Friday, December 20, 2002

One of the more intriguing sentences, to me, in the Boston Globe's original coverage of what has become the massive scandal of abusive behavior by Catholic priests, and the coverups by their superiors, was this quote from a 1985 internal church memo:

Our dependence in the past on Roman Catholic judges and attorneys protecting the Diocese and clerics is GONE.

What I found intriguing was the implication that there was a time when the church could rely on Catholic judges and prosecutors to violate their oaths of office if it meant protecting the church.

Well, it seems the author of that memo may have been a bit pessimistic. It turns out now that the Boston archdicoese was able to lean on prosecutors to get prosecutions squelched at least as late as 1988...

From the world of medicine, we have a wonderful object lesson in the effectiveness of price-based market incentives.

The FDA requires new medicines to be carefully tested for their effectiveness; you don't get to sell a new pill unless it has definitively proven itself more effective than a placebo. However, they don't require you to prove that it is more effective than other medicines that were already on the market. So, we know that two classes of new, high-tech blood pressure medications, ACE inhibitors and calcium channel blockers, both work to reduce high blood pressure. But are the calcium channel blockers, at $500 a year, really worth the premium over the ACE inhibitors, at $250? A recent study tried to address the question --- and just for a laugh, they threw in the low-tech, old-fashioned, disfavored alternative, diuretics, generic drugs which have been around for decades, and cost $25 a year total. The envelope please?

Compared to participants who took the diuretic, the ACE inhibitor group had, on average, about two points higher systolic blood pressure, the top number in the blood pressure reading. Blacks in the group had a systolic blood pressure four points higher.

There was a 15 percent higher risk of stroke overall for the ACE inhibitor group and a 40 percent higher risk for blacks. The risk for heart failure among all groups was 19 percent higher, and the risk for hospitalization or treatment for the chest pains of angina was 11 percent higher. Further, the risk of needing a coronary bypass operation or angioplasty was 10 percent higher.

Compared with participants who took the diuretic, the calcium channel blocker group had, on average, a systolic blood pressure about one point higher and a 38 percent higher risk of developing heart failure.

Faced with this study, Homo Economicus would immediately abandon the use of the new drugs except for patients in which diuretics were themselves, for some reason, completely unsuitable. But medical observers don't expect the same behavior from Homo Sapiens:

Analysts say that the results of the government study that were announced yesterday were likely to have little effect on sales of the newer drugs, in part because drug makers will continue to urge doctors to prescribe their medicines as additional treatments for heart patients who need more than one drug to control their blood pressure. ...

Which they attribute almost entirely to massive promotional efforts by the drug companies, which puffed up the new drugs, and trashed the old generic alternatives, says one of the new study's authors, "more based on opinion than fact". In 1996, the New England Journal of Medicine featured more ads for calcium channel blockers than anything else --- and none for diuretics, as their makers have no money to spend on the ads. And the influence of big pharma spread beyond the advertising pages:

Another study, published in The New England Journal of Medicine in 1998, reviewed 70 medical journal articles that discussed calcium channel blockers and found that 96 percent of the authors who supported the drugs had financial relationships with the drugs' makers. Among the researchers who published work critical of the drugs, only 37 percent received financial support from the companies making the products.

And yet, asked to explain the situation, company spokesmen fall back on the rationality of markets:

"Physicians still are in control," said Christopher Loder, a spokesman for Merck. "Doctors will not prescribe a medicine unless it delivers value."

Which is right, to an extent --- these are well-educated, highly trained professionals, operating in their field of professional expertise. If we don't see rational behavior from these guys, how can we possibly expect it in, say, the stock market?

Thursday, December 19, 2002

The elephants in India have apparently gotten into the habit of raiding villages for booze. Skippy the Bush Kangaroo suggests that that's not so different from the rampaging elephants down in Washington. But while the pundits on safari set their sights on Trent Lott, let's not lose sight of the rest of the herd. If you aren't following along, I give you:
  • John Snow, corporate welfare queen. It seems that Dubya decided to replace his last treasury secretary with a former CEO whose major achievements were getting favors from the government, and who didn't show much aptitude for running the business; in fact, he was initially hired as a lobbyist, and had the company maintain a golf course near D.C., well used for discreet meetings with his friends in government, as a strategic asset.

    As a businessman, however, Snow was mostly a bust. He successfully lobbied to have CSX gain a huge chunk of Conrail but then botched the execution of the merger. He also managed to have Washington block a merger of the Burlington Northern Santa Fe Corp. and Canadian National Railway Co. and forestalled efforts by freight customers to obtain better bargaining terms. But all that didn't translate into much for shareholders. In the past decade, CSX's stock is off 17 percent while the S&P 500 is up 111 percent. Snow is leaving the company with more debt than it has had at any time in the past seven years. Today CSX has difficulty generating sufficient cash to meet all its obligations. And this is the man President Bush has hired to manage the nation's debt? As Jesse Eisinger sharply notes in today's Wall Street Journal: "Mr. Snow is clearly a guy who understands deficit spending."

    Such a change from Paul O'Neill.

    Joe Conason has more, including Snow's peculiar compensation package, which was set up to reward him for leaving the company to "an appointment to public office".

  • Possible Lott successor Bill Frist, widely touted as the Senate's only doctor. But he might be better known as the elephant who raided the hospitals; his more relevant medical ties are to the family business, the Columbia/HCA hospital chain, which could almost be described as the Enron of health care --- they grew like topsy on acquisitions fueled by shady business practices, with a healthy dose of fraud, some of which directly compromised patient care. For which they've been assessed $1.7 billion in fines, and counting. Then they went bust.

    Frist is also rumored to have had a role in giving Eli Lilly the get-out-of-lawsuits-free card which somehow wound up in the Homeland Security bill.

    (To be fair, Frist's partisans could argue that he wasn't directly involved very much in running Columbia. But here in Massachusetts, we're looking a little more skeptically at arguments like that these days; Billy Bulger, current President of the University of Massachusetts, and for years a State House political kingpin, routinely denied any connection to the activities of his brother, the notorious gangster Whitey Bulger, right up until a Congressional committee showed up to put him under oath. Then he took the fifth.

  • And of course, as long as we're talking about civil rights, let's not forget the guy who told Southern Partisan magazine that

    You've got a heritage of ... defending Southern patriots like Lee, Jackson, and Davis. Traditionalists must do more. I've got to do more. We've all got to stand up and speak in this respect, or else we'll be taught that these people were giving their lives, subscribing their sacred fortunes and their honor to some perverted agenda.

    (Ain't it peculiar how "sacred" drifts from "honor" over to "fortunes" in Ashcroft's paraphrase of the Declaration of Independence?) In case you've forgotten what agenda Robert E. Lee, Stonewall Jackson and Jefferson Davis subscribed to, here it is, described in the widely quoted "Cornerstone speech" by CSA Vice President Alexander Stephens before the war:

    Our new government is founded upon exactly the opposite idea [to racial equality]; its foundations are laid, its cornerstone rests upon the great truth, that the negro is not equal to the white man; that slavery -- subordination to the superior race -- is his natural and normal condition. [Applause.] This, our new government, is the first, in the history of the world, based upon this great physical, philosophical, and moral truth. This truth has been slow in the process of its development, like all other truths in the various departments of science. It has been so even amongst us. Many who hear me, perhaps, can recollect well, that this truth was not generally admitted, even within their day. The errors of the past generation still clung to many as late as twenty years ago. Those at the North, who still cling to these errors, with a zeal above knowledge, we justly denominate fanatics.

    And in case you thought that the war was about "State's Rights" and not slavery, you should know that an early, strong support for that account of the conflict was the same Alexander Stephens, in a book he wrote after the war, when slavery had been discredited.

    Ashcroft's quote is a lot more explicit and inflammatory than the remarks that got Lott into trouble. But it's not the only inflammatory remark in the interview; on the previous page, he makes a point of noting that "... many Americans believe that providing an abortion is a crime against humanity".

Now, where the heck is the wildlife patrol?

Wednesday, December 18, 2002

Yesterday, I suggested that the Bush policy of taxing the poor more to lower taxes on the rich makes sense --- if you think that the rich are the people who, by their actions, have demonstrated that they have more use for the money.

Of course, I don't think they really believe that. I do think it's transparent, open class warfare. But one of the reasons it finds purchase is that some of the comfortably well-off, whose taxes Dubya and Co. propose to lower, seem to be a bit clueless about what the lives of many of their fellow citizens are like.

For example, let's just do a quick compare and contrast between this:

The most amazing part of this last week was seeing my hometown through an immigrant's eyes, wide amazed eyes. Everything that she saw and asked me about I saw anew from her eyes. It has been quite an experience so far. ...

What has struck me the most are her observations of our wealth, something we take for granted every minute of every day of every week. Most of us live our lives thinking nothing of the choices we make. A new car? No problem. A new home? We'll go to the bank tomorrow. Should we eat out or make dinner at home?

and this:

As chief operating officer of the Greater Boston Food Bank, Carol Tienken is used to sad stories. Lately, though, the food pantries and soup kitchens throughout Massachusetts that rely on her supplies have been reporting an unusual twist: They're seeing more demand from the well-heeled. "One woman who used to work for a food pantry now [is] a client," says Tienken. "She drives up in her Volvo, and she's on the other end, asking for food."

Such stories aren't uncommon. In Phoenix, St. Mary's Food Bank is accommodating scores of laid-off Continental Airlines workers. In Atlanta, former WorldCom employees are frequenting local food banks. ...

As they always have, food banks continue to serve primarily the working poor. But it appears that laid off workers, after months of fruitless job-searching, are exhausting their unemployment benefits and pushing food-relief demand to highs not seen for at least a decade. ...

For example, "Roswell [and Alpharetta] are upper-income suburbs of Atlanta," says Barbara Duffy, executive director of North Fulton Community Charities. "But we have seen dramatic growth in need -- we see 80 to 100 families a day" -- up 40% since January.

I don't mean to suggest that the author of the first piece (Sean-Paul Kelly, writing on his generally interesting blog The Agonist) is either callous or insincere. But the way he can write in apparent ignorance of the degree of hunger in this country says something about us, and whatever it is (increasing class stratification? willful blindness? unwillingness to confront our real circumstances?), it can't be good...

Tuesday, December 17, 2002

Dubya and Co. are really taking it on the chin in left blogistan for floating their modest proposal to pay for their tax cuts for the rich by raising taxes on the poor. But think about it --- if you never had much money, you won't miss it. On the other hand, if you do have money, you grow attached to it, and it creates all sorts of problems of which the poor have no inkling.

Take the poor beset Pritzker family, wracked with dissension as movie starlet Liesel Pritzker sues her elders for "raping and pillaging" her billion dollar trust fund, leaving her bereft with a few paltry millions. Or the Bronfmans, who are seeing the art collection that they painstakingly assembled over decades at Seagram's auctioned off to pay for corporate debt. Or worse yet, L. Dennis Kozlowski and the Rigas family, who for a few trifling misjudgments have been brought so low that they must submit to the shame and degradation of flying coach.

Obviously, these are the people who need more money. You wouldn't waste it on the poor, who don't amass great art collections, but toss their money away on transitory things like food and rent.

Sunday, December 15, 2002

So, am I the only person having trouble making sense of the American media's reporting on Venezuela --- not so much testing it against reality, as just trying to figure out what they say is going on? Forget the rumors of covert coup plotting, or anything like that; the story of events on the public stage is itself either nonsense or obviously skewed.

Take this New York Times article about the business shutdowns which have paralysed the country's economy, including the critical oil business, which is a major supplier to the United States. The media of record in the U.S. are routinely describing the event as a "general strike". But a strike is an action of labor against management, and if you read through the article, the owners and managers of shuttered dry cleaners, cafés and furniture shops turn out to be strike supporters, who have chosen to shut down the businesses themselves, and speak as if it is entirely their own choice when to reopen --- which would mean that their own employees aren't striking, but have rather been locked out. (Matters are more tangled at the state-owned oil company, where upper management, installed by elected president Hugo Chávez, is trying to keep things running, but the white-collar middle managers who run the company day-to-day are overwhelmingly supporting the "strike"). And the demands of the "strike's" leaders have nothing to do with labor conditions, but are entirely political --- specifically, they want early elections, even if the country's Constitution has to be amended to provide for them.

Meanwhile, back in Washington D.C., our petroleophile administration, not ordinarily a great friend to labor movements at home or abroad, might be expected to express grave concern and call for the restoration of oil shipments and civil peace, not necessarily in that order. For one thing, the current disruption of Venezuelan oil shipments is a real strategic issue for the United States, which gets 13% of its oil imports from Venezuela. Instead, they have issued statements publicly calling for elections --- effectively, lending the full support of the U.S. government to the demands of the leaders of the general whatever-it-is, which is causing disruption of oil shipments.

Shades of the CIA-inspired trucker's strike in Chile which provided PR cover for the brutal coup by Pinochet...

Speaking of labor actions... as I write, New Yorkers are in a tizzy about the prospect of a major transit strike.

Now in Paris, this sort of thing happens all the time. I was there once a few years ago, and heard an announcement while I was on the Métro, that la ligne une was delayed to to trouble with a conducteur. My French is shaky enough that I didn't know if the reference was to people or power lines, so I was somewhat surprised to hear later that it really was one guy shutting down the line as his own particularly focused job action.

So the prissy Parisians have to deal with this sort of thing all the time. And they can handle it. And New Yorkers are worried that they can't. Are they really so frail?

Hmmm... surveying the nominations for Dwight Meredith's Koufax awards, I see I've may have garnered one. Or maybe not; the nomination was for "best idiosyncratic blog", which isn't on Dwight's list. That surprised me for a bit; I really do think of myself as trying to do mostly political commentary from a left-of-center perspective.

Then I looked at my output for the past week, and found not a single post --- not one --- about Trent Lott.

It's not that I don't care, really. I just didn't think I had anything to add to what other people were saying, and didn't see the point of adding echoes to the chamber. (Though then again, there seem to be folks around who do need to hear the message another few times before it really sinks in --- Colby Cosh, for instance, who apparently still thinks that

The argument against [Lott] generally takes the form "I know he's not a racist; I know he didn't mean it; but he's got to go anyway, because his comments are going to be used against him by the Democrats."
days after such matters as Lott's interview with a neo-confederate rag which described the Voting Rights Act as "punitive", and his vigorous opposition to the desegregation of his own college frat left even sensible Republicans acknowledging that Lott's problems were very real).

But, on the other hand, there are so many equally egregious things flying around --- the appointments of Iran-Contra sleazeballs to high posts, or the apparent coverup of Dubya's own insider trading at Harken, even as he preaches responsibility in business. It's somewhat of a surprise to me, I confess, that this thing in particular has captured public attention.

Not that I'm complaining...

Also, getting back to the awards themselves, I'm a bit surprised at the lack of attention for Jeanne D'arc's consistently thoughtful Body and Soul, and Meredith's own PLA.

By the way, the comments on the PLA "Koufax award" post, in addition to nominations, include a debate about whether the award should really be named after Koufax, a superb left-hander to be sure, but arguably not as good as Lefty Grove. I know it's a long shot, but as a Red Sox partisan, I'd like to suggest remembering a little-known left-handed fireballer named George Herman Ruth, who was on the squad in 1918, the last time they won the world series, and was one of the keys to the team's success. Not only was Ruth a superb pitcher, with a stellar 1.75 earned run average in his best year (1916, 44 games, averaging nearly eight innings pitched --- let's see a modern pitcher match that!), but he was quite versatile, hitting unusually well for a pitcher, and even occasionally playing in the outfield. Unfortunately, he left the team after a dispute with management, and apparently his pitching career ended shortly after that. I'm not really sure what became of the guy...