A severe economic distortion . . .

is occurring as the store shelves are stripped of popcorn in anticipation of the Great Debate tonight. Actually, 9 guys with indistinguishable policy positions flanking a blowhard bubbleheaded egomaniac and each getting in about 5 minutes of yacking over an hour and a half is not a debate. But if I had the chance to be a disruptive force in political discourse (hopefully without the egomania) here are a couple of offensive gaffes I would kindly offer.

Bibi and the bomb: Benjamin Netanyahu, the Zionist Organization of America, and Mike Huckabee do not give the tiniest shit if Iran gets a nuclear weapon. Israel possesses 100 to 200 nuclear weapons, and the means to deliver them. That's supposed to be a secret that nobody ever mentions. If Iran were to exercise it's purportedly "existential threat" by somehow smuggling its one low yield, untested nuclear weapon into Tel Aviv, the nation of Iran would cease to exist along with every city, shrine, ayatollah, military facility, industrial plant, bridge, highway, railroad, cultural institution and most of the population. Persian culture would essentially become extinct. Everybody knows that.

No, Bibi just doesn't want Iran to have the opportunity to rejoin the international community. He wants no agreement with Iran of any kind, and he wants the sanctions to remain forever. We can argue about why he wants that and why that is or is not a great idea, but that's what this is really all about. If Bibi gets his way, Iran will develop a nuclear weapon. That doesn't bother him.

Investment in health research: Yes, I have from time to time complained about the slow but steady shrinkage of the National Institutes of Health, which is hard on me personally. But you know what? That's not the most important place for us to be investing if we want to have a healthier population. As Ronald Bayer and Sandro Galea lay it out in NEJM, the comparatively poor health of the U.S. population has nothing to do with high tech medicine and everything to do with our severe underinvestment in the social goods that actually determine people's health. As they write:

[T]here is now broad consensus that health differences between groups and within groups are not driven by clinical care but by social-structural factors that shape our lives. Yet seemingly willfully blind to this evidence, the United States continues to spend its health dollars overwhelmingly on clinical care.

Everybody who works in any capacity in public health knows this. It's the central, obvious, undisputed fact of health policy, which is really all policy. Everything we do as a polity directly and powerfully affects people's health, from our tax code to our transportation infrastructure to our law enforcement practices. But we almost never talk about policy that way.

I could throw out a few more. The basic idea is, our political discourse consistently and pervasively misses the point. It's always a feint, a misdirection, from the real issues. Sometimes that's pretty transparent, as with the personality-driven and horse race focused coverage of electoral campaigns. But it's also true when politicians and pundits purport to be talking about substance. It's a shadow play to distract you from everything that really matters. Never forget that.

Note: Sorry for the absence over the past few days. I've been busy. But it should give me a few interesting things to write about.