Month: November 2014

Where “Family Planning” Is Deadly

India’s controversial population control policies are in the news again now that a dozen women have died and many others have fallen ill after undergoing surgical sterilization at a government-run camp:

The women were paid 600 rupees apiece, or almost $10, said Dr. Amar Singh Thakur, joint director of health services in the central Indian district of Bilaspur. One surgeon performed surgery on 83 women in the space of six hours on Saturday — meaning he could have spent only a few minutes on each patient, Dr. Thakur said. The women began to fall ill around five hours after being discharged, Dr. Thakur said, experiencing giddiness, vomiting and low blood pressure. Sixty-seven women are being treated for septic shock in hospitals, and four are in serious condition and on ventilators, he said.

India’s sterilization drives began as part of a national population control policy under Indira Gandhi in the 1970s and continue today on a state-by-state basis. David Whelan emphasizes just how creepy this is:

In India’s pursuit of the dream birth rate, human beings are reduced to whole numbers, children to fractions and fallopian tubes to mobile phones. It’s become a weird meta-game for states, where their total fertility rate (TFR) is ​calculated, aggregated, and ranked. Rajasthan declared it would it would ​sterilize 1 percent of its pop​ulation during 2011 in exchange for mobile phones and lottery tickets for cars, like the monstrous Santa Claus of eugenics.

Basic human rights go out the window. In 2012, a single surgeon, Dr. Rajendra Prasad, conducted 53 sterilizations in Bihar without the aid of, oh, ​such trifles as running water or sterilizing equipment. One woman was apparently three months pregnant and miscarried 19 days later. In Uttar Pradesh ​you can trade getting snipped for guns, which is perhaps the most cynical population control ever conceived: Prevent people from reproducing and assist them in killing each other. Give whoever came up with that one the fucking Nobel Peace Prize.

On top of the obvious moral issues at hand, Dhiraj Nayyar questions whether such programs are even effective:

In fact, India’s fertility rates have been declining sharply for reasons that have nothing to do with sterilization programs. In 1971, the Indian average was 5.1 children per woman. That figure declined to 4.5 in 1981 and 3.6 in 1991; it now stands at 2.4, just above the level (2.1) at which a population stabilizes. Over that period, there has been no marked increase in sterilization programs; the government has focused more on building awareness about family planning and disseminating contraception. What has changed, especially after economic liberalization in 1991, are the living standards, rates of urbanization and education levels of the population.

Filipa Ioannou touches on the class dimension of sterilization-based family planning programs, both in India and elsewhere in the developing world:

This sadly probably goes without saying, but: India’s sterilization initiatives are disproportionately pushed upon the relatively powerless rural poor. In 2012, 53 women were sterilized in a single two-hour period in the state of Bihar; the operations took place in a middle school without access to running water or sterilizing equipment. Bihar has the lowest per-capita income in India; as of the 2011 census, it also had the lowest literacy rate. In 2013, the state said it planned to open 13,000 sterilization camps—temporary field hospitals where procedures are performed en masse. And last year in West Bengal, the fifth poorest of India’s 29 states, more than 100 women were dumped unconscious in a field after a mass sterilization gone wrong at a hospital that could not accommodate their numbers. When questioned in parliament, health officials said that in the period from 2009 to 2012, the government paid compensation to families due to 568 sterilization-related deaths.

Insult Of The Day

Alex Massie proves that the art has not been lost in Britain:

A Labour party determined to win would not have chosen to be led by Ed Miliband. A Labour party truly enthused by the prospect of returning to power would not have kept Ed as leader long past the point at which it became clear he’s a gawd-help-us, what-were-we-thinking, sad-sack, head-in-hands, fingernails-on-a-blackboard atrocity never happier than when accosting innocent strangers, most of whom claim to be called “Gareth”.

Why Iran’s Liberals Are Rooting For The Nuclear Deal

Azadeh Moaveni brings up a little-discussed reason:

The hard-line political forces in Tehran most opposed to a nuclear compromise with the West also dominate the institutions—the Revolutionary Guards, the judiciary, and various security bodies—that perpetrate the most serious rights abuses, ranging from summary executions to the detention of journalists, religious and ethnic minority activists, and Iranians with connections to the West. For most of the past decade, these hard-liners exploited times of tension with the West, such as periods when the threat of a U.S. military strike was amplified, or when Iranian nuclear scientists were being assassinated. For the hard-liners these were opportunities to crack down on regime critics, and expel them from universities, newspapers, government ministries, and city councils.

The fear among Iranian dissidents is that a breakdown in nuclear talks would prompt another wave of repression. Inevitably, a breakdown would be seen in Iran as the West having rejected reasonable Iranian overtures (just as the West would see it as Iranian rejection of reasonable Western overtures). Hard-liners would depict this rejection as more evidence of Western disrespect, even contempt, for Iran, and would try to exploit any sense of renewed tension to push their oppressive agenda. That would be especially easy if threats of a military strike by the United States or Israel were revived.

No Latin Mass For These Latin Masses

Michael Paulson discusses a new Pew survey showing the Catholic Church on the decline in Latin America, where evangelicals have made major inroads in recent years:

PR_14.11.13_latinAmerica-overview-18A sweeping new survey, conducted by the Pew Research Center, finds that 69 percent of Latin American adults say they are Catholic, down from an estimated 90 percent for much of the 20th century. The decline appears to have accelerated recently: Eight[y]-four percent of those surveyed said they were raised Catholic, meaning there has been a 15-percentage-point drop-off in one generation. The findings are not a total surprise — it has been evident for some time that evangelical, and particularly Pentecostal, churches are growing in Latin America, generally at the expense of Catholicism. But the Pew study, which was conducted by in-person interviews with 30,000 adults in 18 countries and Puerto Rico, provides significant evidence for the trend, and shows that it is both broad and rapid.

The region remains home to over 40 percent of the world’s Catholics, but the trend is unmistakeable. Adam Taylor adds:

Their reasons for leaving one Christian church and joining another are complicated:

Across the region, the report found, more than 80 percent of former Catholics who had joined the Protestant church did so because they were seeking a “personal connection with God,” while 69 percent said they enjoyed the new style of worship at their new church. Fifty-eight percent said they had converted after the church reached out to them, the report noted. Pew’s report also points to a smaller, yet still considerable, number of people who don’t profess a religion — the “unaffiliated.” These people tend to be younger than Catholics and Protestants and don’t necessarily see themselves as agnostic or atheist: Most just have “no particular religion,” the report notes.

Peter Blair illustrates how the selection of Pope Francis was partly to stem the tide:

[I]t’s possible to read much of Francis’s papacy so far as an attempt to appeal to Catholics and former Catholics in his home region. The friendly, personable style of communication, his closeness with evangelical leaders both before and after his election as Pope (Argentine evangelicals said Francis was “an answer to our prayers” upon his election), his forthright attitude towards the Devil, even his lukewarm or perhaps hostile attitude to Pope Benedict’s liturgical reforms—all of this is consistent with an attempt to stem a growing defection to Protestant churches.

Dissents Of The Day

Several readers push back against this post on the escalating US involvement in Iraq:

I watched that Daily Show interview, and I came away with the sense that Samantha Power basically won the exchange, and that Jon Stewart came off as obsessed with how the media has framed ISIS, rather than how the US government has seen the threat and dealt with it. The point that you think was Stewart’s strongest – that the rhetoric of ISIS being some sort of comic-book super villain who threatens our very existence is overblown – is simply beside the point in the real world. Power agreed with that point but also pointed out that ISIS still represents a real regional threat and a level of terrorist organization and military capacity we haven’t had to deal with before. Stewart agree with that, which basically makes his existential point moot.

It’s not as if the US can only fight “existential threats”. We can also fight significant regional threats, to keep them from every getting to that existential level.

It doesn’t matter if they never would anyway; they are still something that needs to be dealt with. And the lack of any ability of the regional powers to get their act together on their own to deal with ISIS is itself a strong argument for our involvement. The question left hanging as to why they can’t get their act together is of course important, but it’s also hard for a diplomat to honestly answer in public without offending the very people we are trying to get to work together. Power made oblique mentions of the sectarian issues involved, and that’s probably enough to point to the answers there. But the mere existence of those problem is itself a compelling reason for US involvement. Without us, for whatever embarrassing reasons, the regional powers wouldn’t get together to effectively fight and contain ISIS. So that in itself answers the question of why we need to get involved.

So, Stewart lost, and the fact that you think he won tells us all we need to know about why your view is losing this argument in general, on both sides of the aisle in Congress and in the Obama administration. You and Stewart are focused on vague “existentialist” arguments that the actual policy-makers are not terribly concerned about. Though one can always find a scary hyped quote from Butters to make fun of, it’s not how the actual policy is coming about.

Another reader:

I love the blog, love what you’re doing, loyal subscriber. But dude, you are overreacting on the ISIS front. You dropped the ball on the Iraq invasion and so did I, but you’re missing it here as well.

1) Was ISIS capable of taking Saudi Arabia, that’s the defining question. There’s almost certainly a strong 5th column for ISIS in the KSA, you’ve got long, desert borders, a Saudi military with no real combat experience, and ISIS would only have to take Mecca.

2) What would be the fallout from an ISIS take over in Saudi Arabia? Would the world’s economy be better off? Would Iran be more or less likely to create a nuclear weapon? How about our security when a major oil producer is an overt sponsor of terrorism?

3) If the threat is real, and serious, then how best to handle it? First, you want to use the minimal necessary force to contain the threat. In a crisis the first thing to do is stop it getting worse, right? Do you go storming in guns blazing? Well, sure, you could, but then you’re just reinforcing the passivity, the weakness of most local forces. You’ve taken on the responsibility and deprived the locals of same. How is that a good idea?

4) But you still want ISIS contained. So you do the minimum necessary: air power and a trickle of arms. You don’t take over, you just make sure your side doesn’t quite lose. Everything else is on the backs of the locals, so they are forced to step up, to mature.

5) ISIS is in a geographical box. The Kobani failure destroys their aura of invincibility. Contain, degrade, leave them to be nibbled to death by Kurds, Iraqis, Jordanians.

I think Obama’s got this. I think he’s right and you should re-examine your assumptions.

One more:

As will likely be pointed out by others, the great hole in your argument about the current US involvement in Iraq is this: “the decision to re-start the Iraq War last August.” Because as you correctly pointed out, the US invaded Iraq in response to 9-11 – despite the two having no connection at all – created the Sunni insurgency, and destroyed our moral authority by embracing torture.

But the US isn’t “re-starting” anything. We’re not invading a country under false pretenses. We are not creating a new insurgency. We are not operating prisons in Iraq (much less sites of torture). Instead, before last August, there was already a war going on – a Sunni jihadist war with Bathist/Alawite Syria, Shiite Iraq, and Sunni Kurdistan. Obama is not starting this war; he’s helping out two of the sides, Sunni Kurdistan and Shiite Iraq.  If Obama had done nothing, the war would still be going on.

And from a strictly selfish perspective, over 6500 Americans have died in Afghanistan and Iraq. But not one has died during this current war – because the US isn’t doing any fighting on the ground, and is not an occupying power.

But hey, Obama restarted the Iraq War. It’s exactly the same as what Bush did. That is a convenient thing to argue for someone immensely frustrated with the region, but it isn’t very true.  Just like conflating it with Vietnam. Really? But I guess we should just abandon the Kurds and let jihadist roam free, because of what Bush did and what you supported in 2003.

Quote For The Day

“It may be tempting to embrace the violent power of the state as the solution to ideas and expression you find hateful and ugly. But I promise you: the day that the United States bans hate speech, such a law will be invoked against a pro-Palestinian activist, to pick one example. I promise. That is inevitable. Whether the elites that so credulously embrace the notion of empowering the police state to squash harassment like it or not. And it may be tempting to embrace the coercive power of large corporations to limit speech online. But I promise you: that power will also be used against you by your antagonists, who are opportunistic and learn quickly.

Lefty Twitter might be obsessed with policing language. But they won’t actually get to do the policing themselves. Instead, they will hand that work off to the same broken institutions and corrupt authorities that they themselves have diagnosed as broken and corrupt. And that is one of these fundamental, existential paradoxes within contemporary left-wing orthodoxy today: simultaneously recognizing that we live within structures of intrinsic, intentional inequality and injustice, and yet forever ready to abandon that skepticism towards those structures when it seems convenient to do so, ” – Freddie deBoer.

A National Eating Plan? Ctd

A reader exclaims:

Look! We almost had a national food plan – it got to the white paper stage.

Another reader:

This is a topic in which I am extremely interested and see the many challenges. In my mind, it is a fact that we are harming our health, the planet, animals, and the economy with the current SAD (Standard American Diet). So many places to go with this it’s hard to be succinct. First off, I agree with Bittman, Pollan, et al on the goal they are trying to achieve, but I have issues with the means. Anything like a “National Food Policy” coming from Obama will be derided immediately as nanny-state-ism by half the country. But there are pieces I think he should address anyway:

The corn and soy subsidies have got to stop. Why is our gov’t subsidizing the thing that is making us sick and costing us billions in health care costs (maybe trillions if you factor in other costs to the economy)? And while we’re at it, I have ZERO problem with government taxing heavily sugar-laden “foods”.

Food safety: Get the pesticides and chemicals out of our food (and our personal care products, while you’re at it). Most of the 80,000 the chemicals used in the US today have not been suitably tested by the EPA and these are creating tremendous hidden health and environmental  issues.

Regulations for meat producers for both food safety and animal rights should go forward. It SHOULD make meat more expensive and that’s OK. We should be eating much less meat anyway, so let the higher prices reduce consumption so it’s a win-win.

But secondly, maybe what these writers are really trying to achieve is this: get people talking about these issues to raise awareness. Maybe the government isn’t the sole answer to all these interrelated problems, but we can’t get the market to adjust unless people understand the problem and want to make changes.

Maybe Glenn Beck can help: I just read that he has health issues (an autoimmune disease) which he is treating with diet and lifestyle changes. Hopefully he’ll become a source for all his viewers on the benefits of healthy eating and lifestyle. We really need someone like him (i.e. from the other side of the aisle) to support this discussion to reach all those who say “keep your gov’t hands off my Big Gulp”.

Love, love, love that you have brought this issue to your website. Would love to see more.

Update from a reader with more:

In regard to your skepticism regarding the Pollan-Bittman reworking of national food policy, I would like to call to your attention an effort to actually do that, just not in a direction P-B would likely deem appropriate.

Rather than ever more micromanagement of the national diet, with longer lists of “bad” foods and shorter lists of “good” foods, my (small, non-profit, moms-in-sneakers) organization, Healthy Nation Coalition, is calling for a scaling back of the Dietary Guidelines for Americans so that they are focused on the acquisition of adequate essential nutritional (at one time the sole focus of federal dietary guidance).  Rather than continue a (failed) effort to prevent chronic disease through avoiding foods (eggs, whole milk, butter, gasp, even meat) that are wholesome and nourishing and expanding the recommendations to include views on sustainability (despite the fact that, as far as I can tell, no farmers sit on the Dietary Guidelines Advisory Committee), we think it would be a good idea if federal dietary recommendations stuck to clear, science-based advice that the public could actually use.

There’s been some media attention paid to this angle recently as well, and we think the folks in Washington might be ready to listen to an alternative to P-B.

Another:

Your reader asked: “The corn and soy subsidies have got to stop. Why is our gov’t subsidizing the thing that is making us sick and costing us billions in health care costs (maybe trillions if you factor in other costs to the economy)?” Easy answer: because these crops are grown primarily to beturned into meat at torture factories, and the government is devoted to heavily subsidizingAmerica’s extreme over-consumption of meat.

Subsidized fossil fuels are turned into artificial fertilizer; artificial fertilizer is turned into further-subsidized corn and soy; corn and soy are turned into meat – all in an extremely cruel, inefficient, and polluting process. We are eating fossil fuel products, and about half of the nitrogen in our bodies came from fossil fuels. It is outrageously unsustainable, but it is the only way to provide such vast quantities of cheap meat.

Gruberism And Our Democracy

In general, I tend to agree with Tyler Cowen that off-the-cuff remarks by academics at conferences should not be vulnerable to political use and abuse. We need spaces where we can riff and think out loud without being held responsible for every phrase. But then again, this is 2014, where nothing anyone has ever said or written can be forgotten if you have a dogged web researcher to root it out. And when those remarks come from someone who helped design and write the ACA, and speak to the way in which it was constructed and sold to the public, it’s a legitimate gotcha.

Of course, a large amount of what Gruber said is hardly unusual in Washington. Gaming the CBO scoring, framing the pros and cons in deceptive ways, making it easy for congressmen to vote for something without being hit by 30-second ads in the next election cycle: all this is part of messy governance. But Gruber’s remarks about the stupidity of the American electorate are so typical of a certain Democratic mindset they’re worth unpacking.

And as we noted earlier, Chait makes the point that Gruber really means ignorance rather than stupidity:

Very few people understand economics and public policy. This is especially true of Obamacare — most Americans are unaware of the law’s basic functions or even whether their state is participating. Since people know so little about public policy in general and health-care policy in particular, they tend to have incoherent views. In health care and other areas, they want to enjoy generous benefits while paying low taxes and don’t know enough details to reconcile those irreconcilable preferences. Gruber’s error here is that, by describing this as “stupidity” rather than a “lack of knowledge,” he moves from lamenting an unfortunate problem both parties must work around to condescending to the public in an unattractive way.

I actually think this makes it worse. The only reason Americans are ignorant about the ACA is that they were never clearly told what it was designed to achieve and how it would work. The debate was had among elites, using often technical language – who really knows what a vague “public option” means, for example? – and then sold to the public with either blanket reassurances (if you have an insurance policy, you can keep it) or terror stories about a government take-over (which it wasn’t). The reason for this failure by both sides to lay out the actual plan in ways anyone could understand was political. Neither side wanted a free-wheeling debate with unknown consequences; one was aiming for passage (something never achieved before), and the other was rooting for failure (for rank partisan reasons). Neither side was really interested in a real debate about the pros and cons.

This remains a huge disservice to democracy and it helps explain why our elites are so despised. I mean: why couldn’t Obama or leading Democrats actually make the simple case: we’re going to give subsidies to the working poor to get private health insurance and force insurers to take anyone regardless of pre-existing conditions. We’re going to make this affordable for the insurance companies by mandating that everyone get insurance, thereby including more young, healthy people in the risk pool to offset the costs of the sick. And we’re going to make sure that insurance is better than in the past, and is not subject to lifetime caps or getting booted off the minute you get sick.

That wasn’t that hard, was it?

Most people understand that there are trade-offs in life; most people have insurance of one sort or another and are cognizant of how insurance works – the bigger the pool the better. And to my mind, the trade-offs are worth it. If someone were willing to explain the ACA in simple, clear and honest terms, I think most Americans would back it. What’s maddening is that American politicians never speak this way. A proposal is either all honey or all vinegar. And each side assumes that that’s the only kind of argument Americans are prepared or able to understand. So, it isn’t really ignorance that’s the problem – because that can be fixed. It really is a cynical assumption of most Americans’ stupidity.

The Republicans are shameless in their deployment of this – tax cuts always good! no trade-offs ever! – but so too are the Democrats. There really is a mentality out there that sees politics as finding a way to deceive voters to give them what they need but for some inexplicable reason don’t actually want. They really do treat people as if they were stupid. If some smidgen of honesty could be used against a politician in a sound-bite, he’d prefer bullshit. The most obvious example was Obama’s categorical pledge that no one with insurance would ever be forced to change – even though the minimal benefits of an ACA plan were greater than those in many existing private sector plans. You can call this a lie – which it was – or you can call it a cheap dodge to get what you want with a little flim-flam. But no one would ever have said such a thing if they had bothered to make the good faith argument that change for the better requires some trade-offs, that some will benefit and others may take a hit. Obama pledged to be that kind of honest, straight-talking president. Often he is. On the most important domestic policy achievement of his presidency, he wasn’t.

I support the ACA; but I cannot support the kind of politics that made it happen. And I refuse to believe that a democracy has to operate this way for change to occur. Gruber’s arrogance and condescension are just meta-phenomena of this deeper dysfunction. Someone needs to treat Americans as adults again before this democracy can regain the credibility it so desperately needs to endure.