Month: September 2010

A reader writes:

Another excellent piece you've penned, Andrew. Scares the bejabbers out of me. They've got the full authorized power of laws set in place, which our weak, rightist Supreme Court will not undo—authorizations to do these horrible things. They have the Republicans and half the Dems backing them, making legislative mandated changes nearly impossible; and the media Right has thrown in some 25-40 of the populace into the support for this Century of Fear they are conjuring, which will thwart any real change in the legislatures.

And we thought history was ending? The US is turning into the right-of-center state the right has been claiming. And Obama is at the steering wheel? No one to the left of him or to the principled right of him is electable. We are in deep doo-doo — Unless some new brand of genuine Conservative and Middle Ground Liberal coalition, of the older principled forms, pull together with some new candidates and perspectives.

But for now, it seems to be going in the opposite direction from this needed corrective. Sigh.

"You aren't responsible for Quran burners. Don't hold Muslims responsible for 9/11," – Will Saletan.

Julian Sanchez has posted an indispensable summary of the Constitutional and statutory laws that the Bush Administration broke when it spied on many thousands of innocent American citizens. The American government obeying the law in national security? What a concept.

Felix Salmon thinks the White House knows that little can be done to bring down unemployment:

On the call, [White House economic advisor Jason] Furman valiantly tried to paint policies like cash-for-clunkers and the extension of unemployment insurance as being all about creating jobs, but the fact is that it’s hard for any government to create jobs, beyond simply hiring more people, and the effect of those policies on the unemployment rate was surely minimal at best. … [W]hile keeping the economy from slipping back into recession is something doable, bringing unemployment back down, even to where it was when Obama first took office, isn’t. They’re not going to admit that in public, but neither are they going to expend too much effort tilting at windmills.

Michael Scherer's guess:

In [Bill Galston's] view, the Tea Parties have more in common with Barry Goldwater than H. Ross Perot. They are an intra-party reformist cause, at a time when the nation desperately wants reform. In a midterm cycle, where the choice is between change or the same, it may not matter so much that many of the reforms the Tea Party seeks–like major revisions to entitlements–are not very popular. In other words, the silly campaign rally signs and DNC oppo may matter less than the fact that Tea Partiers are shaking up the Republican Party, which is good for the Republican brand.

That's the optimistic view. I would like to share it. But the social and cultural baggage of the movement – and its support for the unrestrained war machine and visceral recoil from a majority-minority America – seem to point in the other direction. But if they manage to get a GOP House to back real cuts in entitlements and defense, and actually cooperate on some kind of deal with Obama for long-term debt reduction, I'll be more than happy to change my mind. But I see an ideological rigidity that would prevent this. Which would mean more stalemate. Which means more debt.

Yglesias searches for meaning:

[I]t’s kind of nuts, isn’t it, that we have the general in charge of an ongoing war commenting on some guy in Florida being a jerk. Even nuttier is that he might well be right that this episode will endanger the lives of Americans soldiers. But that really raises deeper issues about Afghan society and the wisdom and nature of America’s engagement with it. The essence of a digital, globalized world with billions of inhabitants is that there’s always going to be some jerk somewhere doing something ridiculous.

Mackey is updating.

A reader writes:

You wrote: "Why not an emergency assistant at your doctor's for 24-hour help, or even just a phone call?"  There is such a thing; it's called an answering service, with on-call doctors.  Doctors who are on-call are available to return patients' calls at all hours of the night.  As far as I know, every primary care practice is connected to an answering service and has a doctor on-call at all times.  But as for going beyond that and having someone available for in-person visits during the night … well, you've just described emergency rooms, haven't you?

Yes, but not in a hospital and with someone connected to a doctor who knows you. Another writes:

I'm sure you are going to get a bevy of email responses from your early morning, ill-advised post on emergency room visits. I am a private practice pediatrician in Kansas City, Missouri. I am in a practice that currently is the only one in my immediate area taking medicaid. I work 60-80 hours a week. We offer evening hours and Saturday hours. There is only so much we can do.

1. "Emergency assistant" – this is concerning on two levels.

First, what type of assistant? A doctor? A nurse practitioner? Will we get paid to keep our doors open, lights on, computers running? Further, a private practice office is not equipped to handle most emergencies. In our practice, we have enough equipment to stabilize a patient, but we are not an ER. If it truly is an emergency, they are worse off coming to most private practices. Which brings up the true problem….most "emergencies" are NOT emergencies. They can wait until the office opens. And I will challenge any ER doctor who says that we private practice physicians aren't doing our jobs.

2. "Phone call" – most practices are required to offer some sort of 24 hour service for after hour/off hour assistance by the insurance company contracts they sign. We contract ours through a local children's hospital. I recently heard some statistics that of the 400+ plus patients who planned on going to the ER, only 10 or so were actually recommended to go. Over 95% of ER visits were prevented just by this after-hour nurse triage system.

I know that's brief, but just wanted you to understand that I am working hard to give my patients a true medical home, and that the problem goes much, MUCH deeper than the hours posted on the door.

Your call. Alternatives welcome.

A reader writes:

I totally agree with your reader; the way Twitter has connected the community and reported on events has been nothing short of amazing. Old media (Denver Post, Boulder Daily Camera) is linking to the Google Tweet maps to give the most up-to-date reporting on a fire that has burned over 7,000 acres and destroyed 53 reported homes so far. Evacuees have been using this to check on homes. Basically, it has been the go-to source rather than government officials or traditional journalists. And many citizens have gone out into the field themselves; check out this video report from someone who normally covers triathlons (…how Boulder). Stunning amateur photos here and here. The HuffPo covered the social media experience of the fire here.

The Twitter stats on #boulderfire are here. Laurasrecipes (the top tweeter) has been posting important info on where to donate, fire conditions, house status, etc. She writes a food blog. EpicColorado, a university-based research lab, has been the most consistent and solid reporter. Suzanbond has also done better reporting than many news sources. While they have provided important citizen journalism, new media source BoulderChannel1 has not and is getting roasted on Twitter for its shoddy reporting. (Search #boulderfire @boulderchannel1) This seems to me the type of narrative you like – a new media source falls short of good journalism and is subsequently policed by other users.