cab drollery

They Knew

2009-11-25T03:30:00.000-08:00

A doctor friend of mine asked why I had such a bug up my ass when it came to pharmaceutical companies. After all, I'm benefiting from a clinical study which provides me with free drugs to control my cardiac arrhythmia. Surely I can't be so ungrateful as to ignore that. I told her that I could cheerfully be so ungrateful, because after years of following the pharmaceuticals I could honestly say that their good works (research and development of life saving drugs, as in my case, at least I think so) are roundly offset by their greed when it comes to marketing. Recent history has shown that patients' well-being are happily sacrificed to sales, cheerfully and knowingly.

She scoffed, but in yesterday's Los Angeles Times I got the perfect rebuttal to her smugness. The Vioxx scandal got revisited.

Thirty studies involving more than 20,000 people demonstrated an increased risk of heart attacks and strokes linked to the drug Vioxx, which was taken off the market in 2004 after generating billions of dollars annually in sales. However, this information was not easily accessible to the public, and the Food and Drug Administration's reservations about the drug were lost in a blizzard of direct-to-consumer marketing, according to a study and commentary published today in the Archives of Internal Medicine.

The analysis showed that safety concerns about Vioxx, a nonsteroidal anti-inflammatory manufactured by Merck & Co., arose at least four years before the drug was withdrawn. Under new FDA rules, however, manufacturers are now required to disclose the results of post-market safety studies. ...

The issue is crystallized further in a commentary by Dr. Lisa M. Schwartz and colleagues of the Veterans Affairs Outcomes Group. They point out that the FDA, as the repository of post-marketing surveillance studies, is a weak opponent to the media-savvy and heavily funded pharmaceutical industry.

"The Vioxx story really highlights the difference between marketing and informing," Schwartz wrote in the commentary. "If physicians and patients had had the facts, it would have taken an alchemist, not a marketing department, to turn this lemon into gold." [Emphasis added]

Four years. And in those four years people died of heart attacks and strokes because their doctors were not aware of the risks. Studies which would have informed patients and, probably more importantly, their physicians were hidden for four years.

I don't know which is worse: that pharmaceutical companies can hide this information or that the government helps them do so, if only by negligence or by the lack of eyes focused on the task. Theoretically at least, the new and improved FDA is halting this kind of practice. Post approval tests are supposed to be reported to the FDA and the FDA must make those reports available to the public. That, at least, is a start.

But it must be cold comfort to those who lost loved ones the last time around. It probably doesn't help that the company involved argues that these test results are questionable. It should also be cold comfort to the rest of use who know that these ghouls own a huge chunk of the table labeled "Health Care Reform."

Finally!

2009-11-24T03:30:00.000-08:00

There is something exceptionally sweet in finding someone who not only analyzes an issue the same way as I do, but who presents that analysis in far better prose than I am capable of. I came across that kind of serendipitous moment in this column by Issac Bailey of The Myrtle Beach Sun and featured by McClatchy DC. His subject is the decision by the Department of Justice to try the alleged conspirators in 9/11 in New York City in the environs of the Twin Towers and the hysterical response to the announcement of that decision.

His lede grabbed me by the heart:

I didn't know we had so many scared conservative leaders.

There are a fair number of scared liberal ones as well, given the rhetoric from Washington, Columbia and New York.

But I thought conservative leaders and pundits were the "Bring it on!" types who crave confrontations with terrorists.

Heh.

That craving is usually satisfied vicariously by sending young Americans to war, usually with inadequate support, equipment and protection, but I digress. Mr. Bailey then takes aim at one of the reliably conservative huffer-and-puffers, Cal Thomas:

But Cal Thomas, one of the country's most widely read columnists, took the cake with this assessment:

"The administration's first mistake is to label these men 'criminals,' as if a terrorist attack and the announced objective of forcibly 'Islamisizing' America were the same as robbing a bank," he wrote. "The 9-11 attacks were an act of war, as much as if a nation-state had attacked us. Trials should not be held for war criminals until the war has been won."

First notice the inconsistency, which is abundant in this debate. Thomas chastises the administration for calling terrorists "criminals" then goes onto to label them "war criminals." Call them terrorists or murderers or kidnappers or hijackers or kamikaze, radical Islamists. I don't care. Just bring them to justice and prevent other planned attacks.

Thomas also makes a sleight-of-hand argument about how there should be no trials "until the war has been won." Others like him say we are in a war and therefore must temporarily put aside our ideals. Never mind that standing on principles in the toughest moments is the ultimate show of strength. Those same critics even complain that more people aren't calling our efforts "The War on Terror."

We are in the midst of a war that won't ever end because no president will dare declare mission accomplished against radical Islamic terrorism. And yet we are told parts of the Constitution should not apply until the war is won.

Why not just throw the whole thing out. That'll prove how tough we are.

And that's what it's all about, really. Either we believe that our Constitution is one of the most sublime gifts ever offered to humankind because of its stern insistence on due process, on the rule of law, and on the limitation of government in matters of civil liberties, or we don't. And if we don't, we stand right next to the governments we excoriate daily in the newspapers: China, Iran, Cuba, North Korea.

If our Constitution only applies when the sun is shining and Wall Street posts another high, then we are not only not exceptional, we are sadly run-of-the-mill cowards.

I was brought up differently.

Dissed Again

2009-11-23T03:59:00.000-08:00

Doyle McManus is one of those Los Angeles Times columnists who makes me crazy. I usually don't like what he has to say, but I almost always have to agree that he's right. His latest opinion piece is a perfect example of the discomfort he causes in me.

The great healthcare debate hasn't been a triumph of mass politics on either side. Congress isn't being stampeded by the public into passing a bill -- and it's not being stopped by the public from passing one, either.

Instead, the debate has turned out to be a battle of old-fashioned special interests and parochialism. The most important players have been the insurance industry, the American Medical Assn., labor unions and the AARP, the senior citizens lobby. As for parochialism, last week's most blatant action may have been Senate Majority Leader Harry Reid's insertion into the bill of a $100-million Medicaid bonus for Louisiana, whose senior senator, Mary Landrieu, has been one of the holdouts.

One reason for this resurgence of backroom politics is simple: Polls show the public to be fairly evenly divided on healthcare reform and understandably confused by its details. But there's also a deeper reason. In modern American politics, with its professional lobbyists and millions of dollars in campaign advertising, public opinion isn't always the most important thing. ...

For members of Congress who anticipate tough reelection campaigns, what's most important is not what voters think of healthcare proposals today, but which interest groups will spend money in their states to shape voters' perceptions next year. Groups on both sides, from the U.S. Chamber of Commerce to the unions, have already announced millions of dollars in planned advertising spending to do just that. [Emphasis added]

Now, I'm not certain that Mr. McManus is correct about the polls showing that people are evenly split on healthcare reform. They might be split at this point on the watered down, weak-for-consumers, great-for-insurers bills which are currently being offered, but I suspect that more than half of the American public desperately want health care to be less expensive and more accessible than it is right now. In other words, Americans want some of that change President Obama promised during his campaign for the White House.

That's not what we are going to get. The promises of a grass-roots level campaign for important issues were just that, promises. We should have expected that once President Obama turned over his email lists to the national party. We also should have expected that after the president invited the insurance companies, pharmaceutical companies, and medical equipment providers to the White House for their input at the very start of the process. They got the first and largest bite.

Lawrence R. Jacobs of the University of Minnesota's Humphrey Institute of Public Affairs has an assessment that pretty well sums up the process:

"This is not being fought by the White House as a grass-roots campaign," Jacobs noted. "Civic engagement at the community level has largely been bypassed. . . . The Obama strategy has been to neutralize the stakeholders so they don't block a bill -- so they don't pull a Harry & Louise," a reference to the insurance industry advertising campaign that helped sink then-President Clinton's healthcare reform proposal in 1994.

In other words, it's politics as usual from the White House and the 111th Congress. The sad part is that we let them get away with it.

Sunday Poetry: Jim Harrison

2009-11-22T16:00:00.000-08:00

Poem of War

The old rancher of seventy-nine years
said while branding and nutting young bulls
with the rank odor of burned hairs and flesh
in the air, the oil slippery red nuts
plopping into a galvanized bucket,
"this smells just like Guadalcanal."

* * *

The theocratic cowboy forgetting Viet Nam rides
into town on a red horse. He's praying to himself
not God, though the two are confused
in the heat of vengeance. The music
is the thump of derricks, the computerized
lynch mob geek dissonance. Clint Eastwood
whispers from an alley, "George, they
were only movies." Shock and Awe.
God is only on God's side. War prayers
swim in their tanks of pus like poisoned
frogs in algae laden ponds. The red horse
he rides is the horse of blasphemy. Jesus
leads a flower laden donkey across the Red Sea
in the other directions, his nose full of the stink
of corpses. Buddha and Mohammed offer
cool water from a palm's shade while young
men die in the rocket's red glare
and in the old men's hard puckered dreams
René Char asked, "Who stands on the gangplank
directing operations, the captain or the rats?"
Whitman said, "so many young throats
choked on their own blood." God says nothing.

-- Jim Harrison February 13, 2003

(Published at Poets Against the War.)

Shut Up! Shut Up! Shut Up! Cut Her Mic!

2009-11-22T06:27:00.000-08:00

For those naive enough to be laboring under the delusion that the Obama administration's Department of Justice is any different than the Bush administration's, allow me to disabuse you of that misconception.

Candace Gorman, one of the saintly lawyers representing those being held at the Guantanamo Bay Prison Camp, has just been slapped around by the Department of Justice. Here's the latest in the saga of her representation of Al-Ghizzawi, a man who even the government admits was mistakenly swept up during the fervor of the GWOT. Go read her post. Now. I'll wait.

So, there you have it. It isn't bad enough that Mr. Al-Ghizzawi has been held illegally for years, that he's ill and desperately needs medical attention, that he's been cleared for release, so therefore isn't entitled to the relief of habeas corpus, now his attorney has been told she doesn't have any right to publicize the case by referring to a legal document that was unclassified by the DOJ. Of course, the DOJ has now decided it screwed up, so Ms. Gorman, and only Ms. Gorman has to stop talking about this latest travesty.

This isn't about national security, this is about a government agency which has decided to apply a little discipline to a gadfly who happens to believe in the legal system this nation brags about constantly, except when it's inconvenient.

Thanks to The Talking Dog, the information contained in the post Ms. Gorman was forced to take down is still available. Also thanks to The Talking Dog, Ms. Gorman's Writ for Habeas Corpus (her second, a highly unusual circumstance), is available in PDF format.

For those of you who blog, I urge you to post on this incredibly abusive behavior by the Department of Justice. For those of you who don't, I urge you to ask your elected representatives to look into this unconscionable behavior by the Holder DOJ. Acknowledge that they are busy with this whole Health Care Reform issue, but point out that another basic right, that of free speech, is also important, at least in a real democracy.

It's time we stop cutting this administration any slack. It's abused the slack we've given for the past ten months.

Sunday Funnies

2009-11-22T03:30:00.000-08:00

(Cartoon by Lee Judge / The Kansas City Star (November 20, 2009) and featured at McClatchy DC. Click the image to enlarge.)

Bonus Critter Blogging: Polar Bears

2009-11-21T16:00:00.000-08:00

(Photograph by Norbert Rosing and published at National Geographic.)

Sovereign Impunity

2009-11-21T11:00:00.000-08:00

If the front page of Watching America is any indication, the bloom is off the rose when it comes to President Barack Obama. He's no longer seen as "savior" by either the left or the right, in this country or in the rest of the world. Some articles do provide a fair assessment of the enormous mess he inherited and the moves he has made these past eleven months in trying to fix things, but many simply note the glacial pace at which his administration tends to move.

One such article, written by Jonathan Power for the Jordan Times, focuses on a subject whch garnered a lot of ink and electrons when it first came up and which just as suddenly was dropped by the American news corporations, that of investigating the prior administration for their role in kidnapping and torturing people in connection with the "Global War On Terror." Mr. Power's primary target is that of Henry Kissinger, the Teflon don of war criminals, but it's clear Mr. Kissinger's behavior is as good a metaphor as any for those in the Bush-Cheney administration.

Someone, somewhere, has to say it and thus confirm what the Pentagon always feared would happen if an international war crimes court were established: that the US harbours war criminals of its own and they have served not that long ago at the apex of power in the American government.

No one is going to act like the recently deceased Robert McNamara who served as secretary of defence under presidents John F. Kennedy and Lyndon Johnson. In one speech, he described himself as a war criminal - for being party to the nuclear bombing of Hiroshima and Nagasaki and for his role in the Vietnam war.

The Obama administration has to move faster. After a furious public debate, it has agreed to look into whether senior members of the administration of President George W. Bush should be prosecuted for war crimes, including torture. But the process is achingly slow. One wonders if it will end up hitting a brick wall, as did the talk that has gone on for decades about prosecuting Henry Kissinger, the former national security adviser and secretary of state to president Richard Nixon. [Emphasis added]

The slow pace is no accident. Once the dramatic announcement was made, the pressure was off. The news media, after an unusual burst of reporting at the decision, went silent. There were more pressing issues to cover: the economy, the stimulus package, health care reform, the latest activities of Sarah Palin.

Now, it is entirely possible that Attorney General Eric Holder is in fact directing a thorough-going investigation and it is also entirely possible that he has imposed an effective gag-rule on the Department of Justice with respect to the investigation. We don't know, however, because nobody has bothered to ask. Apparently the subject of war crimes committed in our name is just not very interesting.

The problem is that unless that question is asked, thereby reminding the nation and the world of that painful period of our recent history, we can't be sure that anything is happening, anything at all. This would be tragic, because it renders the concept of justice meaningless when it comes to those in power. Mr. Power refers to a comparable situation in which the questions never stopped coming and finally resulted in a definitive answer:

After [Chilean President Augusto] Pinochet was arrested in London in 1998, the ruling by Britain’s highest court, the House of Lords, crystallised half a century of debate on the legal and political problems of accountability for crimes against humanity. For the first time in a high court anywhere it was decided that sovereign immunity must not be allowed to become sovereign impunity. [Emphasis added]

That is something this nation and its leaders need to learn.

Joe's Gig

2009-11-21T04:02:00.000-08:00

Joe Lieberman, the Connecticut independent, got himself a very nice committee chairmanship by promising to caucus with the Democrats in the Senate and to vote with the Democrats on everything but "the war." The fact that Mr. Lieberman has broken that promise over and over again, most recently when he threatened to join the Republicans in filibustering the Senate health care reform bill, doesn't appear to disturb Majority Leader Harry Reid and the Democratic leadership a whit. Lieberman still chairs the Senate Committee on Homeland Security and Governmental Affairs.

Now Mr. Lieberman has an issue he can run wild with, and he is doing just that. Tim Rutten, a Los Angeles Times columnist, notes with disgust the senator's unerring instinct for opportunism.

Sen. Joe Lieberman insists on pushing ahead with a Senate inquiry into the mass murder at Ft. Hood, despite White House and Pentagon anxieties that the probe could compromise the prosecution of alleged killer Maj. Nidal Malik Hasan.

It's always interesting to see how many friends due process has in times of extreme stress. Given what looks like the security authorities' wretched mishandling of the Hasan case -- the guy appears to have done everything but paste an "Osama bin Laden Rocks" bumper sticker on his car -- there's every reason for the administration and the FBI to want to put off a legislative reckoning for as long as possible. "We want to guarantee everyone a fair trial" is always good cover. But in this case, it has the additional virtue of being true.

For Lieberman's part, the Connecticut independent -- funny how that latter noun seems synonymous with "opportunist" in his case -- has an unerring instinct for plucking the political moment's low-hanging fruit. The chairman of the Senate Committee on Homeland Security and Governmental Affairs told Fox News that he wants to know whether Hasan's signs of "Islamic extremism" were "missed or ignored."

Those of us who have followed this terrible story can answer "yes" -- a conclusion we've reached even without the benefit of subpoena power. But these aren't questions that should be addressed in the politically charged, highly partisan atmosphere of Capitol Hill.

Of course, the concept of a fair trial doesn't matter to Mr. Lieberman. He has already convicted Major Hasan and is ready to construct the gallows. But then, for Joe, it isn't about a fair trial, it's only about Joe: getting Joe face time on the Sunday Morning Talk Shoes, getting Joe's mug plastered all over the front pages of daily newspapers, getting Joe quoted as often as possible. If it messes up a criminal investigation, too bad.

That Joe Lieberman still has a committee chairmanship is a testimonial to the kind of leadership Democrats have in the Senate and what they consider important. And that is both disappointing and scary.

Friday Cat Blogging

2009-11-20T16:00:00.000-08:00

Apples and Monkey Wrenches

2009-11-20T04:10:00.000-08:00

Yesterday I vented on the latest attack on women's reproductive health. Today, the editorial board of the Los Angeles Times offered an editorial on the subject which is confusing, tepid, and contains one of the real clangers in the debate.

It begins by implying that the argument over mammography (a diagnostic test) is just like the argument over hormone replacement therapy for menopausal women (a treatment):

Hormone therapy after menopause was standard practice after a 1991 study found that it reduced the risk of cardiovascular disease -- until a study 11 years later found the opposite. Since then, the treatment has been linked to other health problems -- and found to have some advantages as well. Some doctors highly recommend hormones; others warn their patients away from them.

"Reasonable people may differ" seems to be the message.

Bull!

HRT was cut back after several studies showed that the therapy had significant, often deadly side effects for many women. I don't believe I have seen any studies which show that mammography (again, a diagnostic test) has caused any strokes or blood clots or any other life-threatening conditions. What studies have shown is that the test has had a significant impact in the fight to reduce breast cancer in the country.

The "center-left" board, perhaps aware of those latter studies and certainly aware of the potential consequences if the government panel's recommendations on the use of mammography are followed, then finally admits that until a better diagnostic test is devised, current mammography guidelines should remain in place. The board even acknowledges the real problem facing women:

Just about everyone knows a hard-to-ignore anecdote about a life saved by mammography. And many fortysomething women would gladly undergo the discomfort of mammograms, plus any anxiety or unnecessary biopsies, to be among those saved by early detection. But if the panel's findings lead insurance companies to eventually restrict coverage, these women might not be able to afford the health screenings they and their doctors believe are worthwhile. [Emphasis added]

OK, so the editorial board finally got there, but not until after making this rather appalling pronouncement:

As much as we would like to believe that every life is worth endless amounts of money, there are limits on resources for healthcare. It makes sense to locate those resources where they do the most good.

And that apparently is not women's health.

When Is It Going To Be Their Turn?

2009-11-19T07:25:00.000-08:00

November has not been a good month for American women. The American Council of Bishops (Roman Catholic) got involved in health care reform by insisting that no government money, including the subsidies paid for health insurance for those who could not otherwise afford it, could be spent on abortion. They found a sponsor in Congressman Bart Stupak, and his amendment passed. The Senate bill also contains similar language, although it is reportedly not as restrictive as the Stupak amendment.

Although abortion is a legal medical procedure, the House (including Speaker Nancy Pelosi)felt that rather than push back against the anti-abortion forces they'd go along with them just so they could pass a health care reform bill. The excuse, once again, was "Don't let the perfect be the enemy of the good." Well, that bill is NOT good, especially for women. It is, in fact, deadly.

But wait, there's more.

Now a government study suggests that annual mammograms for women under 50 are unnecessary. Nice, eh? I guess the panel has decided that women under 50 don't get breast cancer, or at least shouldn't. Joan Vennochi of the Boston Globe takes on that issue in her latest column and points to the direct consequences of both the Stupak amendment and the government study for women.

Now, a government panel is telling women in their 40s that they don’t need routine mammograms. According to the US Preventive Services Task Force, the benefits of screening are supposedly outweighed by the potential for unnecessary tests and procedures and the anxiety they might cause.

You want anxious women? Take away health insurance coverage for routine mammograms.

Yes, these are simply guidelines; they are not yet part of any legislative proposal. The panel said it did not consider costs in the analysis.

On their face, they don’t stop any woman who wants a mammogram from getting one at any age.

But the panel’s guidelines can help health insurance companies position themselves down the road for this high anxiety-inducing outcome - the denial of coverage for routine mammograms for women between the ages of 40 and 49.

That, in turn, creates a two-tier health care system: Those who can afford to pay for screening on their own, and those who can’t. Those who can’t afford it are left to ponder the somber words of Dr. Daniel Kopans, a radiologist at the Massachusetts General Hospital Cancer Center.

Kopans told The Globe that the panel’s recommendations “will condemn women ages 40 to 49 to unnecessary deaths from breast cancer.’’ Maybe Sarah Palin’s “death panel’’ warning isn’t hyperbole after all. [Emphasis added]

Of course, all of this could have been avoided with a single-payer health system, but that was taken off the table even before the table was bought by the insurance companies and medical providers. Instead, we get a half vast program that maximizes profits for insurance and pharmaceutical companies and minimizes coverage for millions, over half of of whom are women.

Ms. Vennochi notes the dreadfully unfair results:

...somehow, health care costs will be reduced. But, at whose expense will those reductions come?

As women are finding out, every aspect of health care reform won’t be win-win for everyone. Cost control is a necessary part of the reform equation. But no one has yet cut treatment for erectile dysfunction. Why are women the first losers out of the reform box?

Why indeed?

Things That Make You Go Wow!

2009-11-18T03:34:00.000-08:00

I spent the 45 minute train ride I had to make yesterday to Anaheim by reading the paper version of the Los Angeles Times, and I'm glad I did. I found this article in the business section and it reminded me that we still have plenty of innovators and risk takers in this country who, with a little financial help, can make a big difference in the economy and in the green revolution we so desperately need.

The potential for profit is blowing in the wind, and Green Wave Energy Corp. plans to catch it.

Among its secret weapons: an 11-foot-tall, blazingly white, nearly indestructible prototype generator that produces as much as 11 kilowatts of electricity using gusts of wind.

The fiberglass contraption could make homespun, do-it-yourself wind power a reality, Chief Executive Mark Holmes said. A model version recently stood amid yachts in a Newport Beach shipyard before being disassembled for updates, but Holmes envisions it moving soon into the backyards and rooftops of homes and businesses. ...

Unlike most windmills' propeller-shaped turbines, the Green Wave products operate on a vertical axis, merry-go-round style.

More than 20 U.S. companies build or are developing vertical-axis turbines. Around 200 urban or rooftop units were sold in 2008, double the 2007 number.

Sales of small wind turbines soared last year to $77 million and 10,500 units capable of generating 17.3 megawatts of electricity, marking a 78% increase in capacity sold from 2007, according to the American Wind Energy Assn. {Emphasis added]

The benefit of a vertical axis rather than that used by the propeller-shaped contraptions is that it is can catch the wind from more than one direction, which takes much of the geographical restrictions out of the picture. Wind gusts from any direction will spin the "merry-go-round" and generate electricity. The principle isn't exactly earthshaking, but its application just might be, if only on a small scale at this point.

Like most start-up companies, Green Wave Energy has had to learn the financial ropes by trial and error, but here too the company has shown resourcefulness:

Holmes has invested $100,000 of his own money since Green Wave launched in October 2008 with a vast underestimation of the resources, time and effort needed to operate.

Development costs have been about $1.7 million, about four times higher than the team had expected.

The crew quickly learned the value of resourcefulness.

Friends, family and other investors, who have pitched in $110,000, have given Green Wave access to $1.5 million in facilities, supplies, vehicles, equipment and services, Holmes said.

The company has no official employees. Instead, all partners who provide services, equipment and working space are considered shareholders and officers. Most Green Wave workers have day jobs, such as the man who engineers corneas for eye replacement surgeries when he isn't designing turbine parts.

Using shareholders' properties -- the shipyard, a 10-acre manufacturing facility in Perris, two others in Santa Ana and Costa Mesa, and a garage in Orange -- saves thousands of dollars in rent a year. Instead of using an expensive wind tunnel to test the strength of the turbines, team members hitch a 4-foot prototype to a truck bed and go for a 55-mph spin.

The really hard part, however, is getting through the dark thicket of governmental rules and regulations, which in California can be daunting, ironically because of environmental concerns. Still, Holmes himself has taken on the job of getting educated in that area as well. It may take several years before the company can ease into a more traditional manufacture and sales mode, but in the mean time, it's still in business:

Meanwhile, in the desert near Victorville, Green Wave is participating in a joint venture to construct and operate a 5-acre park filled with 70 wind turbines. The first 40-foot-tall, $350,000 colossus could be turning its 50-pound blades by February, Holmes said.

A venture capital firm has initially promised 90% of the $26.5 million to develop the park, which could be finished in two years. Green Wave and other partners will raise the rest.

The turbines could each bring in $160,000 a year if the park works out a power-purchase deal with a California utility, Holmes estimated.

That's a pretty decent start for a start-up. It's also a pretty good example of what can happen when good people find a good idea and get down to the business of making it work for the benefit of us all.

I am encouraged.

Fred Hiatt Takes A Day Off

2009-11-17T03:40:00.000-08:00

There's quite an eyebrow-raiser on the editorial page of the Washington Post today. An editorial actually takes the Republicans to task for hypocrisy and focuses on Sen. Jeff Sessions of Alabama for his ludicrous and dishonest charges when it comes to a nominee for the federal appeals court. Pretty amazing stuff.

DURING THE BUSH administration, Republicans decried Democratic attempts to filibuster judicial nominees. Some went so far as to label such filibuster attempts unconstitutional and threatened to exercise the "nuclear option" to ban the procedural tool in nomination matters.

Yet now Republicans are threatening to filibuster in an attempt to thwart confirmation of President Obama's first judicial nominee, Indiana federal Judge David F. Hamilton. The Senate is scheduled to vote on cloture Tuesday on Judge Hamilton's nomination to the U.S. Court of Appeals for the 7th Circuit. The prospect of a filibuster is made all the more ridiculous because Judge Hamilton has been rated "well-qualified" by the American Bar Association, enjoys the support of both home state senators, including Republican Richard G. Lugar, and even wins praise from the conservative Federalist Society of Indiana.

Sen. Jeff Sessions of Alabama, ranking Republican on the Judiciary Committee, has distorted Judge Hamilton's record on the trial court in an effort to rally the GOP caucus. ...

Now, I doubt the Washington Post would have been so generous had President Obama nominated someone not approved of by the Federalist Society (which is a tell of sorts on both the nominee and the man doing the nominating), but the fact that Sen. Sessions would take on even this kind of appointment makes it clear that Republicans have no compunctions about continuing their "Just Say No" crusade. And here's the amazing part: WaPo called them on it.

Now might be a good time for President Obama to start sending in dozens of nominations for the federal bench (which desperately needs those positions filled). Who knows, Harry Reid might take a day off and whoever is second-in-charge might get a few of those nominees to the floor of the Senate for a vote.

Unsurprising News

2009-11-16T03:53:00.000-08:00

We've watched as the credit card companies and banks have upped fees and interest rates quickly before the law limiting both becomes operative in February, 2010, so we shouldn't be surprised that the marketing geniuses at pharmaceuticals are doing the same before any health care reform bill takes effect. Still, the rather dramatic increases, as reported by the NY Times, are rather shocking.

Even as drug makers promise to support Washington’s health care overhaul by shaving $8 billion a year off the nation’s drug costs after the legislation takes effect, the industry has been raising its prices at the fastest rate in years.

In the last year, the industry has raised the wholesale prices of brand-name prescription drugs by about 9 percent, according to industry analysts. That will add more than $10 billion to the nation’s drug bill, which is on track to exceed $300 billion this year. By at least one analysis, it is the highest annual rate of inflation for drug prices since 1992. [Emphasis added]

The White House claimed a victory when PHARMA and its members agreed to the cost reduction and the Senate dutifully wrote that promise into several of its versions of the reform bill, but once again, the public will pay for the hollowness of the promise:

...the drug makers have been proudly citing the agreement they reached with the White House and the Senate Finance Committee chairman to trim $8 billion a year — $80 billion over 10 years — from the nation’s drug bill by giving rebates to older Americans and the government. That provision is likely to be part of the legislation that will reach the Senate floor in coming weeks.

But this year’s price increases would effectively cancel out the savings from at least the first year of the Senate Finance agreement. And some critics say the surge in drug prices could change the dynamics of the entire 10-year deal. [Emphasis added]

The drug companies have trotted out their perennial excuse for the price hikes: more money is needed for research into newer and even better drugs, especially since the patents on current drugs run out. Oddly enough, I have yet to see a news article which puts forth the annual budget for any given pharmaceutical company's research as compared to the budget for marketing (advertising and the free rides given to doctors and hospitals for prescribing the drugs). That would be useful information at a time like this, yes?

I knew there had to be a reason for PHARMA to make such a grandiose gesture at the White House: its representatives knew it was actually going to be a windfall of enormous proportions. But, hey! It's the marketplace at work.

Sunday Poetry: Lawrence Ferlinghetti

2009-11-15T16:00:00.000-08:00

Speak Out

And a vast paranoia sweeps across the land
And America turns the attack on its Twin Towers
Into the beginning of the Third World War
The war with the Third World

And the terrorists in Washington
Are drafting all the young men

And no one speaks

And they are rousting out
All the ones with turbans
And they are flushing out
All the strange immigrants

And they are shipping all the young men
To the killing fields again

And no one speaks

And when they come to round up
All the great writers and poets and painters
The National Endowment of the Arts of Complacency
Will not speak

While all the young men
Will be killing all the young men
In the killing fields again

So now is the time for you to speak
All you lovers of liberty
All you lovers of the pursuit of happiness
All you lovers and sleepers
Deep in your private dreams

Now is the time for you to speak
O silent majority
Before they come for you

-- Lawrence Ferlinghetti

To Count Or Not To Count

2009-11-15T12:00:00.000-08:00

Comes the dawning: if Senators Vitter and Bennett have their way and the census excludes noncitizens from the decennial count, a number of states will lose seats in the House of Representatives. California could lose five. New York could lose two. In addition, and just as important, federal aid based on population would also drop, something the already battered California budget could not bear.

Private groups who have been paying attention have gotten the message and two disparate tactics are being contemplated, according to the Sacramento Bee:

Steve Gándola, president and chief executive officer of the Sacramento Hispanic Chamber of Commerce, wants to count all Latinos in the 2010 census, including millions of noncitizens. ...

And the Rev. Miguel Rivera, who heads the National Coalition of Latino Clergy and Christian Leaders, wants illegal Latino immigrants to boycott the U.S. census as a way to show their displeasure with Congress' refusal to overhaul national immigration laws. His motto: "No legalization, no enumeration."

Rev. Rivera is fully aware of the implications of the proposed action, but he counters the argument of loss of federal monies by pointing out that very little of those monies are directed to the barrios in a way that would make a difference. The only thing worse than the streets in those areas are the schools, he contends, and he may very well be right. He wants immigration reform and he sees this action as a way to get Democrats in Congress to start paying attention to the problem.

Still, such an action has the effect of shutting out immigrants, legal or illegal, and of silencing them, which is the obvious intent of Vitter and Bennett. Hopefully, the comments of DHS Secretary Janet Napolitano last week calling for immigration reform which included a pathway to citizenship for those who are here without permission (see my post here) will change Rev. Rivera's mind and those of his organization.

A better way to put pressure on Congress is to show the clout that immigrants have in this country, documented or not. The chart that is included in the Bee article shows what happens if noncitizens and illegal immigrants get excluded from the count. The California and New York delegations should have copies placed on their desks. One California congressman has already seen the problem:

In the House, California Democratic Rep. Joe Baca of Rialto responded by introducing the Every Person Counts Act, which would not allow anyone to be excluded from the census based on their immigration or citizenship status. Baca said the Vitter-Bennett amendment clearly violated "the spirit of the Constitution."

Indeed it did: the Constitution says nothing about counting "citizens," it refers only to "persons." That has been interpreted to mean all people get counted, even immigrants.

Citizenship has never been a requirement, dating back to the first census in 1790, when each slave was counted as three-fifths of a person, said Clara Rodriguez, a sociology professor and census expert at Fordham University in New York.

"Slaves were not citizens," she said. "They did not become citizens until after the Civil War."

In the days of the Homestead Act, she said, there was no concern about the status of people who settled in Oklahoma and elsewhere because the nation was being flooded with immigrants: "I don't think that anybody was asking whether they were citizens," she said.

The Vitter-Bennett amendment was defeated in the Senate by cutting off debate, but I doubt those two gentlemen have admitted defeat. I anticipate another attempt as the Census draws nearer. That kind of mean spiritedness isn't easy to choke off, but passage of Rep. Baca's bill would be a good start.

Then maybe Sen. Vitter will go change his diaper and focus his attention elsewhere.

Sunday Funnies

2009-11-15T03:30:00.000-08:00

(Cartoon by Jim Morin / Miami Herald (November 12, 2009) and featured at McClathcy DC. Click on image to enlarge.)

Bonus Critter Blogging: Hawksbill Turtle

2009-11-14T16:00:00.000-08:00

(Photograph by Nick Caloyianis and published at National Geographic.)

I Give It A 7: Catchy, But You Can't Dance To It

2009-11-14T12:00:00.000-08:00

There was an interesting take on Attorney General Eric Holder's announcement that those charged with the 9/11 conspiracy currently held at Guantanamo Bay would be tried in a civilian court in New York City by Geoffrey Robertson in the "Comment Is Free" section of the U.K's Guardian. While Mr. Robertson finds much to cheer about in the administration's decision, he also expresses his disappointment in one key part of the decision.

The US attorney general, Eric Holder, deserves two cheers for his brave decision to bring the alleged 9/11 conspirators to an open trial in New York rather than to put them through a discredited military commission process. But his demand for the death penalty will be counterproductive: the obscene ritual of lethal injection will bestow on convicted defendants the martyrs crown they so desperately crave.

This is a trial that must be seen to be fair – not only by the American media (which to judge from the questions at Holder's press conference has already made up its mind that the defendants are guilty) but throughout the world. Much will depend on the choice of judge, who must be conspicuously independent and of sufficient steel to reject evidence obtained by torture – there is no doubt that Khalid Sheikh Mohammed has been waterboarded. ...

The death penalty decision will ultimately be for the jury, and it can only be hoped that they will refuse to contemplate the spectacle of convicted defendants, spot-lit and stretched on a hospital trolley, in some auditorium which must by law be large enough to accommodate relatives of their victims. Does Holder plan to requisition a baseball stadium?

It would be a martyrdom beyond the wildest dreams of the most fanatical Islamic terrorist. There is one reassuring precedent – the jury trial in Virginia of Zacarias Moussaoui, who was alleged to be the "20th hijacker". The jury rejected the prosecution's overblown demand for his death, although the judge had unfairly allowed them to hear tapes of the last moments of Flight UA93 in order to inflame their prejudices. [Emphasis added]

Snark about stadia aside, Mr. Robertson does raise a valid pragmatic point. At this point, the death penalty is not a punishment in the eyes of these Islamic fundamentalists. It is a reward. Whether guilty or not, they will be revered as martyrs. But Mr. Robertson also looks to the barbarism of the death penalty to which this country clings so desperately. If Mr. Holder is going to try the defendants in this country, he really didn't have much choice in the matter of the punishment being sought.

There was, however, another option (which Mr. Robertson pointed out), one which might anger the right wing, but which would signal the intent of this administration to return the US to the world community, and herein lies the most interesting part of the essay:

There is, of course, a better solution. The 9/11 atrocity was, in international law, a crime against humanity and there is no doubt that the UN could have provided three international judges and the kind of trials currently being visited upon Charles Taylor and Radovan Karadzic. That would end not with one word from the foreman of the jury ("Guilty"), which will hardly convince doubters, but with a closely and carefully reasoned judgment setting out the case for guilt beyond reasonable doubt. But international courts cannot impose the death penalty and American attachment to this punishment is still unassailable.

I have long argued that the attacks on 9/11 were criminal acts and should have been handled as such, just as the first attack on the World Trade Center was, rather than as a matter of high-level national security and all the secrecy and suspension of basic civil rights that entails. I am now willing to admit that there might be an even better way of handling those crimes, the way Geoffrey Robertson suggests.

Unfortunately, this country, which still willfully insists on remaining in the grips of the simplistic views on revenge and retribution of spoiled children, might have squealed like those same children refused an extra serving of dessert. That's where leadership, real leadership comes in. President Obama could have taken the extra step and referred the matter to the UN, preparing the country with a speech that spelled out with great specificity on how those attacks were clearly a crime against humanity for which the entire world needed to bear witness and to bring judgment. That just might have defused the yammering of the far right and would have nudged the rest of the country towards some semblance of adulthood, especially as it pertains to the death penalty. If we expect to be seen as civilized, then we must take on the trappings of civilization, including the one which sees the death penalty as an excuse for perpetrating the violence we suffered.

That, of course, didn't happen. Still, President Obama did take a step towards adulthood, albeit a baby step, by moving this high profile case to a civilian court which will hopefully accord these defendants all the rights that other defendants charged with a crime in this country have: the right to knowing precisely what the charges against them are, a vigorous defense, the right to full disclosure of all evidence against them and all evidence which might exonerate them, and the right to a jury. And for that I am grateful.

Good News/Bad News

2009-11-14T04:43:00.000-08:00

A real effort at immigration reform has been simmering on the back burner while the Obama administration addressed more pressing needs: the economy and health care reform. Now Janet Napolitano, Homeland Security Secretary, believes it's time to move the issue to the front, preferably next year. She cites some pretty good reasons for that.

From the Los Angeles Times:

The government has beefed up border security and workplace immigration enforcement, and now should begin the work of overhauling immigration laws, Homeland Security Secretary Janet Napolitano said Friday.

"The hope is that when we get into the first part of 2010, that we will see legislation begin to move," Napolitano said. The legislation should not only give law enforcement officials more tools to fight illegal immigration but create a "tough pathway" for undocumented workers to gain legal status, she said. ...

She said the "tough pathway" to legal status would require illegal immigrants to register, pay a fine, pass a criminal background check, pay all taxes and learn English.

Critics responded that immigration reform was code for a blanket amnesty, and that the strides Napolitano cited in enforcement were overstated.

While I agree that enforcement efforts haven't been totally effective -- traditional border crossings at the Mexican-US border have been better policed, but many would-be immigrants are chancing the far more dangerous routes through the desert --there certainly has been a decrease in the flow. The Obama administration has also shifted the target from the undocumented worker to the companies that employ them, handing out fines to employers who were particularly sloppy in complying with the laws currently on the books, but there are still plenty of businesses looking the other way when bogus social security and green cards are presented.

That said, I think Secretary Napolitano, who knows about the subject of immigration from her days as governor of Arizona, has suggested an interesting and a positive way of dealing with the estimated 12 million undocumented immigrants already here. If the "illegal" has been here for years, worked hard, paid taxes, and not engaged in criminal behavior, why not give them a way to change their status?

The path Ms. Napolitano has suggested is certainly not an easy one for those who wish to stay, and her plan can hardly be equated with "blanket amnesty." Critics such as Tom Tancredo and Lou Dobbs who don't want any brown people from Mexico, Central, and South America soiling our nation know this is the case, but would rather appeal to the baser instincts of the electorate.

The argument that those here without an invitation have already broken the law is a specious one. People who have fudged on their income tax returns when it comes to deductions have also broken the law, several in fact since the returns are signed under penalty of perjury. I don't see any mass round-ups of citizen-felons. Only those who engage in really egregious fraud get nailed for tax evasion.

The argument that this is the wrong time to explore such reform, either because the economy is still ailing and unemployment is high or the midterm elections are so close, is also wrong-headed. True immigration reform is long overdue. The fact that the Secretary of Homeland Security was allowed to make such an announcement is strong evidence that President Obama fully intends to push for good legislation on the issue and to do so in 2010.

Members of Congress standing for re-election in the midterms need not fear dealing with the issue, as at least one leader for immigration reform has noted:

Ben Johnson, executive director of the American Immigration Council, said, "Candidates who stand up for rational, comprehensive solutions to this complex problem don't lose races."

I think he's right.

I also think that President Obama is going to have to do a much better job in openly pushing for such a "rational, comprehensive solution" than he has for health care reform. Whether he's going to do so is still a large unknown.

Friday Cat Blogging

2009-11-13T16:00:00.000-08:00

When The Perfect Is The Enemy Of The Not Good Enough

2009-11-13T03:45:00.000-08:00

Sometimes someone gets it so right that it is unnecessary to add a thing. Ellen Goodman's latest column is such an occasion.

Here's just a taste:

But the balance and the burden shifted. It’s now abortion rights supporters being told they must make further concessions or lose health care reform altogether. And, as Colorado Representative Diana DeGette said, “a lot of the people are angry. They feel like the liberals and progressives always cave in because they want the bigger goal. We have to draw the line somewhere.’’

Where exactly do you draw a line when the opposition keeps moving it? How do you compromise with those who are uncompromising? These questions are too common in our polarized climate, but the stakes are even higher in this debate.

If prochoice Democrats turn back reproductive rights, it proves that they can be rolled by intransigent opposition. And once rolled, it’s all downhill.

Now go read the entire column.

Then send each of your Democratic congress critters a voided check written to the DNC for "$0.00 NOT ONE RED CENT". If you have Republican representatives, send each of them a wire coathanger.

The Business Of Medicine

2009-11-12T04:00:00.000-08:00

The Boston Globe continues to publish articles on the way pharmaceuticals and medical equipment manufacturers buy their way into the practice of medicine. The latest involves a law suit against Lahey Clinic in which a cardiologist claims he was fired because he fought against pressure brought by two senior colleagues to use a particular heart stent which he thought was not always the best one for his patients.

Dr. David Gossman, who worked at Lahey for more than 20 years, alleged in a lawsuit filed last month that Dr. Richard Nesto and Dr. Thomas Piemonte pressed him and other cardiologists to use Medtronic stents, because they believed if the hospital increased its use of the product, Medtronic would let Lahey participate in clinical trials for a new heart valve. Trials of the CoreValve are scheduled to begin next summer. Testing medications and devices can help hospitals and physicians attract patients.

Gossman, who lives in Westford, also said in the lawsuit - filed against the hospital and the two doctors in Massachusetts Superior Court - that Piemonte has financial ties to Medtronic. Piemonte is director of interventional cardiology and sits on Lahey’s “inventory committee’’ for the catheterization lab, which chooses products and approves contracts with companies.

The clinic denied the firing was connected to Dr. Gossman's refusal to use the stents, but at the same time revealed the ties between at least one of the physicians and Medtronic:

Lahey spokesman Steve Danehy said yesterday the hospital’s corporate compliance department investigated the allegations and found them to be “totally groundless.’’ Gossman, he said, was dismissed for “misconduct’’ that occurred months before he said he was pressured to use Medtronic stents. ...

Danehy said Piemonte is a member of Medtronic’s speakers bureau - he receives payments from the company to lecture to other physicians about their products - and that the wives of both Piemonte and Nesto own stock in Medtronic. Piemonte’s wife is a sales representative for the company and sells pacemakers and defibrillators but does not do business at Lahey, Danehy said. [Emphasis added]

Excuse me? Is there an outbreak of olfactory nerve damage among the clinic's officials? Even from the West Coast that description of the ties between Medtronic and the two senior cardiologists smells bad, especially given the medical equipment maker's recent history:

Minneapolis-based Medtronic has been embroiled in ethics scandals in the past several years. In 2006, the company reached a $40 million settlement with the federal government over accusations it paid illegal kickbacks to doctors for using its spinal devices.

And earlier this year, a doctor who was a consultant to the company published a study that made false claims about a Medtronic bone-growth product, saying it had much higher success in healing the shattered legs of wounded soldiers at Walter Reed Army Medical Center than other doctors there had experienced, according to Army investigators.

Now, it may very well be that Dr. Gossman was terminated for cause, in which case he'll lose the lawsuit, but Lahey Clinic, by allowing for such arrangements as described in the article, sure gave him a rather nifty way to leave his former employer with one sizable black eye. It also gave the Boston Globe a chance to underscore once again just how the practice of medicine is affected by the marketing departments of companies such as Medtronic.

There oughta be a law ...

11th Day of the 11th Month

2009-11-11T04:20:00.000-08:00

It's Veteran's Day.

To all the men and women who served this country in the military, my thanks for your sacrifices and my best wishes. To all of the families who lost their loved ones, either while serving or as a result of service, my condolences.

In the best of all possible worlds, this would be "Remembrance Day," a day in which we look backward at the contributions our quiet heroes made in the past. Unfortunately, we do not live in such a world. We are still making veterans, still calling upon men and women to risk everything for reasons that are not always clear, too often for reasons that are kept deliberately ambiguous. Even today, our president is considering just how many more soldiers will be sent to the war in Afghanistan.

Our hope for those new and soon to be veterans is that they are lucky enough to come home. That, sadly enough, is really not enough, because those who come home are soon forgotten, their needs quickly ignored except by a few. Too many of them come home with deep wounds, both visible and not visible, to a country that doesn't have jobs for them or the means to reintegrate them after their service.

Steve Lopez, Page 2 columnist for the Los Angeles Times, has a gut-wrenching and heart-breaking piece on what happens to many of the returning soldiers:

Floyd Meshad, Vietnam vet, was in a Ralphs supermarket in Westchester when his cellphone rang at 9 o'clock one evening not long ago.

It was Meshad's suicide hotline, and a soldier was being patched through.

Meshad, a psychiatric social worker, walked outside the store so he could concentrate while trying to talk the soldier out of killing himself. He gets lots of calls like this from all over the country, more now than ever, and he knew one thing:

This soldier, calling from Florida, was serious.

"He was an Iraq vet being sent back for his fourth tour, his wife had left him after the third tour . . . his house was being foreclosed on, he had two kids," said Meshad, who runs the crisis line as part of his National Veterans Foundation, a Los Angeles-based nonprofit with a full menu of services for soldiers and vets. ...

"Anxiety is off the charts" in Iraq and Afghanistan, Meshad said, due in part to the prevalent use of improvised explosive devices that make for constant stress. And the soldiers are bringing the war home.

"PTSD is rampant, TBI is rampant, suicide is rampant, divorce is rampant, violence is rampant," Meshad said. "We're in a world of trouble with our veterans. . . . They're coming back angry, frustrated, broke, they can't get jobs. . . . We're going to see violence. We're going to see homelessness."

Mr. Lopez points out that the Veterans' Administration hospital in Westwood, California is swamped with soldiers desperately needing mental health care, that the professionals there often have case loads of 400 to 500 and are themselves are being crushed by the stress such work involves.

This is the price of war, but those costs are never embraced by our government as fully as the appropriations for the war itself are. The VA is still underfunded and ignored, except when the results of that neglect (mold on the walls of hospital rooms) are discovered, and then the attention focuses more on the failure of the VA than on the means to correct it.

Instead, we set aside a day to "honor" our heroes. Then we forget about them for another year. We conveniently ignore our part of the bargain.

And that is shameful.