What a Quagmire Looks Like

Posted on by

I’ve just begun to read Geoffrey Perret’s new book Commander in Chief: How Truman, Johnson, and Bush Turned a Presidential Power into a Threat to America’s Future. I’ve not gotten far enough into it to endorse the whole book, but I must say I loved the introduction. After encountering the genius who said “The Islamo Fascists have failed to bring on the quagmire” in Iraq yesterday, I feel compelled to quote a chunk of it (emphasis added).

Three wars — Korea, Vietnam, Iraq — all launched at moments of national crisis, all of them unwinnable.

They were unwinnable for many reasons, but the place to begin is this: in North Korea, North Vietnam, and Iraq, the enemy always held the strategic initiative. The most powerful country in the world found itself dancing to its enemy’s tune, not its own. At times it was possible to seize the tactical initiative — crossing the 38th parallel, launching an aerial blitz against North Vietnam, flattening Fallujah. But the loss of the strategic initiative rules out the path to victory implicit in the military paradigm; namely, that one country imposes its will on another. Instead, the country that has chosen to wage the war finds itself wrestling with an insoluble challenge: a political victory requires a military victory first, because there can be no effective government without security and stability. But a military victory requires a political victory first, in the form of a government strong enough to establish a state monopoly on violence.

That’s precisely where we are in Iraq, and that’s precisely what a quagmire looks like.

As commanders in chief seek military success, only to fail, then lurch off in search of political gains and fail again, time is used up. And time is not neutral. It strengthens the enemy. Knowing that, the enemy is never in a hurry. The longer the struggle lasts, the better their prospects. …

… These modern wars are managed rather than won. It is possible to lose them, yet impossible to achieve victory. …

… in Iraq, the United States is facing an insurgency that has widespread popular support. More than 250,000 young Iraqi males turn eighteen each year, and beyond Iraq, there is an aggrieved Sunni community of more than a billion people. The Iraq insurgency will never run short of manpower, money, or munitions; nor will terrorist groups across the Middle East.

There is a limit to the number of people that the United States can kill, capture, or incapacitate. In Iraq, it can kill tens of thousands, possibly more than a hundred thousand, but not millions, not in the name of liberation, not in the presence of television and camcorders. There are limits to what even a superpower can do without turning the entire civilized world against it. [Geoffrey Perret, Commander in Chief: How Truman, Johnson, and Bush Turned a Presidential Power into a Threat to America’s Future (Farrar, Straus and Giroux, 2007), pp. 5-7]

I go on a rant from time to time — most recently here and here — about how our invasion of Iraq fulfilled Osama bin Laden’s fondest hopes, and how the longer we stay there the better for al Qaeda. I like the way Perret puts it — Time is not neutral. Time is on the enemy’s side. The more time they get, the stronger they will be.

The ever oblivious Max Boot argues that we must give “give Gen. Petraeus and his troops more time–at least another year–to try to change the dynamics on the ground.”

The reality is that Iraq has been experiencing a fairly low-grade civil war until now–one that has been contained by the presence of U.S. troops. While the troop surge in Baghdad hasn’t yet decreased the overall level of violence–suicide bombings, which are notoriously difficult to stop, remain undiminished–the presence of more Iraqi and American troops on the streets has managed to reduce sectarian murders by two-thirds since January. Sunni fanatics are still able to set off their car bombs, but Shiite fanatics are not able to respond in kind by torturing to death 100 Sunnis a night. In other words, the surge is containing the results of the suicide bombings, slowing the cycle of violence that last year was leading Iraq to the brink of the abyss.

The real reality is that Shiites are playing us, according to Peter Harling and Joost Hiltermann, writing for Le Monde diplomatique:

Baghdad’s relative calm is mostly the result of the ability of violent players to preempt the plan and neutralise much of its sting. This is true of both Sunni insurgent groups and Shia militias tied to the government. Followers of Shia militia leader Muqtada al-Sadr have gone to ground, waiting for the storm to pass and allowing US forces to go after Sunni insurgents.

Sunni insurgents responded in two ways, depending on their affiliation. Key commanders of patriotic groups (as they call themselves) withdrew from Baghdad with their heavy weaponry in anticipation of large-scale cordon-and-search operations. They left nominal forces in place to avoid giving the impression of retreat and defeat. Residents in some Sunni districts report that insurgents still roam at will, untouched (indeed, unnoticed) by US military operations, issuing permits and claiming protection money. They melt away when their district’s turn comes.

Even as the Bush administration unveiled its plan, jihadists linked to al-Qaida in Iraq opted to intensify their trademark suicide attacks, announcing a martyr campaign to create a bloodbath in Baghdad. True to its word, the group took credit in February for the largest number of car bombs ever, and the pace has hardly slackened since. Part of al-Qaida’s plan, besides foiling any US sense of progress, is to draw the Sadrist Mahdi Army out into the open and expose it to US attack. Both sides would like US forces to do their dirty work for them.

(Joost Hiltermann is deputy program director for the Middle East and North Africa with the International Crisis Group in Amman; Peter Harling is the organization’s senior analyst based in Damascus.)

They’re playing us, people. The Shia are playing us to kill Sunnis for them, and al Qaeda is playing us to kill Shia for them, and the Sunni are probably playing us too. And here is the great unvarnished idiot Max Boot explaining to us that what’s going on in Iraq is “just a low-grade civil war,” and if we keep slogging away we’ll win eventually.

But time is not neutral. Time is on the enemy’s side. The more time we give them, the stronger they are and the weaker we are. And yes, this is a quagmire. In fact, it’s going beyond quagmire stage and turning into a sinkhole.

America Is Pissed

Posted on by

A new Gallup Poll says “Congress Approval Down to 29%; Bush Approval Steady at 33%.” A whole bunch o’ righties are hootin’ about this today. A typical comment:

I guess the lockstep Pelosi-Reid foot soldiers who routinely bloviate in the comments here can rest assured that not even one out of three people in this country approve of the Democrat congress.

I guess the lockstep Pelosi-Reid foot soldiers who routinely bloviate in the comments here can rest assured that not even one out of three people in this country approve of the Democrat congress.

I can only hope the Democrats keep doing what they’re doing – ensuring a lost war, raising taxes by the largest amount in world history, trying to shut down talk radio because they can’t effectively compete, holding our Troops hostage while their approval whittles down to nothing, etc.

Don’t blame us. Blame those rightwing neeeeeocons at Gallup.

Even Bush has a higher aggregate approval rating.

Too sweet.

Sure. What do you want to bet a lot of people are pissed at Congress because they haven’t impeached Bush yet?

An Open Joke

Posted on by

Paul Kiel writes,

The White House’s Privacy and Civil Liberties Oversight Board has been an open joke ever since it was launched as a result of a recommendation from the 9/11 Commission’s 2004 report. The panel was supposed to keep a sharp eye on the government’s possible infringement on citizens’ civil liberties. But it turns out that it’s a bigger joke than people even realized.

Yesterday, one of the board’s five handpicked members, Lanny Davis, resigned. Davis, a former Clinton White House official, left over “administration attempts to control the panel’s agenda and edit its public statements.”

Justin Rood described the Privacy and Civil Liberties Oversight Board last November:

The board can’t demand documents; it can’t force bureaucrats who actually implement the program — and who might be aware of malfeasance — to speak with them under oath. Instead, its sole and complete authority is to take the administration at its word.

Well, actually, its sole and complete authority is to be a mouthpiece for the Bush Administration. John Solomon and Ellen Nakashima write in today’s Washington Post:

The Bush administration made more than 200 revisions to the first report of a civilian board that oversees government protection of personal privacy, including the deletion of a passage on anti-terrorism programs that intelligence officials deemed “potentially problematic” intrusions on civil liberties, according to a draft of the report obtained by The Washington Post. …

… one section deleted by the administration would have divulged that the Office of the Director of National Intelligence’s civil liberties protection officer had “conducted reviews of the potentially problematic programs and has established procedures” for intelligence officials to file complaints about possible civil liberties and privacy abuses.

The passage would have been the first public disclosure of an internal review identifying such potentially intrusive intelligence programs. In its place, White House officials suggested more modest language, which ended up as a substitution in the final report.

What exactly is the point of having a Privacy and Civil Liberties Oversight Board, again?

The panel was created by Congress to address concerns about the government’s growing anti-terrorism surveillance powers but placed under the supervision of the White House without investigative tools such as subpoenas. Some in Congress are pushing to make the board completely independent.

White House spokeswoman Dana Perino called the editing “standard operating procedure,” saying it was appropriate because the board remains legally under the supervision of the Executive Office of the President.

In other words, anything Bushies can get away with is, by definition, “appropriate.”

The document obtained by The Post shows the length that White House officials went to make some changes.

One deleted passage divulged that the board had sent a letter in late January asking Bush to issue an executive order to all federal agencies to fully cooperate with the privacy board. It was prompted by board members’ concerns, including a lengthy delay in receiving a briefing on the National Security Agency’s warrantless eavesdropping program and White House efforts to keep the media from attending a planned public board meeting scheduled just weeks before last November’s election.

Arthur Schopenhauer said, “Fame is something which must be won; honor, only something which must not be lost.” Nah, Schopenhauer was wrong. The Bush crowd never had any honor to lose.

A Black Matter for the King

Posted on by

J. Bacevich is a West Point graduate and Vietnam veteran with 23 years of service in the U.S. Army. Today he is a professor of international relations at Boston University. Bachevich saw from the beginning that the Iraq War is a sham and an atrocity, and he has spoken out against it in books and newspaper articles. I’ve quoted him from time to time.

Andrew J. Bacevich’s son was killed in Iraq.

There must be nothing sadder than a parent who must drag himself through the long years of the rest of his life after the death of a child. As of this morning we have lost 3,401 of our children. Fifty U.S. troops have died this month. This is an ocean of sorrow.

Jules Crittendon writes,

A beloved son who followed in his father’s footsteps and gave his life for his country, as his father had put himself in harm’s way in another war four decades before. So Andy Bacevich begins the terrible journey of a father who has to bury a son, and decide for himself what it means.

And Steve Clemons writes,

Now we must add to the count of this tragic conflict another American son — and of course, more Iraqi sons and daughters and American daughters.

I had the pleasure of meeting Andy Bacevich at the home of former Congressman Dave McCurdy this last holiday season. We spoke for a bit about the Iraq war as well as the absence of American strategy and dearth of strategists in government today. I had no idea his son was serving until now.

But this young man did serve his nation — but his death is so incredibly tragic, like the others — but his even more because his well-respected father has been working hard to end this horrible, self-damaging crusade. It’s incredibly sad.

To answer my own question above. Andrew Bacevich’s son’s life was precious — and his life and his untimely death matter greatly for just waking up and realizing we are achieving nothing in Iraq today and that responsibility must be borne by the perpetrators of this mess.

My sincere condolences to the Bacevich family.

Whereupon the rightie blogger — I started to call him the “worthless scumbag rightie blogger,” but I’ll try to contain myself — of Riehl World View blasted Steve C. for using the death of 1st Lt Bacevich for “anti-war propaganda.” Referring to “Andrew Bacevich’s son’s life was precious” the rightie wrote, “So precious, apparently, Clemmons simply couldn’t wait to dash that off, I guess. What a disgrace.”

Disgrace, yes, but the disgrace is not Clemmons’s. Riehl is one of the Bush Bitter Enders who maintains the fiction that to criticize the war is denouncing the troops. But it is no disgrace to be honest, and to say frankly that when our children die in Iraq their lives were wasted. The disgrace would be to hold our tongues and acquiesce to the obscene fiction that killed them. The disgrace is to be one of the brain-dead lackeys who supports Bush’s war.

Josh Marshall speaks to this —

There’s a shameless game of moral chicken that war supporters play in which they dare opponents to say the war is a mistake because, they claim, saying so would then dishonor all the men and women who’ve already died in its cause. So to spare the dead that ignominy, kill many more of our children. All to avoid swallowing that bitter pill. But I think there’s a converse to Bates’ argument that I agree with, though I disagree with his claim about the moral reckoning. And that is that the service and the sacrifice wash the death clean of the folly of the leaders who ordered them into the battle.

Josh refers to the scene in Henry V that takes place the night before the Battle of Agincourt, when Harry meets some common soldiers and tells them that he is only “a gentleman of a company.” Ol’ Bill Shakespeare wrote this bit of dialog:

BATES

Ay, or more than we should seek after; for we know enough, if we know we are the kings subjects: if his cause be wrong, our obedience to the king wipes the crime of it out of us.

WILLIAMS

But if the cause be not good, the king himself hath a heavy reckoning to make, when all those legs and arms and heads, chopped off in battle, shall join together at the latter day and cry all ‘We died at such a place;’ some swearing, some crying for a surgeon, some upon their wives left poor behind them, some upon the debts they owe, some upon their children rawly left. I am afeard there are few die well that die in a battle; for how can they charitably dispose of any thing, when blood is their argument? Now, if these men do not die well, it will be a black matter for the king that led them to it; whom to disobey were against all proportion of subjection.

George W. Bush and all who support his war have betrayed our country and the troops. And when a beloved son dies, they expect us to accept his murder and keep silent about the crime. They think it is a “disgrace” when we give voice to our outrage and shake our fists at the criminals.

If I believed in hell, I’d want a special place set aside there for all good Bushies.

Bogeyman Taxes

Posted on by

Ezra Klein had an op ed in yesterday’s Los Angeles Times titled “Give bigger government a chance” online and “Government by Bake Sale” in the print edition. Ezra argues that there’s a backlash growing against conservative arguments that “smaller” government is always better, taxes are always “too high,” and privatization is the answer to all problems. He writes,

Libertarian humorist P.J. O’Rourke likes to say that “Republicans are the party that says government doesn’t work, and then they get elected and prove it.” Over the last few years, that’s been true. But government can work, and increasingly, Americans appear to be anticipating its return. A new Pew Research Center poll finds that public support for a societal safety net and for government protections is at its highest levels in more than a decade — which suggests that Americans don’t think bake sales are the way to fund their schools or that Philip Morris is really who they want subsidizing law enforcement. And in recent elections, the once popular “Taxpayer’s Bill of Rights” amendments that seemed so unstoppable a decade ago are being rejected and, in Colorado, repealed, as voters finally tire of paying the costs in broken infrastructure and insufficient public services.

Digby adds:

The Republicans just run on cutting taxes while promising all kinds of government largesse to get elected and get their hands on the treasury. It’s a very nice little racket that has far less to do with any kind of political philosophy and more to do with their inherent greed and corruption. They go as far as they can until the nation gets fed up and then they leave the field to the Democrats to clean up the carnage. …

… It’s not that taxes were ever popular, any more than paying your electric bill is “popular” or buying a new furnace is “popular.” But until the GOP hit on their free lunch propaganda they were just considered a fact of life (“death and taxes”) as long as the rich weren’t perceived to be getting off easy and the government was delivering services to the people. Republican campaign tactics and governance have pretty much destroyed that resigned acceptance by making people believe that taxes are inherently evil and if the government needs to do something it will magically find the money some other way. The truth is that the Republicans have been running a game that’s the equivalent of you or I taking off work without pay for weeks so we can go to Vegas and play roulette with our credit cards. One only hopes “the grown-ups” haven’t gone so far that we will have to spend the next decade suffering from the hangover.

What is it with Americans and taxes? I’m sure if you went about asking people “Do you think taxes are too high?” most of them would say yes, because that’s what they think they’re supposed to say. We’ve had years of politicians and pundits shrieking at us that taxes are too high, so it must be true, right? When some notion becomes embedded into our national mythos it can take real courage to say out loud no, I don’t think that. So most people reflexively will concur that taxes are too high, whether they are or not.

Of course, then you have to consider what “too high” means, and compared to what? Americans, I believe, pay lower taxes overall than people in many other industrialized democracies. But let’s just say “too high” is “more than I think I ought to be paying.”

Right after the 2006 midterm elections, Lawrence Levy of New York Newsday wrote a column about the suburban voters who had swung away from Republicans and voted for Democrats.

Suburbanites are not anti-change, just anti-extremism of any stripe – whether Democrats in the ’70s or Republicans in the ’90s. They’re not anti-government. Many people move here for more and better government services. And they’re not anti-tax. They’re willing to pay high taxes, to a point, if they feel they’re getting good value.

That’s true generally of northeastern suburbanites, up to a point. Many years ago I moved from suburban Ohio to suburban New Jersey. New Jersey property taxes were many times higher. But my old Ohio suburb had crummy public schools (conventional wisdom said that public schools are always bad, and if you cared about your child’s education you sent him to Catholic school whether you were Catholic or not), and if there was a snowstorm you could wait days before the street in front of your house was plowed. The New Jersey suburb I moved to valued good public schools, and roads were cleared before the last snowflake fell.

But a few years later I witnessed the state of New Jersey gripped by mass hysteria over taxes. As explained in this Wikipedia article about Democratic Governor Jim Florio,

The Florio administration started during the late 1980s recession. Faced with a projected 1991 deficit of $3 billion, Florio asked for a $2.8 billion tax increase. It was the largest increase of any state in U.S. history. The money generated would balance the budget, increase aid to public schools and increase property tax relief programs. Governor Florio also eliminated 1,500 government jobs and cut perks for state officials.

A grassroots taxpayer revolt in 1990, spearheaded by a citizens group named “Hands Across New Jersey” founded by John Budzash, a postal worker from Howell Township.

My problem, as always, is that I actually read newspapers, and I knew that the new income taxes were very progressive (there was also a 1 cent sales tax increase). My state income taxes didn’t change at all, because my income wasn’t all that glorious. But people all around me were going nuts over the tax increase, whether it affected them or not. I saw “Dump Florio” bumper stickers on cars of people who appeared to make even less than I did. In fact, at one point a secretary where I worked was going around with a big “Dump Florio” pin on her chest, and I knew good and well she made less than I did. When I told her that her taxes weren’t going to go up, and explained to her how much one actually had to make before they did, she was dumbfounded. She’d been worried she wouldn’t have enough money left over from the new state taxes to live on.

Then what’s everyone so worked up about? she asked. You tell me, I said. You’re one of the people who is worked up; I’m not.

Mr. Budzash was on television and radio every time I turned around. Someone pointed out to him that, given what he probably made, his personal tax increase (if any) was negligible, and that Howell Township schools — a poorer district — would benefit a great deal. These facts appeared to throw him; apparently they were news to him. But he quickly recovered and declared he didn’t want to tax rich people overmuch because he might be rich some day himself.

Notice that some of the income tax money was to be applied to property tax relief programs. A few years later, when Republican Christie Whitman became governor, she lowered the Florio income and sales taxes. But to pay for this she cut the amount of state money going to public schools, fiddled a bit with state pensions, and outsourced the New Jersey Department of Motor Vehicles to demons from the Fourth Circle of Hell. In many parts of the state property taxes had to be cranked up even more to make up the difference.

The moral here is that in America, taxes are the bogeyman.

On the other hand, I think Lawrence Levy is right when he says people are less bothered by taxes when they feel they are getting value for their money. And they’re more willing to tax themselves when they value the services the government is providing. My neighbors in Ohio (who included Mean Jean Schmidt) were not bothered by crumbling public schools and snow-covered roads, but my neighbors in New Jersey wouldn’t have put up with them for a minute.

Another point: When I was a child, the grownups used to complain about their tax money going to foreign aid, but they didn’t gripe so much about domestic spending. I don’t believe most (white) voters got worked up over “entitlements” until they realized a substantial part of Lyndon Johnson’s “war on poverty” programs were helping blacks.

The moral to that is that people are less bothered by taxes if they think they (or some group they identify with) are getting the benefit of whatever the government is doing with the taxes.

That’s why it makes me crazy when people say government is “too big” without explaining what they mean by that. Awhile back some pollster asked people if they thought government was doing “too much” or “not enough.” Most people were true to their conditioning and said “too much.” But too much of what? Not enough of what? Seems to me the government is doing way too much that it shouldn’t be doing but not enough of what it should be doing.

I think large parts of the American public might agree with the argument that we should be using our tax dollars to invest in ourselves rather than burying it in the sand of Iraq. Instead of vague promises to cut taxes and spending (the latter of which never seems to happen) Democrats should be telling people “We’re going to see to it that you get value from your tax dollars.” Then deliver lower college education costs, better infrastructure, universal health care. I’d like to see it tried, anyway.

Unhealthy Care

Posted on by

I found some newspaper items this morning that provide a good follow up to the “Demand Supply” post from last week. The first is from an editorial in today’s Atlanta Constitution:

After two decades of steady improvement, the death rate for Georgia babies could soon be on its way up again. While neonatologists in specialized nurseries have achieved remarkable success at saving the lives of medically fragile infants, the rate of babies born too soon to Georgia mothers has been slowly rising since 1994. These babies are at a much higher risk of death in their first 12 months of life.

More ominously, the percentage of Georgia women getting adequate and early prenatal care has actually declined since 1999. Experts believe the lack of prenatal care, as well as chronic conditions such as diabetes and obesity that are more prominent in young mothers today than a generation ago, will result in higher infant mortality rates in the years to come, as has already happened in Mississippi and several other southern states.

If Georgia could achieve the U.S. average in infant mortality, the lives of approximately 220 babies would be saved each year. As it is now, approximately 1,100 Georgia babies don’t make it. Merely approaching the U.S. average will require much more intensive, targeted public health nursing in communities where teenage pregnancy rates and births to unwed mothers remain exceptionally high. That intense approach occurs now in only a handful of Georgia counties.

The price of such early intervention is small compared to the high cost of caring for premature babies, which can reach $4,000 to $5,000 a day in neonatal units and often extends well beyond the nursery in treatment for chronic lung problems, cerebral palsy and other conditions.

This illustrates nicely why our health care “system” is, essentially, screwy. The U.S. health care industry is driven by profit. On the whole we do a bang-up job at creating and marketing innovative health care products that make somebody a lot of money. But we neglect those functions that are not profitable. Thus, many U.S. hospitals have sparkling state-of-the-art intensive care units for newborns with all the equipment, medicines, bells and whistles one might want. Babies born with health problems get excellent care in them. It’s also very expensive care, and somebody makes a nice profit from selling the equipment, medicines, bells and whistles to hospitals.

But there’s no profit to be made from providing basic prenatal care to poor, uninsured women, so on the whole we’re not doing that well at all. When compared to babies born in other industrialized nations, U.S. babies come into the world with a higher rate of health complications, which results in infant mortality rates that are higher than they should be, in spite of our superior intensive care gizmos.

I want to add that you absolutely cannot explain this problem to a rightie. The usual excuse for our infant mortality problem is that in U.S. physicians count some hopelessly compromised infants as “live births” that would be considered “stillbirths” in other countries, even though they might live for a very brief time. Stillbirths are not counted in infant mortality rate, which is calculated from the number of babies born in a nation that die before their first birthdays. Thus, righties argue, our high infant mortality rates are just a statistical illusion. This Wikipedia article discusses the issue.

On the other hand, as Ampersand documents here, if you factor in stillbirths — thus wiping out the discrepancies — the U.S. still doesn’t compare well. So much for the statistical illusion.

And if you see the huge differences in infant mortality rates among states and populations within the United States, I can’t see how anyone can claim there isn’t a problem. But righties are wondrous creatures who can not see any problem if it might require a tax increase to fix it.

See also this editorial in today’s New York Times —

The explosion in the use of three anti-anemia drugs to treat cancer and kidney patients illustrates much that is wrong in the American pharmaceutical marketplace. Thanks to big payoffs to doctors, and reckless promotional ads permitted by lax regulators, the drugs have reached blockbuster status. Now we learn that the dosage levels routinely injected or given intravenously in doctors’ offices and dialysis centers may be harmful to patients.

As Alex Berenson and Andrew Pollack laid bare in The Times on May 9, wide use of the medicines — Aranesp and Epogen, from Amgen; and Procrit, from Johnson & Johnson — has been propelled by the two companies paying out hundreds of millions of dollars in so-called rebates. Doctors typically buy the drugs from the companies, get reimbursed for much of the cost by Medicare and private insurers, and on top of that get these rebates based on the amount they have purchased.

Although many doctors complain that they barely break even or even lose money on the costly drugs, for high-volume providers the profits can be substantial. One group of six cancer doctors in the Pacific Northwest earned a profit of about $1.8 million last year thanks to rebates from Amgen, while a large chain of dialysis centers gets an estimated 25 percent of its revenue, and a higher percentage of its profits, from the anemia drugs. It seems likely that these financial incentives have led to wider use and the prescribing of higher doses than medically desirable.

You might have seen the television ads in which people declare “I’m ready to start my chemotherapy!” I think those are for Procrit, but I’m not sure. Expensive ad campaigns for prescription drugs have always struck me as weird, but if they didn’t drive up demand for prescription drugs I’m sure the pharmaceutical companies would stop the ads.

Finally, here is an article that refutes the claim that American cancer patients survive at higher rates because they get advanced drugs that are not available elsewhere.

The clinical reality for metastatic colorectal cancer is that the FDA-approved combination regimen of IFL (irinotecan, bolus fluorouracil, and leucovorin) plus Avastin increases median overall survival by 4.7 months. This small increase comes with a host of side effects, which impinge upon quality of life, as well as placing a burden on the patient and the healthcare system.

While this small increase is hailed by the FDA as being impressive, the clinical reality is that there is no cure for metastatic colorectal cancer. The much-vaunted blockbuster drug Avastin is simply an antibody supplement incorporated into an already complex chemotherapeutic drug regimen that may slow down the cancer process depending on the genetic constitution of that individual. The cost of drugs for metastatic colorectal cancer alone would exceed $1.5 billion per year if all the patients in the U.S. received treatment.

The clinical reality for metastatic breast cancer is similar. The latest treatment with Herceptin followed by lapatinib and capecitabine only increased the median time to progression from 4.4 to 8.4 months. Furthermore, 70% of patients do not respond to Herceptin, and resistance develops in virtually all patients.

Of these two big killers, both remain incurable, and this sobering fact contrasts with the glowing reports on Avastin and Herceptin emanating from the financial and tabloid media.

The authors (George L. Gabor Miklos, Ph.D., Phillip J. Baird, M.D., Ph.D.) also say,

It’s easy to tell when an area has run out of ideas. The hype becomes extreme, and technology substitutes for brainpower. The cancer research area has reached this sorry state. The tiniest increase in the survival time of drug-treated cancer patients or median time to progression is touted as a cure, and wildly unrealistic claims about personalized cancer medicine emanate from the highest governmental and academic sources. …

…Is the future of cancer medicine one in which doctors become financial advisors, telling their patients whether they can or cannot afford expensive treatments of dubious survival value?

Although the authors don’t say this explicitly, I infer that cancer research itself is being driven by the desire for new money-making products rather than by science or even the well-being of patients.

Awful Aughts

Posted on by

Awhile back I wrote a post correcting a claim by Fred Thompson that Calvin Coolidge’s tax cuts had been good for the economy. They weren’t. But while I was researching that post I found some other remarkable parallels between the Roaring Twenties and today, an era I like to call the Awful Aughts (as in 00s).

One of those parallels is with our remarkable inability to rebuild the Gulf Coast after Hurricane Katrina. During the Coolidge Administration, the United States experienced several nasty natural calamities. Among these:

On March 18, 1925, a tornado that ripped through Missouri, Illinois and Indiana killed 689 people and devastated many small towns.

On September 18, 1926, a massive hurricane hit Florida and the Gulf Coast. The Great Miami Hurricane (this was before big storms were given people names) killed 372 people and injured more than 6,000. Almost 18,000 were left homeless, and property damage was estimated to be between $80 million and $100 million. That would be something like $2 billion today. But remember there wasn’t nearly as much developed real estate in the region as there is now.

In April 1927, floods along the Mississippi River covered 4 million acres, drowning several thousand people and leaving about 600,000 people homeless. Property damage was in the neighborhood of $300 million.

On September 29, 1927, a tornado tore through St. Louis and destroyed more than a thousand homes.

And if that wasn’t enough, in September 1928 a Category 5 hurricane roared through the Caribbean and the Bahamas, then struck Florida near Palm Beach on September 16. At least 2,500 people were killed when storm surge from Lake Okeechobee breached the dike surrounding the lake, flooding hundreds of square miles. Flood waters covered the land for several weeks, and thousands were left homeless.

As awful as these disasters were, it’s more instructive for us to see how the Coolidge Administration responded. In brief, many of the devastated areas stayed devastated for a long time. This created pockets of economic stagnation in the United States, which became a drag on the entire U.S. economy. Although the Great Depression didn’t officially begin until after the stock market crash of 1929, in actuality large parts of the United States fell into depression in 1926 and 1927.

Please note that I am not saying hurricanes and floods caused the Great Depression. Rather, what we see in the response to these disasters was part of a pattern. Calvin Coolidge believed that cutting taxes and reducing government spending was about all that government needed to do to help the economy. He did cut taxes, and unlike our current “president” he cut government spending, too, and made government regulatory policies much friendlier to business. In short, he did everything the Club for Growth might have asked. But his frugality allowed large parts of the country to rot, economically speaking, and the rot eventually helped bring the whole bleeping house down.

There were other many other drags on the economy in the 1920s, such as a crisis in agriculture. For a number of reasons I won’t go into now, food prices fell and farmers were unable to make a decent living. Millions of farm families lived in abject poverty. Calvin Coolidge himself was from a poor farm family that had suffered deprivation in the 1890s, but in spite of this Coolidge was remarkably unsympathetic. He famously said, “Well, farmers never have made money. I don’t believe we can do much about it. But of course we will have to seem to be doing something.” Whereupon he embarked on a series of tepid, cosmetic “solutions” that didn’t help farmers at all. And he vetoed all bills by Congress that might have given the farmers some relief.

Note that there was little sympathy for farmers in non-farming America. Apparently city dwellers of the time thought it was hilarious that only 10 percent of farm families had running water in their homes or owned a bathtub, which were impossible luxuries to most farmers.

But let’s get back to the disasters. The 1926 hurricane unavoidably killed what had been a booming real estate market as well as tourism in Florida. (The real estate developers were so frantic to downplay the effects of the storm that they actually hindered Red Cross efforts to raise relief funds; bad publicity, you know.) Miami Beach itself was rebuilt fairly quickly with private money, but the region became economically depressed three years before the Great Depression was supposed to have begun.

I want to look in particular at the 1927 floods. Coolidge appointed his commerce secretary, Herbert Hoover, to lead disaster relief efforts. David Greenberg wrote,

Hoover threw himself into his task, but the funds he secured were insufficient. Private philanthropy simply came up short. Public debate swirled around a strong response from Washington—in both dollars and symbolism. Coolidge resisted both. Governors, senators, and mayors asked him to visit the flood zone. “Your coming would center eyes of nation and the consequent publicity would result in securing millions of dollars additional aid for sufferers,” the governor of Mississippi wired. But Coolidge demurred. He declined requests from NBC to broadcast a nationwide radio appeal, and from humorist Will Rogers to send a telegram to be read at a benefit.

To be fair, up to that time it was not considered the federal government’s job to respond to disasters. But people read newspaper accounts of the horrible suffering caused by the floods, and then they look at the federal budget surplus made possible by Coolidge’s frugality, and they put two and two together, as it were.

But Congress had adjourned, and Coolidge declined to convene a special session to pass an emergency appropriation. Only in late 1927, when Illinois’ Frank Reid, the Republican chair of the House Flood Control Committee, held public hearings was Coolidge’s hand forced. In his December 1927 State of the Union message—they were often done in December back then—he endorsed federal flood-control measures. But he insisted that local governments and property owners bear most of the costs. Coolidge’s plan also called for spending hundreds of millions dollars less than the Senate and the House bills. Deadlock ensued. Will Rogers remarked that Coolidge was going to further postpone relief legislation in “the hope that those needing relief will perhaps have conveniently died in the meantime.”

It must not be forgotten that African Americans bore a disproportionate share of the suffering. To spare New Orleans, the levee at Caernarvon, Louisiana, was dynamited. This was to divert water from the main part of New Orleans and into St. Bernard’s Parish. According to Wikipedia,

During the disaster, 700,000 people were displaced, including 330,000 African-Americans who were moved to 154 relief camps. Over 13,000 evacuees near Greenville, Mississippi were gathered from area farms and evacuated to the crest of an unbroken levee, and stranded there for days without food or clean water, while boats arrived to evacuate white women and children. Many blacks were detained and forced to labor at gunpoint during flood relief efforts.

The flood was a factor in the Great Migration of southern blacks to norther cities. It also soured African American support for the Republican Party, for a lot of reasons that can’t directly be blamed on Coolidge. But that’s huge topic I don’t want to get into now.

Anyway, David Greenburg writes that Coolidge eventually was maneuvered into signing a federal relief bill for the flooded region in May, 1928. That was thirteen months after the flood.

To explain why this is significant, I want to go back to the earlier Coolidge post, about how Coolidge’s tax cuts really didn’t provide the healthy economic growth that conservatives claim it did. I provided this quote —

Even before 1929, signs of economic trouble had become evident. Southern California and Florida experienced frenzied real-estate speculation and then spectacular busts, with banks failing, land remaining undeveloped, and mortgages foreclosed. The highly unequal distribution of income and the prolonged depression in farm regions reduced American purchasing power. Sales of new autos and household consumer goods stagnated after 1926. [Eric Foner, Give Me Liberty: An American History (Norton, 2005), p. 800]

And the stagnation in consumer goods sales was a critical factor in bringing on the Great Depression.

Coolidge did what he thought was the right thing. He cut taxes. He cut federal spending. He refused to throw money around on what we’ve come to call “entitlement” programs. He expected the farmers and the flood and storm survivors to get along without federal government help. He was a good conservative, in other words. And he and Hoover just about flushed the whole country down the toilet.

And I thought of this yesterday when I saw this article in the Washington Post by John Barry — “Our Coast to Fix — or Lose.” I urge you to read the whole article, but for now I just want to point to the ending: “The failure of Congress and the president to act aggressively to repair the coastline at the mouth of the Mississippi River could threaten the economic vitality of the nation.”

And I thought of this when I read at Bonddad Blog that consumer sales are dropping. And that our infrastructure is crumbling from neglect. And on and on.

Coolidge actually had some advantages over Bush. He paid off government debt, and he didn’t get us into a bleeping war that soaked up our bleeping resources. The long-term crisis we face now is not as much with farmers (although they’ve got their problems) as it is with our shrinking manufacturing base.

I’m just sayin’ that in the 1920s most people thought the economy was swell. The stock market went up, up, up. Lots of people made fortunes, The rich got richer. Good times.

But then, as now, income disparity grew. While the rich grew richer, most people didn’t. Many parts of the nation were suffering economically even as the 1920s roared on. Retail sales slowed, then dropped, about three years before the Great Depression swallowed everyone. I’m just sayin’.

Speech, Free and Subsidized

Posted on by

Today a number of rightie bloggers are complaining that a conservative student newspaper at Tufts University has been found guilty of “harassment” by the Student Life Committee, allegedly for publishing racist and anti-Islamic smears. Here is what the conservative student newspaper says about it:

Showing profound disregard for free speech and freedom of the press, Tufts University has found a conservative student publication guilty of harassment and creating a hostile environment for publishing political satire. Despite explicitly promising to protect controversial and offensive expression in its policies, the Tufts Committee on Student Life decided yesterday to punish the student publication The Primary Source (TPS) for printing two articles that offended African-American and Muslim students on campus. The Foundation for Individual Rights in Education (FIRE), which has spearheaded the defense of TPS, is now launching a public campaign to oppose Tufts’ outrageous actions.

From the Tufts University web site:

The Committee on Student Life (CSL) today released a decision finding The Primary Source, Tufts’ conservative journal, guilty of harassment and creating a hostile environment.

As a result of the verdict, all pieces in the Source must now be attributed to specific authors. The CSL, which is comprised of students and faculty members, also recommended that “student governance consider the behavior of student groups in future decisions concerning funding and recognition,” according to a copy of the decision that was sent to the Daily.

Today’s result stems from an April 30 hearing during which two separate cases against the Source were heard. In one, David Dennis, an African-American senior, said that the Source’s Dec. 6 carol “O Come All Ye Black Folk” constituted harassment and the creation of a hostile environment. In the other, the Muslim Students Association brought the same two charges against The Primary Source for its April 11 piece “Islam – Arabic Translation: Submission.” Both of these Source pieces were unsigned.

Regarding the content of the offensive material, I mostly agree with what Fontana Labs says at Unfogged:

My initial inclination is to say that while publishing this sort of thing is irritating and nasty– like its predecessor, the satirical carol “Oh come all ye black folk,” this item isn’t really intended to spark an interesting conversation so much as it’s intended to marginalize people who get enough of that already– it’s not the sort of thing that should be banned by harassment policies.

Part of the difficulty here, I think, is the tendency for college students in general and “Campus Conservative” types in particular to be a little bit too attracted to the idea of stomping on sacred cows no matter what the day-to-day effects. This unfortunate attachment is just increased by going the official-sanction route. Fantastic: more conservative students who are bitter about being kept down by The Man.

My general view is that colleges and universities have an understandably janus-faced view of student agency: sometimes they’re adults, sometimes they’re not. This puts the institution in the awkward position of officially endorsing the virtues of autonomy and free expression while inconsistently applying pressure on uncomfortable exercises of this freedom.

He’s probably right about that. Even though the offensive material has all the literary and intellectual value of used kitty litter, these children conservative students just get even uglier when they feel oppressed. Better to let them get the bile out of their systems and into public view. Thirty years from now some of them will run for political office, and then their opponents will dig up this muck and leak it to news media, and then they’ll be sorry.

The conservative students argue that since their Muslim piece was factual, it can’t be censored.

A panel consisting of both faculty and students found the publication guilty in flagrant abuse of what harassment case law and regulations actually say, and demonstrating total ignorance of the principles of a free society. Even in libel law (one of the oldest exceptions to the rule of free speech is that you can be punished for defaming people) truth is rightfully an absolute defense. Here, the fact that TPS printed verifiable information—with citations—was apparently no defense, nor was the fact that the ad concerned contentious issues of dire global importance. Such an anemic conception of free speech should chill anyone who cares about basic rights and democracy itself.

See what I mean about getting uglier when they feel oppressed? But this argument has two weaknesses.

I understand this newspaper was chartered and funded by the university’s Student Life department. If that’s not true, then what the students put in their newspaper ain’t none of the Student Life department’s business. If it is true, then in effect the Student Life department is the newspaper’s publisher. And publishers, right or wrong, do get the last word on what goes into the publication. That’s not censorship or libel; that’s capitalism. Writers and editors who work for all kinds of publications in the real grown-up world often have very little freedom to write and publish whatever they want. They write and publish what the publisher says they can write or publish.

Student newspaper staffs are forever overstepping the bounds of the principal’s or dean of student’s taste and getting into trouble for it, and the students eternally holler they are being censored, but in reality the youngun’s are assuming a lot more freedom than they’ll have if they go into journalism or publishing when they grow up.

I agree with the conservative student that what they published probably was not libelous, as I understand libel law, but I don’t think that was the problem the Student Life people had with it. The Student Life group thought it created a hostile campus environment for black and Muslim students, which is a different issue from libel.

I can appreciate how nasty it is to be in a hostile environment, but whether the conservative student newspaper by itself was rendering all of campus life hostile is a judgment call. As much as I sympathize with the black student who complained about the racist piece, sometimes it can be a mistake in the long run to enforce the rules of polite society too rigidly. Sometimes you just drive the ugliness underground where it festers out of sight and becomes even more dangerous.

Even though the conservative students put a disclaimer in their publication that their views do not reflect the views of Tufts University, in reality I believe it’s still a publication of Tufts University. If someone were to sue the newspaper for damages — I don’t think that would apply in this case, but let’s pretend — any money rewarded by a court would, I assume, come out of the university’s hide. So I have some sympathy with the university in this case, and I disagree that students have an absolute right to publish anything in a student newspaper.

The moral is, if you want the unfettered freedom to write and publish any damn fool thing you want, you have to pay for it yourself.

My second quibble with the conservative student is his assumption that factuality and truth are the same thing. Alas, it ain’t necessarily so.

It’s the oldest propagandist trick in the world to present carefully selected facts to tell a lie. You could, for example, pick through a biography of Adolf Hitler and compile a list of completely factual statements that would make Hitler himself seem like a perfectly nice guy. You’d have to leave out the part about the Holocaust and World War II, of course, but it could be done.

The point is that an isolated statement may be completely true and still be used to say something that is not the truth. And someday maybe I’ll elaborate on that, but not right now.

Don’t Blame Vietnam

Posted on by

Atrios has a couple of posts up, here and here, that question the myth that being against the Vietnam War somehow destroyed the Democratic Party. He writes,

For the record, in the 1974 election, before the full end of the war but certainly after the Democrats had become tainted by antiwarness the democrats picked up 49 seats in the House, increasing their majority to 291-144. In the Senate they picked up 3, for a total of 61.

This did follow the 1972 election where, yes, they lost 13 whole seats in the House, leaving them with only 242 seats. That year they gained 2 seats in the Senate, giving them a total of 56.

And then came the 1976 election, post-war, where Democrats picked up the presidency, 1 House seat, and stayed even in the Senate. …

…I’m sure someone has written about this, and maybe it reaches back farther than I remember, but this whole “Vietnam destroyed the Democrats” myth seems to be one which has recently taken hold. I don’t remember it from my teens, though I do remember that Jane Fonda sold a very popular line of exercise videos.

I’ve written about this before. See, for example, “Don’t Blame McGovern” and “Don’t Blame McGovern II.” It is not true, as some would have you believe, that George McGovern lost the 1972 election to Richard Nixon because McGovern was anti-war and Nixon was pro-war.

First, unlike our current Creature in the Oval Office, in 1972 Nixon fully acknowledged that it was time to withdraw combat troops from Vietnam and was in the process of doing so on election day. Of course, Nixon could have done the same thing four years earlier, and today the Vietnam Memorial would be only half as wide. (Indeed, as we now know that Nixon sabotaged Lyndon Johnson’s peace initiatives so that he could run against the war, were it not for Nixon the wall would be very small, indeed.)

Nixon was elected to his first term in 1968 in part because he promised to end the war in Vietnam. You can argue that in 1968 Nixon was the “peace” candidate, in fact. His Democratic opponent, Hubert Humphrey, had been Lyndon Johnson’s Vice President, and of course in 1968 Vietnam was Lyndon Johnson’s War. I doubt Humphrey would have continued LBJ’s policies, but in 1968 there was widespread belief that he would.

But Nixon’s first term dragged on, and the war was escalated and then de-escalated, but didn’t end. Unlike Bush, however, Nixon was not holding out for some hazily defined “victory,” but rather “peace with honor,” meaning he wanted to wring some concessions out of the North Vietnamese before we left so that the U.S. wouldn’t lose face. But just about half of the U.S. military deaths of Vietnam — half of the people named on the wall — died while Nixon was diddling around. By the time McGovern began to campaign for the nomination, at least some people were saying the hell with honor; let’s just get the bleep out.

But in 1972 Nixon and Kissinger were very openly trying to end the war before the election. And just a week before the 1972 general election and Nixon’s landslide victory, Henry Kissinger held a press conference at the White House and declared that “peace is at hand.” The warring parties were right on the edge of a peace agreement, he said. This announcement turned out to be a tad premature, but Americans didn’t find out until after the election.

So, you see, this was not at all parallel with the current state of affairs.

As I discussed in the original “Don’t Blame McGovern” posts, McGovern’s candidacy had several strikes against it that had nothing to do with the war. Notable among these was the visible dumping of his original Vice Presidential candidate, the late Thomas Eagleton of Missouri. But there were several other problems that you can read about in the old posts and that I’m not going to go into here.

As Atrios argues, although McGovern was badly trounced, election results overall from the 1970s just don’t show a clear pattern of the Dems getting punished wholesale at the polls for Vietnam. The Republican Party didn’t really begin its ascent into dominance until Reagan was elected in 1980. That was seven years after the last U.S. combat troop was withdrawn from Vietnam, and five years after the fall of Hanoi. Saigon.

So why did the Democratic Party fall apart? In short, the party had been sustained since FDR’s time by the New Deal coalition, and that coalition collapsed in the late 1960s and early 1970s. Certainly Vietnam was a factor, but so was the counterculture, and the civil rights movement, and the feminist movement, and the New Left generally. I’ve spelled this out in detail in the past; see, for example:

“Hey, Hey, LBJ …”

“How the Democrats Lost Their Spines”

“How the Democrats Lost, Period”

“Can Dems Find Their Mojo?”

There are many factors that came together in the 1960s and 1970s that resulted in a weakened, spineless, and soulless Democratic Party. I explain these in detail in the posts above, which I wrote as a kind of series last August. But there are two major factors I’d like to point out:

In the 1970s and 1980s, white voters left the Dem Party in droves and began to vote Republican, mostly because Nixon, Reagan, and others did a bang-up job exploiting racism. I think the racist backlash to Dem support of civil rights and antipoverty programs cost Democrats far more, in the long run, than the war in Vietnam did.

Second, in the late 1960s and early 1970s, New Left ideologies discouraged young activists from getting involved in party politics. Instead, progressivism broke up into single-issue advocacy movements that competed with each other for funds and attention. The New Deal coalition dissolved, nothing took its place, and the Democratic Party itself lost clear identity and purpose. IMO it’s important to look hard at this second issue, because I see a lot of activists today making the same mistakes the New Left made years ago.