialized medicine treats children like Bella [his daughter, who was born with a genetic abnormality], and children like Bella don't survive," Santorum told The Des Moines Register today, the first leg of a three-day swing through Iowa. "Children like Bella are not given the treatment that other children are given." Santorum said the new health care law, championed by President Barack Obama, will mean disabled people are denied care more often, and repealing it is the best way to address mounting national debt.

How dare he? Where does he get the idea that children like his daughter don't survive in countries with socialized medicine? In Great Britain or Canada? And the US is not doing very well in international comparisons of infant mortality, either.

This is like that 2009 American interpretation of the chances that Stephen Hawking would have survived in one of those death panel countries:

In an editorial on July 31, Investor's Business Daily warned of end-of-life counseling in health care reform by saying people like Stephen Hawking "wouldn't have a chance" in the such a system.

People such as scientist Stephen Hawking wouldn't have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.

In fact, Professor Hawking lives in England, where he has been treated by their National Health Service. And by his own account, it saved his life.

And what about the United States of America? Santorum does admit that some problems exist:

Santorum said that disabled children are denied care today.
“It’s not like this isn’t happening now,” he said. “But it will happen more under a much more budgetarily-driven health care system.”

Budgetarily-driven? What does Santorum think private health insurance companies are? Charities? Suppose that you have child who needs 30,000 dollars worth of treatment every year? Will your insurance company just agree to pay for all of it or will their be all sorts of lifetime caps and other limitations, hmh? And what about a severely autistic child or young adult who really needs long-term residential care? Does the money for that care fall down like manna from heaven in this here great country?

No. The most expensive cases end up in the budgets of the states, in most cases, and what have we learned about the states, recently? They are cutting, cutting and cutting.

It is not the smearing of other health care systems that angers me so much about Santorum's inane statements, but the way the sufferings of Americans under the free-market-for-all-who-can-pay system are so minimized and belittled.

That is what angers me about all that death-panels crap. You don't have to have an explicit death panel if the price of care is set high enough. You don't have to have an explicit death panel if insurers decide whether your expensive cancer surgery will be covered. You don't have to have explicit death panels if states decide to solve their budget problems by no longer covering the care of the most expensive medical cases. But the outcome will be the same.

Why Worry About Inflation And Not Unemployment?

On one hand politics is a mess, a chaotic war all based on greed, fear, desire to do good and egotism. And other emotions. It's like a gigantic daytime television show but we are not allowed to call it that so we use sport and war metaphors to make it look properly serious.

But on the other hand some types of politics are extremely easy to interpret. For instance, almost all the political pressure right now is in the direction of protecting the rich: The famous Ryan budget proposal which slashes away at the heads of the poor and the elderly but offers tax cuts to the rich, and also the recent statements by Ben Bernanke, the Federal Reserve chairman:

The Federal Reserve has two jobs, which is often referred to as a dual mandate. One is to maximize employment. Bernanke has testified that there are things the Federal Reserve can do, like buying assets through quantitative easing, that will result in job creation.
However, the Federal Reserve's other job is to maintain price stability and not let inflation spin out of control. The Federal Reserve does that through selecting an inflation rate -- what it calls targeting -- and doing what it takes to maintain that rate. The commodities that are increasing in price, especially oil for gasoline, are being driven by fundamentals, notably demand from China and emerging markets, which are out of the Fed's control. There is very low core inflation, which is inflation on everything other than commodities like oil and food. This core inflation rate is what the Federal Reserve targets, and right now it is lower than what the Fed has targeted.

So the Fed is doing neither of its two jobs. Unemployment is too high, and inflation too low, so it should be doing whatever it takes to stimulate the economy. The natural question that puts pressure on Ben Bernanke is: "Are you worrying too little about unemployment? And are you worrying too much about inflation?"
But if you got all your sense of the world from the questions that were asked during the press conference, you would expect that unemployment wasn't a major problem and crushing inflation was just around the corner.

...

Bernanke himself reflected these priorities. He cited keeping the financial sector from collapsing as the extraordinary measure the Federal Reserve has accomplished. He discussed current Federal Reserve efforts as something that will prevent a slow down rather than promote a faster recovery towards the long-term trend of growth. He seemed far more worried about inflation than about the current level of unemployment, and more worried about the Federal government's deficit than putting fiscal policy into play.

Why is the government worrying about the deficit, worrying about the future governments (over which it has no control) and why is the Federal Reserve worrying about non-existing high inflation? Why is nobody worrying about unemployment enough?

The easiest and most obvious explanation is not that we have somehow slipped into an alternative reality or that politicians are extremely incompetent but that they are doing what those with power wish them to do.

Unemployment does not hurt the well-off but inflation does, because it affects the value of fixed income sources, including interest income. The focus on government deficits instead of the current high unemployment stops looking so inexplicable when one understands that such deficits might require future tax increases which would affect the higher earners more. Unless government budgets could be cut.

But not defense! Because that's the one part the rich want to be kept as private armies are still too inefficient and inexpensive. Hence the cuts need to be in Medicare, Medicaid and Social Security, all programs which neither the wealthy nor most of the politicans will ever really need for themselves or their families.

I'm waging a class war here, all by myself! No, I'm not. And neither am I arguing that all wealthy people are evil or that all poor people are saints or that all the wealthy would agree on the pro-rich policies or that all the poor would be opposed to them. But if you strip the policy proposals to their bare bones, take out the bits which are technically required and the bits which are neutral, then what remains IS something very class-tinged. And it is a good explanation of the events I cannot otherwise decode.