Archive for the ‘Health’ Category
For months now we have been left with the impression by the news media and the Republicans that Americans are in revolt against Obama’s health care legislation. What’s the evidence? Polls have shown more Americans currently disapprove than approve of the legislation. Now we have a poll that finally asks several of the right questions, including whether the law should have done more!
“A new AP poll finds that Americans who think the law should have done more outnumber those who think the government should stay out of health care by 2-to-1.”
Read the article here: AP Poll: Repeal? Many wish health law went further Many of us have thought that there was something seriously misleading about polls that simply asked whether you favor the President’s health care legislation. We now have a good idea why. The Democrats should not run away from health care. They need to tell the American people that if the Republicans take over, they could lose any chance for getting the health care that the majority of Americans need and want.
Compromise is at the heart of American politics; yield in order to gain. Politicians and citizens compromise because self-interest demands that they do so. But at times they also compromise because they come to see the other person’s point of view. Or as Obama likes to put it, they stand inside the other guy’s shoes. This doesn’t necessarily mean, as Bill Clinton was so fond of saying, that I feel your pain. We don’t have to go this far to see the other person’s point of view, although sometimes we might. We just have to be willing to engage in an imaginative act that allows us to step outside of our comfort zone. Functioning democracies depend on this ability. Without it they descend into gridlock, civil strife, and even civil war.
However, sometimes we can’t empathize with others. Not, for example, because they are hardened criminals whose ways are simply unacceptable, but because the ways in which other people understand and experience the world are beyond our powers of imaginative reconstruction. Our failure here is not due to a lack of good will. It relates to a distinction that the philosopher William James makes in his essay, “A Will to Believe,” between two kinds of hypotheses: living and dead. That the earth is round is a living hypothesis for most every American in 2010. That the earth is flat is a dead one. This was not always true. For much of human history the opposite was the case. Today there are those for whom God is a living hypothesis, and the Deity is a vital and accepted feature of their experience. But others, convinced atheists, can make no connection with this hypothesis. They do not experience God as a living hypothesis and no amount of arguing or cajoling will change their minds. Agnostics on the other hand experience God as a living hypothesis, but they also experience the notion that there is no God in a similar fashion. They have what James calls an option: a choice between two living hypothesis, although it is possible that they may never choose.
How then does this relate to Obama and health care? Obama is a savvy politician, who is both politically and philosophically pragmatic. This doesn’t mean that he is without values. It means that he thinks about their realization in terms of what will work. And this may mean modifying his goals, compromising if necessary on his goals, in order to create some reform. Obama is also a storyteller, one who understands that storytelling requires being able to see different points of view. As a storyteller he appreciates the importance of empathy in the go of human life. It wasn’t accidental that he spoke of it when he nominated Judge Sotomayor. And he has also spoken about empathy as a lesson that he learned from his mother. That he can listen and stand inside the other guy’s shoes is one of his strengths as a storyteller and as a politician. Empathy, no doubt, can be an important tool in a politician’s toolkit. But it can also be an Achilles heal.
Obama made several tactical judgments on how best to pass health care legislation. One of them, however, was not actually a tactical judgment, although it could be read this way. It was actually an assumption. He believed (at times) that his use of empathy would be reciprocated by the opposition. Obama has an unusual ability to empathize with others. It is natural for him to take the perspective of others. He assumed too much, or had too much faith, in the opposition possessing a comparable skill. Although he certainly understood that powerful special interests would be aligned against him, he appears to have forgotten how James’s notion of live and dead hypothesis could come into play.
There are forces out there, forces for whom the idea that the federal government can be a force for good is a dead hypothesis. The birthers and teabaggers fall into such a camp. It is not that they merely have firm convictions or values. It is that the hypothesis that the federal government can be a force for good is simply not a part of their repertoire. It is a dead hypothesis. There are Republicans in Congress who believe this. And there are also Republicans in Congress who need to pretend to believe it so that they can get reelected. A fatal brew for a reformist president whose natural inclination is to try to compromise with the opposition, and who was once convinced that a cooperative bipartisan approach to health care would carry the day.
So where does this leave Obama? Of course he knew that his initiatives would give raise to strong opposition. But there is a difference between strong opposition and folks like the teabaggers. There will be no compromising with those for whom health care reform is part of the dead hypothesis of “the good federal government.” Resurrecting the federal government for them is like resurrecting God for the confirmed atheist. And there will be no compromising with those who have been captured by them or their ilk. They will hold their ground on every new initiative, and they will carry along the entire GOP, unless the self-interest of (some) Republicans leads the party in another direction. (Pay attention here to how Brown handles himself in Massachusetts.)
It’s not that Obama doesn’t know this. Yet he has been hesitant to acknowledge the limits of empathy and compromise, not just intellectually but perhaps more importantly emotionally. The paradox here is that recognizing the limits of empathy and compromise may very well lead to substantial movement on legislation that Obama supports. The savvy politician in him knows this. It’s going to have to bring the storyteller along, at least for now. There will always be times for tales.
Most Americans generally shy away from absolutes. They don’t like to think of themselves as driven by dead hypothesis. Most Americans are more like agnostics than atheists or the religious when it comes to the federal government, ready to shift one way or the other depending on circumstance. They will become (temporary) believers if they are given something that they believe will work. Give them a reason to believe that the federal government can be an active and helpful feature of their lives and they will take it. Give them a reason to believe the opposite, and they will, at least for the time being. Regarding health care, Obama’s rhetorical task is clear. He must help make (temporary) believers of the agnostics with regard to the federal government.
Albert Einstein……………………………………………………John Dewey
Well, it turns out that while physicists and poets can kiss their most productive years good-bye when they are barely out of adolescence, philosophers and other types of humanists just keep ticking…peaking in their late 40′s and 50′s but with hardly any drop off after that. At least so says Dean Simonton, a psychologist at UC-Davis. The lead on this comes from a post on Andrew Sullivan’s site today,“The Age of Brilliance.”
Sullivan quotes a piece by Jonah Lehrer:
While physics, math and poetry are dominated by brash youth, many other fields are more amenable to middle age. (Simonton’s list includes domains such as “novel writing, history, philosophy, medicine”.) He argues that these fields show a very different creative curve, with a “a leisurely rise giving way a comparatively late peak, in the late 40s or even 50s chronologically, with a minimal if not largely absent drop-off afterward” (italics added).
Do I believe it? I guess it depends on how one measures “productivity,” among other factors. But it’s nice to know that one researcher in this area thinks that the twilight years can still be golden years for those engaged in studying philosophy or writing novels. (But then again, there are poets who have done their best work later in life. Perhaps we shouldn’t leave it to psychologists to evaluate these matters.)
Btw, John Dewey was in his mid-seventies when he wrote and published Art As Experience, which is considered by many to be one of his most important books. He published his, Logic: The Theory of Inquiry, a work of more than 500 pages, when he was nearly 80. Einstein, best work in his 20′s through his mid-30′s.
It has been over a year and a half since I began UP@NIGHT and my career as a pundit, for lack of a more refined label. I suppose part of the challenge was to see how a philosopher by trade might do in the prediction business. How I would stack up against the pundits in the media. You know, mano a mano.
I thought that it would be fitting and fair to readers, and myself, to look at blogs in which I predicted the outcome of events in the political world to see if my track record was any good. Low and behold, I discovered that if I had been a betting man, I could have made some good money. So, without further ado, and no false modesty, here are the predictions. Roll Over Nostradamus.
The titles are linked to the original blogs.
Semi-correct, although not a exactly a prediction:
Obama, Spock, and the New Star Trek Nation, June 6, 2008. (UP@NIGHT was one of the first blogs, if not the first, to make the connection between Obama and Spock on the Web. It has now become a commonplace.)
The Twelfth Cylon Revealed, May 30, 2008 (I claimed that McCain is the 12th and missing Cylon on the TV show Battlestar Gallactica. I still hold to the proposition that he may prove to be a Cylon. The new series should reveal the truth.)
It’s Going to be Webb for VP, Probably, May 16, 2008
Still up in the air:
Obama’s Pragmatism (or Move over Culture Wars, Hello Political Philosophy), December 14, 2008; reposted April 7, 2009 (Argues that Obama is a philosophical pragmatist, not merely a political one, and that his approach will have an impact on the culture wars. See also, Obama: Conservative, Liberal, or Ruthless Pragmatist?, May 7, 2009; Bronx on the Court, Empathy, and Obama’s Pragmatism, May 27, 2009.)
GOP, Inc. to be Permanently Downsized, January 30, 2009
Leaving aside the Cylon revelation, looks like UP@NIGHT was right about 90% of the time. So I ask you, can you afford not to read UP@NIGHT?
[First posted December 26, 2009. Reposted January 3rd, 2010 to start off the new year and add "Obama's Pragmatism." ]
UPDATE, January 22, 2010.
With the unexpected victory of Brown in Massachusetts I am going to have to amend what I claimed above, namley, that health care will not be stopped by a filibuster in the Senate. It wasn’t stopped, but now it would be. Nevertheless, I am not pulling the original prediction about health care (yet). The Democrats can’t afford not to pass it, which was the thrust of the original blog. No one knows what form it will take at this juncture, or when it is going to happen, but the Democrats will get something they can crow about.
I am prepared to admit that my sense of humor can be as sick and dark as the next guy. But I was not prepared for the front page of Sunday’s New York Times.
Splashed across most of the top of the front page was this photo, with this headline:
A Place Where Cancer Is the Norm
The article was about about M.D. Anderson hospital in Houston.
As I recall, there was recently much press over the fortieth anniversary of the Beatles’ iconic Abby Road photo:
So, here is my conclusion: there are people at the New York Times with a pretty sick sense of humor (no pun intended) or this is one of the most brilliant pieces of political commentary that we have seen in years. The Times is really making a statement about the health care system in the U.S., comparing it to the British system which manages to produce healthy and beloved artists, while we have people walking around in the Texas sun with I.V’s and pink sandals.
Perhaps there is a third option: incompetence.
If you think that the insurance industry can be trusted to police itself without a public option and new federal regulations, just check out the clip below. It would be nice to believe that this is just an isolated incident, but we have all heard too many stories about companies cutting coverage when coverage cuts into their profits.
(Photo: Donald Stout/The Times-Picayune)
Senator Mary Landrieu, Democrat of Louisiana, doesn’t believe that we need a public option to help hold insurance companies in check. Here is her web site: Senator Mary Landrieu. Please send her a message.
I know. You can’t, won’t, don’t believe it. You just know that the Democrats are going to let an opportunity of the century slip through their collective fingers. Fear not. This time they have a secret weapon. The Republican Party.
Far be it from me to defend the two party system, but it does have its virtues. One of its virtues is that its vices–patronage, the seniority system, pork, and assorted perks, etc.–can actually work to help unify a party when the stakes are especially high. And the stakes are extremely high in the case of health care. The Republicans are unified against it. (Olympia Snowe is the outlier who proves the point.) The Democrats must unify against their unified adversaries to remain the dominant party. Self-interest, in all likelihood, will win the day this time around, although unity will require some intense horse trading between Democrats.
The unity of the Republicans is not accidental. It has two basic grounds: ideological and tactical. On the ideological front, as divided as Republicans are over how far to carry the culture wars, the party remains committed, more so than ever, to the notion that government is fundamentally a threat to individual freedom. Various wings of the party still define freedom in negative terms, that is, individuals should be allowed to satisfy their own preferences, primarily through the market, without government interference. It’s not the government’s place to help protect and nurture individual growth and development. This is a private matter. (There are, of course, exceptions, for example, prayer in classroom.) On the tactical front, the Republicans have little choice but to continue to appeal to an increasingly strident anti-government base, because they cannot afford to lose it. The vast majority of Republicans in Congress could not survive if the base were to desert them in even modest numbers. They must remain united for the foreseeable future as the anti-government party if they aren’t to disappear. And the best way to do this is to select causes or issues and rally around them.
Turning to health care: it’s clear to most Americans that the market is not working. It cannot satisfy individual preferences, or even when it does, there is a legitimate fear that it will not continue to do so. (Everyone has heard of someone who was denied coverage arbitrarily by a health insurance company.) Individual preferences simply cannot hold out against the power of the insurance industry. The industry has itself become a quasi-tyrannical government, deciding on who lives or dies, and it does so often based on its bottom line. There is a palpable sense of vulnerability in the land, and for most Americans it’s not being caused by the government.
Enter the Democrats. Since the 1930′s they have been more committed than Republicans to the notion that the government has a role to play in the self-development of individuals. Self-determination requires not only a society in which tyranny is absent (the right’s position), but one in which the government helps nurture the well-being and education of its citizens. And the government must at times defend citizens against corporate forces that the little guy simply cannot fight. The Democrats are positioned to be on the winning side of the health care debate.
“But wait,” you say, “this is not a matter of which party has the majority of Americans behind it. It’s a matter of lobbyists, and they have bought not only the Republicans but many Democrats. These Democrats will continue to cater to the health insurance industry.” Here is where the party system will come into play. There is a point at which the self-interest of members of the Democratic Party will shift from the bucks that they have gotten from the lobbyists to the necessity of preserving party unity. Why should this be true now when it hasn’t been in the past? The stakes are simply higher and things have moved along too far. For a Democrat to be responsible for the defeat of significant health care legislation at this stage would not only gravely injure the party, it would open the door to retribution from other party members in terms of patronage, pork, etc.
The Democrats who are indebted to the insurance industry will hold out as long as they can to cut the best deal they can for their clients. And there indeed are some Democrats who are ideologically closer to the Republicans and would prefer less government involvement. But unless they plan to change parties, at some point, push will come to shove. The Democrats will have to fall in line. They will have to unite. (For example, Democratic Senators would have to vote to support a Republican filibuster in the Senate in order to hold up health care reform. Politicians, however, don’t vote with the opposition party to support its filibusters. Could this happen with Lieberman? Yes. Likely? No, unless he decides to become a Republican.)
Will the reform be substantial? It will not satisfy those who want national health care insurance. Yet it will have to be substantial enough to start cutting costs, cover most of those who do not have insurance, and gut the power of the insurance companies to decide who has insurance. To fail at these basics would seriously undermine the Democrats with their most vocal supporters, and it would run the risk of creating turmoil in the Democratic Party as politicians have to explain a weak plan after all of the hype. There would be some serious finger pointing. And the unified Republicans would be waiting in the wings to gobble up pockets of isolated Democrats.
Of course, predictions are dangerous. However, if I were a betting man, I would bet on this one. And so is Obama, a man who has always understood the place of self-interest in “community organizing.”
The analysis in this piece draws on insights from J. David Greenstone’s The Lincoln Persuasion. Greenstone was a professor of political science at the University of Chicago during the time that David Axelrod was an undergraduate political science major. It seems that others in Obama’s circle were acquainted with Greenstone’s work, for example, Cass Sunstein.
April 26, 2009. The United States declared a public health emergency today. Although it appears that no one has died or become seriously ill in the U.S. from a new strain of the swine flu, health officials are taking no chances. All of the traditional measures to combat epidemics have been set in motion. Funds will be made available for anti-viral drugs, and time-tested and effective methods for tracking and preventing the spread of disease will be utilized. The CDC (Center for Disease Control) is reassuring the public, citing its decades of experience in handling epidemics and its recent preparation for pandemics.
However, former Vice President Cheney, through a spokesman, is calling on the CDC to avoid thinking within the box in deciding on measures to halt this attack on our nation. “We can’t afford not to act with every means available to us,” said his spokesman. Inside the CDC there is mounting pressure to consult with agents from the CIA to examine how harsh interrogation techniques might be of service. With fear mounting and pressure growing, expert legal advice is being sought in order to provide the proper “legal cover” for actions that international agreements have outlawed as torture.
“Look,” said a representative from the former VP’s office, “you gotta do what you gotta do. There are swine out there who, or I should say, that are dangerous. We need to know what, where, and when.” The plan seems to be to find the pigs that are harboring the terrorist virus, and apply harsh techniques, torture if you will, in order force them to provide operational intelligence.
There has been some concern that the swine won’t talk. But everyone should know that swine are among the most intelligent animals, according to experts in covert intelligence. A spokesperson for the CDC insists that with proper guidance, waterboarding a pig is possible, and it will get the animal to talk, and talk fast. (He then handed this reporter a copy of Animal Farm.)
Questioned about violating the rights of these animals, a Cheney spokesman said, “What’s the difference? Whether it’s a human animal or an animal animal. If it attacks you, or if you believe that it might possibly attack, you go after it.” There was little response to a question directed to Cheney himself (as he was walking his dog) by one reporter, “What about all of the innocent pigs, for example, the three little ones, that were just minding their business, trying to build lives for themselves?” Cheney did say that if we could apply harsh techniques to the virus itself, we would. But since we don’t have the technical means to do so, as many of the swine as possible gotta be boarded.
Asked to comment, The White House declined, claiming that as an inanimate object it had little to say. Although a spokesman for the President did say that if the tactics were forward-looking enough, and did not constitute a threat to his domestic agenda, he might be able to get his team behind the CDC. In any case, no CDC employee will be prosecuted for actions deemed acceptable by agency lawyers.
A spokesperson for the Humane Society claimed to be too upset to return this reporter’s call.
Owl look alike, Owl, and Twain
Benjamin Franklin famously declared, “Early to bed and early to rise makes a man healthy, wealthy and wise.” Yet it appears that Mark Twain was on target in challenging Franklin’s maxim with George Washington’s response, “I don’t see it.”
Empirical study has confirmed that there is no inherent benefit in being an early riser. As a matter of fact, night owls, those whose circadian clocks are set so that they are more alert later in the day, are penalized by a folk wisdom (Franklin’s) that is simply false. This is a more serious issue than you might think. Imagine, and I am speaking here to you “early risers,” if you were forced by the expectations of friends, bosses, and colleagues to rise by, say, 1:00 AM day after day. So that to get a good night’s rest, you would have to fall asleep (and stay asleep) by 5:00 in the afternoon. This parallels what is asked of night owls, that is, to fall asleep and wake up hours before their bodies are ready. This at minimum leads night owls to work at less than their optimum (and in some leads to an unending battle with sleep deprivation).
Leon Kreitzman does an excellent job summarizing research and insight into differences in sleep patterns in today’s New York Times. As a night owl, I want to thank him for his efforts. Here is an excerpt.
This evening/morningness is less a matter of choice than of genetics. Being bright-eyed and raring to go first thing in the morning is not just a case of how much sleep someone has had, nor is it a reflection of willpower. Genes may largely determine it.
It might be envy on my part, but those early-rising larks I have known have often seemed to my bleary early-morning eye to adopt a smug moral superiority based on Benjamin Franklin’s maxim, “Early to bed and early to rise makes a man healthy, wealthy, and wise.” But there is no basis for Franklin’s claim. Catharine Gale and Christopher Martyn of Southampton University followed up a 1973 survey that had included data on sleeping habits. More than 20 years later they found no evidence among the survivors that following Franklin’s advice was associated with any health, socioeconomic or cognitive advantage.
If anything, owls were wealthier than larks, though there was no difference in their health or wisdom. Gale and Martyn wryly offer the thought that “it seems that owls need not worry that their way of life carries adverse consequences. However, those who cite Franklin’s maxim to encourage their children to go to bed early may wish to consider whether their practice is entirely ethical.”
UPDATE, May 7th, 2009 I recently read about a study that suggested those who slept in the day were more likely to develop a condition that preceded hardening of the arteries. However, as far as I could tell, the study did not make any distinction between night owls and those who are forced to work at night, but who are actually day people. If I can locate the research, I will post it.