Friday, October 30, 2009
More than 5700 people worldwide have now died from swine flu since it broke out in April in Mexico and the United States. There was a jump of 700 last week. The biggest rise was in the Americas where 636 deaths brought the region's total to 4175.
The Ukraine has shut all of its schools and banned public meetings, after four deaths were reported there.
The child death toll in the U.S. now stands at 114 and rose 19 last week. 40 to 50 would have died in a normal flu season.
Adult figures are much less reliable. 2, 500 hospitalizations and 530 deaths have been reported to the CDC.
It is estimate that perhaps 800 Americans had died in the swine flu pandemic. Millions and millions have been infected with the virus, according to the CDC>
There have been 440,000 cases of the swine flu in this period.
All of the nearly 600,000 courses of tamiflu liquid have been released to states by population. The real problem with antiviral drugs isn't a shortage, it's that too few people who should take them are seeking medical care. This includes pregnant women and people with asthma. The two main drugs are Relenza and Tamiflu.
There are 26.1 million vaccine doses available, an increase of 10.5 since the previous week. About half have gone to children. Originally it was predicted that 40 million doses would be available by now. President Obama has said he is frustrated by the delays and shortages.
Most people who get H1N1 flu will likely recover without needing medical care.
The WHO says that a single dose of vaccine is enough to immunize adults and children over 10.
The CDC recommends thast patients up to 24 receive the vaccine.
Swine flu started with pigs, but it's no longer a pig virus. It's a human virus and it's spread by humans.
This is a new virus, and the seasonal flu vaccine doesn't protect agaiinst it. People who had the asian flu in the 50s might have some immunity.
Swine flu symptoms are much like seasonal flu symptoms.
Most cases have been in children and young adults.
There are high risk groups:
Pregnant women, who are six times more likely to have severe disease than women who are not pregnant,
Children under two.
People with asthmna.
People with lung conditions
People with liver problems
People with neurological didorders
People over 65 get it severely, but rarely get it.
WebMd.com has more info on specific risk categories.
Actually, swine flu is treated much the same as any virus, unless it occurs in one of the high risk groups, or the symptoms are peculiarly severe.
H1N1 is also spread like regular flu, mostly through the air.
In other words, the flu is the flu is the flu. But swine flu is different and distinct. Certain groups are at higher risk, and the drama lies in making the vaccine universally available.
Thursday, October 29, 2009
I have to go out. I'll put down some pre-game notes, then update later.
Pedro, self- proclaimed most influential player to to ever enter Yankee Stadium, is going to get his butt kicked. Manuel will leave him in the game too long.
A-Rod is going to come to life with 5 ribbies. Jeter will make a couple of outstanding plays.
The Yankees will maul the Phillies relievers.
Burnett will have six outstanding innings. Hughes and Jaba will be effective in relief.
Seeya after the game.
Wednesday, October 28, 2009
I called tonight's game right. So note that I have the Yankees tomorrow, 'cause I like Burnett over Pedro, But then the next night, I'm back with the Phils and Cole Hamels. And remember, Phillies in 7. Take it to the bank. I feel it.
I couldn't watch all of the series game, so I switched over to the Knicks, but omigod do the Knicks stink bad. I mean they really could do worse than last year.
Gallo hit 7 threes was the only good news and believe me that wasn't enough as Miami won 115-93. The Knicks were 37.9 percent from the field.
I really could get forced into football. I like that Mark Sanchez kid.
Tuesday, October 27, 2009
I like the Phillies in seven.
Of course I don't LIKE the Phillies. I HATE the Phillies. But then I hate the Yankees too.
I mean that I think the Phillies will win in seven games.
This is the first Series at the new Yankee Stadium. The Yankees have won the championship 26 times. But this is a hitters' park, and the Phillies, A-Rod to the contrary notwithstanding, are hitters.
The most awesome power hitter on either team is Philies first baseman Ryan Howard, who's batting .355 with 14 RBIs in the postseason so far.
The most awesome pitcher is the Yankees' C.C. Sabathia who's 3-0 with a miniscule 1.19 ERA. But Philadelphia's Cliff Lee is a near match for Sabathia with a 2-0 postseason record accompanied by a an almost-scratch 0.74 ERA.
The Phillies intend to start the venerable Pedro Martinez in Game Two. My guess is Lee wins Game One, but Pedro loses to A.J. Burnett in Game Two, before Cole Hamels, in a comeback, beats Andy Pettitte in the third game.
At first base, Mark Teixeira of the Yankees is a nice player, a crackerjack fielder, but Ryan Howard of the Phillies is Babe Ruth redux, and this Yankee Stadium was built for him.
Yankees second baseman Robinson Cano is average in the eyes of anyone but a Yankee fan, whereas Craig Utley of the Phils is an All Star, both in the field and at bat.
Derek Jeter is a clutch postseason player and the idol of the Big City, but Jimmy Rollins is a better player.
Alex Rodriguez is better than Pedro Feliz, but Carlos Ruiz is better than Jorge Posada. Jayson Worth, Shane Victorino and Raul Ibanez are a lot better than Melky Cabrera, Johnny Damon, and Nick Swisher.
So, position player for position player, except for A-Rod, the Phillies are the far superior team.
The Yankees get the edge in pitching, especially if Hamels doesn't turn it around.
Mariano Rivera is a major advantage, but closers only get in the game when their team is winning at the end.
Now, as a Mets fan, my question is not only who will win, but for which team am I rooting. I'm afraid that here again the answer is the Phillies.
I really really hate the Phillies, but I have always rooted for the National League team, and I expect that instinct to remain the same.
I was born a Brooklyn Dodgers fan, which implies hating the Yankees. I can't change now. Besides, I could never root for Jeter, or for manager Joe Girardi, who said the other day, "We're trying to do this for pops, Mr. Steinbrenner." Anybody who kisses ass that brazenly must lose.
Monday, October 26, 2009
When Ted Turner invented cable thirty years ago, he looked out on the horizon and asked himself, "Now what shall I put on this network of mine?" Answer: The basics. News, Sports, Movies.
Now this many years later, the formula is still in place, and partially prospers, e.g. TBS broadcast the MLB divisional matchups.
But one element is failing, and failing badly, and it is the very flagship of the Turner empire: News
Bill Carter of the New York Times reports that in prime time for October, CNN will be fourth and last in the 25-54 year old demographic the networks use to charge out their advertising.
CNN will finish behind Fox, which for a long time has maintained a huge lead, but also behind MSNBC, which has also slipped relatively, and behind HLN, which is a Turner property.
Three pf CNN's four shows, Carter reports, between 7 and 11 pm finished fourth and last. Each of the CNN shows were thumped by their Fox competitors, and lost to the MSNBC shows, even Anderson Cooperr 360 whish got beat by the10 pm repeat of Keith Olbermann's Countdown, which has its first run at 8pm. Anderson was also bested by Nancy Grace on HLN, and overwhelmingly by Greta Van Susteren on Fox.
The only CNN show to finish better than last was Larry King who beat the new Joy Behar show on HLN at 9 pm. Lou Dobbs got beat at 7 pm by HLN's Jane Velez Mitchell.
CNN takes its biggest clobbering at 8 pm when long-time leader Bill O'Reilly gets about 880,000 viewers; Olbermann clocks 295, 000; Nancy Grace gets a solid 269, 000. Campbell Brown is way back in the field with 162, 000
CNN released a statement saying, "CNN's ratings are always going to be more dependent on the news environment, much more so than opinion-based programming especially in prime time."
Yes, but Campbell Brown didn't get the TODAY show for a reason. She's not good enough.
You don't want Wolf Blitzer as your principal anchor, because he's Wolf Blitzer, and not Brian Williams.
When Anderson Cooper had his New Orleans moment, I thought that was going to be a turning point for CNN, but they couldn't follow up, and now Cooper is treading water.
They absolutely positively have to get rid of Lou Dobbs. You can't argue that he grows out of "the news environment."
Soledad O'Brien is probably not going to do much better than she did at Jeopardy. And the White House isn't helping. Fox has jumped 9% since Communications Director Anita Dunn took aim at FNC.
Fox has a show on at 3 am called Red Eye, which beats a re-run of Campbell Brown.
CNN Prexy Jon Klein can say what he wants. CNN is dead in the water. Oh sure, the next time there's a big story, they'll vault to the top, but the duration of big stories is shrinking. They stay hard, breaking, news for a brief while, then turn into opinion fodder. And now that the spectrum on Fox and MSNBC goes from all the way from right to left, the red meat for Wolf, and AC, and Campbell is gone before you notice.
It's makeover time.
Sunday, October 25, 2009
I picked this up from Paul Brown (no relative) of the Guardian. http://www.guardian.co.uk/profile/paulbrown
"New Orleans can no longer be protected from hurricane storm surges, according to the US army general in charge of the city's defenses."
"General Robert Van Antwerp, Chief of the Army Corps of Engineers, said his team was in 'persistent conflict' with the Misssissippi River."
'If you ask can I protect the city, the answer is no. Can I reduce the risk? Yes.'
When Brown asked Gen. Van Antwerp if the city should be abandoned, he said "That is outside my brief."
The Mississippi delta is sinking a cm. a year. Sea levels are rising at an accelerating level, and will be two meters higher by the year 2100. Most communities, therefore, will be submerged.
In a typical hurricane season, land disappears at the rate of an acre every six minutes. 2300 sq. miles of marsh and swamp have been lost in 50 years because of salt-water intrusion. It is estimatedd that to save the delta's wetlands and its settlements from sinking by diverting the Mississippi would cost $200 billion.
There is no sign of a willingness to spend that kind of money. I wouldn't buy New Orleans real estate.
Saturday, October 24, 2009
No question what the most recent buzz word has been. Robust. From robur, oak. A strong public option to be included in an eventual health care reform law. Being fought for by House Speaker Nancy Pelosi, who needs 218 votes, and has 200. The robust plan would cost $871 billion over the next years, and would provide insurance coverage to 96% of uninsured Americans. There are alternative plans, but the Congressional Budget office says the robust plan is best for the economy. If the Senate doesn't follow suit, the House leaders will force their hand in conference.. In the end, this is not going to be about Olympia Snowe, or even Harry Reid or Nancy Pelosi. It's going to be about Barack Obama. Who happens to be very good at his job.
Friday, October 23, 2009
I guess there was a moment or two today when people were talking about Fox News capo Roger Ailes running for president. Of the United States.
When Roger got around to shooting it down, he said he couldn't take the pay cut. He wasn't kidding. He is said to make $24 million a year, more than his boss Rupert Murdoch. And he's earning it. Fox News had cash flow of $500 million last year.
I used to work for Roger, as a senior producer on the NBC cable channel America's Talking, which ran from 1994 to 1996, and carried a somewhat oddball roster of programs, including such titles as, Am I Nuts, Break a Leg, Have a Heart, Pork and Bugged!
Roger was actually a popular boss, in the rah-rah football coach style of leaership, but the shows stunk and nobody watched, so when Andy Lack wanted to take the channel position for NBC News, it wasn't much of a battle.
Lack's vision wasn't much more enlightened, however, and he was saddled with an awkward partnership with Microsoft.
Meanwhile, Ailes tapped into Rupert Murdoch's treasure and started another network, this time without the eccentricity.
At first Fox had only limited carriage on cable systems, but they increased coverage by paying for it. Eventually, and while I was now Executive Editor or of MSNBC, Fox far outdistanced us. In fact we sometimes got beat by Fox, CNN and Headline News, "fourth of a possible three."
Why? Well the truth is, FNC has always executed well -- good graphics, good direction, good promotion.
But also, and this is key as you look at the current war between Fox and the Obama White House -- Roger has a good commodity in "fair and balanced news."
Of course, fair and balanced news is a red herring. The only kind of real news is objective, accurate and complete reporting of the facts. Over the years, the most sincere effort to report news on cable has come from CNN. There was no sense in Roger competing directly with CNN, especially since he sincerely saw them as a liberal network. Ailes also knew that Lack was completely at sea, striving to find an agenda in cahoots with Microsoft at a time when the Internet was barely getting a foothold.
Ailes was no longer tempted to go with shows like Am I Nuts, instead hiring Bill O'Reilly, who had just been dumped from his syndicated talk show. O'Reilly is in many ways the image of Roger's working class populism, although O'Reilly was raised in Irish Catholic Long Island.
Back in the days of America's talking, Ailes was also the Executive producer of Rush Limbaugh's radio show. He's now embraced another radio phenom, Glenn Beck, who's pushing FNC into an activist stance with tea parties and other banner waving efforts.
Beck is scarier than O'Reilly. Now John Stossel is being added to the mix, and maybe Lou Dobbs. FNC may be heaaded toward full blown demagoguery.
The Obama White House is waving red meat at Fox. I'm not sure that's wise. The genius of Fox is that it can make a shitload of money by attracting a huge percentage of its "natural" audience of self-proclaimed fair and accurate viewers.
I think Mr. Axelrod, you should let it go. Unless maybe a certain amount of polarization is necessary. Maybe Olympia Snowe shouldnt be allowed to run the country
On November 3rd, Mayor Mike Bloomberg, an independent running as a Republican, will almost certainly defeat his Democratic rival Bill Thompson and be re-elected. His current margin is 16%, though it's static.
There are a couple of unusual things about this race. First, Bloomberg has spent $65 million of his own money. But that isn't too much for the mayor, whom Forbes magazine ranks as the 8th richest American, with a fortune of $20 billion. Those numbers are a guesswork based on public information, but the guy clearly ain't hurtin.
The other thing different about the mayoral election is that Bloomberg strongarmed the City Council into permitting him to run an extra, third, term. Polls show that people prefer term limits, and would probably have supported them in a referendum, but are now going along.
Bloomberg has been mayor since 2002. Even though he has alienated some groups, notably unions, he is generally thought to have done a good job, one for which he seemed supremely unqualified.
He has stood up to the incredibly Machiavellian politicians in Albany. He took on the teachers union, and began running the schools himself, with good results.
Another very rich local politician, NJ Governor Jon Corzine, former senator and former Chairman of Goldman Sachs, is in a neck-and-neck race with Republican rival and ex-US Attorney Chris Christie. Corzine was hugely popular when he got the job, almost as unpopular now. There's also an independent candidate that could give Corzine the edge he needs.
Politics, never the most popular sport, is having an especially tough time right now. For a while these monied candidates could come across as apolitical, but that appeal seems to be wearing thin
Wednesday, October 21, 2009
We had never really hated the Phillies. They eliminated the Dodgers on the last day of the 1980 season, which was a heartbreak, but then it was the Yankees in the Series, so we actually turned around and rooted for the Phils -- the Whiz Kids of Robin Roberts, Richie Ashburn, Del Ennis and Curt Simmons -- but then watched Philadelphia lose to the Yanks.
Thirty years later, the Phillies took it all for the first time in their 97-year history, behind legendary players like Mike Schmidt, Pete Rose, Tug McGraw and Steve Carlton.
But that was all before current Phillie shortstop Jimmy Rollins said, at the beginning of 2007, that the Phillies were "the team to beat" in the NL East, a remark clearly aimed at my New York Mets. Of course, it was much more galling when he proved to be right, even though the Colorado Rockies went on to win the Series. Then, in 2008, Phillies star pitcher Cole Hamels said the Mets were "choke artists."
The Mets were so bad this year, we got sick of booing Rollins and Hamels.
So now we hate the Phillies, who are winning Game 5 of the NLCS as I type. If they win, they clinch.
Tomorrow night, the Yankees play Game 5 of the ALCS against the Angels. This is much more straightforward. We have ALWAYS hated the Yankees.
I personally cannot root for the New York Yankees. They have some players I like, notably first baseman Mark Teixeira. Jeter is supposed to be a nice guy, but always seems smug to me.
A-Rod represents celebrity baseball. I guess I'd hate him a lot less if he played for the Mets, which came close to happening when the team was run by a bozo called Steve Phillips.
Torre just pulled Vicente Padilla. I might let to find out how this one ends.
I think it's Phillies vs. Yankees. Ultimate Nightmare. I'll root for the Phucking Phillies, if I give it much attention at all.
Tuesday, October 20, 2009
Pope Benedict XVI has set up new structures within the Roman Church that allow Anglicans, including married priests, to become practicing Catholics while maintaining much of their own liturgy and identity -- a kind of church within a church.
This may look like a move toward ecumenism, especially since it is a joint announcement from Pope Benedict and Dr. Rowan Williams, the Archbishop of Canterbury, but in fact, it is divisive and not ecumenical, and Lambeth Palace is said to have tried mightily to block it.
The poaching RC agenda here is to create a haven where right-wing Anglicans can escape gay priests and bishops, women priests and bishops and same-sex-couples. Similar traditionalist structures have been formed among Episcopalians in the United States.
Not only individual Anglicans but parishes and even entire Dioceses will be able to convert.
I think of Benedict as the Tea Party Pope, or mutatis mutandis, the Tridentine Pope, after the 16th Century Council that launched the Counter-Reformation and gave birth to the Jesuits.
Some commentators are saying this Anglican absorption is kind of a closet liberal move because, by extension, the romanized Anglicans could welcome married roman priests and nuns into their new "Personal Ordinariates". That strikes me as absurd, because it's not what either Canterbury or the Vatican wants. This move is essentially and exclusively aimed at excluding homosexuals and women, by now well-established as enemies of Ratzinger and Williams. Married priests and bishops who are anti-gay are are just as lethally anti-gay as non-married ones, so that this semi-sensational step by the pope is in every way more separatist than unitary.
There are 80 million Anglicans in Communion with Canterbury. There are 500,000 in the the so-called Traditional Anglican Community, which split off in 1991. It is this latter group that can be expected to gravitate toward Rome.
Monday, October 19, 2009
Sunday, October 18, 2009
Slate's got a Mark Fiore cartoon called "Obama's Other Premature Awards."
1 - This young mother awardedthe health reform saved my baby award
2. Unemployment prize, Obama got me a job
3. Polar bear climate change, and he didn't eat me.
4. Get us home (from war)
5. Imagined screenplay
6. Lyrical speeches to come.
I'm not really capturing it.
Watch it yourself.'
Be warned. Bilious. Not funny
Saturday, October 17, 2009
Dexter Filkins's piece in the Sunday Times Magazine on Gen. McChrystal and his effort to win in Afghanistan is must-read (maybe not as must-read as David Rohde's Times account of his 7 months of captivity by the Taliban in Pakistan).
Filkins gives a partial profile of McChrystal, West Point graduate, intellectual, intensely focused warrior. He also gives a sense of the desperate intensity of the fighting man, and the feeling that more troops will not shorten the war.
Filkins deals rather briefly with Hamid Karzai, but it seems to me that Karzai is the real weak link here. It's like Diem in Vietnam vs. the Viet Cong. The Taliban and al-Qaeda control the hearts and minds, and even though the American generals have learned a lot about relating to the locals, they don't speak the language, they don't really know the religion and culture, and their camouflage is like neon clothing.
The Taliban controls the heroin trade, and we can never compete with them for opium profits. That's a huge factor in the eventual outcome.
Karzai has been offered a deal: enter a runoff, then accept some of his election rivals into a coalition government, implicitly recognizing fraud in the first round. The US clearly wants him to take the deal, but he has so far refused..
I'm sure Obama understands all this. It doesn't help him to have McChrystal predicting defeat without the infusion of tens of thousands more troops.
Petraeus claims victory in Iraq but let's see how the factions there get along after January elections.
We don't win this kind of war. It's not even clear how we get into them, or how they grow.
I like Joe Biden's approach, although I'm skeptical of that, too. At the end of the day, in both Vietnam and Iraq, we lost. Sometimes, I'm afraid that means not trying to win.
Friday, October 16, 2009
It's got to piss you off the way the banks, after being helped back on their feet with $750 billion of taxpayer bailouts, are now fighting an overhaul of financial regulations.
In the first two quarters of this year, Goldman Sachs set aside $11.36 billion in employee compensation, or $386,429 per employee. Even Goldman's CEO Lloyd Blankfein has conceded that there is good reason fo anger over bankers' compensation.
These dizzying sums are doled out at the same time that the country is experiencing 9.8% unemployment, and home foreclosures are up almost 30% from a year ago.
The president said in a speech last night that the banks can't "game the system", an expression he uses often.
The banks give lip service to the need for regulations, while simultaneouisly fighting them, for example waging a battle against a Consumer Financial Protection Agency.
Bank of America CEO Kenneth Lewis has been asked to forego his 2009 salary and bonus, but BOA also suffered a big loss last quarter, while the big investment banks are starting to turn things around. Still, it would be nice to see pay czar Kenneth Feinberg go after the other high rollers. The public is not going to get behind the recovery until the bankers are put in their place.
Thursday, October 15, 2009
This Glenn Beck dude is truly off his rocker. He did this 4-minute riff on his show you've probably seen on You Tube already, wherein he weaves the famous 1979 Mean Joe Greene Coke commercial, the Paul Anka Kodak jingle, The Times of Your Life, together with a teary shaggy dog story about kids staying out past their curfew, the moral of which was, "The Party's Over."
I don't care who you are, what you believe. what you think of this guy, those tears were fake.
Mind you, I don't have much use for "The Ed Show" on MSNBC either. Even Olbermann wears me out. But this bit was really way beyond the pale.
And yet, and yet, Glenn Beck knows what he's doing when he calls for a return to simpler times, and when he says that only common sense and hard work will lead us there.
From that kernel of wisdom, the guy extrapolates some mean jingoistic and racist notions, for which he is said to get paid more than $20 million a year.
Things are getting so nutty.
Wednesday, October 14, 2009
That's the magic number. The first time the Dow industrials closed above 10,000 since October 2, 2008. Like all milestones, passing it feels good, like we're getting somewhere. 25 of 30 stocks in the Dow bundle rose today. Many economists spent the day making light of the 10 grand figure, pointing out that retail sales, among other indicators, are down, though less than expected. Two key performers were Intel and JP Morgan Chase. Small businesses, however, are not doing nearly so well.
The Wall St. Journal puts the question like this: is this just a temporary rush higher, or a new floor for the great heights to come. The Journal warns that wherever the Dow was today, it won't be there tomorrow. Spoilsports.
Elsewhere in the Journal, E.S. Browning reports that the Index has made a 53% gain in seven months, much faster than expected.
Of course, the economy is a much broader reality than the stock market, and central to the economy is jobs. Jobs, jobs, jobs, with unemployment expected to reach 10% by the end of the year. Also, overall prospects depend on real earnings, not prospective earnings.
Yet we all know that stocks have a significant psychological component, so no matter how you slice it, today's Big Number is good news, even if stocks slip below the 10,000 mark tomorrow. It will hover there for a while, giving the bulls room to run.
Tuesday, October 13, 2009
Well, we've now had our Olympia Snowe moment. But watch out, she's got her finger on the trigger.
Now, we move on to the Harry Reid, Chuck Schumer, get the most liberal plan possible moment.
Then the Nancy Pelosi moment.
Then the reconciliation moment.
Then the filibuster moment, maybe an Al Franken moment.
Then, a law, including the public option, I think maybe -- watered down somehow.
I think the public option will ride in on the strength of the CBO numbers. This isn't an easy sell, but it can be made: the public option is cheaper, because it offers choice
The battle lines are drawn. A spokesman for the insurance industry's trade group said Monday: "We cannot support this legislation in its current structure." To which the White House responded, "The insurance industry has decided to lead the charge against health reform, and everyone recognizes their motives: profits."
The likely trillion dollar price tag on this prospective legislation should be measured against total health care costs for the country of about three trillion dollars. Health care costs have risen faster than inflation and the growth in national income.
Many of these costs could be sharply reduced without any reference to the current Washington debate about insurance.
Take misdiagnosis: error rates of 1.4% in cancer biopsies; 20-40% in emergency room and ICU care. Patient surveys of misdiagnosis range from 8% to 40%.
The two top underlying preventable causes of death are tobacco and obesity. Relatively recent statistics -- the year 2000 -- listed the causes of death accordingly: tobacco (435,000; 18.1%), poor diet and physical inactivity (400,000;16.6%), alcohol consumption (85,000;3.5%),. Other causes: microbial agents (75,000), toxic agents (55,000), motor vehicle crashes (43,000), incidents involving firearms (29,000), sexual behaviors (20,000), drug abuse (17,000).
Just off the top of my head, that's about 2.5 million preventable deaths. Add that to misdiagnosis. I can't tell you that number. It is certainly big. And both tobacco and obesity threaten more people than just the sufferers.
The US rates 38th in the world in life expectancy; 21st among developed countries. Canada's life expectancy average is 82.1 years. The life expectancy for citizens of France is 80.9 years and the everage life expectancy of those living in the U.K. is 78.9 years. In the United States, the average life expectancy is 78.1. But more important than life expectancy averages is the fact that in each of of those nations, every single citizen has access to health care. The United States is the only developed country in the world that does not offer health care to all of its citizens.
Though people born in other countries live longer than in the U.S., Americans who make it to 55 years of age live 8-9 months longer, because of an excellent level of surgery, end-of-life treatment, advanced testing and expensive prescription drugs. And these are precisely the items in which most money is invested.
A high percentage of medical treatment is devoted to iatrogenic, i.e., doctor caused, illness.
It is estimated that the number of people having in-hospital, adverse drug reactions to prescribed medicine is 2.2. million,
The CDC has estimated that "tens of millions" of antibiotics are prescribed unnecessarily for viral infections every year.
The number of unnecessary medical and surgical procedures performed annually is 7.5 million, about 30%.
The number of people exposed to unnecessary hopspitalization annually is 8.9 million.
For these reasons, some experts say the medical system itself is a greater cause of death than either heart disease or cancer.
Cancer recently passed heart disease as the leading cost of death in the U.S. And as baby boomers age, cancer numbers will continue to grow dramatically, even if current economic conditions do not improve. The total cost per year is already about $210 billion.
Great progress has been made in both heart and cancer treatment. But some of the advances are chimerical. Stents, for example, are given to many heart patients who don't need them, who are not even manifesting the requisite symptoms.
To treat an aggressive cancer with drugs like herceptin, avastin and zometa can cost up to $300,000 per patient per year.
In a USA article in July, an expert is cited: "These therapies may give patients a few more months, but they are not a cure. Given those limitations (he) and others question whether these drugs are worth it." In fact, as new drugs are developed, they tend to have a narrower efficacy, and therefore a higher price. (Those of you who've been following the health care debate, will be thinking "death panels" at this point) .
In 1965, approx. 5% of US GDP was spent on health care. In 2004, heaalth expenditures were approx. 16% of GDP, and it is projected that by 2014 we will be spending nearly 20% of GDP on health care. Examining the numbers more carefully shows that we are not, however, overly efficient in spending money to cover these costs nor to keep them in some kind of check. In fact it is not surprising that the CBO says the Baucus/Snowe plan and, for that matter, the public option, will save money by allowing consumer choice.
Choice of what? How about starting with the things that both matter most and are free, or close to free: diet, environment, activity, psychology (high self-esteem). Each of us can start working on those four areas tomorrow. No insurance required, private or public.
My favorite example is bottled water. 89 billion liters are consumed worldwide every year, worth roughly $22 million. Half is drunk in Western Europe, where it was already part of the culture before the current explosion, because of pollution of the water supply for centuries.
There are studies showing bottled mineral water to contain harmful substances, including arsenic.
Americans drink 240 to 10,000 times as much bottled water as tap water, even though in many cases the tap water is healthier, and in some cases like Dasani and Aquafina, the bottled water IS tap water.
The global bottled water industry has exploded to over $35 billion. That does not buy health. It would buy a public option.
Monday, October 12, 2009
I think it's obvious that the White House is making a big mistake by picking a fight with the Fox News Channel, calling it a "wing of the republican party."
Just look at the ratings. Bill O'Reilly gets more than 2 and a half the number Keith Olbermann pulls in. FNC beats Chris Matthews by about three times, and Hannity and Colmes doubleRachel Maddow's ratings. Fox clobbers CNN even more throughly.
Fox started out very badly (I was there on July 15, 1996, a member of the MSNBC launch team, and executive editor for ten years after that) , but moved ahead for good when 9/11 caused national mass hysteria, and a huge, potential, flag-waving audience
You cannot beat Fox at its own game. The best way to beat Fox is not to treat them like the bully on the block, but to ignore them, to treat them fairly, to go on with their talent. Fox has to figure out a way to make Obama its friend.
I have worked with Roger Ailes (I was a Senior Producer when he ran a network called America's Talking for NBC News), and I know how he fights. As Andy Friendly once put it, "Roger stabs you in the front." Roger made Limbaugh a media giant, and I do mean giant.
Roger lost the battle to save AT, even though he had GE Chairman Jack Welch on his side. He lost it to Andy Lack, the President of NBC News' who had Bob Wright, CEO of NBC on his side, at least for the time being.
No sooner did he lose America's Talking, than Roger got taken in by Rupert Murdoch, to start up his "Fair and Balanced" Fox News Channel. I've always felt that FNC would never have done any better than America's Talking if it hadn't been for Rupert's backing. It's also true, however, that Fox executes its programming very well, which wasn't always true of MSNBC, which until fairly recently, kept changing its programming and its talent in what seemed like whimsical fashion. They have now got things running very smoothly and tightly.
Fox's audience will always have a ceiling, dictated by the conservative population. But in cable terms, that ceiling will also be high. You have to be willing to concede the Fox audience, because CNN and MSNBC split the liberal audience -- although in the past, MS has tried the conservative route (remember Alan Keyes?)
The point, for me, is the White House should be perceived as above the fray, and my guess is that Ailes will be happy to play it that way. Obama should too.
Sunday, October 11, 2009
The events of the weekend serve to remind that the time for action on gay rights is now.
Gays should be able to inherit property now, should be able to marry now, should be able to enlist and serve in the military now. Every single right afforded to any person should be given to gays now.
One obstacle to this once-and-for-all change is the Roman Church, which teaches that homosexuality is forbidden by natural law. The Catholic doctrine of natural law is both antiquated and wrong. The Pope is against abortion. There is nothing wrong with abortion. The Pope is against birth control. There is nothing wrong with birth control, including condoms, which should be widely disseminated.
There is nothing wrong with homosexual behavior.
All of this activity should be protected by the law, in the name of privacy.
There should be no question about this, and laws that protect these sexual rights should be passed immediately.
I guess I understand why President Obama is walking on eggshells in so many areas, but I wish he'd stop.
As Lady Gaga said at today's rally, "Are you listening? We will continue to push your administration to pring your promise to reality."
Gay rights now.
Saturday, October 10, 2009
But we clearly don't like ourselves, as witnessed by the reaction in the media to President Obama's receiving the Nobel Peace prize.
Here is Adam Nagourney, political correspondent of The New York Times: "Whatever it meant on the world stage, in the United States the award to Mr. Obama was a decidedly mixed blessing. It was a reminder of the gap between the ambitious promise of his words and his accomplishments. " This reminds me some of Mr. Nagourney's writing during the Democratic primary campaign, when he targeted Obama for being all words.
The Nobel Committee said it attached special importance to Obama's vision of and work for a world without nuclear weapons.
Michael Moore would probably say, "Well when are you gonna do that? You haven't got rid of any nuclear weapons yet." Instead Moore contented himself with this line, "Congratulations President Obama on the Nobel Peace Prize -- Now please earn it.'
Let's not forget who's peddling a new movie.
It is true that the president gathered his Afghan war council just hours after announcing he would accept the nobel Prize. Obama is being held to ransom by General Stanley McChrystal, who says he can't win in Afghanistan without up to 60,000 more troops. It's highly likely that the general will be disappointed, at which point it will become Obama's strategy and Secretary Gates's strategy and Petraeus and McChrystal will just have to do what they're told, with more troops, but fewer than they say they need. That is going to be a very difficult moment, and it won't be in Michael Moore's next simplistic movie.
The Nobel committee said that Obama has "created a new climate in international politics." That, they said, means that "multilateral diplomacy has regained a central position." That is something Obama has actually done. It is an accomplishment, in spite of all the American media saying the award is being given for no accomplishment.
For reasons I don't quite understand, the American press has turned unpatriotic. Their first reaction to this award was, "He doesn't deserve it," rather than "how terrific that he got it."
What the Nobel Prize is celebrating is what French President Nicolas Sarkozy said: "It confirms, finally, America's return to the hearts of the people of the world." I think it's important that we recognize that that is a good thing
Friday, October 9, 2009
The president said he was surprised to get the Nobel Peace Prize, and I can imagine he was. After all, he's probably still learning to find his way around the White House.
But, after all, it's not surprising. It's inevitable.
Barack Obama was elected president because he represented hope, and hope is what this award stands for too. Hope that he can rally the world to dig out of near-depression; hope that a man named Barack Obama has a better chance of leading mainstream Islam to put down the nihilism of the suicide bomber; hope that he can be a judicious military leader, asserting political control over the always-hawkish generals; hope that he can show the world that there is nothing abstract about the threat of an overheated environment; hope that a new spirit of cooperation can prevail after centuries of nationalism.
The chairman of the Nobel committee said today that "Barack Obama is trying to change the world." I think he is. That's worth something. Like, say, the Nobel Peace Prize.
Thursday, October 8, 2009
After 11 days of deliberation, and after the judge managed to calm one troubled juror who raised the prospect of a mistrial, a Manhattan jury today found 85-year-old Tony Marshall guilty of grand larceny and conspiracy to defraud his mother Brooke Astor, philanthropist and doyenne of New York society.
There, I've done it -- used the word "doyenne" to describe Brooke Astor, who was 105 when she died two years ago. The word had to be invented for her. I remember throughout the 90s, when she was in her 90s, still photographed at two and three different charity events featured in The Times society pages each Sunday, wearing different outfits from different top designers.
Marshall now stands convicted of trying to swindle Mrs. Astor out of her 180 million dollar estate, and the charge of grand larceny requires him to serve a prison sentence of one to 25 years.
Both Mrs. Astor and her late husband were rich people who were liked, who did good things. In her case, on the day of her funeral, Fifth Avenue in front of St. Thomas's Church had to be shut off to traffic and to accommodate the crowds.
In the course of the five-month trial, prosecutors accused Marshall of convincing his mother to sell a Childe Hassam painting she held in her possession so he could get a $1.2 million dollar commission, and of pushing her down a hallway to scare her into changing her will. He was also accused of getting his mother to give him a $1.4 raise when she was too ga-ga to understand what was going on.
Seen by prosecutors, and allegedly by Mrs. Astor when she was alive as the power behind the throne was Tony's wife Charlene, who was accused of nothing in the trial, and who when exiting the courtroom today, shouted, "I love my husband!" Brooke Astor supposedly said once of Charlene: "She has no class and no neck." (She said this to the butler, according to Meryl Gordon in a comprehensive piece on the Astor scandal in Vanity Fair).
The D.A.'s case was predicated on Mrs. Astor's mental state during the period Tony claimed she was most munificent toward him. The old lady had even reached the point where Tony and Charlene had scared her into believing she was running out of money, while her worth still hovered near $200m.
The case against Tony was brought by his own son, Phillip. He recounted to ABC News how he called his father and told him he had filed for guardianship of the estate. "Charlene stayed on the line and I said that I was sorry that I had to do this. And she goes, 'Well, I bet you are.' Something to that effect. At which point I said, 'Well I'm sorry you made me have to do this.'"
Since the case seemed to boil down to Tony Marshall taking advantage of his mother's Alzheimer's, it raises in dramatic fashion the issue of elder abuse. Of the 72 witnesses, most of them gave either technical or eyewitness accounts of the effects of Alzheimer's on Mrs. Astor, or on the aging in general.
There are many such cases. It's just that very few involve a payoff of such magnitude.
Speaking of payoff, does today's verdict mean Phillip controls the estate? or does the estate revert to the will just before those Tony tried to rewrite, and thus to charity. I'll get back to you. Or watch for the Made-for-TV Movie.
Wednesday, October 7, 2009
It's amazing the things you can find out if you get out for a breath of fresh air. Today, I learned that Vasily Kandinsky fell in love with his third wife, Nina because he liked her voice on the telephone -- her voice that was 30 years younger than his.
It's a big advantage to retiring in New York to be able to drop in to one of our museums along Fifth Avenue's "Museum Mile": the Metropolitan, the Guggenheim, the Museum of the City of New York, El Museo del Barrio, the Jewish Museum, Goethe House, the Frick Collection; and just a couple of blocks off The Avenue, the Whitney, and the Modern.
A few weeks ago, I strolled through the Frick, with its tasteful collection of European Masters, where I spent some extra time with Rembrandt's Spanish Rider. Then another day, at MoMA, I went to the little Vermeer exhibit they've built around the loan of the Dutch artist's The Milkmaid from Amsterdam's Rijksmuseum. What a picture! The milkmaid's apron in folds of shaded blue tinted with underpainted white , her yellow bustier a unique mustard, her cap is photographic. The light in the room is perfect, the result of many hours work. The curatorial experts claim the look of contentment on the face of the maid betrays a recent sexual experience. I don't see it, but then I'm not an expert. On Dutch painting anyhow. For me, what stands out is the milk. I feel I could put my finger out and let the white liquid pour over it.
More recently, I stopped into the Museum of Modern art for MoMA's equally small exhibit of the Monet water lilies and related works from their collection. I guess these small exhibits will be popular during this time of this-is-not-a-recession.
The giant triptych of water lilies that make up the most popular picture at the Modern -- stopping place for countless lunchtime visitors -- has been hung just so, curved as the artist wanted, and perfectly lighted. Of the other pictures, I'd point especially to Agapanthus, the Lily of the Nile, a plant near the water lily pond in Monet's garden. The colors are great. the flowers a delightful splash of pink.
Today, I went farther uptown, where the Guggenheim is showing about a hundred paintings of the Russian-German-French artist Kandinsky.
Kandinsky was both brilliant and prolific. At the University of Moscow he originally studied, and distinguished himself in, law and economics, before turning to art in 1895, at 30.
Kandinsky was in Moscow at the outbreak of the first European war. When Hitler took over, he closed the famous Bauhaus where the painter was staying. Kandinsky and Nina moved to Paris. He died near the French capital at Neuilly-sur-Seine.
As I was led around the great spirals of the Guggenheim by the audio guide, I was most struck by Kandinsky's sprituality, sensuality and romanticism. All of this within his rigorous pursuit of the abstract.
He is constantly experimenting with color. There is one picture that is brown. It is his only brown picture, the only time he used brown. There is a blue picture from his Paris period that will be recognizable to anyone who has visited Paris, especially on a spring day. It is that color.
Kandinsky loved horses, and he portrayed them most often with a rider up -- sometimes the rider was St. George slaying the dragon, a popular subject of Russian iconography. In fact, Kandinsky remained intensely Russian throughout his huge opus of thousands of works.
Midway through his life, Kandinsky lived in a small Bavarian town near Munich called Murnau. One painting from that time is called the Blue Mountain, and, believe me that is one very blue mountain.
The Guggenheim show makes much of the relationship between Kandinsky and music, especially the Austrian-American composer Arnold Schoenberg. The audio guide to several of the pictures contains snippets of Schoenberg, proferring the notion that abstract art and atonal music are peas in the same pod. It is manifestly true that watching the paintings and hearing the music at the same time is a pleasant experience.
I always find hiking up the winding Guggenheim gallery space to be rather tiring (Tallesin, Frank Lloyd Wright's Wisconsin home, is on 600 acres), so I took the elevator down to the street and a very brisk wind.
Tuesday, October 6, 2009
President Obama met with about 30 Congressional leaders at the White House this afternoon. During the session, the following exchange took place between the president and his erstwhile opponent John McCain.
"Time is not on our side," McCain told the president, then added, "This should not be a leisurely process." Obama snapped back a few minutes later, according to some participants, "John, I can assure you this won't be leisurely."
McCain got his elbows in the game last week as well, when he accused National Security Adviser James Jones of trying to avoid alienating the "left base" of the Democratic Party when he gives the president military advice. Jones took strong exception to McCain's remark.
On CNN, Jones said that "the good news in Afghanistan is that the Al Qaeda presence is very diminished. He also said he didn't foresee the return of the Taliban.
If Jones is right about those observations, it would probably put the lie to Gen. Stanley McChrystal's plea for another 40,000 troops. A reply to the general is what the president is formulating in White House meetings this week.
That's why McCain can get away with shooting from the hip, enabling him to say that Obama isn't listening to his generals. McChrystal, for his part, gave an interview to David Martin of CBS News a few weeks ago, large parts of which were excerpted in Martin's piece tonight on the CBS Evening News. This was in open defiance of McChrystal's boss, Secretary of Defense Robert Gates, who wants his generals to shut up in public.
McChrystal wants a total of 400,000 people between the army and the police -- doubling its current size., along with 40,000 more US troops. The general -- like Sen. McCain -- says there's not much time. He thinks he's got 12 months to turn this war around, and that's not even enough time for the corrupt Karzai government to get its act together.
McChrystal's beginning to sound more and more like William Westmoreland, and the Republicans are running interference for McChrystal and Petraeus (who has recently been treated for prostate cancer).
Obama has made it clear he won't reduce the Afghanistan strategy too counterterrorism alone. And Obama says those who link such a notion to V-P Biden are wrong.
In Vietnam and Iraq, we learned that the United States does not do well in battling insurgents on their home turf. This is a lesson John McCain never learned in captivity.
Obama is fighting catastrophic unemployment and a shrinking health care reform bill. He does not want to be seen as the president who ignored the generals in Afghanistan. It is political considerations like this that lead into the quagmire.
Monday, October 5, 2009
The new Supreme Court session got underway today. The newbie, Justice Sonia Sotomayor asked more questions than Clarence Thomas generally asks in the course of several years.
This court will hear several free speech cases. The first of them -- tomorrow -- concerns a Virginia man convicted for selling videotapes of fighting pit bulls and sentenced to 37 months in prison. But then the appellate court struck down the law as unconstitutional, holding that there is no exception to the 1st Amendment for animal cruelty as there is for obscenity. The government is trying to get the Court to create another exception to the 1st Amendment, in what free-speech advocates fear will be part of a continued erosion of that fundamental right.
The case will test Soyomayor's commitment to principle over the prejudicial elements of the crime. Dogfighting is repugnant and the government can certainly arrest fight organizers. The question is whether selling fight images by someone who did not participate in the fight is protected by the First Amendment. Sotomayor is viewed as more likely to side with the appellate court and free-speech advocates than Souter would have been.
Broadly speaking, Justice Sotomayor is expected to vote along the the same lines as Justice Souter: the so-called liberal wing of the court, which also includes Bader Ginsburg, Stevens, and Breyer. The conservative justices are the Chief, Roberts, and Alito, Scalia, and Thomas, with Kennedy as the moderate swing vote.
There are some very big cases in the docket, e.g. the scope of the federal government to regulate commerce; the limit of congressional authority to insulate independent agencies from executive control.
Then there's gun control. The Court has just recently agreed to consider whether the Second Amendment applies to state and local governments. During the summer, the NRA joined the fight against Sotomayor's confirmation. With an estimated 90 million firearm owners in America, SecondAmendment activists are a potent political force. The Right is already making threatening noises about whomever may get named to succeed Justice John Paul Stevens.
Sonia Sotomayor has a reputation as a wise, pragmatic judge. Even though she's the newest member (she's not the youngest -- Roberts is), in a session dominated by sensitive issues, she may turn out to be the pivotal member.
Some of the key issues before the court are: gun rights; whether juvenile crimes can be punished by life sentences without parole; the display of religious symbols on public lands.
Justice John Paul Stevens is thought likely to step down during this term.
Some think Justice Soyomayor will be more sympathetic to proseutors in cases derived from the crriminal courts. The same for National Security cases.
Because Roberts would like to make his mark as presiding over a productive court, he may make a determined effort to get her support on big cases. Because she seems a tough judge, he may have to pay for this compromise. She has been around the block. On the Second Circuit, Judge Sotomayor heard appeals in more than 3000 cases and wrote about 380 opinions. I'm guessing that the team of Sotomayor and Roberts, though ideologically opposed, may turn out to be a dynamite team: he because of his extraordinarily quick mind, and she because " a wise Latina woman with the richness of her experience (may) more often than not reach a better conclusion than a white male who hasn't lived that life."
Where did I hear that before?
Sunday, October 4, 2009
From The Guardian:
The good news is that fewer young people in the UK are using heroin and crack, the substances most likely to cause addiction, increase crime and pose serious health risks. The bad news is the number of under-25s seeking treatment for cocaine dependency is rising significantly. Overall, the number of young adults seeking help for misuse of heroin, crack or powder cocaine fell from 14,000 in England in 2005 to about 12,000 in 2008.
The National Treatment Agency's annual report, to be published on Thursday, is expected to confirm that both the shift away from heroin and crack and the growing problem of cocaine addiction in under-25s has coninued in 2008-09. One must assume similar trends here in the US, although overall cocaine use here is down, Heroin and crack are increasingly associated with losers rather than risk-takers. Heroin and crack are seen as dirty, nasty, horrible drugs, whereas coke is seen as a party drug, like booze. Also cocaine is a combo drug, used at top strength, along with strong pot, strong alcohol and ecstasy.
This generation of multi-drug users has, for the most part, more money to keep their drug use going, and because they use a tangle of drugs, they can be harder to cure.
One suspects that pot and coke have become part of a "party bag," along with alcohol and that the bag itself is becoming the new drug of choice.
Saturday, October 3, 2009
Star Florida Quarterback Tim Tebow suffered a concussion in a game against Kentucky last Saturday. Although Tebow coach Urban Meyer did defer to the team's medical personnel and their advice, he also said he thinks Tebow will be able to play against LSU on Oct. 10.
By setting these expectations, Meyer is suggesting that a concussion is no worse than a sprained ligament or a ruptured tendon. But the fact is we really don't know when a player with a brain injury should reurn to the field.
The NFL has improved its approach, performing base-line cognitive testing after a concussion. And the league has just released a sudy showing that Alzheimer's and other memory-related diseases have been found in former NFL players at a much higher rate than in the normal relation.
The coaches and players around Tebow are saying that tough players can fight through concussions. Tebow's offensive coordinator says "he's the toughest guyin college football without question, without a doubt in my mind." Florida linebacker Ryan Stamper, enunciated perfect macho idiocy, saying, "everyone gets concussions. Stuff like that happens. I guess because it happened to him everyone is blowing it up."
Let's hope that Tim Tebow's well-known Christian beliefs contribute to using his head and protecting his brain.
Friday, October 2, 2009
The Reverend Jesse Jackson says he's "truly disappointed" that Chicago didn't get the Olympics.
The Rev. wonders if video footage of the beating death of a 16-year-old had anything to do with it.
Probably not. South America has never hosted the Games; the U.S. has hosted eight times, four summer, four winter. Brazil's Lula is an exuberant left-leaning leader, more popular within the IOC than Obama.
Taking a simple view, where would you rather go see the Olympics? Rio or Chicago? I know I'd rather go to Brazil. Obama was, by the way, lucky to lose, since the games are big money losers for the host city, with only the TV network coming out ahead.
It's not the kind of loss that will be remembered for long, but it does add to a definite losing streak for Barack Obama.
The public doesn't want to escalate in Afghanistan, but the president will find it hard to say no to Gen. McChrystal.
We may be out of the recession, but 263,000 jobs disappeared from the economy last month, against predictions of 180,000. Unemployment is at 9.8% not counting 571,000 people who have dropped out of the work force. That leaves 15.1 million Americans out of work, a huge number.
Health care reform is floundering. Without the public option, the eventual bill is likely to be a sell-out to the insurance companies.
So it's hard to find a win for President Obama.
I guess he's better off than David Letterman. I found the comedian's mea culpa for his intramural predatory activity to be altogether too jokey. He's lucky tonight's show is on tape.
Dave's 62. The women he pursued are probably way younger. He snagged the women he wanted because on the show, he has all the power. Not only is he the talent, but his company owns and produces the show. So, even though the women were undoubtedly glad to satisfy his desires, he is still the oppressor.
The general public will probably be fairly forgiving, but we'll see how Letterman weathers the tabloidization of his hanky panky.
Not a good week for losers.
Thursday, October 1, 2009
The Pew Research Center has just released a poll that shows an apparent decline in support for abortion, after two decades of majority support for abortion rights. The public is now just about evenly split on abortion, which would be a swing of more than 10 percent in the last year.
This strikes me as astonishing. One reason given by commentators is President Obama's support for abortion rights, accompanied by his opposition to the actual performance of abortions
Other polls show a higher percentage of support for abortion rights. The wording of the questions differ, and the Pew Survey shows a significant dropoff in overall concern over the issue. Also, consistent "pro-life" support comes from white, non hispanic Catholics.
The Roman Church has been diminishing in size but increasing in conservative political bias since the 60s. It's worth noting that six members of the Supreme Court are Catholic: Chief Roberts, Alito, Scalia, Thomas, Sotomayor and Kennedy. Of those, Roberts, Scalia, Alito and Thomas, would probably vote "pro life" out of religious belief, rather than legal conviction.
Orrin Hatch, speaaking for conservatives, tried to put anti-abortion language into the health care reform bill. He failed. The president points out that the bill already prohibits any money being spent on abortion.
The Pew data shows that of those who support abortion rights, only 11 percent cited religious beliefs as the primary influence on their opinion, whereas among those who say abortion should be illegal, 53 percent said their view was guided by faith.
The percentage of liberal Democrats who regard abortion as a "critical issue" has dropped, according to Pew, to eight percent from 34 percent in 2006. This probably means liberals feel protected on the issue.
On the liberal side, these numbers are about the legality of abortion, while on the conservative side, they are more about morality.
This reflects an emerging national split on all political issues. The vigilante, lunatic fringe right, led by Rush Limbaugh, Glenn Beck, Sarah Palin et al are simplistic and moralistic, while Obama and his party are trying to find a pragmatic course on health care reform, Afghanistan, financial reform, and Iran. Sometimes, like in the case of abortion, this means that liberals seem to suffer a diminution of passion, when what they are really doing is taking their position for granted. That could turn out to be a mistake, especially if the High Court ever takes an abortion case.