Obama’s Proposals Are Pretty Modest

That’s Jordan Weissman take:

Combined, Obama’s hikes would raise $320 billion over a decade, or $32 billion per year. That’s just a smidge more than 1 percent of last year’s federal tax revenue—more than a rounding error, but not much more. Obama isn’t looking to soak the rich at this point so much as lightly spritz them.

Christopher Flavelle declares that Obama’s “prescriptions mostly demonstrate the timidity of the ideas that Democrats are willing to offer”:

At some point, I hope a leading Democratic politician offers prescriptions that challenge the status quo — if only to remind Americans that what now seem like the outer bounds of policy choices actually represent a narrow range of options, at least by the standards of other developed countries.

Daniel Gross points to a tax loophole Obama hasn’t targeted:

[C]apping IRA amounts does little to address the way Romney really made his money—and that represents one of the most egregious, income-inequality-inducing wrinkles in our tax code. It’s the factor that has really allowed hedge-fund titans and private-equity barons to routinely mint Rockefeller-size fortunes. It’s called the carried interest rule, and Obama doesn’t look like he’s ready to do away with it yet.

Drum sees this as part of a larger strategy:

This actually fits with everything Obama has been doing lately: neither his legislative proposals nor his executive actions have been world shaking. It’s all small-ball stuff, designed as much to make a point as it is to actually make a difference. If you put them all together, Obama’s actions are a way of showing that (a) Democrats are reasonable folks, (b) they’re on the side of the middle class, and (c) Republicans continue to be the party of plutocrats, adamantly opposed to even modest proposals that would tax the rich ever so slightly more.

Book Club: Should Even Heroin Be Legal?

It’s time for our first selection of 2015: Johann Hari’s new book, Chasing the Scream: The First and Last Days of the War on Drugs, which you can buy here in hardcover and here for the e-version. From the publisher’s description:

It is now 100 years since drugs were first banned [in the US by the Harrison Act]. On the eve of this centenary, journalist chasing-screamJohann Hari set off on an epic three-year, 30,000-mile journey into the war on drugs to uncover its secrets – and he found that there is a startling gap between what we have been told and what is really going on. As strange as it may seem at first, drugs are not what we have been told they are; addiction is not what we think it is; and the drug war has very different motives to the ones we have seen on our TV screens.

In Chasing the Scream, Hari reveals his startling discoveries entirely through the true and shocking stories of people across the world whose lives have been transformed by this war. They range from a transsexual crack dealer in Brooklyn searching for her mother, to a teenage hit-man in Mexico searching for a way out. It begins with Hari’s discovery that at the birth of the drug war, Billie Holiday was stalked and killed by the man who launched this crusade – while it ends with the story of a brave doctor [in Portugal] who has led his country to decriminalize every drug, from cannabis to crack, with remarkable results.

Miranda Collinge of Esquire calls the book a “fascinating, extensively researched and heartfelt contribution to a debate over drugs policy that continues to rage today”:

It’s a pattern Hari observes again and again through the decades: a zealous, misguided or sometimes deeply prejudiced person in power decides to eradicate the social blight of drugs, forcing, even offering, the drugs trade to criminals, while the hopeless and the helpless are caught in the crossfire. He meets scientists, counsellors, addicts and dealers who point out the folly of this approach, which he backs up with studies of murder rates, the workings of the human brain and, particularly memorably, self-fellating rats.

bookclub-beagle-trJohann has a hard time writing a bad sentence. I’ll be up-front bout my friendship with him, which is deep. He made some mistakes in the past, for which I think this book is by far the best atonement. It’s very hard to put down, and it offers a series of gripping narratives about this blight on our world – not of drugs, but of the failed “war” on them.

By the way, Johann will be in DC talking about his book at Politics and Prose on January 29, then in NYC at the 92nd Street Y on the 30th, then in Baltimore at Red Emma’s on the 4th of February. He’s even more engaging in person than in prose.

Pete Guither of DrugWarRant “highly recommends” Chasing the Scream:

… I’ve read so much about the war on drugs that it’s hard to get excited about reading a book about it. But less than halfway through the first chapter, I couldn’t put it down – it’s an amazing read. … For drug policy experts like me, it’s a great read with some fascinating personal perspectives, while filling in a few historical knowledge gaps.

Decca Aitkenhead is also impressed by the book:

[Johann] has never spoken publicly about [his plagiarism scandal from 2011] until now. My other worry was whether johann-hari-680x1024anyone would want to read yet another polemic about drugs. I wouldn’t, and I’m quite interested in the subject. The prohibition-versus-legalisation debate tends to be interminably dreary, chiefly because neither side ever seems to change anybody’s mind.

“I think that’s totally right,” Hari agrees. “I did not want to write a 400-page polemic about the drug war. I didn’t want to have an argument about it, I wanted to understand it.” For that matter, he admits, “It’s struck me that, actually, polemic very rarely changes people’s minds about anything.” He says so as a former columnist? “A recovering former columnist, yes.” He laughs. “It’s not just that polemic doesn’t change people’s minds. It says nothing about the texture of lived experience. People are complex and nuanced, they don’t live polemically.”

Hari’s book turns out to be a page-turner, full of astonishing revelations.

I had no idea that the war on drugs was single-handedly invented by a racist ex-prohibition agent [in the US], who needed to find a new problem big enough to protect his departmental budget. One of the first victims of his ambition was Billie Holiday, whose heroin addiction enraged him to the point where he hounded her to death. After he’d had the singer jailed for drugs, she was stripped of her performing licence, and as she unravelled into destitution and despair, his agents continued to harass her, even summoning a grand jury to indict her as she lay dying under police guard in a hospital bed.

Politico published a long passage of the chapter on Holiday:

Narcotics agents were sent to her hospital bed and said they had found less than one-eighth of an ounce of heroin in a tinfoil envelope. They claimed it was hanging on a nail on the wall, six feet from the bottom of her bed—a spot Billie was incapable of reaching. They summoned a grand jury to indict her, telling her that unless she disclosed her dealer, they would take her straight to prison. They confiscated her comic books, radio, record player, flowers, chocolates and magazines, handcuffed her to the bed and stationed two policemen at the door. They had orders to forbid any visitors from coming in without a written permit, and her friends were told there was no way to see her. Her friend Maely Dufty screamed at them that it was against the law to arrest somebody who was on the critical list. They explained that the problem had been solved: they had taken her off the critical list.

So now, on top of the cirrhosis of the liver, Billie went into heroin withdrawal, alone.

Her NYT obituary from July 1959 is here. As far as Johann’s credibility with the book, Malcolm Forbes is more than assured:

Given that he devotes his last 70 pages to detailed notes with sources and a lengthy bibliography, it seems a safe bet to say we can [trust the book]. (There is even a link to audio recordings of the quotes that appear within the book, along with the invitation to email Hari with any errors found.)

Meanwhile, The Guardian‘s Ed Vulliamy scrutinizes the book from the far left:

Legalisation would no doubt suit places such as Vancouver, New York or Liverpool. But how would it work in wretched barrios around the cities of central and South America, townships of Africa and eventually dormitory towns of China and Bangladesh? Hari insists that “responsible drug use is the norm, not the exception”. He reports a UN statistic that “only 10% of drug users have a problem with their substance. Some 90% of people who use a drug – the overwhelming majority – are not harmed by it.” But this is not the whole story in the desperately poor, wider world that services the countries where Hari’s book is set. …

Because if hard drugs are legal, who is going to make them? Presumably the experts who already do, working not for narco syndicates but Big Pharma, another kind of cartel. And do we really trust Big Pharma to manufacture methamphetamine and process crack or heroin in order to sell as little as possible in the developing world? That’s not how Big Pharma works; that’s not how capitalism works.

And from the right-wing Spectator, Duncan Fallowell:

Hari also blames Washington for the horrific battles between drug gangs in Latin America and the Caribbean. But non-prohibition is no guarantee of peace and harmony. Look at the merciless gang wars in central Africa over precious stones and metals. And prohibition can be a vital tool: against illegal logging in the Amazon for example, or the slaughter of elephants.

He says the war against drugs has been going on for a century and is still not won, so it’s been pointless. Some wars are eternal and to expect otherwise is utopianism — the war against weeds, for example, which is called gardening. The war on drugs can be called public health. One of Hari’s own informers raises this: ‘We need to approach drug addiction not as a criminal justice situation but as a public health situation.’

That indeed is how it is regarded. Criminal prohibition was never considered enough in itself, even to the most rigorous Washington hardliner. It should be noted that liberalisation has already begun in some US states and that the world’s harshest anti-drug laws — by far — are in Muslim and Asian countries, which Hari ignores.

John Harris calls the book “important and largely convincing” but still had mixed feelings about it:

Chasing the Scream is a powerful contribution to an urgent debate, but this is its central problem: in contrast to the often brutal realities it describes, it uses the gauche journalistic equivalent of the narrative voice found in Mills & Boon novels. Amid Mexican sand dunes, he tells us, Hari thought about the drug wars’ endless downsides as he “ran my fingers through the prickly hot white sand” and crassly imagined the joyous lives of local teenagers in a world free of gangsters (“Juan, stripped of his angel wings, is chatting with Rosalio about World of Warcraft”).

Barbara Spindel points to the personal nature of the book:

Hari notes at the outset that he has been close to several addicts — that they “feel like my tribe, my group, my people” — and he confesses that, while not narcoleptic, he for years took “fistfuls” of narcolepsy pills because they enabled him to write for weeks without rest. He structures the book as a personal journey, weighing the pros and cons of legalization himself as he presents them to his readers. … “Chasing the Scream” is a riveting book, and Hari is an effective storyteller; he would have been better off keeping the focus off of himself and entirely on Chino, Rosalio and the others.

David Robinson credits Johann for “talk[ing] to some truly amazing people in the three years he spent researching this book,” but Robinson had qualms about its conclusions:

[Johann’s] ex is an addict. So when Hari points out that “the opposite of addiction isn’t sobriety. It’s connection,” it comes straight from the heart: his ex is passed out on his spare bed as he writes. “If you are alone,” he adds, “you cannot escape addiction. If you are loved, you have a chance.”

I’m sure that’s true. But am I going to vote to legalise crack, and have children smoking their father’s legally held crack stash just as, in my day, they used to smoke their dad’s cigarettes? I think not.

The Dish will be debating such questions starting in mid-February. To join the conversation, buy the book at this link (if you’d like to help out the Dish with a little affiliate revenue) and email your thoughts to bookclub@andrewsullivan.com.

The Politics Of “Fertility Fog” Ctd

A reader summarizes his email upfront:

Testosterone doesn’t boost sperm count like your one reader hinted.  It’s quite the opposite  (see here). At the very least, please clear that issue up so others aren’t misled.

Also, below is my story of how testosterone replacement made me sterile and almost left my wife and me needlessly childless.  It’s a story worth sharing so others aren’t disappointed when they decide to have kids.  Testosterone is given way too freely without mention of the fertility side effects and without dealing with underlying conditions.

I have read with interest your posts on fertility, especially the recent comments from men.  Regarding the 42-year-old fellow with low sperm count, he noted the issues of stress and other factors that impacted sperm quality – this is all very true.  He also mentioned that the doc said “to keep trying and come back in 8 months…If we weren’t pregnant, he’d give me a shot of testosterone to boost my system as another step in fixing my sperm count issues. “  Testosterone does NOT boost sperm count – it can actually reduce it.  In fact, testosterone is a prime candidate for what some hope will be the first male-oriented hormonal contraceptive. He’s probably thinking HCG or human chorionic gonadotropin, which is used to boost male fertility.  Why do I know this?  I was given testosterone but never told the impact it could have on fertility – until it was almost too late.

About 5 years ago I presented to my doctor with erection and low energy problems.  He tested and found I had low testosterone and prescribed testosterone gel, which I used for a few years.  After grad school and at the ripe old age of 40, we decided it was time.  After a few months of trying I tested my sperm with a home test kit.  It’s pretty cool; it comes with a microscope, slides, and everything else you need to do a basic test.

There was nothing moving on the slide.  A visit to a fertility clinic confirmed that I was 100% sterile.  It was then that I did some research and discovered that a side effect of testosterone replacement is infertility.  An endocrinologist switched me to HCG, which has the dual benefit of boosting testosterone AND sperm production.  Today I am 43 and have a 12-week-old daughter at home.

Turns out doctors prescribe testosterone all the time without considering the root cause and without explaining the fertility impact.  In my case, I actually had sleep apnea that was only discovered after yet another endocrinologist insisted I check it to rule it out before continuing HCG after my wife got pregnant.  I’m fit and otherwise healthy – sub 1:50 half marathoner – and yet I still have sleep apnea.

Bottom line, if a man wants to get his significant other pregnant, stay away from testosterone.  And if a doctor suggests testosterone, insist on a full workup to rule out apnea, pituitary problems, and other issues before taking the stuff.  You might find yourself infertile otherwise and, perhaps, overlooking a more serious medical condition.

How To Tell When Time Is Up

Chrissie Giles investigates how medical professionals deliver diagnoses of terminal illness:

Individual words matter. Professor Elena Semino and colleagues at Lancaster University have been conducting a study of how certain kinds of language are used in communication about the end of life. They’ve created a set of over 1.5 million words, collected from interviews and online forums, where patients, carers or healthcare professionals meet to talk with their peers.

Violence or war metaphors (“battling my disease”, “keep up the fight!”) can be disempowering or disheartening for people with cancer, potentially demanding constant effort or implying that a turn for the worse is a personal failure. But in other contexts, they can empower people, helping someone express determination or solidarity, or bringing a sense of meaning, pride and identity. “You don’t need to be a linguist to realise what metaphors a patient’s using,” says Semino. Doctors should ask: are those metaphors working for the patient at that point? Are they helpful, giving them a sense of meaning, identity, purpose? Or are they increasing anxiety?

Heads Up

I’ll be live-blogging the SOTU at 9 pm tonight, and we’ll be covering other reactions among the blogs and tweets thereafter. Tune in.

Update from a reader:

Know that I’ll be drinking IPA out of my sweet new Dish mug during the State of the Union tonight. One healthy chug every time the camera focuses on a scowling Republican.

The Flu Shot Is Still Worth Getting

Aaron Carroll begs everyone to get some perspective:

I see headlines telling people the vaccine is “only 23% effective”. I’d like a list of all medicines people take, diets they go on, behaviors they change, devices they employ, and procedures they undergo which are better than 23% effective. I’m willing to wager the number is quite low.

In other flu news, Kaleigh Rogers covers research on a “universal” flu vaccine:

If clinical trials go well, a new u​niversal flu vaccine that would treat all strains of flu with a single shot could be just five years away. That would mean a future where nearly 20,000 p​eople won’t die due to a pandemic of the virus. A future where we wouldn’t have to spend a week in bed in misery even though we got​ a fucking flu shot this year.

Researchers at the Icahn School of Medicine at Mount Sinai and at Canada’s McMaster University began developing the vaccine three years ago after the discovery of a subclass of antibodies. When the body encounters influenza, it naturally produces these antibodies, which are able to recognize all strains of flu and mutations of the virus.

Until such a vaccine becomes a reality, Meeta Shah warns that emergency departments (EDs) are being overrun:

When interviewing emergency department directors regarding their experiences with this year’s flu season, I was shocked to hear the numbers.  Some EDs reported volume increases 15 to 25 percent higher in December compared to November or when compared to last December.  One director I interviewed joked that this epidemic was so significant he had colleagues who had coined it “The Flunami.”

Why is this important? Well, increased volumes like this don’t make it easy for an ED to function normally, and puts a strain on resources and staff. You or your loved one may need treatment from an overcrowded ED that is struggling to be efficient amongst this chaos.

The President’s Approval Hits 50 Percent

Obama Bump

Obama’s numbers are on the upswing:

His approval rating has risen nine percentage points in the past month alone, while his disapproval has dropped by 10 points. The gains are pretty even across the board, but the biggest are among Democrats (10 points), moderates (10), Hispanics (22), and even white evangelical Christians (10), who generally tilt heavily toward the GOP. Obama also has gained 19 points among adults younger than 30.

Sargent cautions that it’s “too early to say whether Obama is really in the midst of a sustained recovery”:

But one thing that will be worth watching is whether positive feelings about the economy — and about Obama — boost support for his individual initiatives, particularly those which Republicans are criticizing most bitterly, and whether they scramble the political landscape more generally.

Josh Marshall doesn’t want to read too much into recent polls:

Just as we should probably all resist the urge to write doomsaying chin-scratchers on the end of the Obama dream when the President’s numbers are soft, we should probably equally resist the urge when they’re more robust. The economy is by no means everything. The President won reelection solidly with a still anemic economy. But it’s always the place to start when the numbers move.

Something Harry Enten will be keeping in mind:

The approval rating at which an incumbent president running for re-election goes from an underdog to a favorite is in the high 40s. Obama can’t run again, and the relationship between his approval rating and the eventual 2016 Democratic nominee’s chances is a bit messier. But if Obama’s popularity inches up a bit more, he may go from being a drag on the nominee to an asset.

Nate Cohn comments along those lines in today’s NYT:

The balance of evidence suggests that the break-even point for the presidential party’s odds of victory is at or nearly 50 percent approval. If the only thing you knew about the 2016 election was Mr. Obama’s approval rating on Election Day, you might guess that the Democrats had a 37 percent chance of holding the White House with a 46 percent rating — rather than a 23 percent chance with a 41 percent rating. The difference between 41 and 46 might be worth between one and two percentage points to the Democratic candidate in 2016 — the difference between a close race and a modest but clear Republican victory.

Making It Harder For Cops To Take Your Stuff

That’s what Eric Holder did last week. Drum is pleased:

It’s bad enough that civil asset forfeiture even exists as a legal doctrine, but it’s beyond comprehension that the feds would actively encourage abuse of forfeiture laws by creating a program that allows police departments to keep most of the money they seize. This is practically an invitation to steal money from innocent people. So good for Holder for ending this program. If cops are going to be allowed to seize property from people they merely suspect of crimes—or, in some cases, pretend to suspect of crimes, wink wink nudge nudge—they sure as hell shouldn’t be allowed to keep the stuff and sell it in order to buy themselves a bunch of shiny new toys.

McArdle also welcomes the news:

Libertarians like to say that the nearest thing to immortality on this earth is a government program. Programs change their names or get absorbed into bigger programs, but they rarely just die. I’m pleased to see that there’s an exception to this rule, and it’s one that really matters. We’re all a little bit more free today.

Balko insists that “this new policy is one conservatives should love”:

First and most obvious, civil asset forfeiture is a major affront to property rights, a principle conservatives hold dear. The idea that the government can take your property without ever even charging you with a crime, much less convicting you of one, is a pretty appalling abuse of power. And sure enough, much of the effort to reform these laws over the years has come from the right. (Although to be fair, the laws themselves were pushed heavily by the Reagan administration as part of the 1980s drug war — albeit with little-to-no resistance from Democrats).

The other reason the right should cheer this move is that it’s basically a nod to federalism. Several state legislatures saw civil asset forfeiture as unfair and moved to make it fairer. The suitable sharing program thwarted their efforts. Holder’s move ends that interference. It returns policymaking on this issue to the states. Personally, I think there’s a Fifth Amendment argument to be made that the federal government should actually prevent the states from engaging in the practice. But allowing state legislatures with a conscience to end the practice on their own is a good first step.

Kleiman hopes the new policy has a big impact:

The order excludes federal-state-local task forces, but – if I read it correctly – does include the multi-jurisdictional local task forces where much of the worst mischief has been done; some of those agencies are entirely dependent on forfeiture funds (plus Byrne Grant money) and thus under no control whatever from civilian authorities. There’s more to be done to rein in the forfeiture system, but this is a terrific start.

Jacob Sullum is more skeptical:

Holder’s policy explicitly exempts “seizures by state and local authorities working together with federal authorities in a joint task force,” “seizures by state and local authorities that are the result of joint federal-state investigations or that are coordinated with federal authorities as part of ongoing federal investigations,” and “seizures pursuant to federal seizure warrants, obtained from federal courts to take custody of assets originally seized under state law.”

Since there are hundreds of federally funded “multijurisdictional task forces” across the country, that first exception could prove to be very significant. Holder’s order “does not prohibit the worst uses of the equitable sharing asset forfeiture program, particularly excepting seizures in which there is federal task force participation or direction,” says Eapen Thampy, executive director of Americans for Forfeiture Reform. “As virtually every drug task force I know of has a federal liaison on call, this means business as usual by local law enforcement using civil asset forfeiture through the Equitable Sharing Program to enforce the Controlled Substances Act and other federal statutes. In other words, the exception swallows the rule.”

Even if the new policy ends up having teeth, Leon Neyfakh expects civil asset forfeiture to continue “because the majority of America’s 50 states—42, to be exact—still have laws on the books providing huge incentives for police departments to keep doing it”:

According to Louis S. Rulli, a professor at the University of Pennsylvania Law School who has studied civil forfeiture closely, no fewer than 26 states allow police to keep 100 percent of the assets they seize. And Scott Bullock, a senior attorney at the Institute for Justice—the libertarian public interest law farm—says there are 16 others where police keep 50 percent or more.

“The law has to be changed in the states too,” said Bullock. “This closes one window, but you’ve got to close all the windows.”