Month: June 2007

The headline is about their increasing liberalism, and that’s true so far as socialized medicine is concerned, alas. But what strikes me most about the latest poll of the next generation is the distinctions they make. Instead of seeing "drugs" as an amorphous category, they distinguish between largely harmless marijuana and an addictive upper like cocaine. Instead of conflating all the moral issues, they have no problem with gay dignity and equality, but retain many of the moral conflicts of their parents with respect to the far more troubling issue of abortion. This doesn’t strike me less as a sign of their liberalism than of their intelligence and experience. You simply cannot persuade most sane people who have smoked pot, or know people who do, that it is even a minor threat to social order or cvilization. And you cannot tell people who know and have grown up around gay people that we are the threat to the family that the Christianists claim. All of which should make us more optimistic about the future, because it suggests that, in the long run, reason and experience actually do work to make the world a marginally less stupid and cruel place. In the case of the lives of gay people and their families, it already has.

"A government that is big enough to give everything that you need and want is also big enough to take it all away," – Barry Goldwater.

A worthwhile blast of the bleeding obvious. Money quote:

Six months ago, the Iraq Study Group endorsed a gradual downsizing of American forces in Iraq and the evolution of their mission to a support role for the Iraqi army. I do not necessarily agree with every recommendation of the Iraq Study Group, and its analysis requires some updating given the passage of time. But the report provides a useful starting point for the development of a “Plan B” and a template for bipartisan cooperation on our Iraq strategy.

We should understand that if the re-deployment of a downsized force is to be safe and effective, our military planners and diplomats must have as much time as possible to develop and implement the details. We will need the cooperation of the Iraqi government and key states in the region, which will not come automatically. The logistics of a shift in policy toward a residual force will test military planners, who have been consumed with the surge. In 2003, we witnessed the costs that came with insufficient planning for the aftermath of the Iraq invasion. It is absolutely essential that we not repeat the same mistake. The longer we delay the planning for a re-deployment, the less likely it is to be successful. 

This will become the next sane Republican consensus. But it is anyone’s guess whether the Bush administration will listen. My bet is they won’t – unless they really have no option (which, with Cheney’s contempt for the constitution, never seems to happen) .

Readers have asked me to address a central point in Gabriel Rotello’s argument: that if we had sustained the levels of fear after the retroviral drug breakthrough in 1996, we might have reduced HIV to a sliver and even ended it altogether. This is epidemiologically highly dubious, but let’s pretend it’s valid. I guess there are two points to make. If sustaining fear meant hiding or concealing the astonishing turn-around in HIV treatment, then no ethical journalist should have done so (though many did). Getting the news out about hope in HIV care was and is essential to saving lives. Repressing such news – for fear of breeding complacency – essentially tries to sacrifice an existing sick population for a future HIV-free world. In 1996, I felt the need to tell the truth about the miraculous turn-around, but also an ethical obligation to reach as many sick gay men as possible with the good news. Many had given up; many didn’t know new treatments could save them. I’m proud I helped spread the news. I know the essay saved lives. To accuse me of fomenting HIV when my goal was to help many men survive is deeply unfair. I watched a friend who refused to believe in the good news die in front of me. It scarred me and made me determined to reach others.

The second point is that there is an obvious paradox in any successful treatment for a virus like HIV. If it makes the diagnosis less grave, it will also make it seem less terrifying. More important: It will make it seem less terrifying because it is objectively less terrifying.

And if it is objectively less terrifying, people will be less likely to wear a rubber every time. This is human nature. We can try to prevent sex without condoms or sex that risks infection, but all intimacy risks infection at some point. There is no completely risk-free sex. And relaxing the extreme strictures of the plague years is a perfectly rational assessment of costs and benefits. That equation changed in 1996 for good. You either deal with that or you stay in the same stopped-clock position Rotello has occupied for over a decade.

Under those circumstances, I think it’s more realistic to accept the change and work to develop new strategies for health maintenance. Sero-sorting – restricting sex to people within the same HIV-status – has been by far the most effective barrier against HIV transmission among gay men in this new world. San Francisco has led the way in reducing HIV transmission through sero-sorting. Marriage helps too, in channeling sex into love and commitment. Fear as a weapon cannot last for ever. And fear-mongering is not a substitute for serious efforts to maximize gay men’s health and freedom. And, yes, both matter.

Dan Drezner took this moral test from Harvard. So did I. We both scored very low. The test appears to measure how much people should be forced to pay for accidental or negligent injury of others. I guess our responses simple reflect the fact that we both believe in personal responsibility.

Lee Rosenbaum is worried:

What most alarms me is that the sea change wrought by the growing importance of art fairs and auctions means that most purchase decisions are now being made under these frenetic, crowded conditions, far removed from the undistracted, unhurried contemplation that subtle, complex and profound pieces require to produce their effect. Under such harsh conditions, works that lend themselves to being easily comprehended in a brief glance are the species most likely to survive and thrive.

We are entering the era of Snap-Judgment Art.

I’m struck by how many readers seem to believe that the Gospels mandate an expansive welfare state. I can’t see it myself. Jesus was admant about eschewing politics; and his injunction to help the poor was not an injunction to get taxed in order that others may help the poor (or more generally with government attempts to reduce poverty, to keep them poor). And, of course, in socialist countries, the government both takes more of your money and tells you that the needs of others are the state’s business, not yours. No big surprise, then, that no other country gives even half as much in charity as Americans. A free society, low taxes and limited government actually leaves people with the means to do good. The French give one twelfth of what Americans give. Britain is the second most generous country, and, despite Tony Blair’s best efforts, still the least socialist of the European powers.

A reader writes:

As I understand it, "Sicko" also looks at the French system – which is very different from the NHS and shouldn’t be placed under the rubric "socialized medicine."

The French system is a mixed public-private system that covers all residents of France. Social security "charges" paid by employees and employers pay all or part of most health care services. Many people also have a "mutuel," a private insurance company that pays for services beyond what Social Security, aka Secu, pays. (And the unemployed also are covered; if you lose your job you don’t lose your health insurance.)

The U.N.’s World Health Organization surveys the health care systems of nations around the world and in its most recent survey named the French system as the best in the world. From my own experience, I concur.

My wife and I have had stays in hospitals, public and private, and have been well satisfied by the quality of care. Hospitals we have stayed in are the equal of the best in the U.S. Fees are far lower than those in the U.S.

Does the French system have problems? Sure. It runs a big deficit each year. And, yes, Social Security charges (which pay health insurance, pension, disability and unemployment insurance) are very high for both employees and employers. Doctors who are under the Secu fee schedule (though they are self-employed) complain the fees are too low. Nurses also complain about low wages. According to the WHO, France spends much less per patient than the U.S. does. If I recall, France’s per patient cost is a third less than that of the U.S.

If for some reason you missed this wonderful moment, watch Ann Coulter melt in the face of the truth. Chris keeps up the pressure – to his credit. I’d back Elizabeth Edwards for president in a heartbeat.

About as good a Pet Shop Boys parody as you’ll find. Hey, it’s my blog: