Author: Andrew Sullivan

Kevin D. Williamson fights back against the Church Of Norquist and for a reality-based fiscal conservatism:

I myself do not favor a VAT; I’m a flat-income-tax guy, myself. But, as I always insist, taxes are secondary. Every dollar you spend is a dollar that has to be raised in taxes, eventually. There is no way around that, Sunshine. You can clap as hard as you want, but Tinkerbell still has to fill out a 1040. Can I imagine a universe in which a VAT is preferable to our current system? Yes, I can. But the problem is not the engineering of the revenue code — it is spendthrift congressmen of both parties.

So, no, I don’t favor a VAT. But I also do not favor letting conservatives’ position be defined by magical thinking — magical thinking of precisely the sort that already has destroyed the Republican party’s credibility on fiscal restraint and has undermined the conservative movement’s credibility in the process.

The GOP has been listening to the likes of ATR for a generation, buying into the canard that they can do the feel-good stuff (cutting taxes) without worrying too much about the hard part (cutting spending). The results are all around you, and they are dismaying …

The fact that Mr. Ellis would use the word “apostasy” to describe my thinking and Andrew’s on the issue is telling: We’re supposed to accept his vision on faith, in spite of three decades’ worth of evidence (or more) that cutting taxes while allowing spending to run wild is a recipe for ruination.

Ryan Ellis can stamp his feet all day, but the evidence speaks for itself: Santa Claus is no fiscal conservative, and no model of responsible governance. Taxing and spending are the same issue, and Ellis is on the wrong side of it.

Balko writes about the shameful way that police officers treat whistleblowers in their midst, and highlights an interesting parallel:

A few years ago, I attended a conference on the use of police informants. In one session, the "Stop Snitchin'" movement, which discourages African Americans from cooperating with police, came up. I was astonished to hear one hip-hop artist and activist say he would not cooperate with the police even if he had witnessed the rape and murder of an old woman in broad daylight. He just didn't trust the police. I told him his position was absurd: Whatever his concerns about the police when it comes to the use of drug informants (concerns I share), they shouldn't prevent him from cooperating with the investigation of an innocent person's murder. His response: "Isn't the Blue Wall of Silence really just the most successful Stop Snitchin' campaign in history?"

Daniel Larison skewers a Tea Party hero:

Santelli had no problem with the financial sector bailout, but vehemently complained about relief measures for debtors. To put it a bit crudely, it is the Santellis of the world who make people want to believe that there is some higher moral law or some divinely-instituted justice that holds everyone accountable, because in this world it is so very clear that there are two sets of rules: one for the powerful and wealthy, and another for the rest. Put another way, if the Tea Partiers desire fairness and a world in which reward depends on effort and talent, they shouldn’t have anything to do with Santelli, who cheered throwing their tax dollars at Wall Street and deeply resented far fewer tax dollars being directed towards relief for the middle class.

A reader writes:

Oh my friend, it has gotten so much worse than that. Surely you have seen the newest gay acronym: LGTBQA (where Q = Questioning and A=Allied). Holy crap, just call it the "Non Straight" gang and have done with it. This is the kind of actual political correctness that needs to be decried.

Another writes:

I usually use the GBLT acronym myself, because it reminds me of a really good BLT.

We just need a vowel! Another:

Another reason homophobes, or those looking to incite them, use "homosexual" is because of the sub-conscious response to the word. 

To those who say, "I don't care whom you have love, just do it in your own home," the term "homosexual" conjures images of the very thing they detest – same-sex intimacy and sex.  The very thought of two men or women experiencing the physical component of love is enough to throw the bigoted masses into hysterics. Also, ho-mo-sex-ual has so many syllables to grotesquely draw out.  With the right emphasis and accent, it just sounds dirty.

Another:

As a seminary student, while I agree with your reader's guess that the far right's use of the word "homosexual" betrays a desire to see it as only a psychological abnormality, I think it's far simpler than that for most . "Homosexual" is the word they see in their Bibles (nevermind that no word in the entire Greek and Hebrew corpus really translates as such; they don't care to hear this). "Gay" is their coworker or friend. "Homosexual" is what God despises in their minds. The same cognitive dissonance is leveled by their use of "illegal alien" instead of "the immigrant among you", which the Scriptures command us to look after with charity.

A reader writes:

I am respiratory therapist and set people up on CPAPs all the time.  It truly is amazing how many people are diagnosed with obstructive sleep apnea and find some benefit from CPAP therapy.  The main problem that I encounter is that during their sleep study they are told that they will sleep much better as soon as they get their CPAP.  I tell all of my patients that it take a minimum of 6-8 weeks before they will truly be comfortable with the CPAP and sleep with it on all night.  Some never get used to it, and for them, surgery is an option.  But as Americans, we want relief right away.

Another writes:

I'm an otolaryngologist and head/neck surgeon, and I just read the post "The Dish At Ten: The View From Your CPAP" and there were some potentially misleading statements. 

The first reader stated that his/her sleep study found 150 disturbances per hour (the correct term for that is respiratory disturbance index, or RDI.  The apnea-hypopnea index, or AHI is actually used more often to assess the severity of sleep apnea). The reader found relief from a dental appliance (that's the term for intra-oral devices that put gentle traction on the lower jaw or the tongue).  I find it hard to believe that someone with an RDI of 150 could be treated with a dental appliance alone; the sleep apnea is just too severe.  It would be important to get a sleep study with the dental appliance in place to see how much it actually helped.

The second reader described a common operation called septoplasty, usually done because the thin bone and cartilage separating the right and left nasal passages are crooked.  He/she was incorrect to say that we "don't use general anesthesia because it's too dangerous".  In fact most septoplasties are done under general anesthesia (I do all my septoplasties under general) unless the patient is really sick and cannot tolerate it.

It is also incorrect to say that nothing can be done about the soft palate.  In fact, most surgery for sleep apnea involves some sort of surgery on the palate, and septoplasty alone is usually not that effective.  The back of the tongue is also a common site for obstruction in sleep apnea, and there are some techniques used there as well.

The big problem with surgery for sleep apnea is that it is difficult to determine who will improve.  If someone has huge tonsils, we can usually be confident that they will do better if we do a tonsillectomy, but for most others it still is a challenge to predict the outcome.  CPAP, when tolerated, is almost 100% effective.  Weight loss helps too.

Another:

My Dad's sleep apnea almost killed him. Over the last few years he had put on a significant amount of weight.  In the Fall of 2009 he literally started to swell up.  I finally convinced him to go to the hospital on Valentines Day 2010.

He was suffering from congestive heart failure and pneumonia.  Within a day of being in the hospital he went into cardiac arrest and was put on a ventilator.  Two months later – two bouts of respiratory arrest as they weaned him off the ventilator and a kidney failure chaser – he was out of the hospital.  He was discharged 100 lbs lighter and with a CPAP machine.  

The entire episode was brought on by 30 years of undiagnosed sleep apnea.  Now he's the picture of health thanks to his CPAP.

Another:

I've been puzzled by the absence of "conservatism" in the discussion of remedies for sleep apnea. The more conservative remedies would be weight loss, dietary change and exercise, wouldn't you say?

Another:

Ok, I'm thinking sleep apnea is another self inflicted wound of fat America. If readers differ, please send pictures of skinny apnea patients wearing masks. I know the fatter I get, the more I snore – partners alert me. Just like every other damn part of our body, as we gain weight it sticks and we expand. In the case of the throat, it narrows the airway and creates loose flesh. I'm no doctor, so correct me if the painfully obvious ain't so.

I am tired of wasting medical dollars treating self-inflicted health conditions. Lung cancer from smoking. Heart disease from smoking and eating. Diabetes from a sugar diet. We all have to take financial responsibility for our actions and be held accountable by our health insurance. I don't want to contribute to smokers lung cancer care. I have a few habits I need to contribute a bit extra for too.

There is a connection between some sleep apnea and being overweight. But it's by no means the only cause. It can be caused by too muscular a neck, rather than too fat a one, as well as large tonsils, obstructed sinuses, or more than usual soft tissue in the throat and soft palate. The risk increases a lot if you have diabetes. And I think it's just hard to take a position that all behavioral-related illnesses should not be covered by insurance and others should be – because the judgment is often hard to make and sick people are still sick. Heart disease is by far one of the biggest health problems, for example, and is obviously connected in many cases to lifestyle – but may also be genetic or caused by other factors. But we cannot determine who is helped based on moral judgments. Ditto diabetes, which can be caused by many things, including a sugary diet. 

The cost of treating sleep apnea, of course, is small compared with most diseases. 

(Photo by Flickrite baslow)

Rick Hertzberg explains why he's a liberal:

I value political liberty and political rights (freedom of thought, speech, conscience, and the press, the right to vote, civil equality) more highly than economic liberty and economic rights (property rights, freedom of enterprise, freedom from want, economic equality). I’m in favor of progressive taxation and generous public provision of education, pensions, and health care. I think people should have enough to eat and a roof over their heads, even if they haven’t done much to deserve it. I reject the idea that the market is the singular bedrock of society while everything else is a parasitical growth. I want government to do something about environmental degradation and gross social and economic inequality. I’m a secularist and a supporter of equal rights for women and gays. And when it comes to wanting World Peace, I’m practically a Miss America contestant. So I’m a liberal.

My response would be, taking Rick's points in order:

I also revere political rights (freedom of thought, speech, conscience, and the press, the right to vote, civil equality) but regard them as underpinned by the emergence of the autonomous individual that modern economic liberty made possible. I believe in simple and flat taxation of income and consumption and a generous public provision of education (the key to opportunity), but I think the welfare state should remain a minimal safety net and means-test benefits for those who are in real need, not grant them to everyone regardless of wealth. I believe in universal better-than-bare-bones healthcare, but oppose the government controlling it, and would be fine with the wealthier buying more of it and thereby getting better treatment.

I don't believe in mandatory provision of food and shelter to those who have decided to be free-loaders, as opposed to the unlucky or incapable. I think the market is the least worst system of allocating wealth and creating growth without which no welfare safety net can be afforded. I think the government absolutely has a role in protecting public goods like the environment, but should do so with great modesty about the limits of its own wisdom. I believe government should only try to redress economic inequality if such inequality becomes so great it threatens social cohesion and stability. I'm a secularist because I am also a believer, think the state hurts faith, rather than enables it, and that Christianity is more authentic the further from actual power it gets. I believe in world peace but also believe that this can only be achieved by the threat of war at times, and that military action should be a very last resort – but a real one, against those who would threaten us or destabilize the world.

Discuss.

Jamie Kirchick reports from Belgrade:

How does Petrovic and his team ("me and my friends," as he describes them) claim to cure homosexuality? Quite simply: Patients must cut out junk food from their diet, "drink a lot of water," "reject anything that is diarrhetic, alcohol, caffeine," engage in "physical activity," "rest [at] appropriate times." Plus, one "must think about good things." Oh, and receive regular enemas.

There's an audio interview with the "doctor" as well.

A fascinating moment in a radio debate between Chris Coons and Christine O'Donnell:

"Where in the Constitution is the separation of church and state?" O'Donnell asked him. When Coons responded that the First Amendment bars Congress from making laws respecting the establishment of religion, O'Donnell asked: "You're telling me that's in the First Amendment?"

Yes, the crowd gasped. And I'm told I overstate Christianism in the GOP.

Fox's Brian "All Terrorists Are Muslims" Kilmeade, says he's sorry he misspoke, and keeps his job. Can you imagine if he'd said "All Terrorists Are Jews" or "All Terrorists Are Asian" – which is more offensive than Rick Sanchez's descent into anti-Semitism? It's official now, then: you can smear some groups but not others, if you want to stay in your job as a journalist.

Zuckerberg takes on The Social Network:

Ben Heineman Jr. debates the unreality of storytelling:

[F]or me, one of the more interesting questions raised by the film is whether works of entertainment or art presenting themselves as real accounts of contemporary events owe fidelity, not just to story-telling, but also to a search for truth in a journalistic or historical sense. Certainly some of Sorkin's own statements suggest that he didn't want The Social Network just to be story-telling. And, if that is so, then he had an obligation to get closer to the facts.

But, if he did want pure fidelity to "story-telling" there was a different way to shape the movie, which has as its direct forebear the film many believe is the greatest ever made, Citizen Kane.

Orson Welles' classic was based on the life of William Randolph Hearst, but in the movie he was a fictional character, which allowed Welles great artistic license.What if Sorkin had fictionalized The Social Network, including its main character (Sam Kainenborg in homage to the past)? Wouldn't the film have been at least as powerful (perhaps with less of the hokey deposition by-play to trigger flash-backs) without the legitimate,and troubling, debate about the fairness of the portrayal?