Sunday, September 27, 2009

women happiness demonology

We all know how to recognize demons. The demonic voice has one overriding characteristic: he will always use the logic of the system against its structure. Thus, when a voice demands that women play their traditional role in the home, while manipulating the economy so that the median household, just in order to stay still, must throw into the pot 350 more working hours per year – which is the difference between the median household of 1970 and the median household of today – you know you have caught a demon.

Demons have traditionally loved to harrie women, so I was not surprised that the latest happiness survey (with all its iffy premises and methodology) unleashed a lot of demonic voices – from their corners in the press. Of course, since my work in progress is a critique of all these assumptions about happiness, I cast my eyes on the newspaper accounts and was rather happy to see them conform so exactly to my expectations about the total social fact of happiness. The failure to be happy, in the press, was greeted as a great moral default that could be laid at the feet of those whose answers were not satisfactory – who were not happy. And they were, in particular, women.

In the happiness culture, happiness is not only an emotional norm on the personal level, but a collective norm. It is what connects the subject to the total social project. And thus to be unhappy is not only a personal failure but a minor treachery. The pack of demons who go under the traditional values banner and the pack of demons who go under the neo-liberal banner could both, then, agree to hunt the women together. And they do enjoy hunting women, they always have.

Maureen Dowd, whose ears are pricked up whenever the demonic crowd howls, wrote a column about it in which, underneath the usual music about the grave failing of women, liberated women, in this here New World, there was a hint, a shadow of a dissent – as if the real question was not why are women so unhappy, but why are men not. Indeed, a closer examination of the norms around the happiness question should alert us to the connotation of success that hovers over it. If happiness is success, than to say one is unhappy is to say that one is unsuccessful. In fact, at the same time the polls consistently show wild degrees of success among men, especially white middle class men, who are the avatars of these men? They are an increasingly angry bunch of tv celebrities. Newspapers, with their casual, schizo flaneur’s juxtapositon of contradictions, will jump from how happy men are to how angry they are without blinking. But those who think happiness signifies a certain feeling, has a certain emotional valence, are going to have a tough time figuring out this combination of anger and happiness.

There's a nice post on this topic by a medievalist named girlscholar, entitled “House always wins”. I thought that it was of interest because girlscholar seems to accept the idea that happiness is a norm that one should strive for. That we should strive to have a happy life.

Her idea is that the opening of the public sphere to women, the feminist revolution, raised expectations that were disappointed:

“Now, imagine that women's** expectations of the limitless possibilities for their lives are thrown into contrast (a contrast that gets sharper as women age) with the realization that, in spite of (or perhaps because of?) all this, we're still expected to spend enormous amounts of our energy trying to be something we’re not: pretty, thin, young, compliant, non-swearing, perfectly-groomed, dependent, dumb, nurturing, self-sacrificing, quiet-voiced, unconditionally adoring, nonthreatening, patient, or simply never, ever angry. In other words: “feminine.” And the older we get, the more we realize that the house always wins in the end.”

This pretty succinctly expresses a thought I’ve seen expressed, especially by highly educated women in America, before. On the one hand, this has to be right. On the other hand, it has to be a half truth. It is at this point that a further, radical betrayal of the culture is required. I think the experience of women, in the public sphere in the developed economies, has given them every reason to doubt the very foundation of the house - that the house manufactured happiness is really an adequate norm for us on a personal and collectie level. That it gives us the scope and perspective with which to view - to judge -- a “life”.

Of course, the survey is superficial and from a certain point of view stupid. But it is superficial in a telling way. It is my thesis in my work in progress that the goal of living a happy life has given way to the norm that happiness is a form of success, or maybe is success period. One way of thinking about the question of happiness is to think of terms that are close to happiness that would separate it more from the total social fact that it has become. For instance, fun. Imagine a poll in which you asked people if their life was fun. I would imagine you would get a much more baffled, and diversely patterned response. Or pleasurable. Or delightful. The more you gnaw at the semantic cluster around happiness, the more you lay bare the normative presuppositions it hides.

I, of course, have been advocating the view that those presuppositions have a history in which alternatives to happiness were marginalized in the civic order over which happiness presides, conjoining the governors and the governed. In the process of that marginalization, happiness has grown into a monstrous thing that poses a very real threat to human life on earth. This doesn't mean that it was always a monstrous thing, or that we can tell a total history of it. Historically, one of the great liberating dynamics of the happiness culture was that it laid the foundation for destroying the system of dependency, that feudal remnant (to use feudal in the sense given it by the French revolutionaries) under which women were forced to live. But just as the capitalist system and the industrial system that grew up under the form of that culture are now rubbing against the limits of that form, so, too, is the liberated “feminine”.

Women have a special place in the history of happiness because, historically, they were at once marginal and central. Unlike race or class, women were distributed over the whole of the social sphere – and yet of course whatever position they were in, however they were defined elsewise, as women they were the object of the same gaze and judgments – which were, collectively, marginalizing judgments. This is, of course, patriarchy. And all that means is that women were peculiarly sensitive to the demonic voice – to the hunt that has for its object not only the humiliation and destruction of certain subordinate objects within the social sphere, but to make the victim's own actions the basis of her destruction. Happiness seemed to hold the demons at bay, seemed to provide the marginals, the natives, with a weapon taken from Behemoth himself, which is the necessity that happiness be collective. But, in these ill times, happiness has turned against the happy life, emptying it out of all depth and emotion, leaving anger and success as the man’s lot, and as the woman’s, a sense that something has gone terribly wrong with the future.

ps - I was going to do a whole post about this, but I think instead I'll just link. The first link is to the THE essay that Infinite Thought made fun of, here. And then there is Belle Waring's piece on this insanely stupid column, here. I thought of several cutting and clever things to say myself, but it is hopeless in the face of the moronic inferno, represented, especially, by the Mary Beard defense that this is satire - which is a defense that makes me think, oh Mary Beard. You have gone down in my opinion of your ability to judge a text - especially if you feel that to say what you really think would get your in trouble with the establishment. Sad, all the way around.

Wednesday, September 23, 2009

the paranoid method for gnostic historians

Paranoia is not, of course, the delusion that you have enemies; it is the delusion that your enemies have developed a vast and hostile system in which to trap you. It is this notion of the systematicity of entrapment which makes paranoia the methodology of choice for the Gnostic historian.

I am reminded of our current lack of paranoia by a post I read at voyou desoeuvre about the tv series, Mad Men. As my television is a dead little monad as far as tv waves are concerned, I haven’t seen that show – although it sounds like I should rent the dvds. The sixties advertising culture fascinated the tv sitcom writers at the time – I believe the husband in Bewitched, for instance, is an adman; and if he wasn’t, I know there were other admen on other long cancelled tv shows that continue to broadcast carcinogenically deep in my brain cells – and it is surprising, thinking about it, that this high concept hasn’t been mined for nostalgia before.

My paranoia about our present lack of paranoia targetted this graf:

“The crucial scene comes when Don Draper drops in on his bohemian mistress and argues with her beatnik friends, who tell him that the adverts he creates are merely lies. Don’s response, that “there is no big lie, there is no system,” is quite correct. Advertising doesn’t simply lie about the world, on the contrary, as Don’s practice throughout the show makes clear, it tells, or rather constructs, a particular sort of truth, a kind of dream image of capitalism.”

Voyou Dee goes on to put this into the vernacular of Zizek:

“Žižek argues that contemporary capitalism is not based around demanding that subjects conform to a specific identity, but rather demanding that they answer the question, “what do you want?”

All of this is rather shocking, although I guess it shouldn’t be. The beatniks were of course right on the money. Zizek’s argument reproduces the neo-classical one made against Galbraith’s analysis of advertising in The Affluent Society – want, in this view, is a concept about nature, and we proceed from there to our options. This is why, for the neo-classicals, advertisements don’t skew the efficient markets. Galbraith, on the other hand, claimed that did, and that advertisements were part of a system of planned obsolescence – that there wasn’t a true ontological distance between the ad, the system of production, and the consumer side.

However, the issue is deeper than that. Gnostic history is Sunday history – you can’t turn to any one tome for it. You fossick it out of your idle reading matter. But let’s go through a few big lies – systematic lies – produced by the father of lies during the Cold War.

The first, of course, was the configuration of the forces of nuclear destruction themselves. Eisenhower has long ago become a grandfatherly figure, or a moderate Republican, one of the great presidents, etc. We know, though, since James Bamford’s Body of Secrets he revealed that even before the U-2s, Eisenhower had often had SAC penetrate Soviet air space in formations that were designed to look like an attack – in order to sample the Soviet defense response. When the U-2 crashed in 1960, the tip of the iceberg of what the U.S. had been doing over Soviet airspace was revealed, but just the tip. This is Bamford:

“On March 21, 1956, a group of RB-47 reconnaissance bombers took off for target locations within Russia. Almost daily over the next seven weeks, between eight and ten bombers launched, refueled over the North Pole, and continued south across the Russian border to their assigned locations.

They flew in teams of two. One RB-47H ferret would pinpoint and eavesdrop on radar, air bases, and missile installations. Nearby, an RB-47E photoreconnaissance plane would gather imagery. Their assignments included overflying such sensitive locations as Novaya Zemlya, the banana-shaped island where Russia carried out its most secret atomic tests. From moment of takeoff to moment of landing, absolute radio silence was required, even during the occasional chase by a MiG. "One word on the radio, and all missions for the day had to abort," said Brigadier General William Meng, one of the officers who ran the penetration operation. "But that never happened; not one mission was ever recalled."

As in a Fourth of July fireworks display, the most spectacular mission was saved for the end. On May 6, they began the single most daring air operation of the Cold War, a "massed overflight" of Soviet territory. The point was to cover a great deal of territory, quickly. Six armed RB-47E aircraft, flying abreast, crossed the North Pole and penetrated Russian airspace in broad daylight, as if on a nuclear bombing run. They entered above Ambarchik in western Siberia, then turned eastward, collecting valuable intelligence as they passed over key Russian air bases and launch sites on their way toward Anadyr on the Bering Strait. Nearly a dozen hours after it began, the massed overflight ended when the spy planes touched down at Eielson Air Force Base in Alaska.”

This hairtrigger behavior was exactly the kind of thing that could easily have launched a nuclear war. Mad men aptly names the people who designed it – the President and the chiefs of staff. It wasn't revealed until 2002.

All the President's men were further involved in our second big lie, the above ground testing of atom bombs (and, it is believed by some, the occasional thermonuclear device). This did not only poison the ground in Nevada – rather, it poisoned our belief in establishment science. The AEC, for thirty years, maintained that the fallout from these tests was small, manageable, and harmless. We now know that it was worldwide, out of control, and, fatal. Here’s your map of cesium levels for those of you into the whole mutation thing. From the study of just one of the thousands of isotopes contained in the fallout, iodine 131. The NCI’s Congressionally ordered survey concluded this:

“… we evaluated the risks of thyroid cancer from that exposure and estimated that about 49,000 fallout-related cases might occur in the United States, almost all of them among persons who were under age 20 at some time during the period 1951-57, with 95-percent uncertainty limits of 11,300 and 212,000. The estimated risk may be compared with some 400,000 lifetime thyroid cancers expected in the same population in the absence of any fallout exposure.”

The Gnostic historian, avoiding the Zizek, would be well advised to consult a whole other literature. Start with the fantastic photo book plus interviews, America Ground Zero, by Carole Gallagher, who dug up my favorite government description of the citizenry of this country of ours: “the low use segment of the population.” Then dig up the Plutonium Files, about the 4,000 people who, unbeknownst to themselves, were the low use lucky duckies used in experiments financed by the Gov back in the days when capitalism, ever dreamy, was asking – “what do you want?” That capitalism! Quite a joker.

You can follow the path of cancer – which is the secret sharer of advertising in the 20th century – through many a merry big lie in the Cold War days. While the AEC was assuring everyone that an atom blast was just a big cherrybomb, deep in the bowels of the establishment there was a freakout in the late 50s, when the Van Allen belt was discovered – because some speculated that between the U.S. and Russia, we might have fucked the pooch. We might just have released a poison in the population we couldn’t even deal with. To find out how widespread were the effects, as Patrick Tierney shows in Darkness in Eldorado, many a grant was made to anthropologists and health care researchers to take blood samples of isolated populations, which is how Napoleon Chagnon first found himself sampling Yamomami blood in the sixties – which then went into work showing the natural violence of the tribe, thus fitting nicely into the Manichean code of the Cold War – which was a war against “perfectionism” as well as a war against communism. I prefer to follow the cancer trail to Bill Brandt’s brilliant book, The Cigarette Century, which is about much more than cigarettes. There was a bleak war to be fought and won in the fifties against the Public Health/Socialist science of Richard Doll, whose epidemiological study showed the link between lung cancer and cigarettes. Notice, here, how “big” functions – it goes from the atmosphere to the individual lung. Brandt’s account is the account of the merger of science, advertising, commerce, and media. The cigarette companies devised the way the politics in America, and increasingly elsewhere, are fought out – with pseudo-issues and outrage, in a press that is oriented to the false equivalence of fairness and truth. The cigarette companies bought enough big names in cancer research who, for one reason or another, were invested in cancer not having an environmental cause. And by pumping the “doubts” about cigarettes, and making a cig souroundsound out of tv, the companies managed an amazing feat – the number of people smoking cigs after the discovery that they were linked to cancer almost doubled in the next two decades.

Of course, Zizek might brilliantly deduce that these people wanted cancer. The death drive, you see. Others, however, might point out that when cigarettes ceased being advertised in the time honored saturation manner, the wanting went out of the industry, and use declined. Amazing!

I could go into much, much more Gnostic detail. I could write a book! The point however is that when your philosophy converges with that of a spokesman for the ad industry, you’ve probably fucked up somewhere in the chain of your deductions. A dream industry - that is, after all, an advertising phrase. AKA, a lie.

There is no dream industry.

Sunday, September 20, 2009

Waugh and Wodehouse

“It is not accurate to call this an annual event, because quite often the Club is suspended for some years after each meeting. There is tradition behind the Bollinger; it numbers reigning kings among its past members. At the last dinner, three years ago, a fox had been brought in in a cage and stoned to death with champagne bottles. What an evening that had been! This was the first meeting since then, and from all over Europe old members had rallied for the occasion. For two days they had been pouring into Oxford: epileptic royalty from their villas of exile; uncouth peers from crumbling country seats; smooth young men of uncertain tastes from embassies and legations; illiterate lairds from wet granite hovels in the Highlands; ambitious young barristers and Conservative candidates torn from the London season and the indelicate advances of debutantes; all that was most sonorous of name and title was there for the beano.”

Yesterday, I was reminded of a passage in Decline and Fall, Evelyn Waugh’s novel, by some conversation I was having on Facebook. So I looked up the passage, and then read the chapter it was in, and then started reading the whole book over again. And, not for the first time, I thought: this is the funniest book that has ever been written.
It isn’t the deepest funny book, which would surely be Dead Souls. Nor is it funny like Moliere’s plays. De Stael, who said that “one is serious alone, one is gay for others” claimed that the English lacked a true sense of gaiety, a true genius for comedy, such as was found in Moliere. This, of course, goes against everything that the English think about themselves and think about the French. But de Stael was insistant that “gaiety, which is the inspiration of taste and genius”, had nothing to do with what the English call “humor.”

“Most men, absorbed by their affairs, only seek, in England, pleasure as a relaxation [delassement]; and just as fatigue, in exciting hunger, makes every dish easy, continual and intellectually intense work is prepared to content itself with every species of distraction.”

In this way, de Stael thought, the British contented themselves with the most primitive jokes and funny situations, instead of the deeper laughs that sprang from genius and taste. The latter are not extrinsic to life's work, but at the center of it.

Wodehouse, it is plain, would have been seen by de Stael as vulgar. But Wodehouse is one of the funniest of writers, certainly in competition with Waugh.

The difference between them is shown by the paragraph I’ve quoted above, which is the second paragraph in Waugh’s first novel, Decline and Fall. It would have been impossible for Wodehouse, that lover of animals, to have introduced the death of a caged fox, enthusiastically undertaken by drunk gentry, into any of his novels. That scene would have immediately brought down his worlds.

Here, then, is the key to the difference between Waugh and Wodehouse: their attitude towards evil. As is well known, Wodehouse was impermeable to the very idea of evil. There is no role for evil at Blandings Castle. Now, some critics have claimed that there is something prelapsarian about this absence of evil. Myself, I think that it is not so much that Wodehouse’s characters have never tasted the fruit of the tree of knowledge as that they are in two states only: either blindly egotistical, or in love. Wodehouse’s plots are all standard farce, lover’s quarrels or some familial obstruction to the path of love, and what this does is actually set in motion something that is uncommonly difficult for them: paying attention to other people. The Wodehouse power figure – the tycoon, the aunt, the country gentry – are supremely oblivious. Other people for them are pretty much shadows, or at best clay to be worked into shape. They are as self-involved as sheep. Only two things can get a person out of this state: love and fashion. Jeeves is keen not so much because he has a super brain, but because he has a fashion sense – which means that he actually has to look at people in terms of their choices. The purple tie or the straw hat? Having a fashion sense draws him ever deeper into psychology – which is of course a science that is always after Bertie Wooster. Love, likewise, calls for doing some detective work in the world – although of course Wodehouse’s men are all terrible lovers, and require a whole plotload of help just to get to the kiss.

In Waugh, on the other hand, evil is not only there from the beginning, but the terrible, bright flood of attention that floods his pages from the very beginning is, in a sense, radically evil. This is why the only characters in Waugh who aren’t damned are the wicked. Waugh’s patsies – like Paul Pennyfeather in Decline and Fall – are milled through the organized anarchy of all the hopelessly decaying institutions, erected once by better people for nobler purposes, and get to the other end, if they are lucky, with a sort of redeemed passivity. They are not destined for the perpetually renewed innocence of Wodehouse’s plotters, but for the backwaters and marginality appropriate to the limbo they carry with them. Limbo is about as much as one can hope for.

One of the great things about Waugh, and one of the mysteries of his comedy, is that he simply despises the English sense of humor. He associates it with the Victorian bric a brac that always stands in for the ersatz and spurious in his novels (although for that same reason he has a collector’s fondness for it). Like de Stael, he thinks the English sense of humor, that relaxation, is completely depressing – hence, the famous end of Handful of Dust, as Tony becomes the captive of the mad Dickens freak.

In Wodehouse, the world, and not just the humans, are essentially benign and happy – as long as they are undisturbed in their courses. The sunshine, the cats, the pigs, they are all happy. In Wodehouse’s metaphors and personifications, there is an essential bond with the great twentieth century art of cartoon animation. Modern animism, really: the rediscovery that the soul is simply motion. Waugh is the opposite. Waugh’s novels are as funny as novels can be in which all the characters are essentially and irretrievably … unhappy.

Saturday, September 19, 2009

The ghost of H.L. Mencken wakes me up from a sound snooze

I've been hearing this weird laughter this morning. I couldn't figure out where it was coming from. Then I read the NYT, and I realized that the spirit of H.L. Mencken was in the house!

"In the proposal, which The New York Times examined, Mr. Young asserts that he assisted the affair by setting up private meetings between Mr. Edwards and Ms. Hunter. He wrote that Mr. Edwards once calmed an anxious Ms. Hunter by promising her that after his wife died, he would marry her in a rooftop ceremony in New York with an appearance by the Dave Matthews Band."

Hmm, I could comment on that, but no comment could possibly do it justice. I'll... I'll simply... repeat it:

"In the proposal, which The New York Times examined, Mr. Young asserts that he assisted the affair by setting up private meetings between Mr. Edwards and Ms. Hunter. He wrote that Mr. Edwards once calmed an anxious Ms. Hunter by promising her that after his wife died, he would marry her in a rooftop ceremony in New York with an appearance by the Dave Matthews Band."

Thursday, September 17, 2009

Reforming Healthcare - and smashing some idols

A few remarks on zona healthcare

1. The teabaggers, like anti-war demonstrators, are discovering that numbers aren’t headlines. The rush of the street, the vast numbers one imagines oneself to be part of, are dispatched the next day on page A-2 if you are lucky. There’s nothing like the power of not seeing what is in front of your nose – and that is the power of the metro newspaper. Condolences.

2. I’d have more sympathy with this group if, in fact, they had turned out in the street in large numbers long, long ago. Turned out to protest the Bush tax cuts that destroyed the surplus. Turned out to protest the literal trillions spent on a fraudulent global war against terror. The behemoth of those trillions did not even give birth to the little mouselet of destroying al qaeda, which would have been childishly easy to do in late 2001. Turned out to protest the largest hike in medicare spending ever passed, which happened, of course, in 2003 with the passage of Bush’s gift to BigPharma, the pill bill. One should recall that the enormous expenditures were added to government spending on top of enormous tax decreases.

3. So, in general, the teabag crowd is hypocritical and blindly selfish. But the liberal meme that these are ignorant bigots won’t wash. Instead, these are people who feel, rightly, that they have lost symbolic power in this country. Their habit of bashing the government and enjoying the benefits of government spending lends their message its special ductus: spend the money on me.

4. The message, in other words, is all about the Soviet-like decay of the system. The teabaggers, past beneficiaries of a system that is broke, can’t believe the system broke. This is an utterly predictable response.

5. However, the liberal response to the Obama administration’s continuation of Bush policies is more puzzling. The Pentagon gravy train is chugging away at 750-850 billion per, with no handwringing on my side. That is easily 650 to 750 billion dollars too much.

More importantly, liberals, looking at the absolute horror of the Wellpoint-Baucus bill, should be asking, how did we get here.

The old answer was that the single payer was politically untenable. The new answer is that the public option is politically untenable. And the sum total of the answers is: Dems have no intention of “reforming” the health care system. From Obama’s astonishing willingness to keep the old Bush rule of paying ransom prices for pharmaceuticals to BigPharma to the dropping of the public option by Baucus to rigging the public option with the deadweight of provisions to make sure it doesn’t compete with private insurance providers, I’m not sure what is more delusional: the belief Obama is a radical Marxist, or the belief that Obama is a progressive.

6. So, we are given another solution that isn’t a solution. By the team that took over and made its own Paulson’s TARP.

7. The problem needs to be stated over and over again. The U.S. health system is the most costly in the world, and – for all that spending – has the least social scope of any of the major developed economies. It is absurdly expensive and absurdly insufficient. To spend hundreds of billions of dollars more than other countries, and to cover less, could only be accomplished by a very special beast.

8. The reform doesn’t slay the beast. It puts a collar on it.

9. When Obama said, in the presidential debates, that healthcare was a right, not a privilege, he lifted the doubts from my heart. At the moment, he has been piling them back on. The NYT obit of the public option cited a Republican sponsored study that showed that the public option could garner up to 100 million clients. For the Republicans, this showed how bad the public option is. For those whose heads are not up their assholes, this showed that the public option would be, like the post office, one of the most popular government programs ever.

10. Designing a government program that does not compete with – and kick the ass of – private insurers is the sure route to inefficiency and failure. As for the mandate hatched by Wellpoint and Baucus, what can one say? The vileness of the scheme, which exists to shuttle even more money into the hands of private insurers, is in competition with the laughability of the scheme, which essentially raises the taxes (which is what an enforced enrollment in a private insurance program would be) on the middle class to a level not seen since, well, the level on the rich in the pre-Reagan days. This is happening as we have the new reports showing zippo income growth over the last nine years in the median household, and astonishing Golcondas going to the upper 1 percent.
11. A Fanny Healthcare – a government backed entity to which anybody could transfer their current insurance for a cheaper one - is the necessary first step towards shrinking the amount the U.S. pays on a per capita basis for healthcare.
12. The right has made the point, over and over again, that socialized healthcare leads to longer waiting times. And, in one respect, they are right. Waiting times as they are measured now, say by Merrit Hawkins, extend from the time one contacts the healthcare provider to the appointment. The Merrit Hawkins survey showed that when Massachussetts put in place a universal healthcare scheme, waiting times shot up. Why? This is where the right falls silent. The why is because waiting times as measured by MH are a subset of all waiting times. Those who don’t have insurance or who have coverage with a heavy deductible simply don’t call up doctors to make appointments, unless they have to. They try to tough it out. But in a system in which they have coverage, they will make those appointments. In other words, demand shoots up. And given that the supply is stable, what gives is the wait time.
13. This is pretty obvious. Or it should be. On the one hand, the right is actually defending one of the feature of the system that doesn’t extend to everybody – your middle class patient actually benefits from this. That defense could be called, I’ve got mine, Jack, and you can bleed to death. On the other hand, liberals have shut their eyes to the fact that reforming the system will dramatically increase demand. A good healthcare reform would aim at increasing healthcare supply – one way being increasing the number of healthcare providers. We should cut a nice fifty billion per year from the Pentagon budget and devote it to scholarships for medical and nursing students. And we should have a major discussion about what primary care providers do that can be done by trained nurses.
14. We won’t have that discussion. It is easy to see that Dem legislators are influenced by the greedymen of K street – but their actions are partly motivated by the fact that covering the uninsured is not necessarily a votecatcher. Not only are there more overlaps between the uninsured and the non-voting, but the voters are going to be shocked by the increase in waiting times. This is why it is crucial that those voters are given a good, public option, as a tradeoff for universal coverage. Otherwise, universal coverage will fade - it will be successfully subject too vilification and become a welfare-like entity, ringing the neck of liberals.

15. Bus we won’t have this discussion, as I say. Politics at the moment is not only full of hate, but the hate has crowded out reality. The hatred exists for itself. Opinions are adopted not on their own merits, but to “get” the other side. This is the kind of factionalism that happens in old, decaying empires. The American Imperium is dying.

Wednesday, September 16, 2009

What we owe Clement

Those who invent the contradictions that allow society to run on its smooth course surely deserve recognition. Among these inventors, one of the most important was Clement of Alexandria.

Not for his famous dime a dozen misogyny. Rather, it was Clement who managed once and for all to squeeze around a famous passage in the Gospels. In Matthew 19, Jesus is depicted as the sage to whom people come expecting wisdom – a common motif in sage narratives. And after giving the answer to how one can get into heaven – be as a child – he proceeds to make a pretty grave announcement:

“Then said Jesus unto his disciples, Verily I say unto you, That a rich man shall hardly enter into the kingdom of heaven. 24 And again I say unto you, It is easier for a camel to go through the eye of a needle, than for a rich man to enter into the kingdom of God.25 When his disciples heard it, they were exceedingly amazed, saying, Who then can be saved? 26 But Jesus beheld them, and said unto them, With men this is impossible; but with God all things are possible.”

The passage in Matthew is dramatized in Luke:

“And a certain ruler asked him, saying, Good Master, what shall I do to inherit eternal life? 19 And Jesus said unto him, Why callest thou me good? none is good, save one, that is, God. 20 Thou knowest the commandments, Do not commit adultery, Do not kill, Do not steal, Do not bear false witness, Honour thy father and thy mother. 21 And he said, All these have I kept from my youth up. 22 Now when Jesus heard these things, he said unto him, Yet lackest thou one thing: sell all that thou hast, and distribute unto the poor, and thou shalt have treasure in heaven: and come, follow me. 23 And when he heard this, he was very sorrowful: for he was very rich. 24 And when Jesus saw that he was very sorrowful, he said, How hardly shall they that have riches enter into the kingdom of God! 25 For it is easier for a camel to go through a needle's eye, than for a rich man to enter into the kingdom of God.26 And they that heard it said, Who then can be saved? 27 And he said, The things which are impossible with men are possible with God.”

The variations on this theme give us: 1. a series of pronouncements about who gets into the kingdom of heaven and who doesn’t; 2. examples of the “last” – like children – who do get into heaven; and 3. examples of the first (Pharisees, the rich) who come after the last.

The disciples in both cases express astonishment – in Luke, the astonishment has much to do with their desire to secure positions in the kingdom of heaven – and Jesus assures them that what he is saying may seem humanly impossible, but that all things are possible with God.

There’s no indication in the text that he is retracting his statement about the wealthy – or about Pharisees. This presented a problem to the early church, since, like all successful institutions, it soon found itself involved with the wealthy and with money. Luckily, the saying about how all things are possible with God – which would include all things, such as whoring, violence,gluttony, etc. – was seized as an easy out specifically for the wealthy (and not for whores or gladiators, etc.). The man whose eye lit upon how to push a camel through the eye of a needle was Clement of Alexandria.

At the center of what became the orthodox interpretation of the passage, Clement writes:

“Those then who are actuated by a love of the truth and love of their brethren, and neither are rudely insolent towards such rich as are called, nor, on the other hand, cringe to them for their own avaricious ends, must first by the word relieve them of their groundless despair, and show with the requisite explanation of the oracles of the Lord that the inheritance of the kingdom of heaven is not quite cut off from them if they obey the commandments; then admonish them that they entertain a causeless fear, and that the Lord gladly receives them, provided they are willing; and then, in addition, exhibit and teach how and by what deeds and dispositions they shall win the objects of hope, inasmuch as it is neither out of their reach, nor, on the other hand, attained without effort; but, as is the case with athletes -- to compare things small and perishing with things great and immortal -- let the man who is endowed with worldly wealth reckon that this depends on himself. For among those, one man, because he despaired of being able to conquer and gain crowns, did not give in his name for the contest; while another, whose mind was inspired with this hope, and yet did not submit to the appropriate labours, and diet, and exercises, remained uncrowned, and was balked in his expectations. So also let not the man that has been invested with worldly wealth proclaim himself excluded at the outset from the Saviour's lists, provided he is a believer and one who contemplates the greatness of God's philanthropy; nor let him, on the other hand, expect to grasp the crowns of immortality without struggle and effort, continuing untrained, and without contest. But let him go and put himself under the Word as his trainer, and Christ the President of the contest; and for his prescribed food and drink let him have the New Testament of the Lord; and for exercises, the commandments; and for elegance and ornament, the fair dispositions, love, faith, hope, knowledge of the truth, gentleness, meekness, pity, gravity: so that, when by the last trumpet the signal shall be given for the race and departure hence, as from the stadium of life, he may with a good conscience present himself victorious before the Judge who confers the rewards, confessedly worthy of the Fatherland on high, to which he returns with crowns and the acclamations of angels.”

This is an interesting variation on the Luke story. The rich man, after all, turned away in sorrow. And that sorrow, in Clement’s account, turns to a despair that creates rich monsters, who turn away entirely from God. Clement lightly skips over the cause of that despair – that the wealthy man definitely didn’t want to give up being wealthy – which is of course the whole point of the story's existence – and softly reconciles opposites by welcoming the rich, on God’s behalf, into the ecclesia, where they are not required to give all they have to the poor. It is true that this saying of Jesus' somehow does exist, Clement doesn't deny it – but it is a hint, more than a commandment. God, like a mafia captain, might come into your store and say, nice place you have here. Wouldn’t want anything to happen to it – but he isn’t expecting you to shut the store, just give him a cut of the proceeds.

Thus, Clement’s middle ground promotes a cult of philanthropy among the wealthy that reproduces a recognizable state-like role for the church. Rather than giving away all your goods, giving away some of them to the poor – through the medium of the church – suffices. This is a rich moment in economic history – without this middle way, without allowing wealth to have some entrance into the Kingdom of Heaven, the unique relationship of religion to society that grew up in the West could not have existed.

The very position taking of the disciples shows why. While it is all very well to say that the last shall be first, in the Kingdom, when things are righted, won’t the last, then, be the wealthy? Surely infinite poverty is not the prospect offered in the Kingdom. And so, what is right in the Kingdom surely should reflect what is right in the world.

Of course, it is difficult to penetrate what the sage in the gospels is saying, here, as paradoxes pile on paradoxes. Paul, who in all likelihood knew less about what Jesus said than we do, clearly grasped the stylistic essence of the message he did know about with his metaphor of the mirror within which we see darkly.

Augustine added to Clement’s thesis one of his own. Augustine was a great reader, and he noticed that in the context of the story in Luke, Jesus had begun by saying none is good – even he himself – except God. Augustine’s intuition was that this radical claim meant that there were two messages in the text – one for an audience of the impossibly good, the perfectionists, and one for the vast majority. Richard Newhouser, in The Early History of Greed, sees Augustine’s rejection of giving away all one has to the poor – the perfectionist act – as crucial to his rejection of Pelagianism – for it was one of Pelagius’ major claims that the rich should do just that.

What is lost in this controversy is why it would be sinful to be wealthy in the first place. Why would Jesus advice anyone to give all they have to the poor? As Deng Xiaoping once put it, to be rich is glorious. What is wrong with that?

This question points us to another question: how systematic is wisdom? Does the sage’s view of virtue depend upon an insight into the systematic connection of things in the world, or is it, instead, a scattering of occasions? Is it that Jesus is operating within the economy of the limited good? In the peasant view, what one person has, another person does not have – all goods embody a struggle within the limited store of goods. Or is it the struggle itself that is pointed to – to have wealth, it is necessary to rule over men in some way, and to rule over men is to force them to do things for your own advantage.

Or, finally, it may be that wisdom simply isn't made to be pressed like this - that the inhuman thing is to expect consistency.

Monday, September 14, 2009

Bliss RIP

Bliss is dead.

I wrote this about the doggie in 2006 on Limited Inc.

dogs, considered philosophically

Since these are the dog days of summer, the time when, traditionally, LI’s financial life passes before our eyes – summer is Motha Hubbard bare indeed around here – we are more interested in the philosophical topic of the dog. As in – when you walk a dog, whose free will is exercised, yours or the pooch’s? And does this depend on the size of the dog? We’ve been reading Roger Grenier’s The Difficulty of Being a Dog (we have a sideline interest in the literature devoted to dogs, from Cervantes Colloquy to Ackerley’s My Dog Tulip). Grenier’s first essay, enigma, begins with a nice anecdote about Paul Valery. It seems that when people would come to see Paul Valery’s grave, the man who ran the cemetery would tell his dog, “Paul Valery,” and the dog would guide them to the sacred spot. The Ministry of culture caught wind of this, and finally decided (no doubt after several meetings and memos), that the man would have to cut it out. Grenier, who knew Valery, says that in all probability Valery would have liked his grave stone being tour guided by a dog. And after all, in all probability, the dog knew as much about Valery’s poems as the man did.

My own experience has not been with genius dogs, but I’ve known some bright ones. Bliss, my friend S’s dog, is a personable mongrel bitch who can cast the slyest glances, so that it is impossible not to wonder what she is thinking. In fact, thinking is the question monomaniac philosophers always put to the animal kind – can you think? However, dogs make you wonder, instead: what are you thinking about? What, for instance, does a dog plan to do when it gets up in the morning? What, in fact, is a morning to a dog? I have a feeling their divisions of time aren't like ours -- where I see day and night, I imagine the dog sees other divisions of the natural flow. However, I do know that, like me, Bliss’ first thought is to pee. The arrangements that lead to relief, for Bliss, are a bit more complex than my matitudinal stagger towards the toilet. A ritual has evolved. S. must find the leash. She has to find the poop bags. Bliss helpfully either points to the door, or sometimes goes down to nose it.

Now, once the walk has begun, if it is a nice day, surely the dog plans to not only take care of her natural functions, but make the round of her favorite places. Dogs get bored, but they are also compulsive creatures, always wanting the same thing. Also, she looks for messages in the dirt and grass, odors left by other dogs, or humans, or cats. There’s an itinerary. So the plan is to go through with the itinerary, then back to the house. But some would say that dogs don’t plan at all, even though they are clearly leading on the leash. But then, these same people would probably bridle at saying dogs improvise. So in general, I don’t pay attention to those people. It is recommended that they content themselves, if they feel the need for pets, with guppies. Goldfish. A few bottom feeders. Generally, this kind of backbiter and sceptic is sniffed out by dogs straightaway, and barked down the street when they pass. Unhappy sods.

Grenier writes: When I’m in the prescence of a dog, I always ask myself a lot of questions. I may be naïve, but I’m in good company, for Paul Valery himself shared my naivete: “The animal, that inevitable enigma, is the opposite of us in its very likeness.”

And he further writes:

“How can such an understanding exist between two species? It seems more miraculous, more precious to me than any relationship among humans. At the same time, what could be easier? You come across a dog. A word, a caress, and it responds with no further ado. It is the mystery of these exchanges that led me to write this book. But I know it will resolve nothing and that dogs will never cease to amaze me.”

I must recommend the University of Chicago Press cover of the book – the dog on it looks amazingly like Bliss.

Sunday, September 13, 2009

I walked with a zombie

When the Soviet Imperium finally fell, it was because it had progressively destroyed all of its options. This is what the American Imperium under Bush and Obama is doing. Holes appeared in the Soviet Imperium – ravaged ecologies, economic projects that suddenly didn’t work, a puzzling downfall in healthcare, a rise in the criminality of the ruling oligarchy. All of these holes are appearing in the American Imperium, of course. The article in the NYT today about water is a reminder of just how far down the hole we have fallen. When I read the following, about Charlestown, West Virginia, I think of the Aral Sea:

Jennifer Hall-Massey knows not to drink the tap water in her home near Charleston, W.Va.

In fact, her entire family tries to avoid any contact with the water. Her youngest son has scabs on his arms, legs and chest where the bathwater — polluted with lead, nickel and other heavy metals — caused painful rashes. Many of his brother’s teeth were capped to replace enamel that was eaten away.

Neighbors apply special lotions after showering because their skin burns. Tests show that their tap water contains arsenic, barium, lead, manganese and other chemicals at concentrations federal regulators say could contribute to cancer and damage the kidneys and nervous system.

“How can we get digital cable and Internet in our homes, but not clean water?” said Mrs. Hall-Massey, a senior accountant at one of the state’s largest banks.
She and her husband, Charles, do not live in some remote corner of Appalachia. Charleston, the state capital, is less than 17 miles from her home.”

As the article makes clear, these are collateral victims of the oligarchy in place – as in the Soviet Union, the law exists, in the U.S., mostly as a weapon of the powerful, and is utterly meaningless in the face of the entrenched corporate power. Thus, coal companies can dump any kind of hazardous chemical in any area they want to, safe in the knowledge that their clients in D.C. will protect them from any harm.

As the Aral Sea area was becoming the world’s worst ecological disaster, the Uzbek government became ever more involved in fraudulent dealing with Leonid Brezhnev’s son in law (who was just released from his 12 year term in prison) which allowed the cotton coops to continue and made the families at the top of the Uzbekistan state extremely wealthy and powerful.

“Today, public health conditions in the Aral Sea area hve rapidly deteriorated to levels found in the least-developed countries, and proliferating infectious diseases are claiming an increasing share of health resources. Making matters worse is an acute shortage of drugs and supplies. Patients undergoing medical treatment are often forced to pay exorbitant prices on the black market for necessary medicines. Women giving birth in hospitals typically must bring with them all the items the doctors may require, right down to surgical gloves. [Generation in Jeopardy: children in Central and Eastern Europe, 159]

It would astonish me if this doesn't happen in the U.S. in the next five years, in certain areas - like Eastern Kentucky - where civil society has simply died.

The inability to fix an out of control healthcare system in the U.S., where healthcare costs per person have reached absurd levels as the employee based healthcare insurance system is crumbling and there is no substitute on the horizon –– is part of the general return to third world status. Only in an echo chamber that is dead to reason would the argument be made that the Americans have to suffer the highest cost for medicines in the entire world because BigPharma makes most of its profits here. Yet this was an actual argument put forth in the Washington Post. Not only has monopoly power been expanded beyond all reason to create giant inefficient corporations, but the monopoloy comes with a moral dictate that we must do all we can to keep investors in these behemoths wealthy. It is as if the wolves were preaching to the sheep that they need to spread out a bit, in order to give the wolves more time to leisurely attack and devour them.

It is another symptom of the entropic state of power, the gated community mentality, in the American Imperium, impervious to its world parasite status, fats clogging its blood.

Holes appear, too, in the humanitarian attitude among elites that was painfully created in the mid nineteenth century as, for instance, torture was banned. This is from the NYRB on government sponsored torture at Guantanamo. As Phillipe Sands, the author, notes:

On April 24, 1863, President Lincoln signed his General Order No. 100, written by Columbia University professor Francis Lieber, to decree that "military necessity does not admit of cruelty." The United States military formally respected that rule for nearly 140 years—until, on December 2, 2002, Secretary of Defense Donald Rumsfeld signed a memorandum on "Counter-Resistance Techniques" prepared for him by his general counsel, William J. Haynes II.

And thus began the U.S. sponsored torture of Mohmmaed al-Qahtani, as well as many many others. Juntas torture; the Bush administration came in as a Junta, an administration that resulted from an electoral college that makes the U.S. presidential race officially less democratic than the Iranian one, plus, in this case, an interference by the Republican heavy Supreme Court. Junta’s are incompetent – a point quickly made plain before the first year of the administration was out, with the highly preventable attack on 9/11 followed by an invasion of Afghanistan that allowed the top tier of the Taliban and the top tier of Al Qaeda, including Osama bin Laden, to simply escape and set up camp across the border. Junta’s promote the psychopathologies of the ruling class, and of course the Bush cabinet and his advisors were full of old and twisted people, like Donald Rumsfeld and Richard Cheney.

In the event, after allowing the pitifully small group of terrorists that were the supposed target of the Afghanistan war escape (and even, at Kunduz, allowing Pakistan to run a full blown evacuation, with airplanes, of the top Taliban and Al Qaeda leaders) in order to preserve a threat that was credible to an American population awash in debt, hubris, and panic, Rumsfeld’s people devised a nice 15 point agenda of acceptable torture, which went from Category 1 to Category 3. It was never very clear what the torture really was about – it is not as if the Taliban or Al Qaeda made much of a secret of their business. The calculation must have been this: allowing Al Qaeda to keep going was the first order of business, in order to retain a political grip on the American Imperium. But allowing them to actually successfully attack again, on American soil, would definitely demoralize those voters in, say, Charleston West Virginia who could not take showers without burning themselves, but who were ultra-proud to be led by tough talking suits.
As Sand points out, the General Richard Myers was chairman of the Joint Chiefs of Staff at this time, and he signed off on it. Sands interviewed Myers:

“As we moved down the list onto Category II we reached forced grooming (cutting off hair), the use of dogs, and other matters. "Dogs were only to be present, never to be..." His voice trailed off. Removal of clothing? That "would be less fun." Forced grooming? "The last two here are a little...the last one in particular"—referring to the use of "individual phobias (such as fear of dogs) to induce stress"—"you know in general I think, that's how we train. Those are the kind of things we train against." His voice paused. "There was never a physical injury there...," he said, throwing light on the rationale for humiliation.
"I think all of these are in the manual," he then offered.
"They're not," I responded.
"They aren't?"
"No they're not," I said, "none of them are in the manual."
This was a moment that occurs only rarely in any interview: your interlocutor inadvertently reveals the full extent to which he has fallen into a fog. There was one issue on which I had a particular interest. As chairman of the Joint Chiefs, I asked, are you comfortable with all of these techniques being used on American personnel? "Not [the ones] in this memo," he responded without hesitation. The response left open the unanswerable follow-up question: If these techniques are "inappropriate" for us, why are they appropriate for detainees in US custody?”

When the holes appear in the Imperium, those who have a sociological curiosity – which should include all poets, novelists and essayists – have a rare chance: to leap into the hole is to find the strata of scar tissue that constitutes a society’s secret history, its Gnostic unconscious. Sands’ follow up question, the fundamenal asymmetry in which American policy is hatched and grows up, is a product of the combination of supreme power and supreme inequality which is the American holy ghost, the body electric of the American character in the time of its decadence. I live in a zombie country.

Friday, September 11, 2009

Rebecca Solnit

Genesis 1:1 tells us not only how we came to be, but stands as a rule of all good prose: put the hook at the beginning. “In the beginning God created the heaven and the earth.” Not that there isn’t a place for coyness in what follows – after all, we can deduce from the logic of this unalterable statement that nothing will ever be so simple again. The beginnings we remember stand at a slight remove from the works and days they start, as a statue in a park stands at a slight remove from all the green thoughts in the green shade of the joggers, dogs, and loungers - but they wouldn’t exist except for the surrounding clutter of meaningfulness and revery. “Stately, plump Buck Mulligan…” “It is a truth universally acknowledged, that a single man in possession of a good fortune, must be in want of a wife.”

And so it is that I like the beginning of this interview with one of my favorite writers, Rebecca Solnit.

“THE BELIEVER: I’ve seen you referred to as an art historian, a landscape writer, and an art critic, if not more. How do you consider your own work and writer’s identity?

Rebecca Solnit: In Wanderlust, I wrote, “This history of walking is an amateur history, just as walking is an amateur act. To use a walking metaphor, it trespasses through everybody else’s field—through anatomy, anthropology, architecture, gardening, geography, political and cultural history, literature, sexuality, religious studies—and doesn’t stop in any of them on its long route. For if a field of expertise can be imagined as a real field—a nice rectangular confine carefully tilled and yielding a specific crop—then the subject of walking resembles walking itself in its lack of confines.” I have a very clear sense of what I am here to do and what its internal coherence is, but it doesn’t fit into the way that ideas and continuities are chopped up into fields or labeled. Sometimes I say I’m an essayist, because that’s an elegant, historically grounded—if sometimes trivialized—mode of literature, while nonfiction is just a term for the leftovers when fiction is considered to be paramount, and creative nonfiction is even more abject a term.”

Of course, as readers of Limited Inc and this blog know, she is intoning my credo. And that of the tribe of ghosts, our illustrious ancestors: Montaigne, Hazlitt, Woolf, Pessoa – the throng is extensive and shadowy, and we can only really see them, as Odysseus saw in the underworld, when we feed them blood. Our blood.

Solnit has blood to spare. And she makes wonderfully deep points, which is difficult to do in an interview. I don’t want to quote it too extensively, but rather want you, reader, to click on over to it.

And here I’ll contradict myself and quote extensively from it:

BLVR: Thoreau is a touchpoint for you in many of your writings. What is your relationship with him and his work? Kindred spirit? Admirer? Literary reference point? Misunderstood actor? Inspiration?
RS: Yes, (F), all of the above! I think he’s a great example of someone refusing the categories: he thinks about leaves changing color and he also thinks about, and talks about, and cares about, slavery and John Brown and the war on Mexico. In the introductory essay to Storming the Gates I write about the way he’s so insistent that when he got out of jail the morning after that founding act of civil disobedience, he went huckleberrying. It’s an insistence that pleasure and commitment, landscape and politics, the big and the small can and do coexist. He’s himself a great refuser of genre. And a founding father of insurrection against what the founding fathers gave us, and a great writer with an aphoristic way of describing that comes back again and again.

BLVR: Not to mention that “Walking”—his essay about both the pleasures of knowing the landscape from walking it and the future possibilities of an America defined by walking away from the constraints of society—resonates strongly with your work.

RS: Well, actually in Savage Dreams I tore into that essay for changing its mind halfway through about the conquest of the American land and praising the settlers as ax-swinging Adams in a new Eden. But Thoreau as a whole I love—lately I’ve been quoting, as I did earlier, his “I have traveled a great deal in Concord.” Part of my agenda in Wanderlust was to make it clear that you can wander widely on foot within miles of home or go around the world and never travel in any way that matters. I am still struck by how much unknown San Francisco contains after a quarter century in residence there. And I am a homebody in that my main urge is to deepen my knowledge of known and loved places and regions rather than jump into entirely new territory.

Wednesday, September 9, 2009

Daschle, Baucus, and the Wellpoint healthcare joke

Why did we bother
Should have stayed away
Death of a Party

There’s only one goal in health care reform that counts: to get the cheapest healthcare coverage to the greatest number of people. If Government taking over the healthcare system would do that, I’d be all for government taking over the healthcare system. But in fact nobody in the OECD has that kind of system. Which makes sense. As always, economic performance is best when it is mixed. Thus, all OECD countries have the kinds of public/private mixes that optimize what the private sector can do – competing with each other to either lower costs or offer higher quality – and what the public sector can do – guaranteeing basic care for all and operating as a horizon against which all parts of the healthcare industry have to adjust their costs.

This, by the way, includes the U.S. The U.S. just does it extremely badly.

The figures are simple and scandalous. Anne, the analyst who comments at Economist’s View (a brilliant woman), provided a nice link to the OECD breakdown of health care costs as percentage of the GDP and per person. OECD are the European developed economies, plus Mexico. The U.S. is, of course, a joke:

“Total health spending accounted for 8.4% of GDP in the United Kingdom in 2007, compared with an average of 8.9% across OECD countries. The United States is, by far, the country that spends the most on health as a share of its economy, with 16% of its GDP allocated to health in 2007. France and Switzerlandfollowed with 11.0% and 10.8% of their GDP spent on health, respectively. Several EU countries –Germany, Belgium and Austria – and Canada also devote more than 10% of their GDP to health.”

Which means: the U.S. spends 7290 per person, and Canada, 3895.

Now, the U.S. could do this kind of thing perhaps in the 90s, the last decade in history in which the U.S. economy would dominate in the world. It can’t do it now.

Now, a sign that a country is in real trouble is when the policy solutions it seeks aren’t solutions at all. Rather, one side seeks only to aggravate the other side. During the years of Bush, the Great Fly, many whacky and visibly unsuccessful policies, as for instance a Global War on Terrorism that didn’t seem to hurt a hair on Osama bin Laden’s head, was defended because it made liberals mad. This isn’t a strategy that works, outside of highschool cliques. The real world has one characteristic that you can count on: it is real. If your politics is fashioned around attitude, then basically, you’ve lost touch with reality. But reality has not lost touch with you, and will crash into you and hurt you with supreme and utter indifference to your pain and suffering and death. In fact, that is going to happen. And that’s the way things work, baby.

So, given these facts, what are the Dems in Congress worried about? Not giving an unfair advantage to any government supported health plan.

I’ll write that again, so that we can all smell the Daschle cologne on it, that mixture of politico sweat, pure greed, stupidity, and the assurance that once you are tossed on your ass by the voters, you’ll bounce into the back of some lobbyist limousine: they are concerned that the insurance companies might suffer from, well, having to become efficient.

Luckily for the insurance companies, they wrote the Baucus plan. Which, incredibly, seems to be the plan that the Senate Dems are now thinking about rallying round. It is not simply that there is no public option that could cross states, allow for much cheaper coverage, take advantage (o heavens) of government subsidies (like, you know, the ones that are given to banks), and bring the cost of healthcare insurance down to a Canadian level. No, when the Dems jump into the pit of corruption,, they do it like kamakazi pilots.

The plan was written, literally, by Baucus’s chief aid, Liz Fowler. The person who writes Empty Wheel at FDL has been all over the fact that chief aid, Liz Fowler, was recently the VP of WellPoint.

Now, back in the day, I remember liberals howling about Bush’s energy commission, chaired by Cheney, making itself a wholly owned subsidiary of Exxon. Now, big voices in the liberal blog community, like Matt Yglesisas, are simply exasperated that anyone would find a taint or stain in Liz Fowler coming up with a plan that is a … good compromise. A first step! And what does this first step entail? Well, luckily, it doesn’t entail cutting into the profits of insurance companies. Thank God! Rather, it entails robbing you in a truly bold and insane way. I haven’t checked these figures from Empty Wheel, but if true, they are astonishing:

“A bunch of outlets have now released Bad Max's framework on health care.
Here are some ways to think of Max Tax:
Maximum amount a family of four making $67,000 would have to pay for health care, per year:$20,610 (31% of income)
Total amount that family of four would pay in fine if they did not get health care insurance: $3,800
Total amount a corporation with more than 50 employees would pay in fine if it did not offer health insurance: $400 per employee
Total amount a corporation can pay for health care plans without paying 35% tax: $8000 individual, $21,000 family.”

Let’s be clear. The U.S. is the richest nation on earth, but it has devised the most dysfunctional healthcare system on earth. American companies simply can’t remain competitive given the way healthcare costs have been hooked to compensation packages to which they contribute for workers. This system is about to fall apart.
The system has lead to gross and pointless disparities in healthcare, which, as is recognized by the rest of the world, is a public good. And this is actually recognized by the U.S. – one of the things that raise prices in the U.S. is government “interference” in the healthcare market. One has to remember: people who think that the government ‘interferes’ in an economy are living in cloud cuckoo land. The same people who are hollering, today, at the government takeover of medicine, were voting, yesterday, for the largest expansion of Medicare in history, Bush’s pill bill. Beyond the ideological fog, the real cause here is to shift money from whatever sources it can be extracted to the wealthiest sector of the population. MacDonald’s sells hamburgers. The GOP protects the rich. The Dems are like a MacDonald’s that has gone upscale. They want to protect the rich, just like the GOP, but they also want to create great vegetarian fare for working people, plus let’s not forget pate and political correctness for you educated women in the suburbs, y’all! A MacDonald’s that operated like that would soon be serving its last cheeseburger.
Healthcare reform is and should be about making the government kick the medical industry’s ass, so that the cost comes out of that industry. Obama set the worst possible precedent for this business when he compromised with BigPharma about negotiating for prices on drugs. Let’s say it loud: that’s nuts. It is nuts to run a welfare system for the world’s richest corporations. When judging the efficiency of governments, you have to relate the efficiency to the national scope of their operation. In those terms, there is no buggetty buggetty magical reason governments should be less efficient than private enterprise. But just as inkind dealing in private businesses leads to inefficiency and robbery of the customer, so, too, government, when it falls into the hands of corrupt oligarchs who use it as a milk cow to become ever wealthier, becomes a sad spectacle of impotence and bad service.

Sunday, September 6, 2009

shake your money maker - Big Pharma edition

everywhere you turn I'll be making you wet.. –Ludacris, Shake your money maker

In the constant rain of braindeath that falls upon our ill republic, I have to ask whether it really pays to fight it. I fought the war and the war won... indeed.

But I did promise, in my last post about the way the vicious, McArdalizing press was negligently or maliciously injecting the grossest impostures into the discourse on healthcare, and then acting all innocent and shit. Which leads me to the wonderful world of BigPharma statistics.

Now, you might think this is about the most boring topic under the sun. It isn’t. It is actually quite funny.

Our hero, in this post, is a University of New Jersey and Princeton professor in sociology named Donald Light. Donald Light must go to bed every night chuckling to himself -- unless he is terminally depressed. For, over the years, he’s collected a number of BigPharma scalps, at least on paper. He likes to ride out and look at the propaganda that is reliably cranked out by stooges for Merck, Pfizer, GlaxoSmithKline, et al. The stooges go to institutions that bear impeccable names, like the Tufts “Center for the Study of Drug Development”.

It was a prof at Tufts named Joe Dimasi, and his partners, Henry Grabowski at Duke and Ronald Hansen at Rochester, that he bounced around in a review of the 2006 CBO report on R & D costs in the drug industry that was published in Journal of Health Politics, Policy and Law. Here’s the opening shot:

“The CBO study almost exclusively uses the study by DiMasi, Hansen, and Grabowski (2003), three of the industry’s favorite leading health economists, who “put the average cost of developing an innovative new drug at more than $800 million, including expenditures on failed projects and the value of forgone alternative investments”

It is important not to let your eyes glaze over at the kind of newspeak that goes into “value of forgone alternative investments” – because what this means is that, even if 800 million dollars was put into the “development” of x drug, this 800 million dollars wasn’t a physical entity, like the 8 dollars you use to buy a sixpack of Sam Adams Dark. No, the concrete money that was spent, you see, could have been spent elsewhere – for instance, buying securitized mortgages. Thus, you have to account for that too. F. Scott Fitzgerald once said that the rich aren’t like you and me, by which he meant that when the rich spend money, they get to count it twice! It is a cool thing, and you’d have to be a stupid peasant to bitch about it.

But what about that 800 million dollars? And what does average mean? Anytime you see average being thrown about with a big figure, it is best to be on guard. What is probably happening is an outlier is raising the spread, and the person doing the broadcasting is trying to blow smoke up you asshole, as my grandmother used to say.

So Light looks into the methods of Ms Dimasi, Hansen and Grabowski (names to remember next time you have to buy an overpriced medication – they fed, oh just a tiny bit, on your blood). And what does he find?

“The $800 million estimate was based only on new molecular entities (NMEs) developed entirely within the companies selected from those that submitted confidential information to the Center for the Study of Drug Development at Tufts University. Thus the $800 million estimate applied to this, the most costly subgroup of NMEs, and then was widely misrepresented as the average cost for all
new drugs. The CBO does not correct this error. It does note that only one-third of all new drug approvals are new NMEs and reports that “most new drug products have much lower R&D costs than NMEs because they are incremental improvements on existing drugs. . . . Their average direct
cost may be only about one-fourth that of an NME. Their opportunity costs are also lower due to the extent that they take less time to develop” (2). That estimate sounds about right to me, but the CBO continues to feature only the $800 million figure as the grand average. Since the $800 million figure was announced, DiMasi, Hansen, and Grabowski (2005) have written that they are working on estimates of the R&D costs for me-too derivative products that will add all the R&D costs of the original drug to the development costs of a new variation.”

Comedy is timing. Dimasi, Hansen and Grabowski replied to Hansen, and this is what they had to say about “working on estimates of the R&D costs for me-too derivative products that will add all the R&D costs of the original drug to the development costs of a new variation.”:

“These approvals [for NMEs – remember, these are the ONLY innovations in the drug pipeline], for the most part, are line extensions. Firms in this and in many other industries fill out their product lines for a basic product to better serve varied consumer needs and desires (e.g., oral solutions for children or adults who have difficulty swallowing tablets or capsules, more convenient dosing regimens, or different side-effect or efficacy profiles). In the case of drugs and the FDA statistics on NDA approvals, many of the approvals, in fact, are obtained long after the drugs have lost patent expiration by firms other than the sponsor of the original NME (often by small, specialty pharmaceutical firms or generic drug companies). Even leaving aside this substantive point about the makeup of the approval statistics, it is not appropriate to treat the incremental costs of later regulatory approvals associated with an active ingredient as though they were independent of the costs of obtaining the original approval. This would make no more sense than it would to take all of the R&D costsassociated with developing a new automobile model and dividing that by the number of trim lines of that model that the manufacturer happens tooffer for sale and then use that as a measure of the R&D cost of developing a new automobile model.”

Cutting through the obfuscation, DHG cop to the charge and actually defend it on the butter doesn’t melt in my mouth excuse that this is all (sob) for the consumer. To be clear – when the patent is expiring on an NME, drug companies will often tweak it so that they can apply for a new patent, thus extending its monopoly life. And these tweaks, according to DHG, should be costed out by adding the original cost of the NME plus the development of the tweaks. This is accounting for rich people, and its fun and rewarding!

In a recent article by Curtis Verschoor, another often quoted expert on BigPharma R and D, he compared New Drug Applications with NMEs and found that many of the NDAs – they love acronyms in this biz – turn out to be tweaks:

“Examples of NDAs that don’t involve innovation include a new formulation of a previously approved drug, a new salt of a previously approved drug, a new combination of two or more existing drugs, and a new manufacturer.Many times, pharmaceutical manufacturers put up with the high costs of testing and guiding these “new” drugs through the FDA regulatory bureaucracy in order to reap the benefit of extended
patent coverage.With a new patent, a maker can charge the highly inflated prices for which the U.S. market is legendary. Some of the more blatant and callous examples of these consumer gouging business practices include AstraZeneca’s (AZ) re-branding of Prilosec, the heartburn medication, as Nexium. This occurred just as Prilosec was about to become generic. AZ used an expensive marketing campaign to hail the “new” drug (now it’s purple!) as almost being a medical breakthrough—despite the lack of medical evidence to back up such a claim. Such strategy appears to be within the ethical boundaries of this company. Eli Lilly, after losing its Prozac patent, introduced an exact copy with a new color and called it Sarafem.”

But as Dimais, Hansen and Grabowski might well point out, the new color was much more soothing – it was aimed solely at the consumer. Thus, one has to add the cost of developing Prozac to the cost of developing Sarafem to get a fair price.

Or as Ludicras says:

“You know I got it
If you want it, come get it
Stand next to this money
Like - ey ey ey
Shake your money maker
Like somebody boutta pay you
Don't worry about them haters
Keep your nose up in the air.”

But what does it mean to develop a drug? For instance, would you include the costs of testing it on human subjects? Of course you would. And would you ask what is the industry norm for testing on subjects? Well, why do that when you can trust your buddies in the industry. Alas, I have to quote Light at length here – forgive me. Like a shaggy dog joke, this gets funnier as it goes along.

“Even if the median R&D cost per new drug had been stated as $300 million rather than $800 million, the CBO or any rigorous reviewer would have further reason to doubt its validity. At the same time that the study appeared, James Love (2003) issued, on the widely read Consumer Project on Technology (CPtech) Web site, evidence that the average sizes of phase 1, 2, and 3 trials in the study by DiMasi, Hansen, and Grabowski (2003) were substantially higher than those of other sources. DiMasi, Hansen, and Grabowski reported an overall average of 5,303 subjects used in trials
per approved NME, while the Food and Drug Administration (FDA) reported an average of only 2,667 subjects over a much larger sample of approved NMEs (Love 2003). Michael Palmedo, then a staff member of CPtech, updated the FDA study and found the same average number of subjects for NMEs under standard review for drugs with no distinct advantage over existing drugs, but trials for priority drugs used an average of only 1,461 subjects (ibid.: 18). This is close to the average in a study
of R&D costs (Global Alliance for TB Drug Development 2001; also not cited or reviewed by the CBO) of 1,368 subjects that was much more detailed than that of DiMasi, Hansen, and Grabowski (2003). Thus the $800 million average R&D cost per self-originated NME (or $300 million
median cost per newly approved drug) is based on trials with sample sizes two to four times greater than those of other official and reliable sources.

Once again, the range and variation is large, from about one thousand to seventeen thousand subjects, according to the FDA study (Love 2003); so once again using the average represents a strong upward bias, which the CBO does not discuss. The median number of subjects is about one quarter
lower, or two thousand subjects, which puts the average calculated by DiMasi, Hansen, and Grabowski (2003) still further out of line with FDA and National Institutes of Health (NIH) figures (as reported in Love 2003: 10 – 11) and makes the secret data submitted by drug companies still
more suspect. The largest trials are often for NMEs that provide the least additional benefit so that they require large and long trials to make small differences statistically significant. Does this mean the unnamed drugs in the nonrandom sample used by DiMasi, Hansen, and Grabowski (2003) had disproportionately large trials because more of them offered small therapeutic gains? No one can know, because the identity of the drugs is confidential, too.”

Thus, the industry bs is sliced and diced. But a further question remains for the mocking blogger: watching the wretched inhabitants of the hinterlands get in such a sweat about the fat that they are ruled by a black man, and watching the extension of the Bush rule by lobotomy extend itself pleasingly in the media, and everywhere a millionaire newscaster broadcasts a… a…. populist message, is it a bad thing that America is being rooked to the gills, debilitated, its population the cretinous goof in some nightmare practical joke of Capitalists Gone Wild?

Well, the corvine pull of my blood says yes! Oh, let them suffer more and more! But the better angels whose blood is intermixed with mine gently reproves that raven croaking nevermore. It is easy to love the lovely, but the true test of love is to love the patsy who is blindly set on his or her own victimization.

Friday, September 4, 2009

Don't feed the stupid: the case of megan mcardle

I am puzzled that Megan McArdle generates such controversy and attention. Recently, for instance, Crooked Timber has been refuting her, and a number of blogs have pointed out that her rousing defense of big pharma, which she apparently published in the Washington Post (they all dribble down to the Washington Post eventually, all the fun contrarian rightwingers, into the open arms of Fred Hiatt), was based on such non-starter factoids as “Pharmacy companies make 80 to 90 percent of their profit in the American market”. The latter fact, as she said in her defense later, came from her voices, voices that she trusts – voices of big pharma lobbyists, who apparently come to her in her dreams.

And here I am, giving her attention myself. But I’d like to use her merely as a hook to observe two things. One is that the Atlantic and the Washington Post hire and promote people who seemingly are way too lazy to do any reading. This is why, between 2002-2008, Limited Inc was a much more informed resource for finding out what was happening in Iraq than either of those two media venues. When I write a post about, say, the pharmaceutical industry – like this post here – I don’t just add value by gilding the lilies of my prejudice with obfuscatory prose – McArdle’s sole job in this vale of tears – but I – it is a secret, but I’ll disclose it to all - I, well - be prepared, this is big -I – okay, here it comes, my great revelation that will change the media forever! – I use my library card, provided free by the library (socialism at its deadly work!). Thus, instead of waiting around to see if someone will email me some spin, or reading the back issues of Reason Magazine, I can actually go to Ebsco and JSTOR and look up shit. Amazing! It is called research. Surely Atlantic magazine might actually spring for, I don’t know, making available Light and Lexchin’s 2004 article in the BMJ entitled Foreign Free Riders and the High Price of U.S. Medicines.

Anyway, I’m now going to drop the McArdle thing and make a few general comments about the sheer comedy of the right’s so far successful attempt to destroy Obama’s healthcare plan. Of course, that success is partly generated by the fact that Obama doesn’t seem to have a healthcare plan so far, just a plan to tell his liberal core not to be bedwetters and a plan by his staff to drop hints in Politico that really, the “progressives” are children that need to be spanked. In other words, the Daschle strategy, always a favorite in a town in which the oligarchy and its media pets form a corrupt stanglehold on the dying republic. Business as usual.

In these struggles, the first thing to go out the window is reality. Thus, the current controversy pits conservatives, who are against government in healthcare, against liberals, who are for it. That at least is the image. Of course, it is bullshit. Conservatives, if you have memories stronger than that of a debilitated tse-tse fly, voted in the most expensive addition to Medicare since Johnson under Bush. There is no real conservative opposition to the government in medicine. Rather, the opposition is to the balance of benefits. Bush’s pill bill, for instance, nicely sluiced money to pill companies. It was so designed that the government voluntarily gave up using its buyer power to pull down the price of pills. In other words, conservatives happily went along with a program that would enrich investors. And, in fact, government money in medicine has long made American pill companies, American doctors, American hospital companies, and American insurance companies fabulously wealthy. It is this status quo that real conservatives – the GOP politicians – want to preserve, and have voted time and again to expand. Imagine the government making a regulation that Walmart could not use its scope to bring down the price of goods it gets from its suppliers – imagine the reaction from so called conservatives. But as long as they can stuff the government with such rules, they are happy.

Now, the American people have become noticeably more servile over the past couple of decades, but even in this state of spinelessness, a robust proposal to make the rich richer by whatever means possible would probably shock them. Conservatives can’t go out and say, government should be by and for the wealthiest and the noblest, as they used to in the 18th century. Although conservatives are free to float cockeyed theories that the richest have the highest IQ, and are the geniuses who, like Rumpelstiltskin at his spinning wheel, turn straw into gold. The idea that the producers produce the wealth, a commonplace in the nineteenth century, has long been replaced in the media with the fairy tale of CEO Rumpelstiltskins.

Thus, the conservative and neo-liberal strategy is to make sure that any argument about healthcare is immediately shunted to a discourse that only distantly touches on reality. Reality, of course, shows that long before medicare – since the cholera epidemics of 1830, in fact – government has been involved in public healthcare. John Holbo unfortunately replied to McArdle by granting her points some philosophical merit – and thus discussed this: “People have no obligation to perform labor for others. I may not force a surgeon to save my mother at gunpoint. (To be sure, I might. But society would justly punish me for doing so.)” This is arguing at the twelve year old level about a libertarianism designed by twelve year olds. Here’s what the government can do to you in your own house, if you happen not to keep it clean and rats breed in it: they can fine you. They can take it from you. At gunpoint! And if you are a surgeon, but you don’t pass the state’s test for being a surgeon – let’s say you skipped medical school, cause it is full of propaganda, and have set up your business with a table knife and a bottle of ether – they can haul you off to prison! Imagine that. Government has been able to do this for a long, long time. They determine if you are a surgeon or not. Thus, they could easily write it into that determination that you have an obligation to do a certain amount of public service. That, oh heavens, is what happens when you agree to let the government determine the labor market. Now, you could put your foot down and demand that the government not license surgeons. That would be the twelve year old thing to do, but alas, the 'libertarian' point is not called, here, at all, but treated as though it had some serious relationship to the world we live in. So, getting the government out of “healthcare” would not only entail taking down medicare – a position which the Washington Post might be more hesitant to give space to, instead of fun contrarianism in defense of bigpharma – but opposes two hundred years of public health policy involving filtering water for drinking, sanitation, quarantines, vaccination, spraying for mosquitoes and ticks, regulations on the placement of slaughterhouses, livestock inspection, etc. In fact, of course, it is the state’s “intervention” that has produced the lion’s share of the improvement in our health in developed economies. As anyone with a cursory acquaintance with the facts of health history can tell you, rates for things like tuberculosis, cholera, yellow fever, and an enormous other mass of killers all fell precipitously before prophylactics for them were developed, due to public health measures. The widespread treatment of cholera through saline solutions was painfully delayed in the twentieth century, but the treatment of water, beginning in the late 19th century, essentially crushed the epidemic threat posed by the disease. It is amazing what separating e coli from the water you drink can do to help the young and old.

So, I’ve run out of the time I was going to use in writing about Donald Light’s articles about BigPharma R and D. I’ll do that tomorrow.

Today’s motto, which I urge upon Crooked Timber, is: don’t feed the stupid.