Month: February 2014

I don’t read her for the arguments any more. But she sure is feeling things:

I think a lot of people right now, certainly Republicans and conservatives, feel like a guy in a batting cage taking ball after ball from an automatic pitching machine. He’s hitting the ball and keeping up and suddenly the machine starts going berserk. It’s firing five balls a second, then 10. At first he tries to hit a few. Then he’s just trying to duck, trying not to get hurt.

That’s how people feel about the demands and dictates. The balls keep coming at them politically, locally, culturally. Republicans and conservatives comprise at least half the country. That’s a lot of people.

Ten balls a second! So I ask myself, as one does: what does she mean by balls? I can glean the following:

Rules, regulations, many of them stupid, from all the agencies—local, state, federal—on the building of a house, or the starting of a business. You can only employ so many before the new insurance rules kick in so don’t employ too many, don’t take a chance! Which means: Don’t grow. It takes the utmost commitment to start a school or improve an existing one because you’ll come up against the unions, which own the politicians.

Okay, so Obamacare. And yes, it does add a burden of mandated responsibility for employees’ healthcare and your own. Here at the Dish, we’ve gone through the tedious and time-consuming business of figuring out our new insurance policy in the exchanges, and I’ve found a new policy for myself here in DC. It was a hassle, but it would be hard to argue that it’s that much more burdensome than figuring out our insurance before Obamacare. And, in my case, for the first time in two decades, I feel secure in being able to keep my insurance regardless of what happens to my employment situation. I’d go further and say that Obamacare helped give me the security that allowed me to start a new small business. Has that ever occurred to Noonan? Maybe it takes having a pre-existing condition to see it from one potential employer’s point of view.

As for “local, state, federal” regulations on building a house or starting a business: is Noonan really saying that these only exist because of “angry progressives”? Please.

And she fails to provide any evidence that this kind of regulation has intensified these past few years.

Then there’s the invocation of the poor citizens of Arizona, being pelted with gay balls. I understand and sympathize with a sense of bewilderment, especially among fundamentalists and the older generations, at the advance of gay dignity and equality. But, as Jan Brewer noted, there had not been a single incident of alleged gay aggression in Arizona. If any group could be forgiven for feeling that it was being pummeled with a fusillade of balls, it has been the gay and lesbian community, suddenly confronted across several states with bills that would have decimated any protections against discrimination. Has it ever occurred to Noonan that gay people might feel under siege as well? From Russia to Uganda and Nigeria, aided and abetted by American Christianists, gay people are experiencing a wave of hatred and hostility far surpassing the discomfort of a fundamentalist wedding planner. And yet Noonan can only see things from the perspective of those seeking to keep sinners at arm’s length.

At some point, her editors might ask her to complement her feelings with actual arguments. But one senses she doesn’t really have any. Just a hell of a lot of balls.

A reader counters my analysis of these numbers:

On the issue of circumcision, you are biased and unbalanced. You call circumcision “male genital mutilation”. OK, that’s a bias you are entitled to. Attack circumcision as a moral abomination if you must, but eliminating circumcision will do little for healthcare costs. You cite its $1.8 billion cost and italicize it for emphasis. That is unbalanced. The data report you cite says that of the top 20 operating-room procedures, circumcision is the cheapest per procedure by far and is 20th on the list of 20. And the total cost of circumcisions is just 0.069% of total spending of $2.6 trillion on healthcare in 2010 in the US, and less than 1% of total OR procedures.

The biggest source of healthcare costs are in people over 65, of course, and the biggest source of healthcare costs in people over 65 are in the 25% or so of people with chronic diseases such as CHF, COPD or diabetes. The biggest driver of healthcare cost increases is medical technology driving new treatments to market. Circumcision has very little to do with medical costs.

Of course, mutilating infant boys’ genitals is a small factor in the context of the costs my reader cites. And yes, circumcision is itself not that expensive. But its ubiquity means a remarkable use of medical and operating room resources for an elective procedure. And by “elective”, I do not mean, of course, that the boys choose it. Their parents choose it without the patient’s consent. Another reader on the issue in general:

Okay, you win.

For years I’ve been a loyal reader despite the fact that you occasionally hammer on crusades that I can’t get behind – most notably, your war against “male genital mutilation”.  As a parent of two boys, I reflexively had them circumcised at birth; because I was, and because I’d never seen an uncircumcised one in real life, and because I didn’t want my boys to grow up wondering why they looked different than me “down there”.  In that context, I’ve always been annoyed by your relentless stance on this issue.

Until today.  You see, I’m a healthcare actuary by profession, so today you finally hit on an argument that resonates with me – that male circumcision is symptomatic of our society’s over-utilization of healthcare.  Way to keep attacking from different angles until your target finally yields …

Another really took the blogging to heart:

Just thought I’d share that your ongoing coverage reinforced the decision my wife and I made not to circumcise our son. We both come from Southern, conservative, Protestant families where circumcision has been the norm for who-knows-how-long, but our families haven’t made any complaints, and we feel we made the right choice.

Update from another:

I have always rolled my eyes at the term “male genital mutilation.” Same goes for some of the other hysterics of anti-circumcisionists. None of those arguments ever did much for me. (Less sensitivity? Things feel just fine for me down there, thank you. Psychological damage? Please. There are plenty of sources of adult neuroses other than the penis. The anesthetized trimming of a little skin is hardly the worst thing that happened to me in childhood.) And until a month ago I always would have thought that I would have my sons circumcised, like me. I am American, after all, and circumcision is just what we do, right? Why should I make my sons “different”?

But last month, with a newly-pregnant wife, my view changed for a very simple reason: I realized that I don’t have any reason to circumcise. I attended the bris of a friend’s son and saw it all happen. None of it grossed me out. Not the blood, not the scalpel. And the baby didn’t seem to be in any pain. But it struck me quite suddenly that while my Jewish friends have a very good, compelling reason to circumcise – a covenant with their God – I just don’t have one. And as a rational person, it is simply not in my nature to make a permanent and unalterable decision without a good reason.

A rebuttal from a reader:

When discussing what you call male genital mutilation, you keep saying that this is surgery that is done without the patient’s consent. Obviously, a new born can’t consent to anything but circumcision is a very different operation for a newborn than it is for an adult. Ignoring the issue of whether it is necessary surgery, it is a very minor procedure for a baby and a huge deal for an adult. A close friend of mine, born in China, was uncut. He had to be circumcised as an adult (I believe he had the same condition as Louis XVI) and it was as Joe Biden would say, “a big fucking deal.” He was in a lot of pain for a long time and the surgery came with risks of complications and scarring.

You argue that the parent makes the decision to circumcise an infant son without his consent but the parent is also essentially making the decision not to circumcise too. An adult may think/want/believe he is better off circumcised but if his parents did not make that decision for him as a baby, it may not be a realistic choice for him to make as an adult.

In addition to signing the “kill the gays” law, Ugandan president Yoweri Museveni approved an extraordinarily sweeping “anti-pornography” bill last week. “Pornography,” in this case, includes skimpy summer clothes:

According to Uganda’s Daily Monitor, [the law] bans “behavior or form of communication or speech or information or literature or publication in whole or publication in part or news story or entertainment or stage play or broadcast or music or dance or art or graphic or picture or photography or video recording or leisure activity or show or exhibition.” Ugandan media has largely focused on the possibility that the law would be a de facto ban on revealing clothing and has dubbed it the “miniskirt law.” … [I]f a Ugandan stages a play that includes sexualized, under-clothed thighs, she and the journalist who writes a review could both be locked up. Breaking the law could incur penalties of up to seven years in prison.

One consequence of the new law: women, like gays, now find themselves at increased risk of mob violence. Consider:

More than 40 women have been stripped naked in the different towns of Uganda, including the capital Kampala, in the last three days over misconception that they are breaking the law by wearing miniskirts. …

[A]n association of Ugandan women in parliament has lamented provisions of the new anti-pornography’s law that deals with women’s dressing. Rosemary Nyakikongolo, vice chairperson of the Uganda Women Parliamentary Association, claims “parliament rushed to pass the anti-pornography law.” She said the attacks on women are because “MPs passed the law [without] adequate public consultation.”

Earlier this week, police stopped 200 women from marching in Kampala to protest the law. In fact, if not for women’s earlier activism, the law would have been much worse:

Ever since Simon Lokodo, State Minister for Ethics and Integrity and lead proponent for a ban on miniskirts, announced that the Anti-Pornography Bill had been signed into law, women have faced violence, especially in taxi ranks. According to Lokodo, “If your miniskirt falls within the ambit of this definition then I am afraid you will be caught up by the law.”

Except that, despite Lokodo’s most fervent efforts, the miniskirt ban actually never made it into the final legislation. Women across Uganda shut it down. From #SaveTheMiniSkirt online campaigns to Save the Miniskirt parties to formal lobbying to organizing in the streets and off, women shut it down. Women understood that the issue of their clothing was nothing more or less than an attack on women’s autonomy. For Rita Aciro Lakor, the executive director of Uganda Women’s Network (Uwonet), “It’s about going back to controlling women. They’ll start with clothes. The next time they’re going to remove the little provisions in the law that promote and protect women’s rights.”

A recent NYT op-ed by Marcy Darnovsky warning about a procedure that uses donor-supplied mitochondria to allow women with mitochondrial diseases to give birth to healthy children has kicked off a new debate about “designer babies”. Nita Farahany, a member of the Presidential Commission for the Study of Bioethical Issues, emphasizes that using donated mitochondria doesn’t make the donor a “third parent,” as the scare stories would have it:

Embryos that result from these techniques have genetic material contributed from three different individuals, but the mitochondrial donor is not a parent — genetically, or otherwise. When using mitochondria from a donor egg, the resulting egg (which has the nucleus from the intending mother) has 99.9 percent of its coding DNA from the intending mother. The donor provides the energy necessary for the egg to function normally. When the egg is then fertilized by a sperm cell, the resulting embryo carries less than .1 percent of its DNA from the mitochondrial donor.

Ronald Bailey accuses the NYT of “immoral scaremongering”:

The mitochondrial replacement technique is not at all “deeply problematic.” In fact, the FDA panel has finally gotten around to considering a technique that the agency banned after essentially the same procedure was being successfully deployed by team led by fertility researcher Jacques Cohen 13 years ago. Cohen used the technique to help women to give birth to 20 children before the FDA shut down his work in 2001. At a conference some years later, I asked Cohen how the children were faring and he told me that 19 were healthy and one has an autism disorder. As it happens, some research finds a correlation between mitochondrial dysfunction and some cases of autism.

Jessica Grose also dismisses the fears over designer babies and describes what’s at stake for the pregnant women:

When a woman’s eggs have severe mitochondrial abnormalities, they can have many miscarriages, stillborn children, or extremely sick babies who are unlikely to survive past early childhood. “They will suffer immensely because they can’t get the energy” in order for their brains and hearts to grow, says [Nita] Farahany. They can have extreme pain and difficulty breathing. Fixing this huge amount of suffering for both mother and child seems like a far cry from creating “designer babies,” and paramount to any hyped-up concern about a slippery slope.

Although the mitochondrial procedure may not entail the creation of designer babies, Drum figures we’ll get there eventually:

It’s about time we faced up to this, I think. As the technology for this steadily advances, and designer babies become possible, parents are going to get designer babies. If the United States bans it, they’ll go to Switzerland. If Switzerland bans it, they’ll go to China. If China bans it, they’ll go underground. But one way or another, if this technology exists, the demand for it is going to be irresistible.

Greg Grandin researches “the way the advancement of medical knowledge was paid for with the lives of slaves”:

The death rate on the trans-Atlantic voyage to the New World was staggeringly high. Slave ships, however, were more than floating tombs. They were floating laboratories, offering researchers a chance to examine the course of diseases in fairly controlled, quarantined environments.  Doctors and medical researchers could take advantage of high mortality rates to identify a bewildering number of symptoms, classify them into diseases, and hypothesize about their causes.

Corps of doctors tended to slave ports up and down the Atlantic seaboard. Some of them were committed to relieving suffering; others were simply looking for ways to make the slave system more profitable. In either case, they identified types of fevers, learned how to decrease mortality and increase fertility, experimented with how much water was needed for optimum numbers of slaves to survive on a diet of salted fish and beef jerky, and identified the best ratio of caloric intake to labor hours. Priceless epidemiological information on a range of diseases — malaria, smallpox, yellow fever, dysentery, typhoid, cholera, and so on — was gleaned from the bodies of the dying and the dead.

Update from a reader:

It’s important to note that this experimentation on slaves was an ongoing practice. For example, there is the case of J. Marion Sims, considered the “Father of Modern Gynecology.”

Sims created some of the first basic tools for gynecological examination.  But these breakthroughs came through the experimentation of untold, and largely unnamed, slave women (and later in New York City on destitute Irish immigrant women). I learned about Sims a few years ago on a visit to the State Capitol grounds in Columbia, South Carolina which features a beautiful memorial to Sims that presents him as a great hero and pioneer. There have been attempts to “right the record” and include a more complete story of his record along with the heroic inscriptions. These would include the sheer numbers of forced patients and the staggering numbers of surgeries (30 known on one patient).  These were all done without anesthetic, which was known and used at that time.  In any case it didn’t matter.  The pain of the patient wasn’t a consideration.  Gynecological problems that impeded their value as bearers of more slaves was what Sims was attempting to solve in these surgeries.

(Illustration: Diagram of a slave ship from the Atlantic slave trade. Via Wikimedia Commons)