Actually not a bad year on the health care front

Yes, the habit of looking back on this date is arbitrary but I suppose I should do it.

The Affordable Care Act is working, better than just about anybody expected. The number of uninsured adults in the U.S. fell by about 9.5 million. According to a poll, most of the people who gained coverage said they had seen a doctor or filled a prescription, which they could not have afforded previously.

And the relentless, unsustainable growth in spending on health care has stopped. In fact Medicare spending per beneficiary actually declined. It's too soon to say for sure why this has happened, but it's consistent with the ACA working the way it is supposed to, reinforcing an ongoing cultural shift in health care that I've talked about a lot here. Doctors are much more conscious now of the harm done by overdiagnosis and overtreatment. We are far from realigning the financial incentives throughout the health care system to reward quality rather than volume, but the ACA starts the process and private insurers as well as Medicare are trying out new models of payment.

For all of the decades I've been in this field, we've heard the same message over and over. Health care spending is growing unsustainably and fewer and fewer people have access to the care they need. Disaster was looming and nothing was happening to prevent it. Well, all of a sudden, that stopped. The situation actually started to improve. The threat of Medicare driving the federal government to insolvency receded, more people got coverage, and quality actually appears to be improving.

And yet pollsters tell us the ACA is unpopular and one of our two major parties is committed to repealing it above all other causes. It's just crazy. They won't be able to do it as long as Barack Obama holds the veto pen, but the Supreme Court could do it for them by ignoring 125 years of jurisprudence and common sense. They just might.

False Consciousness

I think I've said before that I'm baffled by all these low and moderate income white people who vote for Republicans and think liberals are the Antichrist. You see pickup trucks belonging to carpenters and house painters festooned with "Save America: Vote Out Liberals" and "Obama Sucks" bumper stickers. Sometimes I get this when they also have a confederate flag decal (and what exactly is that supposed to mean in Connecticut?), but it's hard to believe that racism is 100% of the explanation.

These are the people who couldn't get health insurance until the Affordable Care Act. They're the people whose parents are covered by Medicare and who expect to depend on it themselves. They're the people who get workers compensation and unemployment insurance. Their bank accounts are insured. These are all programs passed by Democrats and constantly attacked by Republicans.

If their kids are lucky enough to go to college at all, they depend on the state college and university system. Democrats want more support for public higher education, Republicans want less.

They didn't like the Wall Street Bailout but it's Republicans who want to bail out banks in the future, not Democrats.

I could go on but you get the idea. Do they really believe that Democrats want to confiscate their guns and impose Sharia law? I heard one of those voter on the street interviews just before the election and some codger explained that he was going to vote Republican because "Benghazi, ebola, they just can't do anything right." Is this really the depth of thinking that goes into party loyalty for white working class voters?

It seems to me that there ought to be some progressive politicians who are willing to stand up in public and defend progressive ideas. Some people might just get the message, and the progressive politicians they might just win elections that Democrats lose today. Lots of people say this, of course, I just thought I'd take this opportunity in slow blogging season to put my own gram on the scale. It's time more people try it.

TANJ

That means "There Ain't No Justice." It's a kind of epithet that is common in Larry Niven's Ringworld universe. Anyway, it's true.

Dick Cheney and the guys he hired to shove stuff up prisoners' rectums in order to inflict pain and humiliation are walking around rich and happy.

St. Louis County Prosecutor Robert McCulloch knowingly presented testimony from a witness who he knew was lying -- had her appear twice, and did nothing to impugn her testimony, even though he knew she wasn't even present and was making up her entire story, which was crafted to exonerate a murderer who McCulloch wanted to get away with it. He has now said publicly that he knew she was lying but has no intention of prosecuting her. Of course, that would be a bit of a problem for him since he suborned her perjury. McCulloch is still the prosecutor and Michael Brown is still dead.

Bank executives who sold securities as AAA investment grade that they knew were junk. When they went bust, the global economy went with them. The taxpayers bailed out the banks and the bankers kept their 9 figure salaries and bonuses, while tens of millions of struggling people lost their jobs.

I could go on but you can easily come up with plenty of your own examples. However, it turns out that not everybody believes in TANJ. Greg Caruso, in Scientia Salon, discusses what is called Just World Belief, JWB. This discussion is in the context of a larger discussion about the illusion of free will, which I often touch on here. Sayeth Caruso:

Recent empirical work by Jasmine Carey and Del Paulhus (2013), for example, has found that free will beliefs correlate with religiosity, punitiveness, and politically conservative beliefs and attitudes such as Just World Belief (JWB) and Right Wing Authoritarianism (RWA). They found these correlations by administering their The Free Will and Determinism Scale known as FAD-Plus (Paulhus and Carey 2011) — a 27-item scale used to measure people’s beliefs and attitudes about free will and related concepts — along with measures of religiosity, political conservatism, just world beliefs, and right wing authoritarianism. It’s important here to highlight just how worrisome some of these correlations are. Take, for example, a few of the sample items used to validate belief in a just world.

Just World Belief Scale (JWB) (Lerner 1980):
“By and large, people deserve what they get.”
“Although evil men may hold political power for a while, in the general course of history good wins out.”
“People who meet with misfortune have often brought it on themselves.”

It turns out that people who believe in a just world are also generally religious. It's a forced position: if God is all powerful and God is good, the world must be just, and people must get what they deserve. That means poor people and people who are killed by cops are asking for it. Do read Caruso's essay, starting with the  first part which is here. If you're interested in those kinds of deep thoughts, you might want to bookmark Scientia Salon, where it appears.

And can we please grow up and get over religion?

Solstice thoughts (warning: grim)

It's chilly, snowing wetly, gray -- suitable meteorological accompaniment to my mood.  This has been a year we won't be sorry to see the end of.

Liberals have had a presumption, or a faith, that secular, inclusive, representative government; with protection for civil liberties, rule of law, and regard for the general welfare is the destination of history. Allowing, of course, for some backsliding and some holdouts. But I fear this is not so.

As the crafters of our now fully obsolete constitution rightly feared, majority rule does not ensure any of those values. Majorities are perfectly capable of voting for theocrats, racists and thieves. They are much more concerned, most of the time, about their personal safety and material well being than they are about freedom or what happens to people they don't consider their own. That seems to be the currently prevalent attitude of the American electorate.

Libertarians completely misconstrue the problem, in a trivially obvious way. Freedom requires functioning, non-corrupt government with a commitment to defending it. Otherwise the guy next to you, who happens to be a little bit bigger, or have a more powerful weapon, or better organized allies, will take your freedom away.

While I think I construe the problem correctly, I don't have a good solution. Americans this year have shown themselves to be tribal, cowardly, vindictive, and willfully ignorant. Rule by this majority is a terrifying prospect. Truth and reason have no power.

Too much going on at once

Cuba Cuba Cuba. No, Sen. Rubio, America will not "be less safe as a result of the president's change in policy" because dictators in Venezuela, Iran and North Korea will try to take advantage of the United States. That is probably the stupidest thing anybody has ever said. In the first place, neither Venezuela nor Iran have threatened the United States in any way, nor could they, nor could North Korea, nor could Cuba have done so at any time in its history. And how normalizing relations with Cuba has anything whatsoever to do with those other countries is inexplicable. Just completely idiotic. There is zero economic or national security interest of the United States in not having normal diplomatic and trade relations with Cuba, and the policy certainly wasn't doing anything to promote human rights there. This was long overdue.

As for Sony cancelling release of a movie (which by all accounts sucks a moose) over threats from North Korea (and no, they weren't encouraged by the deal with Cuba, duhhh) that is definitely unfortunate. As Peter W. Singer says at the link a) North Korea has no capacity to carry out any threats (and believe me, if they did, they would be sorry, Obama would have cover under international law to take out Kim Jong Un with a Tomahawk missile, and he would). b) This just says to any crackpot that they can censor any speech they like with an empty threat. But listen up folks: it wasn't Hollywood liberals or the wimpy American people who caved, it was Japanese business executives. They are capitalists whose only purpose is to make profit. People staying away from movie theaters out of paranoia is not profitable.

This is incredible to me. U.S. ground forces have engaged in combat in Iraq, but as far as I can tell this is not being reported in the United States. Explain that!

I could go on -- interesting times, as they say. But the Dow is up 300 points, so I'm cool.

Compare and contrast

The war on some people who use some drugs, which has resulted in the United States having about 1.6 million people in prison at any one time, mostly for non-violent drug offenses, and mostly Black and Latino, even though white people use drugs at the same or higher rates. That's the highest rate of incarceration in the world, destroying lives and families over victimless crimes. (BTW, it's perfectly legal to drink yourself to death.) But countries which have decriminalized drug possession have lower rates of drug use. I could go on with the social harms but follow the link.

On the other hand, people who authorized, designed, and carried out grotesque and brutal torture are walking around wealthy and free, and we're having a polite debate about whether or not it was a good idea.

Just sick.

Physicians for Human Rights points out the obvious

To wit, there were health care professionals working for Cheney's torture operation, and no, they aren't supposed to do that.

Here's one funny quote (ha ha):

Dr Vincent Iacopino, PHR’s senior medical advisor and an author of the analysis, said Cheney was “either terribly misinformed of propagating a lie. Any reasonable person knows feeding does not take place rectally.”

Now that we've all had a good chuckle, the true fact is that physicians participated in torturing people in various ways, enumerated thusly:

• Designing, directing and profiting from the torture program;
• Intentionally inflicting harm on detainees;
• Enabling US department of justice lawyers to create a fiction of “safe, legal and effective” interrogation practices;
• Engaging in torture research that could potentially violate the Nuremberg Code, brought in after World War II to ban “experiments” like those practiced by the Nazis, and could constitute a crime against humanity;
• Monitoring torture and calibrating the level of pain;
• Evaluating and treating detainees for the purposes of torture;
• Conditioning medical care on cooperation with interrogators;
• Failing to document physical and/or psychological evidence of torture.

As for the first bullet, "designing, directing and profiting," that particularly applies to psychologists James Mitchell and Bruce Jessen, who were paid $81 million for their services and have now retired to lives of luxury and ease. They are of course war criminals, as is the also wealthy Richard B. Cheney, and we have now abandoned our national honor.

Still weird . . .

Right now we can all use some diversion. More serious, meaningful weirdness to come.

This advertisement appeared in the Boston Globe some years back. (Verbatim, including punctuation and lack thereof.)

DEMONS, LAWYERS & THIEVES

A dead realm ruled by golden radiation

Left haunted by wealth and power

Orange opposes the papal empire

Where true peace can never flower

A piece of red is answered on yellow

Revolving around the fire's glow

Blue lays out the proposed solution

Grey turns to a dancing white tango

Dedicated to my grandfather

Joseph Chester Kime (Kime and

Bonebrake, J.D. & E.K.,

photographers, Akron.) He bought [sic]

his wife Margaret "Peg" C.

Martin, a high school classmate

of John S. Knight of Knight Ridder,

a Willys Knight (whose namesake

W.J. Willy died with Joseph

Patrick Kennedy Jr. in 1944 (Joe

Jr.'s sister Kick's husband

Willam, Marquess of Hartington,

also died that year. (Kick died in 

'4.))) He died of alcoholism in

1944 (2/2) leaving 3 children:

Joseph, Janet and William (of

DePere, WI) and salesman for 

Employer's Insurance of Wausau

(dec'd. '86.))

Also to C. Nelson Wright (born

Nelson in Rittman, OH) who sold

tools from the trunk of his car

prior to founding Wright Tool &

Forge Co. in 1927. He died Easter

Sunday, 1972.

Please see my ads in the 3/16/90

Globe; 3/1/91 N.Y. Times (&

Harvard Crimson); 3/24/91 S.F.

Chronicle/Examiner. Always

remember Alice Cooper's "Billion

Dollar Babies" and watch out for

spiders!

Richard Bruce Wright, II

b.. 8/31/60, c. 9 am, Akron

 

More from the weirdness file

As promised.

I go to a lot of conferences and meetings and whatnot. At one such, somebody handed me the following business card.

Brokerage Business Centers/Management

Education Development Administrative Offices of:

Dr. Veronique O. Jones

Expert General Consulting Contracts, Assets Management, Real Estate

Investments, Home Buying Services, Loans, Insurance, Travel Services,

Social-Political-Public Relations Liaison, Negotiation/Mediation/Conflict Resolution,

International Services and Cuisine Finder, Promoter, Advertisers, Care Givers,

Research,  Edu-Care Technologies, Fundraisers, Training, Recruiting,

Financial Services, Career-Employment-Business Opportunities,

We bring the best in business and in human nature!

Solutions Reservoir Executive

Okay, I changed the name to protect the guilty. There's also an address and phone number. You would think by now I would have had occasion to use her services -- I mean, something is bound to come up, right? Cuisine finding, if nothing else. Somehow it hasn't happened. 
 

The moral high ground

(Alas, I can't link to the New York Times any more because they have retreated behind the pay wall. So what I am going to do serves them right -- lift a quote without a link. They can decide if their new policy is the right one.)

It seems the hopey changey guy is going to sign a law that will impose sanctions on Venezuelan officials responsible for human rights violations, including violence against protesters. Here are the appalling crimes in the latter category:

Interviews with protesters and other witnesses revealed an apparent pattern of abuses on the part of security forces, who frequently beat, kicked and threatened protesters, and in many cases, shot demonstrators at point-blank range with shotguns loaded with plastic pellets.

That could never happen in a freedom loving country like the U. S. of A. At least I can't think of any examples off hand. (Maybe you can, I dunno.) That's why nobody would think of imposing sanctions on us, right? 

I cannot believe this is even happening

Our corporate media are offering us a fair and balanced response to the United States Senate Select Committee on Intelligence report that reveals details about the Dick Cheney's program of systematic psychopathic sadism that would make Eli Roth vomit. (Don't read the article at the link, please.)

In case you haven't seen PZ's link to this already, Martin Robbins explains that U.S. intelligence services concluded long ago that torture is not an effective tool of intelligence. Like the U.S. Army Field Manual says,

The use of force, mental torture, threats, insults, or exposure to unpleasant and inhumane treatment of any kind is prohibited by law and is neither authorized nor. condoned by the US Government. Experience indicates that the use of force is not necessary to gain the cooperation of sources for interrogation. Therefore, the use of force is a poor technique, as it yields unreliable results, may damage subsequent collection efforts, and can induce the source to say whatever he thinks the interrogator wants to hear. However, the use of force is not to be confused with psychological ploys, verbal trickery, or other nonviolent and noncoercive ruses used by the interrogator in questioning hesitant or uncooperative sources.
The psychological techniques and principles outlined should neither be confused with, nor construed to be synonymous with, unauthorized techniques such as brainwashing, mental torture, or any other form of mental coercion to include drugs. These techniques and principles are intended to serve as guides in obtaining the willing cooperation of a source. The absence of threats in interrogation is intentional, as their enforcement and use normally constitute violations of international law and may result in prosecution under the UCMJ.
Additionally, the inability to carry out a threat of violence or force renders an interrogator ineffective should the source challenge the threat. Consequently, from both legal and moral viewpoints, the restrictions established by international law, agreements, and customs render threats of force, violence, and deprivation useless as interrogation techniques.

 So the CIA went out and paid $80 million (yep, no typo) to two psychologists to design a program of torture (in which they also gleefully participated, by the way). Why? We can speculate, but what is not in question at all is that:

1. It was illegal under United States statutes.
2. It was a violation of international treaties - which also obligate the U.S. to prosecute the perpetrators.
3. It was predictably useless in producing useful information.
4. It demonstrably did not produce any useful information. (You don't have to take my word for it.)

None of these points is questionable, debatable, or a matter of personal ethics. These are facts.  Yet NPR invites one of the architects onto All Things Considered and entertains him with softball questions so that he can explain why none of the above is really true. CBS News states, utterly falsely, that "Both Republicans and the CIA have refuted many of the report's findings." They have disputed them, but they haven't refuted them or even offered any contrary facts. This blatant lie is in the middle of a long article in which they provide stenographic services for one of the $80 million psychologists.

I could go on and on but the point is made. That we are even having a debate about this proves that we are a sick society.

American Exceptionalism, yet again

The UN Special Rapporteur on the promotion and protection of human rights and fundamental freedoms while counter-terrorism, Mr. Ben Emmerson, had this to say today:

The summary of the Feinstein report which was released this afternoon confirms what the international community has long believed - that there was a clear policy orchestrated at a high level within the Bush administration, which allowed to commit systematic crimes and gross violations of international human rights law. The identities of the perpetrators, and many other details, have been redacted in the published summary report but are known to the Select Committee and to those who provided the Committee with information on the programme.

It is now time to take action. The individuals responsible for the criminal conspiracy revealed in today’s report must be brought to justice, and must face criminal penalties commensurate with the gravity of their crimes. The fact that the policies revealed in this report were authorised at a high level within the US Government provides no excuse whatsoever. Indeed, it reinforces the need for criminal accountability.

International law prohibits the granting of immunities to public officials who have engaged in acts of torture. This applies not only to the actual perpetrators but also to those senior officials within the US Government who devised, planned and authorised these crimes.

As a matter of international law, the US is legally obliged to bring those responsible to justice. The UN Convention Against Torture and the UN Convention on Enforced Disappearances require States to prosecute acts of torture and enforced disappearance where there is sufficient evidence to provide a reasonable prospect of conviction. States are not free to maintain or permit impunity for these grave crimes.

It is no defence for a public official to claim that they were acting on superior orders. CIA officers who physically committed acts of torture therefore bear individual criminal responsibility for their conduct, and cannot hide behind the authorisation they were given by their superiors.

However, the heaviest penalties should be reserved for those most seriously implicated in the planning and purported authorisation of these crimes. Former Bush Administration officials who have admitted their involvement in the programme should also face criminal prosecution for their acts.

President Obama made it clear more than five years ago that the US Government recognises the use of waterboarding as torture. There is therefore no excuse for shielding the perpetrators from justice any longer. The US Attorney General is under a legal duty to bring criminal charges against those responsible.

Torture is a crime of universal jurisdiction. The perpetrators may be prosecuted by any other country they may travel to. However, the primary responsibility for bringing them to justice rests with the US Department of Justice and the Attorney General.”

Is that clear?  The acts described in the report are depraved beyond measure. The United States has lost all moral authority, and the only way to restore it is to prosecute the sadistic psychopaths who perpetrated these atrocities. That includes Richard B. Cheney.
 

The summary of the Feinstein report which was released this afternoon confirms what the international community has long believed - that there was a clear policy orchestrated at a high level within the Bush administration, which allowed to commit systematic crimes and gross violations of international human rights law.
The identities of the perpetrators, and many other details, have been redacted in the published summary report but are known to the Select Committee and to those who provided the Committee with information on the programme.
It is now time to take action. The individuals responsible for the criminal conspiracy revealed in today’s report must be brought to justice, and must face criminal penalties commensurate with the gravity of their crimes.
The fact that the policies revealed in this report were authorised at a high level within the US Government provides no excuse whatsoever. Indeed, it reinforces the need for criminal accountability.
International law prohibits the granting of immunities to public officials who have engaged in acts of torture. This applies not only to the actual perpetrators but also to those senior officials within the US Government who devised, planned and authorised these crimes.
As a matter of international law, the US is legally obliged to bring those responsible to justice. The UN Convention Against Torture and the UN Convention on Enforced Disappearances require States to prosecute acts of torture and enforced disappearance where there is sufficient evidence to provide a reasonable prospect of conviction. States are not free to maintain or permit impunity for these grave crimes.
It is no defence for a public official to claim that they were acting on superior orders. CIA officers who physically committed acts of torture therefore bear individual criminal responsibility for their conduct, and cannot hide behind the authorisation they were given by their superiors.
However, the heaviest penalties should be reserved for those most seriously implicated in the planning and purported authorisation of these crimes. Former Bush Administration officials who have admitted their involvement in the programme should also face criminal prosecution for their acts.
President Obama made it clear more than five years ago that the US Government recognises the use of waterboarding as torture. There is therefore no excuse for shielding the perpetrators from justice any longer. The US Attorney General is under a legal duty to bring criminal charges against those responsible.

Torture is a crime of universal jurisdiction. The perpetrators may be prosecuted by any other country they may travel to. However, the primary responsibility for bringing them to justice rests with the US Department of Justice and the Attorney General.”
- See more at: http://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=15397&LangID=E#sthash.8YgrwEKt.dpuf

The summary of the Feinstein report which was released this afternoon confirms what the international community has long believed - that there was a clear policy orchestrated at a high level within the Bush administration, which allowed to commit systematic crimes and gross violations of international human rights law.
The identities of the perpetrators, and many other details, have been redacted in the published summary report but are known to the Select Committee and to those who provided the Committee with information on the programme.
It is now time to take action. The individuals responsible for the criminal conspiracy revealed in today’s report must be brought to justice, and must face criminal penalties commensurate with the gravity of their crimes.
The fact that the policies revealed in this report were authorised at a high level within the US Government provides no excuse whatsoever. Indeed, it reinforces the need for criminal accountability.
International law prohibits the granting of immunities to public officials who have engaged in acts of torture. This applies not only to the actual perpetrators but also to those senior officials within the US Government who devised, planned and authorised these crimes.
As a matter of international law, the US is legally obliged to bring those responsible to justice. The UN Convention Against Torture and the UN Convention on Enforced Disappearances require States to prosecute acts of torture and enforced disappearance where there is sufficient evidence to provide a reasonable prospect of conviction. States are not free to maintain or permit impunity for these grave crimes.
It is no defence for a public official to claim that they were acting on superior orders. CIA officers who physically committed acts of torture therefore bear individual criminal responsibility for their conduct, and cannot hide behind the authorisation they were given by their superiors.
However, the heaviest penalties should be reserved for those most seriously implicated in the planning and purported authorisation of these crimes. Former Bush Administration officials who have admitted their involvement in the programme should also face criminal prosecution for their acts.
President Obama made it clear more than five years ago that the US Government recognises the use of waterboarding as torture. There is therefore no excuse for shielding the perpetrators from justice any longer. The US Attorney General is under a legal duty to bring criminal charges against those responsible.

Torture is a crime of universal jurisdiction. The perpetrators may be prosecuted by any other country they may travel to. However, the primary responsibility for bringing them to justice rests with the US Department of Justice and the Attorney General.”
- See more at: http://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=15397&LangID=E#sthash.8YgrwEKt.dpuf

From the weirdness file

I should probably dig up my weirdness file and post a few bits from it. For now, here's a new one.

I am doing some minor research on workflows in primary care clinics. One of the sites we're looking at is affiliated with a hospital, which has various draconian policies regarding people who are going to be on site and potentially having patient contact. I was required to get a badge, which meant answering a ridiculous quiz, getting a TB test, and antibody titers for measles, mumps and chicken pox. Also passing a criminal background check. I finally got my badge, which has a photo on the front. Then the security guard responsible for embadgement assembled it with two attached cards. One listed the emergency codes. (This is standard hospital speak. For example, Code Amber is child abduction, Code Blue a medical emergency, and so on.)

The weirdness was the card in back. It's titled "Off-Sites Bomb threat Checklist." It's a little form you're supposed to fill out if you answer the phone. (Not sure what "off-sites" means, sorry.) At the top you fill in call-taker's name, date, time, and phone # where the call was received. Then it lists questions to ask and has little spaces for the answers ("Exact words if possible.")

Where is it located? Building? Area?
When will it go off?
Time________ Time remaining
What kind of bomb is it?
What does it look like?
Is there more than one bomb?
What will cause it to explode?
Did you place the bomb?
Why?
Where are you calling from?
What is your address?
What is your name?

Okaaaay. I'm sure most bomb threateners are more than happy to have that conversation and answer all your questions . . . 

Journamalism

Most of you are probably too young to remember the Duke lacrosse team brouhaha, and if you do, you probably don't remember that I steered clear of it here, but I did. It didn't smell right to me and I figured I'd wait and see what happened rather than seize upon it as a parable of all that is wrong with society. The sad part is that frat boys often are racist and sexist and rapes do happen in frat houses. That's why it's always dangerous to seize on a cause celebre to make a wider point about society. Viz also Tawana Brawley.

So, I steered clear of Jackie and UVA, for the same reason. There was nothing entirely implausible about the Rolling Stone story, but quite a bit about it was odd and the lack of corroboration or any journalistic enterprise was unsettling. Where things stand now, we know that some details were wrong -- the date and which frat house it was we can excuse, could be misremembered. However, specifically identifying a real individual as the ringleader who could not have been is really troubling. Something bad evidently happened to Jackie but whatever it was, it was not the story she told.

However, that is basically irrelevant to anyone but the people directly involved. Rapes do happen on college campuses, they do happen in frat houses, and colleges have tended to sweep it under the rug. This was true before the Rolling Stone story, and it is just as true afterwards. For some reason the zeitgeist needed a specific, particularly horrific individual story before it could wake up to this. That should not have been necessary in the first place, and I sincerely hope this debacle won't set back the momentum that was already building.

In case you need your bubble burst

Ed Brayton, at FreeThought Blogs, constantly trawls both the near shores and farthest reaches of Wingnutistan, and his daily catch is unfailingly appalling. Our nation is fifty percent lunatic, it seems. Check it out if you dare.

It's not a bookmark for me because I just can't take it regularly, but if your blood pressure should ever drop too low it's a useful remedy.

The difference between men and women

Should you be among the lost souls who watch television, you will have seen advertisements for Wendy's grease pits fine dining restaurants.

If you are with me so far, you will recall that founder Dave Thomas used to be the commercial spokesperson. He'd appear in an apron avuncularly purveying his ground lips and anuses of played out milk cows, or whatever is in those gray squares. (I make no actual claims, having no actual knowledge.)

To put it kindly, Dave was no poster boy for the healthful properties of his no-doubt yummy products. He was one of those guys who makes you wonder how a belt that goes around the equator can keep his pants up. (And it is a mystery.)

So, tragically, Dave died in at age 69. For a while, recently, his daughter Wendy, after whom the business was named (it's actually a nickname, her real name is Melinda) took Dave's place as spokesperson. Alas, she takes after her father. Apparently the marketing geniuses behind the campaign decided that just wouldn't work. In Wendy's place they hired a cute, anorexic young woman and put a scarlet wig on her.

Connect your own dots.  

Nor all your piety and wit . . .

 . . . can call it back to cancel out one line,
nor all your tears wash out one word of it.

There seems to be a bit of a blogostorm going on right now over whether it was a good idea to pass the Affordable Care Act or not, either because a) we should have passed single payer instead (viz Scott Lemieux) or the president should have "focused" on the economy instead (viz. Krugzilla.)

Yeah single payer would have been nice, but the fact is, the ACA is working better than expected. The Urban Institute tells us that from the beginning of 2013 through September of this year, the number of people in the U.S. without health insurance went down by 10.6 million, and the percentage uninsured went down from 17.7% to 12.3% -- almost 1/3. Of course the improvement was bigger in the states that accepted the Medicaid expansion. And CMS is about to announce (at 4:00 pm today) that the growth in health care spending remains low, and was in fact lower last year than in 2012.

So continued Republican efforts to demonize the bill and take health insurance away from people are just evil. However, the corporate media are going along with the gag, and the bill remains unpopular, even though people are overwhelmingly in favor of everything that's in it. What a world.

Update: Here's the link to the CMS report on health care costs, no longer growing faster than GDP. This, for now, means the crisis people in the health care policy field have been panicking over for 15 years isn't happening after all. (Ditto for the "out of control" federal budget deficit, these two facts being more or less the same.)

The end of HIV?

I don't know why we need to have single days when we're supposed to think about stuff we probably should be thinking about regularly (e.g., why do we have National Pickle Week when pickles matter all the time?) but for what it's worth, today is World AIDS Day.

The One Campaign (Bono's charity) says there's good news: we're at a "tipping point" in that the number of people newly receiving HIV treatment now exceeds the number of new infections. Furthermore, the global incidence of HIV has fallen by 40% since 2001. This is no doubt for a combination of reasons, including better awareness and changes in people's behavior, but one reason is that more people are in treatment. People who take their medications regularly and have suppressed viral loads are much less infectious, maybe even not at all.

But, I don't think this is really a tipping point. There are several problems with that rather glib assertion. The first is that just because people are enrolled in treatment and have a prescription doesn't necessarily mean that they are going to remain in treatment, and remain adherent to their medications. It is definitely not the case that the number of people with unsuppressed HIV viral loads is decreasing. The number of people enrolled in treatment would need to greatly exceed new infections, and adherence to treatment would need to be better, in order for that to happen.

The second problem is that the expansion of treatment may not be sustainable. The wealthy countries are reducing their financing for HIV treatment in poor countries, and the poor countries still can't afford it. Where there is civil conflict, as in some of the areas of Africa most afflicted, treatment rates may well decline. And, since there are more and more HIV infected people alive, the number of people we need to treat is still growing, even as resources are more constrained.

Finally, we are never going to eradicate HIV by treating people. Some people are always going to be out there undiagnosed for a while, and infecting others. The only likely way to eradicate the disease is to have a highly effective vaccine, and that still isn't in sight. Possibly a cure could do it eventually, in principle, but we can cure syphilis and  gonorrhea and they're still with us.

Alas, HIV is just part of our world now. It isn't going away.

What Joe Romm says . . .

I'll have a real post of my own anon, but meanwhile you are required to read this essay by Joe Romm.

Collectively, we are in deep, deep denial. But the hard truth is that this civilization that we built on fossil fuel is terminal. It won't exist much longer. We can plan for what comes after and maybe make it okay, or we can just go on blindly sailing toward disaster. The time to choose is now.