Thursday, April 25, 2013

Morning Reading -- April 25

Looks like this will be a good morning for reading. Most of the links are from the Twitter timelines as usual but today's red meat is in the content of the links, not the cleverness of the Tweets.

Actually this first Tweet is an exception. But it's too clever to skip.
It reminds me of when the Catholic church learned that there was no such person as Saint Christopher. Big problem since Catholics wore St. Christopher medals as a talisman almost as much as crosses. I saw a cartoon of a church sign announcing "MISTER CHRISTOPHER MEDALS ON SALE -- HALF PRICE."


Why Krugman and the Keynesians Are Lackeys for the Neofeudal Debtocracy
by Charles Hugh Smith

The heart and soul of the Keynesian Cargo Cult is the dogma that the cure for all economic ailments is more aggregate demand, i.e. consumption. The Keynesians' fanatic faith in boosting consumption would be merely childishly naive if it didn't directly support a parasitic neofeudal debt-serfdom. Sadly, Krugman and his fellow cultists' single-minded parroting of "aggregate demand" makes them well-paid lackeys and toadies for an extractive neofeudal-neocolonial debtocracy.

Like all cargo cults, Keynesians maintain a magical-thinking belief in the power of wanting more stuff. But in so doing, they embrace and support the mystification that protects the power structure that is dooming the nation and its economy to stagnation and eventual collapse (call it "reset" if you prefer).

By focusing on increasing demand and consumption by any means, the Keynesian Cultists miss the key dynamics of sustainable growth and fail utterly and completely to acknowledge the corrupt and exploitive nature of our cartel-state crony-capitalism economy.
Thus opens a lengthy and well-thought-out attack of Keynesian economic theory which is already being eagerly grabbed by ZeroHedge (which provided this link) and Saifedean Ammous (whom I follow via Twitter).

I have neither time nor patience to refute arguments which are foundational to the austerity cult that has nearly crippled the world economy, but yesterday's non-news that the Reinhart-Rogoff study turns out to be the Mister Christopher of modern economic theory would be a good place to start.  I find it ironic that the term cargo cult is being used to describe foundational flaws in what some call neoliberalism. Some day I may put together a polemic pointing out the same point again and again in a way that the reader can connect the two main dots -- all the theories in the universe cannot change the fact that the real economy depends on real goods and services and unless someone puts energy into the engine it can no longer run. Call it capital investment or stimulus or anything you want. Without it all that's left is rentier activity with no source for further rent. 


Our Feel-Good War on Breast Cancer
By Peggy Orenstein.

This is a long read -- over six thousand words. There is a handy "single page" option if you are reading from a monitor.

I'm not gonna editorialize much here since I'm a guy and this is not guy stuff. Being married nearly forty years will teach you that. But I have followed health care reform enough for the last few years to know that where there is smoke there's fire. And the smoke about screening -- not just for breast cancer but heart disease, colon cancer, prostate cancer and a load of other frightening health issues --  is about ten percent science and ninety percent trolling for profitable new business.
As you read, let that little prejudicial seed sprout and grow quietly in the background. Keep it up for a few years and you may be in agreement.
I used to believe that a mammogram saved my life. I even wrote that in the pages of this magazine. It was 1996, and I had just turned 35 when my doctor sent me for an initial screening — a relatively common practice at the time — that would serve as a base line when I began annual mammograms at 40. I had no family history of breast cancer, no particular risk factors for the disease. 
So when the radiologist found an odd, bicycle-spoke-like pattern on the film — not even a lump — and sent me for a biopsy, I wasn’t worried. After all, who got breast cancer at 35?
It turns out I did. Recalling the fear, confusion, anger and grief of that time is still painful. My only solace was that the system worked precisely as it should: the mammogram caught my tumor early, and I was treated with a lumpectomy and six weeks of radiation; I was going to survive. 
Sixteen years later, my thinking has changed. As study after study revealed the limits of screening — and the dangers of overtreatment — a thought niggled at my consciousness. How much had my mammogram really mattered? Would the outcome have been the same had I bumped into the cancer on my own years later? It’s hard to argue with a good result. After all, I am alive and grateful to be here. But I’ve watched friends whose breast cancers were detected “early” die anyway. I’ve sweated out what blessedly turned out to be false alarms with many others. 
Recently, a survey of three decades of screening published in November in The New England Journal of Medicine found that mammography’s impact is decidedly mixed: it does reduce, by a small percentage, the number of women who are told they have late-stage cancer, but it is far more likely to result in overdiagnosis and unnecessary treatment, including surgery, weeks of radiation and potentially toxic drugs. And yet, mammography remains an unquestioned pillar of the pink-ribbon awareness movement. Just about everywhere I go — the supermarket, the dry cleaner, the gym, the gas pump, the movie theater, the airport, the florist, the bank, the mall — I see posters proclaiming that “early detection is the best protection” and “mammograms save lives.” But how many lives, exactly, are being “saved,” under what circumstances and at what cost? Raising the public profile of breast cancer, a disease once spoken of only in whispers, was at one time critically important, as was emphasizing the benefits of screening. But there are unintended consequences to ever-greater “awareness” — and they, too, affect women’s health.
And further down in the article there is this.
Those early mammography trials were conducted before variations in cancer were recognized — before Herceptin, before hormonal therapy, even before the widespread use of chemotherapy. Improved treatment has offset some of the advantage of screening, though how much remains contentious. There has been about a 25 percent drop in breast-cancer death rates since 1990, and some researchers argue that treatment — not mammograms — may be chiefly responsible for that decline. They point to a study of three pairs of European countries with similar health care services and levels of risk: In each pair, mammograms were introduced in one country 10 to 15 years earlier than in the other. Yet the mortality data are virtually identical. Mammography didn’t seem to affect outcomes. In the United States, some researchers credit screening with a death-rate reduction of 15 percent — which holds steady even when screening is reduced to every other year. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice and co-author of last November’s New England Journal of Medicine study of screening-induced overtreatment, estimates that only 3 to 13 percent of women whose cancer was detected by mammograms actually benefited from the test.
I see Xeni Jardin liked the piece, too. She should know. She's been fighting cancer for some time so she does have a dog in this fight. 
Before I go to the next link I need to add this.

As a guy I have to face a less threatening but no less serious question about prostate cancer. It's different for men, of course, since if we live long enough nearly all of us will develop prostate cancer, and although it may be aggressive enough to kill you, in most cases it grows so slowly you will die of some other cause first.

I'm asymptomatic thus far, but should I begin to have symptoms I have decided in advance for active surveillance, also called  watchful waiting. I can't resist plugging PPACA at this point. Science, actuarial statistics and other reports from various non-political sources that keep up with these matters assure us that there are limits to the efficacy of both screening and treatment options. Those who criticise Obamacare with the R-word (rationing) may be serving their political agenda well but they are doing nothing helpful for science, medicine or good stewardship of limited economic resources. And they may well be doing more harm than good.


Look who now has a Twitter account.
Only four Twitter messages so far and already over quarter million followers.


The Morning Plum: GOP makeover is impaired by delusional thinking
by Greg Sargent

Republicans appear to have persuaded large swaths of the party’s base that the campaigns to cut spending and to repeal Obamacare are moral crusades so urgent that the zeal behind them must never be permitted to weaken even slightly. This has created intertwined delusions — you can keep cutting spending forever with no consequences; one of these days Obamacare will face its grand reckoning — that have restricted the GOP’s maneuvering room on several fronts which are in the news today. 
The New York Times has a big story this morning reporting that Eric Cantor’s drive to soften the party’s image has run headlong into the intransigence of conservatives unwilling to deviate from their austerity-only ideology and agenda. The latest example: The Helping Sick Americans Now Act, which would create a federal “high risk pool,” funded with money from another part of Obama’s health care law, that would allow people with preexisting conditions to get subsidized coverage. 
The move was simultaneously designed to undermine Obamacare while portraying Republicans as compassionate towards those with preexisting conditions. But conservatives opposed it because it did not offer the promise of the complete destruction of Obamacare — a blow to the party’s effort to rebrand itself at a time when it continues to push for Obamacare repeal while offering no meaningful alternative. Yet this isn’t surprising. As Jonathan Chait argued recently in a different context, the GOP will not be able to offer any such alternative until the party untethers itself from the “decision that they’d rather keep taxes low than spend money to cover the uninsured.” 
Meanwhile, on FAA delays, Republicans continue to celebrate the sequester as a victory for themselves, even as they decry the sequester-generated flight delays and blame Obama for them. In a must read, Jonathan Cohn details that this schizophrenic message gets to the core of the party’s larger problem. “In an ideal world, this would shake Republican faith in sequestration as an acceptable budget policy,” Cohn writes. ”They’d start discussions about replacing it with some other deficit reduction plan — ideally, one that didn’t rely so exclusively on immediate and arbitrary spending cuts.” 
Yes, it turns out that in order to cut spending, you have to … cut spending on programs people like. But Republicans have spent years pushing the notion that the deficit can be dramatically reduced with zero in new taxes, and only through spending cuts, with little consequence. (The Paul Ryan budgets could not achieve their purported deficit reduction goals without wiping out large swaths of the federal government, and so they don’t detail with meaningful specificity how they’d achieve those goals.) So Cohn’s ideal GOP rethink of the sequester is an impossibility, too. 
As the big Times piece on Cantor observes, this remains a problem for the GOP. Its efforts to soften its image continued to be stymied by the fact that a “large core of the House Republican conference” has “simply proved unwilling to move beyond the austerity message.”
This applies to the debt ceiling, too. Republicans know the debt limit doesn’t actually give them leverage, because they’ve already revealed they’re not prepared to allow default. But conservatives may insist on a debt ceiling showdown designed to win still more spending cuts, anyway. So GOP leaders are rolling out a new strategy to deal with this problem. And that takes us to our next item. 
► Republicans prepare their debt ceiling strategy: House Republicans are moving forward with an initiative that would require the Treasury Department to pay public bond holders and Social Security beneficiaries even if Congress refuses to raise the debt ceiling. The idea is supposed to be that this takes the threat of default (narrowly speaking) off the table, which in theory will make it politically easier for Republicans to demand concessions in exchange for raising the debt limit. 
In reality, this represents a concession that Republicans are not prepared to allow default — a key tell that reveals they don’t have leverage here, just as they didn’t have leverage last time. 
► Economic insecurity is widespread and pervasive: Ron Brownstein has a must read on some new National Journal polling that shows just how deeply ingrained and pervasive middle class economic insecurity has become. As Brownstein notes: “the results highlight how much economic anxiety and political alienation still shadow daily life, even after the blackest clouds of the Great Recession have lifted.”

I think the GOP is running out of lipstick. 



Family Doctors Consider Dropping Birth Control Training Rule
By Julie Rovner

One of the more popular provisions of the federal health law requires that women be given much freer access to prescription methods of birth control. That includes not only the pill, but implants and IUDs as well. 
But what happens if there are not enough doctors to prescribe those contraceptives?
That's exactly what worries some reproductive health advocates, as efforts are underway to rewrite rules governing the training of the nation's family doctors. 
The proposed new rules, they say, drop existing requirements that family medicine residents be required to undergo training in contraception and counseling women with unintended pregnancies. Several groups are now running letter-writing campaigns to make sure the rules remain.
This link to NPR  is for listening more than reading.

But the listener/ reader can cut to the chase pretty quick. It'a about women's reproductive health which is one of the most inflammatory subjects of the day. It's fair to say that most readers by now already have their minds made up and are not likely to change just because a few facts get in their face.
If you want my opinion, all you need to know is that I am a dyed in the wool, old-fashioned Liberal and I make no apology for that.
Contraception prevents unwanted diseases and unwanted babies. Period.
Anyone arguing otherwise is arguing in favor of both.

Women's health is a medical issue. It is also a private, personal family issue and everyone else needs to keep their noses out of places where they do not belong. That includes, lawyers, clerics, politicians, judges and well-meaning lay people. If you aren't invited, don't butt in. (In the case of religious institutions, as long as they are tax-exempt they should have no complaints about how Caesar runs the country. Hospitals and other institutions run by churches have tax dollars as part of their revenue stream -- Medicare, Medicaid, tax-exempt contributions, etc.)

Again, I have neither time nor patience to argue about medical issues deliberately being conflated with religious or political concerns. Those arguments inevitably lead to discussions about freedom of religion, abortion rights, infanticide, school textbooks, eugenics, conspiracy theories of one kind or another and damn near anything someone wants to bring up.

Quick, get me some tin-foil before I go crazy...


==►  Damn! Breaking now...

Body confirmed to be that of missing Brown U. student
The body of a man pulled from the Providence River is that of missing Brown University student Sunil Tripathi, the state Department of Health confirmed Thursday.
The medical examiner said the cause of Tripathi's death is still under investigation but no foul play is suspected.

Tripathi, 22, was last seen on March 16, and his family had been desperately searching for him. His body was found in the water at India Point Park late Tuesday afternoon.

Tripathi's brother, Ravi, told CNN's "Piers Morgan Live" on Wednesday night that Sunil was never clinically diagnosed with depression, but the family knew he was having mood problems.
"It kind of bound us together. We all came and communicated with him as much as possible, and both our nuclear family and our extended family had extensive contact with him, which is part of what makes this disappearance just so troublesome for us. And so unknown," Ravi Tripathi said. 
Sunil Tripathi was falsely identified on social media as possibly being one of the Boston Marathon bombers, after the FBI released images of the two suspects.
His sister told CNN that the family knew he was not involved. 
"It was incredibly painful for our family. This was coming at a time after 34 days of pain in our family and worry. And we, you know, knew unconvincingly that this was not Sunil, especially when we saw all of the video footage and surveillance that was being released. We were absolutely sure. And it was just very difficult to have the events of that night unfold so aggressively with language that was not based on any actual evidence at all," Sangeeta Tripathi said. 
Tripathi's family said Sunil was on leave from the Ivy League school and living with classmates in Providence.
This is totally wrong on several levels.
The individual has been missing since March and the so-called "identification with the bombing" was speculation.
The lesson is that in times trouble in America if you are brown, immigrant or Muslim you need to be extra careful to avoid being targeted by idle speculation.


Conservative Infighting Kills Effort To “Fix” ObamaCare
WASHINGTON — Three years after Obamacare was signed into law, Republicans on Capitol Hill are locked in an unusually bitter intraparty fight over whether to fix what they see as problems with the law, or to insist only on the unlikely dream of fully repealing the health care law. 
The breach became painfully visible to conservative insiders on a private listserv this week when a top aide to Senator Ted Cruz exchanged a series of terse and combative emails — obtained by BuzzFeed — over House Majority Leader Eric Cantor's attempt to change the law's treatment of patients with pre-existing conditions. 
The emails, which were circulated on the "Repeal Coalition" listserv of activists and congressional staff, show a clear division inside the Republican Party's powerful conservative wing — a division over substance, and strategy. On one side are conservative groups like Americans for Tax Reform, pushing hard for the legislation; while on the other Sen. Ted Cruz' top staffer, the group Heritage Action and others insisted Republicans stay with a simple message: "kill the bill." 
The emails also lay bare an unheard of breach of Capitol decorum: Aides to Cruz, a junior senator, are working actively to undermine the work of the House Majority Leader to provide insurance for sick Americans during a six month gap in the implementation of Obamacare.
More details at the link. Lots more.
I didn't bother to read them all. This much was enough.  No surprises.
I feel bad for the GOP in the same way I feel bad for a family with a relative with substance abuse or anger management issues. You really want to help, but there is really nothing to be done until the individual with the problem somehow gets to the point they want to change.
The sad part is that in the case of Washington we are not talking about someone either immature of off his meds. This is a case of otherwise sincere, well-meaning adults trapped in the same group-think that animates cults.


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