If Healthcare.gov Isn’t Fixed In Time

Bob Laszewski thinks the Obama administration needs a Plan B. Among his suggestions:

Encourage people to call the insurers and private exchanges serving their states directly. The administration should post those phone numbers and web addresses on the first page of Healthcare.gov. If they went directly to insurers, people would have to access multiple insurer sites to shop rather than the one-stop shopping the federal exchange would have provided. If they went to private exchanges, they would have the full shopping experience. However, in either case, they would not be able to get a subsidy by going direct as long as the insurers and private exchanges are unable to access the federal subsidy system. But they could get signed up for coverage by January 1. While this would not help people without the money to buy a policy, everyone would ultimately get the entire subsidy they are entitled to as part of their 2014 tax filing.

Build, as the very top system priority, the subsidy calculation bridge the insurers and private exchanges have been requesting for months but the administration made a lower priority well before October 1. If insurers and private exchanges have the ability to access the subsidy calculator and enroll people in the subsidy program, the administration will have built a workaround system for the interim so people who could not otherwise afford coverage would be able to get a subsidy.

Beutler agrees that backup plans are necessary:

Now obviously Obama shouldn’t contemplate doing any of this if the site really will be working by the end of the month. But if and when it becomes clear to administration officials that it won’t be ready, they’ll need to announce the failure and the workaround more or less simultaneously. The absence of a plan B would create a vacuum for congressional saboteurs, and Democrats would probably get sucked into it. Opposing all proposed solutions won’t be sustainable. And at that point Obama would have to entertain the prospect of allowing Republicans to inflict lasting damage upon his signature achievement.

Ask Charles Camosy Anything: Should Christians Eat Animals?

Yesterday Charles outlined the sins of factory farming. Today he considers what Jesus would eat:

 

In another video, the Christian theologian highlights the biblical case for treating animals as our companions, not our food:

Camosy’s new book is For Love of Animals: Christian Ethics, Consistent ActionMore about him:

Charles Camosy is an assistant professor of Christian Ethics at Fordham University. … His early work focused on medical and clinical ethics with regard to stem cell research and the treatment of critically ill newborns in the neonatal intensive care unit, which was the focus of his first book, Too Expensive to Treat? Finitude, Tragedy, and the Neonatal ICU. His second book, Peter Singer and Christian Ethics: Beyond Polarization, uses intellectual solidarity in an attempt to begin a sustained and fruitful conversation between Peter Singer and Christian ethics.

Our full Ask Anything archive is here.

The Iranian Rubik’s Cube, Ctd

Hooman Majd made important points about the US-Iranian negotiations while they were still ongoing:

Iran and the United States hadn’t talked for five hours in the past thirty-four years. We’ll have to wait to find out whether this is a historic moment, or merely another lost opportunity. But it seems improbable that the Americans and Iranians would make such a production of these talks without some real confidence that signing on the dotted line is within reach. Iran’s Supreme Leader, Ali Khamenei, took to Twitter to emphasize his support for the negotiations and his negotiators, whom he called “children of the #Revolution”—suggesting that hardliners in Tehran would have a difficult time sabotaging an agreement. …

As of Saturday night, it looked like it would take at least one more round of talks to reach a breakthrough. Members of the Iranian delegation indicated that the objections to signing a draft agreement came from the other side, but suggested that the remaining gaps looked too great to overcome in the few hours remaining. Zarif repeated what he had said before these discussions began—that it “wouldn’t be a disaster” if a deal was not signed this weekend.

Reza Marashi makes similar arguments:

One did not have to be in Geneva to see the obvious: more progress was made over the past three days than in the past three decades combined.

The importance of this breakthrough must be contextualized: Compare negotiations under Iran’s former chief nuclear negotiation Saeed Jalili to Foreign Minister Zarif’s current stewardship. It’s night and day, and the metric of success is now clear. The bedrock of these negotiations rests upon a simple but vital premise: It is in the interest of both sides to develop a peaceful solution to the U.S.-Iran conflict, and diplomacy is the only viable pathway that bridges status-quo mistrust to future cooperation.

To that end, both sides acknowledge — and are working to contain — the very real presence of spoilers who seek to maintain or exacerbate a negative trajectory in relations. “We’re not in the business of doing favors,” a Western diplomat told me, smiling. “We’re in the business of pursuing our interests.”However, no less important have been the forces for moderation that do not believe Washington and Tehran need one another as an enemy. As talks concluded, Foreign Minister Zarif and Secretary both emphasized their belief that progress was made and a deal can be reached.

Patrick Brennan’s assessment is much more pessimistic:

Kerry claims he was proud of the work that negotiators accomplished in Geneva this week, but it looks like the parties came to the table remarkably far apart, without any realistic framework for a deal. But the Security Council has passed multiple resolutions demanding that Iran halt its enrichment activities, while Iran’s players seem united in demanding that the deal include a provision explicitly recognizing the country’s right to do so. The International Atomic Energy Agency says there is now a “framework” for a deal with Iran that negotiators will try to iron out over the next three months, but this isn’t what the Obama administration was hoping for — they wanted an agreement on a six-month freeze in enrichment activities, which would then provide time to agree on a broader deal. Now, instead, Iran’s activities will continue unmolested, even if the IAEA’s framework proves useful over the coming months.

Kenneth Pollack notes that any deal will require sidelining Iran’s hard-liners:

We’ve never seen Khamenei actually overrule the hard-liners on an issue of this kind of importance. We’ve seen [previous supreme leader Ruhollah] Khomeini do it, famously, at the end of the Iran-Iraq War. The hard-liners wanted to keep fighting, and [later-president Hashemi] Rafsanjani and the pragmatists wanted to end it. In the end, although he said it was more bitter to him than “drinking poison,” Khomeini agreed to overrule the hard-liners. We haven’t seen that with Khamenei.

Larison argues that France, which derailed the negotiations according to some reports, has made a major mistake:

Iran hawks in the U.S. are predictably pleased with French interference, but no one else should be fooled into thinking that France has done itself or other Western countries any favors. It can’t be emphasized enough that Western actions that block an agreement with Iran on the nuclear issue benefits no one except Iran hawks and Iranian hard-liners, since it makes it more difficult to resolve the issue through diplomacy, and that in turn makes both armed conflict and a nuclear-armed Iran more likely. Perversely, France has given Iran an opening to agree to fewer concessions than it otherwise would have, and by demanding so much in the first stage France has made it less likely that Iran will agree to anything.

Juan Cole echoes:

France can’t possibly want no agreement (unlike Israel), and presumably there must be a way to satisfy Hollande in a confidence-building initial proposal. It may also be that Paris will feel so much heat from everyone else in Europe that they will moderate their hard line.

One thing France must keep in mind is that hawks in Washington actively want a war with Iran, and that if there is no agreement now, that war will be on the front burner if a Republican comes to power in 2017. Since the French opposed the Iraq War and have been traumatized by their participation in Afghanistan, presumably they don’t want to give the American Right such a luscious opportunity, which won’t in the end benefit French interests in the Middle East.

And Scott McConnell leafs through the history books:

France’s relations with Israel have been at least slightly chilly since de Gaulle denounced what he (correctly) perceived as Israel’s desire to hold onto the territory it captured in the 1967 war.  Before that, however, France was Israel’s largest arms supplier and helped get Israel’s clandestine nuclear weapons program off the ground in the 1950s. With Israel and Great Britain, France invaded Egypt in the 1956 Suez Canal crisis, hoping to topple Nasser and cut off aid to the Algerian rebels. The Clash of Civilizations—the fear-inspiring “Islamofascism” narrative—did not originate with Sam Huntington, or American or Israeli neoconservatives, but with French intellectuals trying to bolster international support for their colonial war in Algeria. So it would not surprise me if French strategists imagined a kind of Paris-Tel Aviv-Riyadh triple alliance, unlikely as it sounds, but not much more unlikely than the alliance of Republican France and Tsarist Russia which set the table for World War I.

My thoughts on the Geneva fallout here.

There Is No Shame In Therapy

Iraq War veteran and PTSD survivor Mikey Piro is blogging again. Part of a recent entry:

I am pretty frank about seeing my therapist.  When I tell people (read my civilian coworkers) I am a Veteran who served in Iraq and I sought the help of therapists upon returning home, I usually get one of two reactions. One, the listener doesn’t even bat an eye and listens to me prattle on about this or that. Two, they nod and say, “Of course you did, that makes complete sense. I can’t image what you went through.”

I wish newly returning Veterans could see or hear those reactions from civilians more often. What would be even better, is if we could heard it from more of our own “kind”.

Previous Dish on Mikey and veteran PTSD here, here, and here.

The Iranian Rubik’s Cube

Nuclear Talks in Geneva

So we have two somewhat conflicting narratives coming out of Geneva. The first we aired last night, via Laura Rozen and Marcy Wheeler. There was a general consensus that the French were the ones who derailed the imminent short-term agreement. Their motives? Cozying up to the pissed-off Saudis and also the usual Gaullist need to throw around what’s left of France’s weight. Hollande is set to visit Israel next month as well, inserting France into the occasional glimpses of daylight between the American and Israeli positions on Iran. Christopher Dickey has a must-read on the hardline faction still ensconced in the Quai D’Orsey. Money quote:

Under Sarkozy and his longtime Foreign Minister Bernard Kouchner, the Quai’s policies came to be increasingly dominated by the French version of American neo-cons, many of them former leftists who preached the spread of democracy and dreamed of remaking the Middle East, if necessary, through war.

Sarkozy liked to say if he’d been president in 2003 he’d have backed the American-led invasion of Iraq; Kouchner let it be known he thought an armed confrontation with Iran was more or less inevitable. The key player at the Quai is Jacques Audibert, the director general of political and security affairs, who has pushed a very hard line, insisting that the ideal goal of sanctions and the pressure on Tehran must be the de facto elimination of its nuclear program.

The other must-read is another masterful column from Roger Cohen. On France, he has a more nuanced take:

Its position reflects strong views on nonproliferation, its defense agreement with the United Arab Emirates, and a mistrust of the Islamic Republic that runs deep. There are good reasons for this mistrust. Laurent Fabius, now the foreign minister, was prime minister in the mid-1980s during a wave of Paris bombings that were linked to pro-Palestinian groups but are also believed by French authorities to have had Iranian backing in several instances. Fabius is not about to forget this or cut Rouhani any slack. This is not a bad thing. A deal has to be watertight in blocking Iran’s path to nuclear weapons while acknowledging its right to nuclear energy.

Yesterday, Kerry insisted that the failure of the short-term deal was not a function of French intransigence but of the Iranians being unable to sign off on some of the demands of the P5+1 group, without more consultation at home. In fact, most of the reports coming out today reflect that new consensus. The FT’s take is here. Money quote from Fabius:

“We [France] are not closed . . . we want a deal for regional and international security … France is neither isolated nor a country that follows the herd. It is independent and works for peace.”

Dickey notes:

France insisted that operations of a nuclear reactor at Arak—which is not online yet—be halted, and that current stockpiles of enriched uranium be reduced.These were the sorts of measures that the other negotiators expected to ensue at future stages of the normalization process. The urgent need right now is to stop the enrichment program that exists — freeze it and inspect it — since if it continues Iran soon will be only months, if not weeks, from procuring sufficient material for a bomb. As a result of the French posturing, that enrichment probably will continue, at least for the moment.

So it may be a subtle difference between the ambition of the temporary freeze and the ambition of the later, bigger negotiation. That can still be worked out, it seems to me, because it’s a small nuance. It’s also why this stalling tactic is arguably unlikely to end the process. Because, far from arresting Iran’s nuclear development for six months, it allows it to continue (which no one in the West wants). But you can see how the P5+1 regarded their own unity as more important than an immediate deal and sent the French-fortified proposal to be taken back to Khamenei. The French can say they tried to stop it, and yet not stop it, bolstering their alliance with the Saudis and Israelis while allowing the process to move forward. Win-win. So this became a slightly more aggressive stance designed to test Tehran and vent some of the nervousness about any deal. It could be, in other words, just a bump in the road – and perhaps a somewhat contrived one.

But I should add a caveat here. The crux of these negotiations is unknowable to those outside them. That’s how diplomacy works. We will find out the full story some day, and until then, these parsings of events and statements on an hourly basis need to be seen as entirely provisional.  But as a case study in Great Power diplomacy, it’s crack for poli sci graduates like yours truly.

(Photo: US Secretary of State John Kerry speaks at a press conference after the third day of closed-door nuclear talks at the International Conference Center in Geneva (CICG) on November 10, 2013 in Geneva, Switzerland. By Murat Unlu/Anadolu Agency/Getty Images.)

The Reality Of Serious Weight Loss, Ctd

A reader writes:

I am glad you found this piece and are sharing this with your readers.  This is a subject that is as personal and close to me as can be.  Having gone from 425 lbs to 275 without surgery, I certainly expected to feel much better about it than I do."Self"

Make no mistake, I’m proud of what I have accomplished, but the truth is that I still FEEL 425 lbs.  That fact has been incredibly upsetting and frustrating.  More to the point, because the skin is still there, there is a kind of phantom limb feeling that occurs, which reinforces the feeling of still being as obese as I once was.  I too don’t look the way I envisioned when this journey started.  I find that I look like the proverbial 10 pounds of potatoes in a 100 pound bag.

All of this takes an incredible toll on my mental health.  Any happiness at my achievement is immediately mitigated by fact that weight loss was not the panacea for my appearance and mental health that I assumed it would be.  When you lock up your issues in your weight, you assume that shedding the weight will rid you of those issues.  Like an addict who quits drinking or drugs, you feel the initial euphoria (something akin to a sobriety high), but that wears off, and you are left to live the rest of your life in this new way.

That adjustment is hard for addicts – but I would submit that it may be harder for the obese in one way.  Imagine if an alcoholic still HAD to consume some alcohol to live.  Many alcoholics say one is too many, and a million is never enough. Unfortunately for compulsive over-eaters, this approach isn’t an option and leaves you vulnerable to relapse (and would explain why so many people who lose extreme amounts of weight end up putting it back on).

I really hope this can begin a conversation with readers; I feel like this a topic the Dish is built for.

Another reader:

Wow. This really hit home.

A couple of years ago, at the age of 41, I finally got around to doing what had been my New Years resolution for 15 years running: I lost weight.  And not just a few pounds, but quite a few – 100 to be exact. I did it without surgery, through a series of different “programs”… juicing, nutrisystem, calorie counting, and yes, a good brisk 30-minute dog walk a day.  It took me about 10 months and I’ve kept it off.  When you do something for 10 months and are regimented about it, it just becomes the norm.  That’s what I tell people that ask how I did it.  Find something that works for you and is sustainable.  Because at the end of the day, it needs to be a permanent change.

But back to the subject of the post. I too was disappointed that my body did not bounce back to look like It did in my youth.  My belly looks similar to the woman in the photo shoot.  It’s disappointing because fully clothed, I can catch myself in the mirror and feel fantastic about my accomplishment and the way I look, but getting in the shower in the morning … well, that’s a different story.

What I’ve learned though, is that while improving my appearance was always the biggest reason behind getting in shape, it’s health that has become of greater importance to me.  When I finally got off my butt to lose the weight, my blood pressure was through the roof, and my blood sugar was firmly into the pre-diabetes range, bordering on full blown type-2.  I was maybe two years from some serious health issues and the type of medications you take for the rest of your life.

So when I’m getting in the shower and I catch that ugly belly and backside in the mirror, I can shrug it off and be content with who I am.  But there was a 15-year period where I couldn’t.

Another:

After my last major weight loss and regaining it all and more, I recognized that I was excellent at losing weight, but terrible at sustaining the loss. And I sought to understand why.

I once climbed Mt. Rainier, which, at 14,411 feet, requires that you breathe in a methodical way as you ascend to help your body adjust to the decrease in oxygen in the air. Every breath and every step must be done consciously in tandem to prevent altitude sickness. It requires a level of focus that becomes all-consuming. I don’t remember much about the view during the ascent, but I remember that breathing ritual.

That was my experience as well during weight loss. The focus required is total. Nothing passes your lips without also passing the gauntlet of calorie count, nutrient type, whether it is a “good” or “bad” food, eaten in the right quantities, pairings, settings, company, platings, etc., etc. ad infinitum. The step from healthy attention to unhealthy obsession is a short one, and downhill. The cultural obsession with body image is right there, with its hand on your back the entire time.

A function that is natural and necessary to life, becomes stilted, judged and twisted. And if it works, and you lose the expected weight, it becomes a life sentence to maintain it. Ask a dieter how much of their day is spent planning or anticipating the next tightly monitored meal. How much of their workout is spent staring at the fatuous “calories burned” indicator on the exercise machine readout. It is shocking.

I consider it one of my healthiest decisions to reject the very idea of weight loss as a goal. It took me years to purge myself of the toxic ideas of the diet-and-exercise industrial complex and the self-blame and self-hatred those ideas cultivate and profit from. I consider it malpractice for physicians to prescribe an approach that will be unsuccessful in the long term for 95% of the people who attempt it. What a choice: you can be fat or crazy.

Pinning all your hopes on an unattainable body image (with ever-moving goal posts) and placing the authority on what is best for your body on late-night infomercials is a so sad and so wrong and such a waste. I wish I could put Kozerski’s pictures on every billboard nationwide in hopes of breaking the cultural fever and dispelling the illusion of the perfect body attainable forever through diet and exercise. What we could do with all the brain power being wasted!

I am healthy despite my weight. I eat well, I enjoy moving my body and breaking a sweat. I do not own a scale. I am at peace.

(Image: Self from Kozerski’s series Half. More images from the series can be viewed here (NSFW).)

Why Do Veterans Struggle To Get Jobs?

Many recent vets are unemployed:

A lower percentage of veterans, as a whole, is unemployed (6.3%) compared with their never served counterparts (7.3%). But that’s not true of those who have worn the uniform post–9/11, who had a 10% jobless rate last month.

Sean Vitka pursues the reasons why:

One of the reasons—I suspect the biggest—can be found in an underreported story form just a few days ago. The International Business Times reported that the Department of Veterans Affairs had “stopped releasing statistics on non-fatal war casualties to the public.” It’s likely that the number of people injured from fighting in Afghanistan and Iraq just passed the 1 million mark; of course, we can’t know that, because the data is being withheld.

It’s hard for veterans to find jobs; it’s even harder if they’re disabled. The Department of Labor has the September unemployment rate of people with disabilities at 13.1 percent (and people without at 6.8 percent). If the bills America is paying are any indication, the number of disabled veterans is skyrocketing. America paid disabled veterans $14.8 billion in 2000. In 2011, that number rose to $39.4 billion. The percentages are also climbing. USA Today reported that for the same period, the percentage of veterans with disabilities climbed a staggering 45 percent.

Blockbusted

As Blockbuster gets ready to close its remaining 300 stores in the US, Alexis Madrigal pays homage:

This was our version of the great communal gatherings of the theater! This was our attenuated version of public space! We didn’t even browse the objects themselves, but avatars of the cassettes. Remember? All the tapes were stored behind the counter, and you’d carry this empty box that represented the movie up to the front register and they’d pull it out of their archival cabinet and load it into a clear plastic container for you. Josh Greenberg wrote a book about the creation of the home movie industry, From Betamax to Blockbuster, and he highlights how strange that was, “In the video store, customers browsed movies, represented by boxes that contained nothing more tangible than the experience of watching a movie itself.” For the industry, it was a way of helping you forget you weren’t watching on the silver screen, but the 22″ TV your parents bought at Walgreen’s.

Liz Galvao, who worked at Blockbuster in 2004 and 2005, remembers “one of the best jobs I’ve ever had.” But Jason Bailey, also a former employee, feels differently: “Let’s not soft-soap the fact that this was a chain that ran roughshod over local businesses, gouged customers on a regular basis, employed scores of movie-ignorant dullards, refused to stock controversial titles, imposed a bullshit ‘family’ morality that was hypocritical at best, and operated on a business model that was less about Film than it was about Product”:

Here’s a story that encapsulates everything you need to know about Blockbuster Video:

during a down moment in the initial, training shift for my part-time job at the Big Blue, I posed what seemed a fairly safe small-talk question to the store manager: So, what are your favorite movies? It was an icebreaker that had served me well in my three previous video store gigs; I’d been doing it since I was a teenager, mostly at rinky-dink mom-and-pop operations, but since the slick, well-funded Blockbuster franchise had driven them all out of town, I finally had to give in and go to work for the Evil Empire. But even my cynicism about my new employer didn’t prepare me for an answer I’d never heard from a fellow employee in all my years in the video store business. “Oh, I don’t really watch movies,” my manager cheerfully and matter-of-factly replied. “I mean, I’m around ‘em all day, so I don’t really wanna watch ‘em when I go home.” She wasn’t my manager for long; within a few months, Blockbuster had promoted her to district manager. And that was Blockbuster Video, in a nutshell.

But the Big Blue isn’t quite dead yet; Kathryn Olson presents a map that shows “the company is still going strong abroad, with 1,295 locations outside the U.S., including in Brazil, Mexico, the U.K., and Australia.”