More Sicko

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Cenk Uygur of The Young Turks appeared on CNN’s Paula Zahn show last night to talk about health care and the film Sicko. You can watch the video here. Be sure to check out the spokesperson for the Right, Amy something.

My comments:

The young lady representing the Right kept going on about how she didn’t have health insurance because she was self-employed and wanted some kind of tax credit so she could afford it. However, I’m reasonably certain self-employed people already can deduct 100 percent of their health insurance premiums from their federal income taxes (Form 1040, line 29). So I’m not sure what other tax incentives she might need.

Which takes me to the next point — she was complaining about those awful “regulations” that make insurance so expensive. When the COBRA policy from my last job ran out I was able to purchase a private Blue Shield HMO policy, even though I am 55, overweight, and have high cholesterol. This is thanks to New York state regulations. I’m paying almost $700 a month for it, but by damn I’m insured. In many states I probably could not have purchased private insurance at any price.

This is, I think, critical: Empire Blue Cross/Blue Shield could not deny my application because I applied the same month my COBRA insurance expired. I didn’t have to get a physical or anything; just provide proof of my prior insurance. This was New York law, they told me. Had I waited more than a month, they could have turned me down. In many states I wouldn’t have had even the grace period; I could have been denied coverage just because. These are the kind of “regulations” the Right says are so onerous.

Also in New York, if you start a new job, your new employer’s health insurance provider has to insure you even if you have pre-existing conditions. There may be some loopholes somewhere, but I have never heard of an employed co-worker being denied coverage in all the years I’ve lived around here. That’s another of those damn “regulations” the Right wants to do away with.

Ms. Amy the Tool (who is a pretty girl, but a twit) exemplifies another problem with “The System.” She’s young and healthy and thinks it doesn’t make sense for her to purchase health insurance when she sees a doctor maybe once or twice a year. Never mind that she’s gambling she won’t be in an accident or come down with something serious. Insurance is about risk sharing, and if healthy people aren’t in the system it drives up costs for everyone else.

Finally, the segment implied that Sicko focuses on the problems of uninsured people, but it’s more about insured people who have been ripped off by their insurance providers.

I hope I’m not being too hard on Cenk, who did good.

Also: Nice commentary on Sicko by Maggie Mahar.

Update: I forgot to answer one other thing — Ms. Amy Something mentioned all those Canadians who are dropping dead while on waiting lists for elective surgery. I don’t remember the number she gave. I want to repeat something I wrote last month:

Nearly a year ago the Institute of Medicine issued three reports (key findings here) saying the nation’s emergency rooms are inadequate and getting worse. Among other things, it found:

  • Demand for emergency care has been growing fast—emergency department (ED) visits grew by 26 percent between 1993 and 2003.
  • But over the same period, the number of EDs declined by 425, and the number of hospital beds declined by 198,000.
  • ED crowding is a hospital-wide problem—patients back up in the ED because they can not get admitted to inpatient beds.
  • As a result, patients are often “boarded”—held in the ED until an inpatient bed becomes available—for 48 hours or more.
  • Also, ambulances are frequently diverted from overcrowded EDs to other hospitals that may be farther away and may not have the optimal services.
  • In 2003, ambulances were diverted 501,000 times—an average of once every minute.

    • After these reports came out, David Brown wrote in the Washington Post:

    The number of deaths caused by a delay in treatment or lack of expertise is especially uncertain, though it may not be small. San Diego established a trauma system in 1984 after autopsies of accident victims who died after reaching the ER suggested that 22 percent of the deaths were preventable, said Eastman, one of the Institute of Medicine committee members.

    Our system doesn’t kill people by putting them on waiting lists for elective surgery. Out system has other ways to kill people. If it doesn’t kill them in the ER, it kills them by denying them necessary surgeries. Experimental, you know. And it kills them when it denies them basic medical care.

    A report came out in 2002 that 18,314 people die in the US each year because they lack preventive care services, timely diagnoses or appropriate care. They lack these things because they are uninsured.

    Those people would have been better off in Canada, wouldn’t you say?

    Unserious?

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    Yesterday I wrote about Sen. Richard Lugar’s apparent shift on Iraq policy. Matt Yglesias is skeptical.

    On the subject of US foreign policy, Lugar is one of the most knowledgeable senators, and certainly the Republican member who carries the most respect around town.

    Then again, he’s criticized Bush before and nothing’s ever come of it. “In the past, the administration has been inclined not to disregard congress but to not take congress very seriously,” Lugar said in late December when the administration was floating the “surge” proposal, “I think this time congress has to be taken seriously.”

    Congress, of course, was against the surge. And Bush didn’t take that opposition seriously at all. And when Democratic congressional leaders attempted to make him pay a price for his defiance by attaching to the war funds the administration sought a requirement that troops be withdrawn from Iraq, Bush showed how unseriously he took congressional opposition by vetoing the bill and then accusing congress of denying funds to the troops.

    Democrats made a token effort to override the president’s veto, but with the Republican Party opposed – including Lugar – the veto was sustained, the surge continued, and so it will go until enough Republicans defect to the other side.

    And after Senator Lugar’s speech calling for a new direction in Iraq, one of the Senator’s spokespersons told the Associated Press that the speech was not a signal Lugar would switch his vote on the war or embrace Democratic measures setting a deadline for troop withdrawals.

    Which begs the question, what does Lugar hope to accomplish, and why? Surely he knows Bush doesn’t care what he thinks, so he can’t be expecting to influence Bush’s policy choices. Lugar just won re-election in 2006, so his Senate seat won’t be up for grabs again until 2012. He doesn’t have to tapdance around an angry electorate. If he doesn’t intend to vote his conscience on the war, what was this week’s speech about? Matt asks,

    The shame of it is that he clearly knows better. When Bush pursues a misguided policy in Iraq, we can at least believe that Bush believes in it. When GOP legislators back his misguided policy, we can choose to believe that they, too, are misguided. Lugar, however, can see that Bush’s policies aren’t working. Indeed, dating all the way back to before the war he was raising reasonably prescient warnings and even cosponsored a resolution with Joe Biden that would have thrown some roadblocks in the path of war.

    He knows Bush’s policy won’t work, but in effect – with his votes, when it counts – he’s backing Bush anyway. The question is why?

    You could ask the same thing of nearly every Republican in Congress, of course. Lots of them have been willing to break ranks with Bush over his immigration policy, but not the war. I assume this is because more Republicans still support the war than support Bush’s immigration policy. The latest CNN-Opinion Research Corporation poll says “Anti-war sentiment among Republican poll respondents has suddenly increased with 38 percent of Republicans now saying they oppose the war.” The article doesn’t say how much of an increase 38 percent represents, just that it’s an increase, and it’s still a minority. In any event, Republicans are sharply at odds with the public as a whole, two-thirds of which oppose the war.

    Surely Senator Lugar and other Republicans must realize by now that as long as George W. Bush is free to conduct the war at his discretion, he will make no substantive changes in Iraq policy. Congress can pass resolutions till the cows come home; if there are no binding dates or other non-discretionary benchmarks and no veto-proof majority, Bush will ignore them.

    Simon Tisdall reports for The Guardian:

    Mr Reid will test Republican support for Mr Bush’s policy next month by forcing a series of votes on a withdrawal deadline, a funding cut-off, and restricting the length of combat tours. Until now only a handful of lesser-known Republicans in the House of Representatives have dared to publicly challenge Mr Bush’s conduct of the war. But latest polls suggest that 38% of Republican voters now support a withdrawal, and pressure on the party’s elected politicians is beginning to tell.

    Willing to put your votes where your mouth is, Senator Lugar?

    So I’m Blue in the Face

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    Andy doesn’t get it:

    Moreover, a wholesale shifting of healthcare from the private to the public sector simply means replacing rationing by wealth with rationing by number, and a drastic decrease in individual freedom on both sides of the medical equation. You’d replace insurance company bureaucrats who deny care with government bureaucrats who deny care. Removing the financial incentive from doctors simply means they will provide sloppier treatment. They’re not saints. They’re human beings. And slashing the profit motive from the drug companies will simply mean fewer new drugs for fewer illnesses. This is the trade-off the left will deny till they’re blue in the face. But it’s a real trade-off.

    But for the most part these trade-offs are not happening elsewhere. So why would they happen here if they are not happening in, say, France?

    In one part of Sicko a doctor — I can’t remember if he’s British or French — explained that his income goes up if his patients get healthier. Meaning, if his records show he is providing patients with good preventive care, as opposed to just writing prescriptions, he gets bonuses. Here, doctors get paid for not treating people.

    Patients in those nasty foreign countries like Canada actually have shorter waiting lines in emergency rooms than they do here. They get better general care, which is why they live longer and have lower infant mortality rates. Patients are not being denied care because of some technicality in their private insurance contracts. People are not being driven into bankruptcy by medical bills. Other nations’ plans are not perfect, but nearly all of ’em are a whopping huge improvement on what we’ve got.

    As far as the “fewer drugs for fewer illnesses” line — what’s actually happening is that highly subsidized American Big Pharma cranks out tons of boutique drugs for boutique illness (toe rot; restless leg syndrome) or “new” drugs advertised as breakthrough but which usually are just minor tweaks to the old drugs, or perhaps not as good as the old drugs. “Life-saving” often means “terminal patients get one more month.” That sort of thing. I’ve written about his before; see “Demand Supply” and “Unhealthy Care.”

    Andy continues,

    The European health systems have, of course, been free-riding on private U.S. drug research for decades. Name a great new drug developed in Europe these past ten years. Their own pharmaceutical industries have been decimated by the socialism Moore loves (and many of Europe’s drug companies have relocated to the US as a result). But I fear the left is winning this battle; and the massive advantages of private healthcare are only appreciated when you lose them.

    European drug companies move here because they make money like bandits here. But let’s play Andy’s game. Name a great new drug developed in Europe these past ten years. Then name a great new drug — and I mean really great, and really new, not just advertised as great and new — developed in the United States these past ten years. Most of the “new” drugs I know of coming out of America are either variations on old stuff, drugs that had to be withdrawn from the market after patients developed nasty side effects, or drugs that really don’t deliver all that much — one fabulous “new” drug I discussed here increased overall survival rate in cancer patients by 4.7 months, for example. That’s nice, but that’s the “trade off” Andy doesn’t want to give up for single payer health care. I’m not convinced.

    Update:     Kevin Drum writes,

    This business about America providing all the world’s pharmaceuticals is a common trope on the right, but it’s absurd. There are more biotech startups in Europe than in the U.S. Pfizer is targeting Japan as one of its biggest near term growth opportunities (and Japan is also a major source of new biotech development). And plenty of pharmaceutical research is done outside the U.S.: The #3 pharmaceutical company in the world, GlaxoSmithKline, is British. The #4 company, Sanofi-Aventis, is French. The #5 company, Novartis, is Swiss. #6, Hoffman-La Roche, is also Swiss. #8, Astra-Zeneca, is Anglo-Swedish. Their combined R&D spending is slightly higher than the American companies that make up the balance of the top ten.

    Now, what is true is that American capital markets are both bigger and generally friendlier to startups than European capital markets, which means that small biotech companies often migrate to the United States in order to get funding. My sense is that Europe is improving on this score, but in any case this has nothing to do with the state of European healthcare. What’s more, an enormous amount of basic research is done in American universities and the NIH, most of it publicly funded. This speaks well for our system of higher education, but doesn’t really say anything about our healthcare industry, which is famously hesitant to invest in genuinely innovative (but chancy) new ventures. Ironically for big pharma’s cheeleaders, it turns out that America’s titans of capitalism mostly prefer to leave the risky stuff to the feds.

    No Parades

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    E.J. Dionne writes in today’s Washington Post:

    Quietly, the real debate over Iraq is beginning.

    It’s not about whether the United States should pull out troops. That is now inevitable. The real challenge is to figure out the right timetable for withdrawal, whether a residual force should be left there and which American objectives can still be salvaged.

    The Bush Administration, by its own choice, is not taking part in this debate. The Bushies are still playing kick the can, moving the deadlines for making choices ahead into next year, when they hope to run out the clock. If they can’t have victory, the next best thing for the Bushies is to keep the war as it is until January 21, 2009. That’s the first day of work for the next administration. Then it’s somebody else’s war to lose.

    E.J. Dionne continues,

    The facts are these: We do not have enough troops to commit to Iraq to turn things around militarily, and the political situation is too fractured to give rise to a sudden burst of cooperation between Shiites and Sunnis.

    Colin Kahl, a nonresident fellow at the Center for a New American Security (CNAS), a middle-of-the-road think tank that launches formally tomorrow, sees the American saga in Iraq as the Goldilocks story in reverse. We sent a large enough contingent of troops to give the United States responsibility for security but too few to keep order. “Not hot enough, not cold enough, just wrong,” Kahl says.

    Time is running out, because most Americans no longer believe the administration’s promises that the commitment in Iraq will turn out well if only we are patient. This is why we need to begin planning our withdrawal now rather than waiting until the Army and the reserves hit the breaking point.

    More than two months ago a “WaPo on the web” writer, William Arkin, wrote that the military is at the breaking point. So we can’t wait much longer.

    For that reason, and the fact that political support for the war continues to erode, I do not believe the Bushies will be able to kick that can into January 2009, as they hope.

    Yesterday Republican Sen. Richard Lugar of Indiana urged the president to change course in Iraq “very soon.”

    [CNN] Lugar, the ranking Republican on the Senate Foreign Relations Committee, also sounded a pessimistic note on the prospects for internal political progress in Iraq.

    He said he sees “no convincing evidence that Iraqis will make the compromises necessary to solidify a functioning government and society, even if we reduce violence to a point that allows for some political and economic normalcy.”

    The senator said continuing military operations in Iraq were putting a damaging level of stress on U.S. forces, “taking a toll on recruitment and readiness.”

    “The window during which we can continue to employ American troops in Iraqi neighborhoods without damaging our military strength, or our ability to respond to other national security priorities, is closing,” he said. “The United States military remains the strongest fighting force in the world, but we have to be mindful that it is not indestructible.”

    If Lugar can say these things without being struck by lightning or abducted by aliens, other Republicans may be emboldened to follow.

    Lugar is not yet talking about a “full” withdrawal, however.

    Despite his call for a course change, Lugar said he did not support calls by some Democrats for a complete U.S. withdrawal from Iraq, which he said “also fails to meet our security interests.”

    Rather, he said a “downsizing and redeployment of United States military forces to more sustainable positions” — in rural locations of Iraq, Kurdish areas or possibly Kuwait — might better serve American security interests.

    Kuwait would make it an “over-the-horizon redeployment,” I believe.

    Lugar also warned the president that failing to pay heed to domestic political opposition to the war, especially with a presidential campaign approaching, would result in contentiousness that would “greatly increase the chances for a poorly planned withdrawal from Iraq, or possibly the broader Middle East region, that could damage United States interests for decades.”

    Translation: Republicans soon will have to choose between propping up Bush’s stupid ass and winning next year’s elections.

    Back to E.J. Dionne:

    Oddly, President Bush has more of an interest in this than anyone. “The more time passes, the more our options narrow,” says Kurt Campbell, the chief executive and co-founder of CNAS. “Left unchallenged, the president would fight to exhaustion, and we can’t afford to fight to exhaustion.”

    E.J. — He doesn’t care. All that matters to Bush is not having to say he lost.

    Here’s what’s going to happen: The White House will continue to kick the can and pretend everything in Iraq is going according to plan. But sometime — maybe not September, but before the end of the year — enough Republicans will switch sides on the war that a veto-proof majority will at least seem within reach. At that point the Bushies will scramble to come up with a “new” plan that is either (a) a desperate attempt to redefine the status quo to make it more palatable; or (b) a plan to withdraw some or even most combat troops, accompanied by some bullshit about how this had been Bush’s plan all along, and somehow Democrats are responsible for drawing the war out and making the troops stay in Iraq so long.

    Both plans a and b will involve a greater emphasis on the permanent bases. And no, I don’t want permanent bases in Iraq, either. But if some time this fall Congress settles on a troop withdrawal plan that includes permanent bases, remember that such a plan doesn’t mean there really will be permanent bases.

    When the last of the combat troops left Vietnam in March 1973, official U.S. policy was that an American “presence” would remain in South Vietnam, in the form of military advisers and permanent U.S. installations, guarded by Marines. Two years and one month later, the last Americans were airlifted out of Saigon.

    In effect, once the combat troops were withdrawn almost everyone, including the politicians, just plain lost interest in Vietnam. We had Watergate to keep us entertained, of course. But Congress (in a big reversal from what most of the congress critters had promised to do) stopped throwing money at the South Vietnamese government, and North Vietnam was able to take over, and virtually nobody in the U.S. bleeping cared. Overnight, the nation went from arguing about Vietnam 24/7 to “Vietnam, who?”

    That doesn’t mean the same thing will happen with Iraq. However, maybe it’s OK to deal with withdrawal of combat troops separately from the permanent bases issue. Certainly, right now it seems most politicians of both parties in Washington are talking about permanent bases. Some, like Lugar, who are beginning to make noises about withdrawing combat troops seem to think of permanent bases as a condition for withdrawing combat troops.

    Once combat troops are withdrawn, however, events on the ground in Iraq and political/economic dynamics here in the U.S. could soften support for permanent bases rather quickly. Or not. Depends on a lot of stuff that hasn’t happened yet. Could go either way. I personally would not insist on an absolutist, everybody-out-at-once position if it means combat troops stay in country longer while we haggle in the U.S. It’s OK to get the combat troops out first, then deal with the bases.

    See also: The plan from the Center for American Progress.

    Update: Voinovich joins Lugar.

    Sicko

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    Michael Moore’s Sicko opened this weekend in New York City, and I saw it yesterday.

    I laughed. I cried. So did the rest of the audience, which also broke into loud applause several times.

    This is Moore’s most mature film so far, and I mean that in the best possible way. Other Moore films induced anger, outrage, and sympathy, along with the laughs. But Sicko broke my heart.

    As Ezra says, this film is not so much about the health-care crisis as it is a challenge to America’s thick-headed exceptionalism — that “the way we do things is the best way to do things because … it’s the way we do things.”

    More than that, however, it reveals that democracy in America is fading, fast.

    We may call the United States “the land of the free,” but the truth is that most American working folks live constricted lives compared to people in most other western democracies. Our life choices increasingly are being limited by whatever economic boxes we find ourselves in. People who have worked hard and lived by the rules all their lives must choose between medicine and retirement, or medical treatment and keeping their homes. Working parents find that “quality family time” is an unaffordable luxury. And if we are diagnosed with a serious illness, our very lives are forfeit to the whims of the insurance companies.

    The young are crushed by student loans; the middle aged and older live in fear of losing their health insurance. This is keeping the workforce docile and compliant.

    But most heartbreaking of all is the way in which Americans passively accept the status quo. We have the means at hand to improve the quality of our lives — a representative government — and we don’t use it.

    Moore’s film is not without flaws. The Canadian and British health care systems do have problems, which Moore doesn’t mention. (However, those problems are minuscule compared to ours.) Moore tried to show that because the French do not pay for health insurance, health care, and many other services out of their own pockets, les citoyens have plenty of disposable income in spite of the higher taxes they pay. However, I’m not sure the point came across clearly. The trip to Cuba (partly censored by the Department of Homeland Security) was moving, but I wondered how much the Cuban government helped make it so.

    But one point came across clearly — we Americans are being lied to. We’re told that “socialized medicine” means the government will limit our access to health care; or that we won’t be free to choose our own doctors. But Moore shows us it’s American doctors whose hands are tied — by insurance companies — while doctors in Canada and France and elsewhere are free to practice the best medicine they can practice. And their patients are free to choose their doctors.

    Sicko has its signature Michael Moore touches. One segment follows an American woman trying to sneak her sick daughter into Canada to see a pediatrician. A man who lost the tips of two fingers in an accident recalls that he had to choose which finger to restore, since he lacked the money for both. A woman rendered unconscious in a car accident was charged for the ambulance ride because, her insurance provider said, the ambulance hadn’t been pre-approved.

    But then there was Tony Benn, a former member of the British Parliament, explaining how the British managed to create the National Health Service after World War II. “What democracy did was give the poor the vote, and it moved power from the marketplace to the polling station—from the wallet to the ballot…. And in 1948 the people asked, If you can have full employment by killing Germans, why can’t you have full employment by building hospitals? If you can find money to kill people, you can find money to help people.”

    That line got enthusiastic applause from the Manhattan audience.

    The poor in America have the vote, yet many do not choose to vote. Some who do vote cast ballots against their own interests. And many, as we know, are cheated of their ability to vote. But Moore’s movie was less about America’s poor than about America’s middle class; working people with insurance who are betrayed by the system. Surely the American middle class has the vote. Why aren’t we using it to our own benefit?

    OK, we know why. It’s complicated, but we know why.

    Someone in the French segment said something to the effect that The government of France is afraid of their people. Americans are afraid of their government. I’m not sure that’s true. I think Americans are just plain worn down. We’re worn down by the system, by the lies, by working too many hours, by juggling too many responsibilities by ourselves. And most of us don’t realize that we don’t have to live like this.

    Like I said — Sicko broke my heart.

    No Mistake

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    This is a follow up to the last post, in which I argue that it is the duty of a patriot to speak up about the wrongdoing of his own country. This is called “taking responsibility.” Non-patriots (like Michelle Malkin) confuse responsibility with disloyalty and scream that we liberals hate America because we point to Abu Ghraib before we point to atrocities committed by other nations.

    To this, rightie blogger Neptunus Lex writes,

    Both Maha from the Mahablog and Larisa Alexandrovna from At-Largely make the transparently intentional “mistake” of conflating the actions of the Abu Ghraib criminals – thugs who were ostensibly agents of the state but acting against the state’s interests, in contrast with the state’s orders and who were subsequently punished by the full weight of the state’s power – with the state sponsored actions of thuggish Iranian police in the service of a thuggish regime: A positionally gratifying but soul destroying form of moral equivalence.

    On Lex’s planet, no one in government or the military who hasn’t already been punished for what happened at Abu Ghraib had anything to do with it. Funny; that’s not what it looks like on my planet. The military’s chief investigator of the incident, Maj. Gen. Antonio Taguba, says he was blocked from investigating who ordered the torture at Abu Ghraib. So, we don’t yet know beyond a doubt how far up knowledge and orders went. What we do know is not reassuring.

    Today Barton Gellman and Jo Becker write for the Washington Post:

    The vice president’s office played a central role in shattering limits on coercion of prisoners in U.S. custody, commissioning and defending legal opinions that the Bush administration has since portrayed as the initiatives, months later, of lower-ranking officials.

    Cheney and his allies, according to more than two dozen current and former officials, pioneered a novel distinction between forbidden “torture” and permitted use of “cruel, inhuman or degrading” methods of questioning. They did not originate every idea to rewrite or reinterpret the law, but fresh accounts from participants show that they translated muscular theories, from Yoo and others, into the operational language of government.

    A backlash beginning in 2004, after reports of abuse leaked out of Iraq’s Abu Ghraib prison and Guantanamo Bay, brought what appeared to be sharp reversals in courts and Congress — for both Cheney’s claims of executive supremacy and his unyielding defense of what he called “robust interrogation.”

    But a more careful look at the results suggests that Cheney won far more than he lost. Many of the harsh measures he championed, and some of the broadest principles undergirding them, have survived intact but out of public view.

    Let’s review a few matters that have been in public record for quite a while. We can begin with this handy-dandy timeline from the Washington Post. In short —

    In January 2002, John Yoo (as deputy chief of the Justice Department’s Office of Special Counsel) circulated a draft memo saying the Geneva Conventions and laws of war do not apply to the U.S. military action in Afghanistan. By some coincidence, the first “detainees” arrived at Gitmo a couple of days later.

    A couple of weeks after the John Yoo memo began to circulate, David Addington (then Vice President Cheney’s general counsel) drafted a legal memo in response to Secretary of State Powell’s opinion that Taliban and al Qaeda prisoners are protected by the Geneva Convention. Addington’s memo — prepared for White House Counsel Alberto Gonzales to sign — advised President Bush that “the war on terrorism is a new kind of war, a new paradigm [that] renders obsolete Geneva’s strict limitation on questioning of enemy prisoners and renders some of its provisions quaint.”

    On February 7, 2002, President Bush signed an order based on the Addington-Gonzales memo. A couple of years later the White House propaganda mill tried to claim this order rejected torture. But this claim drags parsing and nuance into the Twilight Zone. Michael Froomkin explained,

    This Bush order applies to the Afghanistan Taliban, and to alleged al-Qaida members in Iraq and worldwide; it says they don’t have rights, but doesn’t say that they should be tortured; rather it says they should be treated “humanely” and that they should be given Geneva-like privileges when not too inconvenient to do so.

    The order accepts the Royalist theory of Presidential power, but says it declines to apply it: “I accept the legal conclusion of the attorney general and the Department of Justice that I have the authority under the Constitution to suspend Geneva as between the United States and Afghanistan, but I decline to exercise that authority at this time.”

    The other catch, of course, is the definition of “humanely.” Take the now-infamous August 1, 2002 torture memorandum to Gonzales, for example. As explained by John Dean [emphasis added] —

    At the time, [Jay] Bybee was Assistant Attorney General for the Office of Legal Counsel (OLC) – an office once called the conscience of the Justice Department. …

    … The Bybee memo was a formal legal opinion of the Office of Legal Counsel interpreting the Convention Against Torture and the accompanying criminal provisions enacted by Congress in 1996 to prohibit torture.

    The co-author of the memo was Bybee’s deputy, John Yoo, now a law professor at Berkeley’s Boalt Hall Law School. But who wrote what is unclear. In the end, Bybee was the senior official who signed off on the legal opinion, so the responsibility for its content is his.

    Bybee’s interpretations guided the Bush Administration for twenty-two months. And a powerful case has been made that Bybee’s extraordinary reading of the law led to Americans engaging in torture at Abu Ghraib and elsewhere.

    The memo defines torture so narrowly that only activities resulting in “death, organ failure or the permanent impairment of a significant body function” qualify. It also claims, absurdly, that Americans can defend themselves if criminally prosecuted for torture by relying on the criminal law defenses of necessity and/or self-defense, based on the horror of the 9/11 terrorist attacks.

    Finally, the memo asserts that the criminal law prohibiting torture “may be unconstitutional if applied to interrogations undertaken of enemy combatants pursuant to the President’s Commander-in-Chief powers.”

    In short, the memo advises that when acting as commander-in-chief, the president can go beyond the law.

    The Abu Ghraib photos became public in 2004. Maj. Gen. Antonio Taguba headed the military investigation of Abu Ghraib. Let’s go to an editorial that appeared last week in the Philadelphia Inquirer to find out what happened next.

    The abuses were systemic and pervasive, he concluded. He suspected, but was not in position to prove, that responsibility for these violations of human rights, military honor, American ideals and international law went far up the U.S. chain of command. [Remember, Taguba says he was blocked from investigating who ordered the torture at Abu Ghraib.]

    His dire account was confirmed and buttressed by subsequent military and civilian investigations (e.g., the Fay and Schlesinger reports).

    Taguba’s report rattled around the Pentagon without much response in early 2004, until the news media broke the Abu Ghraib story in April of that year.

    In an interview in this week’s New Yorker magazine, Taguba says that then-Defense Secretary Donald Rumsfeld’s claims of ignorance about the real scope of the Abu Ghraib crimes struck him as phony then – and still do.

    Here is the voice of American military idealism and honor talking:

    ”From the moment a soldier enlists, we inculcate loyalty, duty, honor, integrity and selfless service. And yet when we get to the senior-officer level, we forget those values. I know that my peers in the Army will be mad at me for speaking out, but the fact is that we violated the laws of land warfare in Abu Ghraib. We violated the tenets of the Geneva Convention. We violated our own principles, and we violated the core of our military values. The stress of combat is not an excuse, and I believe, even today, that those civilian and military leaders responsible should be held accountable.”

    In January of 2006, Taguba was instructed by the Army to retire by January of 2007. No explanation was given.

    Here’s the Seymour Hersh interview     of Taguba, btw.

    Last year PBS ran a Frontline program called “The Torture Question.” This chronology takes us from the formation of the Bush Administration’s “legal” framework for torture through Secretary of Defense Rumsfeld’s involvement in development of torture policies.

    And then there’s the Dickster himself, Vice President Cheney. As Spencer Ackerman wrote, “At every stage in the post-9/11 debate, Cheney and his staff sought to enshrine torture as official U.S. policy, relying on a legalistic distinction between ‘torture’ and ‘cruelty.'”

    How much did Bush, Cheney, Rumsfeld, and military brass know about Abu Ghraib before it became public? How much was explicitly ordered, and how much was just winked at? Why was Gen. Taguba prevented from investigating who ordered what at Abu Ghraib? Why was he asked to resign? And what’s going on that we don’t yet know about?

    Although the degree of complicity with the atrocities at Abu Ghraib is not clear, it’s obvious that Bush and Cheney set the tone that enabled those atrocities. And there have been atrocities. Our good blog buddy The Talking Dog has been conducting interviews with people who worked within such “facilities” as Gitmo and who testify that things were done that should not have been done. Regarding Abu Ghraib, see, for example, this interview with Dr. Steven Miles.

    There’s is a great deal more evidence I could drag into this post to show why I am not satisfied the real perps have been brought to justice, but I want to finish writing this blog post some time today. So let’s go back to Neptunus Lex and his criticism of my post–

    This is discreditable.

    It should have been easy for the left, they could have either ignored Malkin entirely or even deprecatingly agreed: Awful, what the Iranian regime has done, indefensible. Even if it doesn’t add up to a casus belli. Which, although you didn’t mention Michelle, we all assume is what you’re going after. You war mongering pig.

    Too easy, I guess. We cannot agree on even this, that evil is evil, end-period-dot.

    No: Even here we must grapple with ourselves.

    It’s come to this.

    Awhile back David Brooks wrote:

    Some liberals have trouble grasping evil, and always think that if we could take care of the handguns or the weapons of mass destruction, our problems would be ameliorated. But I know the problem lies in the souls of our enemies. [David Brooks, NY Times, February 11, 2004]

    I responded to this with a treatise on evil, which you can read here. This seems to be a common refrain in right-wing screeding — that we liberals don’t know evil, and they do.

    But I know a few things about evil that Brooks, and Lex Neptunus, apparently don’t. I know it is seductive, for example. Most of the really great evil ever done in the world has been done by people who thought what they were doing was good and justified and righteous. The 9/11 attacks are a classic example. Torture, including torture sanctioned by any part of the United States government, is another example.

    This isn’t about “moral equivalence.” It’s about stopping whatever evil I can stop. The 9/11 attacks happened. I can’t stop them now. But evil being perpetrated by my own government is something I ought to be able to do something about, since this is a republic and I am a citizen.

    Another thing I know about evil is that evil does not recognize itself as evil. It denies truth and makes excuses. It doesn’t take responsibility.

    Not taking responsibility should remind us of Hannah Arendt’s writings on the “banality of evil.” She looked hard at Adolf Eichmann, a chief architect of the Holocaust, and concluded that he was not so much consciously and willfully malevolent as he was unthinking. He followed orders without taking responsibility for the consequences. From the Internet Encyclopedia of Philosophy:

    Arendt concluded that Eichmann was constitutively incapable of exercising the kind of judgement that would have made his victims’ suffering real or apparent for him. It was not the presence of hatred that enabled Eichmann to perpetrate the genocide, but the absence of the imaginative capacities that would have made the human and moral dimensions of his activities tangible for him. Eichmann failed to exercise his capacity of thinking, of having an internal dialogue with himself, which would have permitted self-awareness of the evil nature of his deeds. This amounted to a failure to use self-reflection as a basis for judgement, the faculty that would have required Eichmann to exercise his imagination so as to contemplate the nature of his deeds from the experiential standpoint of his victims. This connection between the complicity with political evil and the failure of thinking and judgement inspired the last phase of Arendt’s work, which sought to explicate the nature of these faculties and their constitutive role for politically and morally responsible choices.

    Please note that I am not saying Abu Ghraib is morally equivalent to the Holocaust. I really don’t give a bleep about moral equivalences. The evil that most concerns me, great or small, is evil I might be responsible for, and that I might be able to stop.

    And, of course, if you’ve been following the “Wisdom of Doubt” series, you know I think the real evil that men (and women) do comes not from a lack of morality or religion, but from our capacity to bullshit ourselves about ourselves. People who cannot honestly examine themselves and reflect deeply on their own desires and motives are oh, so easily deceived and seduced by evil.

    So now we see Neptunus Lex, who dismisses Abu Ghraib as the property of the “anti-war left” –” it is the defining moment wherein the moral high ground shifted, where they – up until that moment abiding darkly in the stilt puppet wilderness – walked gratefully into the light of public approbation.” And who assumes he and the politicians he supports had nothing to do with it — not his responsibility. Not something he has to think about. Out of sight, out of mind.

    Yes, evil is evil, especially when it can’t recognize itself. I suggest to Mr. Neptunus that if he wants to see the face of evil, he should go look in a mirror.

    Responsibility

    Posted on by

    Awhile back I wrote a post called “Patriotism v. Nationalism,” which was followed up by “Patriotism v. Paranoia,” “Patriotism v. Francis Fukuyama,” “Patriotism v. Hate Speech,” and probably some other posts. Anyway, in the first post I repeated some quotes about patriotism and nationalism I found in Bartlett’s. Here are some of them, again:

    The difference between patriotism and nationalism is that the patriot is proud of his country for what it does, and the nationalist is proud of his country no matter what it does; the first attitude creates a feeling of responsibility, but the second a feeling of blind arrogance that leads to war. — Sidney J. Harris

    Patriotism is a lively sense of collective responsibility. Nationalism is a silly cock crowing on its own dunghill and calling for larger spurs and brighter beaks. I fear that nationalism is one of England’s many spurious gifts to the world. — Richard Aldington

    “Responsibility” seems to be a common theme:

    What do we mean by patriotism in the context of our times? I venture to suggest that what we mean is a sense of national responsibility … a patriotism which is not short, frenzied outbursts of emotion, but the tranquil and steady dedication of a lifetime. — Adlai Stevenson

    I contend that the primary difference between patriots and nationalists is that patriots value responsibility, while nationalists value loyalty. So you know that when you read this, you are reading the words of a nationalist, not a patriot.

    The “this” is Little Lulu, publishing photographs of Iranian men being bashed by the Iranian religious compliance police for wearing Western dress. They are distressing photographs; the Iranian religious compliance police represent the moral/religious absolutism I warned against in this morning’s “Wisdom of Doubt” post. For the record, I’m against it.

    However, Lulu loses me when she writes crap like this:

    Question: Will these photos be blared across the front pages of the international media with as much disgust and condemnation as the photos of Abu Ghraib or the manufactured Gitmo Koran-flushing riots?

    Answer: Fat chance.

    This is where the patriot (like me) and the nationalist (like Lulu) part company. There are many horrible things going on right now in this world, things that shock and horrify anyone with a heart. But as a patriot, I feel a special responsibility toward what my country does and particular anguish when it’s in the wrong.

    Lulu refuses to acknowledge the wrongdoing and accept the responsibility; she is interested only in blind loyalty.

    On some level — human and spiritual — we’re all responsible for “the whole catastrophe,” as my old Zen teacher used to put it. But as a citizen of this country, it is my duty to speak up when my country has done something wrong. This is not “hating America,” as twits like Lulu assume. It is what a patriot does.

    Lulu continues,

    Question: What do leftist apologists for the Iranian regime have to say about the brutal, appalling, and escalating crackdown on human rights? Yeah, you, Rosie.

    Answer: Nothing.

    The word “nothing” is linked to some videos of Rosie O’Donnell, whom Malkin seems to think is the designated spokesperson of the entire Left. Rosie is the new Ward Churchill.

    It goes on. In fact, I don’t blog about everything that concerns me, because I don’t have time, although some lefties have spoken out against human rights abuses in Iran — here and here are two examples. I send a small donation monthly to Amnesty International because human rights abuses around the globe concern me deeply.

    However, as a blogger, I focus on human rights abuses perpetrated by my own country, because I’m more directly responsible for what my country does than for what the government of Iran does. And I think if all citizens of all countries took responsibility for their own nations’ actions instead of pointing fingers at everybody else, the world would be a better place.

    And I’ve been having this conversation with wingnuts since the late 1960s. It flies right over their pointy little heads every time.