Thursday, July 30, 2009

Health Care: Etiology of a Medical Crisis

According to many people, we are in the midst of a health care crisis. As evidence, people cite the large number of uninsured -- up to 43 million according to some estimates -- and the underlying problem of skyrocketing costs. Only higher education has increased at a rate comparable to health care in the past 30 years. But why has this happened? And does it constitute a crisis?

Health care vs. health insurance
Insurance exists to cover catastrophic costs that the insured would not otherwise be able to afford. If your house burns down, you are suddenly without anywhere to live and, in all probability, you still owe the mortgage on your house. If you die, you leave your family with burial expenses and the problem of making ends meet without your income. Home insurance and life insurance cover these two eventualities by paying a large sum in the event of tragedy, while collecting smaller amounts from a number of people who will never suffer the loss (but who cannot know this in advance).

Health insurance is quite different in that it covers not only extraordinary, expensive medical costs, but also routine costs -- going to the doctor for a sore throat, a flu shot, even a regular checkup. There is no way that you are going to save much money by having someone else pay bills that you know you are going to have to pay. At best, you can realize some savings by being part of a collective with greater purchasing power. However, this comes at an extraodinary cost: it sets up a perverse set of incentives that pull you and the insurance company in opposite directions. For the insurance company, the incentive is to restrict coverage as much as possible. They make money by charging more than they pay out, so it is natural that they will want to limit the occasions on which they have to pay. They have responded by creating special lists of doctors that you must see, tightly controlled lists of procedures that they will cover, and onerous requirements such as forcing you to see a primary care physician to get approval before visiting any specialist. You, on the other hand, have virtually no reason not to seek medical assistance on every occasion. You pay only a small fraction of the actual cost of either the care or the medicine that you receive, so naturally you are going to use this service far more than you would under other circumstances. Usually, the insurance companies have the upper hand, but they can be forced to expand coverage, for example through the law that requires mental health coverage.

The other medical insurance
The perverse set of financial incentives in health care is exacerbated by another problem: malpractice insurance. Large medical malpractice judgements may or may not be common, but they have certainly driven up the costs of malpractice insurance, especially for doctors in certain fields such as obstetrics. They may pay $100,000 or more per year; and although I don't know how much they make, I would have to think that this is a significant fraction of their salaries. Doctors have responded by practicing "defensive medicine," i.e. ordering tests for every conceivable problem. Some of the possibilities may be rare in the extreme, but the doctor is at least protected from lawsuits. The unfortunate part is that the patient has little incentive to reject these tests, because he pays little or nothing for them. In fact, the patient is rarely even consulted; the doctor simply orders the tests to protect himself.

The illusion of preventive care
Some politicians, including President Obama, seem to believe that we can cut health care costs drastically by ordering even more preventive tests and thereby catching problems before they occur. While these tests are certainly cost efficient *for thost patients with the condition*, they are not always cost efficient over the whole population. Only a small fraction of people, perhaps 0.1%, are going to have a given condition, and the money saved on treating those people must be weighed against the costs of testing many healthy people. Besides, 80% of an individual's health care costs are incurred in the last two years of his life, when his body is overtaken by a number of weaknesses at once. Screening people can only save on the other 20% of health care costs, if that.

End game
And here's the thing: there is virtually an infinite amount of money to be spent prolonging a person's life. There is always more research that can be done to discover new cures and new treatments. As long as the money is there, companies will invest. The newest treatments may only have a tiny chance of being successful, but, if you are not limited by financial considerations, who would not want to get them and possibly extend their lives?

At my wife's graduation many years ago, then-First Lady Hillary Clinton gave the commencement address. She cited the story of a young girl with some devastating illness who had used up her insurance's maximum lifetime payout of $2 million, and still was not well. Her mother called every other insurance company she could trying to get coverage. In rejecting her, one representative explained, "We don't insure burning houses."

For Clinton, this was the ultimate insult: sick children are not burning houses. While the comment was insensitive, however, it gets to the root of the health care problem. There is an infinite amount of money to be spent trying to prolong people's lives, but only a finite amount of money available. Somehow, we have to make decisions about when to cut off the supply. Ironically, if Clinton had her way and universal coverage were instituted, the girl would almost certainly have received less care than she already had. The government cannot afford to spend $2 million on every person. In every country with government health care, even basic operations, such as hip replacement surgeries, are rationed, so that people have to wait a long time to get them. More exotic, cutting-edge treatments would have very little place in such a system.

The image of insuring a burning house also nicely captures the confusion that exists in the public mind between health care and health insurance. Of course a company is not going to offer to sell a terminally ill patient health care -- that is the road to bankruptcy, at which point it would no longer be insuring anyone. Nor would a government provide indefinite health care for the terminally ill. Eventually, they would be left to die as best they can, as most of us are at one point or another (those who don't die suddenly, that is). But because people associate health insurance with health care, and therefore with basic things like broken arms and colds, the idea of being without health insurance seems heartless.

The way out
Democrats frequently complain that our health care system is a market failure. Spiraling costs are indeed a failure, but not of the market. The present system of employer-provided health care was not a market phenomenon, but was started in WWII as a way of providing coverage to more people. The AMA successfully fought national health coverage and accepted the current system as preferable, although not perfect. But tax breaks for employers are the root of our current problem. Because it is so much cheaper for employers to provide health insurance than for you to do it yourself, you'd be crazy not to take advantage of the insurance provided by your company. The problem is that you then have no choice. Oh, you may have the choice of an HMO or PPO plan, but your choices are very limited, and they always come from a single provider -- you have no option to shop for better coverage from a different insurer. Your employer makes decisions about choosing an insurer based on things that are best for him: cost, of course, and creating an attractive package that will attract employees, and offending the fewest possible employees. But the person actually using the service gets no choice. Tying health insurance to the employer has also created the problem of "pre-existing conditions," because you have to chance health insurance every time you change jobs. If it were not for the special tax break for employer-provided health care, you could buy insurance yourself and keep it as long as you wanted.

The solution is simple: end tax breaks for employer-provided health care. This is probably impractical, so the next-best thing is to provide the same tax breaks for individuals who buy their own insurance. You could choose from any of a number of insurers, and you could shop for a plan that suited your needs. To cut costs, you could choose to buy actual insurance rather than a health plan disguised as insurance. You could have a deductible so large that you would have to pay for routine doctor's visits, but not for major surgery or in-patient care. This is the sort of option I have on my automobile insurance. If my car gets in a minor accident, I can afford to pay $500 or $800 to have it repaired. If it gets totalled, however, I don't have the money for a new vehicle, especially if my current one is not paid off. I keep my premiums low with a $1000 deductible, so that I have to pay for all the minor accidents. This gives me an incentive to drive carefully and to decide if a minor scrape really needs fixing or whether I can live with it. I can rest easy, however, knowing that I will be covered if the car is wrecked beyond the point of usability. Individuals with health insurance could make the same choices. It might seem prohibitively expensive to visit the doctor without insurance coverage, but consider that you and your employer are probably paying $1000 or more a month for you and your family. If you were able to cut that down significantly, you could easily afford a few doctor's visits now and then and still come out ahead. As an added advantage, you wouldn't have to resent the fact that you are subsidizing hypochondriacs who go to the doctor every time they sneeze and pay only a $10 co-pay. You would have more incentive to take good care of yourself through diet, exercise, and home medication.

What about routine checkups? Well, what about them? Somebody has to pay for them -- you don't honestly think that you get them for free now, do you? If there are people truly too destitute to afford routine checkups, I would certainly be in favour of providing them government subsidies so they could get care. I would even support government subsidies to support basic medical care -- which we already have, incidentally, in the form of Medicaid. What I don't support is the government taking over the health care system so that everyone gets shoe-horned into the same health care package. It is not only bad for the economy; it is not only bad for medical care; it is also, and above all, bad for freedom. Everywhere the government has taken over health care, it has trended toward outlawing private practice, forcing everyone into the same system. And once you are dependent on the government, the government will be making key decisions about who gets what kind of care and, ultimately, who lives and dies.

Wednesday, July 29, 2009

Cowboys

Kids still played "Cowboys and Indians" when I was growing up. Westerns were not as popular then as they were in my parents' generation, but they were still common, especially on tv. (At one point in the early 1970's, almost all of the top prime-time shows were westerns.) I had a complete outfit, with boots, vest, chaps, and hat, and of course six-shooters without orange tips. On the other hand, I've never seen my kids or any of their friends play cowboys and Indians -- I think they would look at me funny if I suggested it to them. I suppose it's not pc to portray this sort of struggle, even in play. Heck, you can't even sit "Indian-style" anymore -- now it's "criss-cross applesauce." If I were an Indian, I would be happy if people acknowledged borrowing cultural things from me. I guess it would have to be "Native-American-style," however, which no one will bother to say (although it's only two syllables longer than criss-cross applesauce).

(The problem with the phrase "Native American" is that it is really clunky. I suppose it is intended to emphasize that they got here before other people from the old world, but their must be a better way. Couldn't they find some Algonquin word that indicates original inhabitants? Even "aboriginals" would be preferable.)

Anyway, cowboys have gone out of style as kids' heroes. They are alive and well, however, as adults' heroes. If you listen to country music, you might get the impression that cowboys are still out wrangling cattle just as they were 100 years ago. In many cases, male singers refer to themselves as cowboys, or female singers refer to men as cowboys. (There doesn't seem to be any female equivalent, but that's okay: I get the feeling that women like the idea of men being cowboys as much as the men like pretending.) It's not a new phenomenon. Jerry Reid sings, "It all adds up to more than this cowboy makes" in "She Got the Gold Mine" (1982), and Hank Williams croons, "I like to ride my hog and to shoot my gun/You know a cowboy's work is just never done" in "Women I've Never Had" (1980). You can find lyrics to this latter song at -- where else? -- www.cowboylyrics.com. Toby Keith's "I should've been a cowboy" makes it sound like he could have chosen the profession of cowboy instead of country singer. I actually thought this was the case when I was growing up, listening to "Mammas, Don't Let Your Babies Grow Up To Be Cowboys." That song was so influential that I wonder if it didn't start the trend.

I find this all a little weird. I can deal with people calling themselves "cowboys" ironically, a little self-deprecating way of saying that it is make-believe, but I've heard it so much that I can no longer think this is the intention. They don't mean it literally, of course; it's used to designate a real man, as opposed to a sissy city-slicker. "You're the only cowboy here tonight," Toby Keith has two girls saying to him in "I'm Not As Good As I Once Was." And when Gretchen Wilson sings, "Bring on those cowboys with their pickup lines," it contrasts with the "little boys" who "fall apart" on seeing her in tight jeans ("I'm Here for the Party"). Still, sometimes I just wish they'd accept that we live in the 21st century. Cowboys are only slightly more real that knights in shining armour, and none of these singers is one. What we have instead are rhinestone cowboys, and I prefer those who acknowledge the fact. As Hank Williams Jr. sings in the song, "Texas Women": "I'm a country ploughboy, not an urban cowboy." Now that I can accept.

Tuesday, July 28, 2009

Gates, Boxer, and Race

I have never found Chris Rock funny, but this video certainly is:



It's actually not new, but it seems appropriate at this time. Professor Gates might have saved himself some trouble if he had watched it. I should add that I am not the adoring fan of police that I once was. Police are generally out to do their job, which is to enforce the law, but they are also in a position of power that it is easy to abuse. I don't think, however, that they systematically discriminate against blacks; as in the video, they discriminate against people who challenge them. And, although I don't always like it, I can't really blame them: the world is a dangerous place, and they do not want you to show any signs of putting them in danger.

Since we're on the subject of racial profiling, it was heartening to see Harry Alford stand up to Barbara Boxer last week when she attempted to make an argument on the basis of race. In defending the Waxman-Markey bill, she put forward statements by the NAACP and 100 Black Men of Atlanta in favour of it (her other exhibit was against the bill). Alford, chairman of the National Black Chamber of Commerce, complained that she was being "racial" and "condescending" to him. On The O'Reilly Factor, Bill O'Reilly defended Barbara Boxer to the extent that he said her opposition to Alford came from her liberal views, not any racial motive. O'Reilly is correct, but he misunderstands Alford's point: why did Boxer cite specifically black groups in support of the bill when Alford appeared before the committee? Would she have done so with a white witness?

Pretty clearly not. Before being interrupted by Alford, she began to say, "So clearly, there is a diversity of...", probably with the intention of finishing her sentence "...opinion in the black community." She was trying to show that other blacks favoured the bill. After Alford confronted her, she said in her defense that "If this gentleman were here, he would be proud that he was being quoted." Apparently Alford should give the citation of a black man more credence because it would make him proud? I didn't follow her logic on that point, but I followed Alford's: that Boxer was not arguing against him so much as setting him up as a dissident in the black community. He was right to call her out on it.

Sunday, July 26, 2009

Marxism

I admit to being something of a Marxist. I've always preferred Groucho. Karl wasn't funny at all -- much too long-winded. His only one-liners were "workers of the world, unite" and "religion is the opiate of the masses." But try using those at amateur hour and see if you get any laughs.

I've seen almost all of the famous Marx brothers' movies, but I honestly can't remember much of them at all. (Two scenes that stick in my head: Harpo irritating the guy at the lemonade stand, and Groucho declaring war because of an imagined slight.) This weekend, I watched A Night at the Opera, which is considered one of their best. And, I'm sorry to say this, I didn't find it very funny.

Am I losing my faith as a true Marxist? Honestly, I've always liked Groucho the best, Chico pretty well, and Harpo not at all -- I put up with him because I have to in order to see the others, but he's really irritating to me. I also don't care much for the musical scenes. Chico can actually be amusing on the piano because of his funny hand motions, but Harpo on the harp is just harp playing -- not at all funny, and not particularly interesting to me. Even some of the wisecracks are nothing more than lame puns.

I did laugh on many occasions, because I love that dry wit. There were just long periods between the good jokes that I didn't find very funny. I think I would enjoy seeing Groucho do You Bet Your Life, because I suspect that his impromptu jokes are the equal of anything in the movies, and probably funnier for being unexpected. Well, I've ordered Animal Crackers from Netflix, so we'll see if that one amuses me any better.

Saturday, July 25, 2009

Breathe-Right

I snore horrendously. At least, I used to before I got a CPAP, a machine that basically blows air up my nose so I can breathe while I sleep. Before the CPAP, I resorted to Breathe-Right strips. These are a little smaller than bandaids and about the same colour. Unlike bandaids, they are quite stiff. When you press one on across the bridge of your nose, it pulls up the outside of your nostrils so more air can get through. Do they work? Well, I got a CPAP, so obviously they weren't sufficient. On the other hand, I still use them regularly along with the CPAP, so I do think they help.

For a long time Breathe-Right strips came in two sizes: small/medium, and medium/large. This is functionally the same thing as having small and large, but I suppose it allows people with large noses to console themselves that they are really medium. This changed recently, however; now it is small/medium and large. The small/medium now also says, "fits most people" or some such language. I guess people who weren't sure about their nose size were buying the large ones and were unhappy about it. Thus ends one attempt to avoid offending people.

I was happy the last time I bought these because they finally had a decent generic brand. There have been generic versions of Breathe-Right strips for years, but never any good ones. The ones from Wal-Mart had a fold right in the middle. If you understood my description of how they work, you will see that this defeats their purpose: they don't pull up on the nasal passages because of the fold. This design is so bassackwards that I wondered whether it was an attempt to get around the patent protection of Breathe-Right. Perhaps they figured they could sell something that looked like a generic version; perhaps they even thought that their version would work, although I can assure you that it did not. So when I found an actual, functioning generic version of Breathe-Right, I was happy because I was sure that the patent protection had finally run out, and I could save a lot of money in my quest to get a good night's sleep.

Monday, July 20, 2009

Obama's citizenship

Since I just saw a news clip about President Obama's citizenship, I suppose the issue is still alive, and I'd like to add my two cents. I've read any number of conservative columnists saying that this is a dead end and that it is fodder for nut cases. I agree on both counts, but neither means that it isn't a real issue. It's probably a dead end because I can hardly imagine a circumstance in which Obama would be turned out of office, and it is fodder for nut cases because this is the sort of thing they thrive on. But I'm still not convinced that there isn't a problem here.

I'm an historian, and I'm used to making historical judgements on the basis of less evidence than I have seen presented in favour of Obama's birth in Hawaii. If he had lived 200 years ago, I would be pretty well convinced that what he asserted is true. But this case is quite different, because Obama is alive and well, and could easily release his birth certificate and end all speculation. Releasing an image onto the internet is clearly not the same thing. Could he get a passport with that image? No. So why should he be allowed to become president on the basis of it?

The strange thing is that Obama is taking a certain amount of heat in public opinion by stonewalling on his birth certificate, and he is spending money defending himself in court cases in order to avoid presenting it. Why would he do that? I have read one conservative commentator suggest that he may be using it as a distractor to keep a portion of his opponents off of the real issues. If the heat ever gets too serious, he could just present the birth certificate and prove that he was right all along, making his opponents look like idiots. That strikes me as an unusually subtle political tactic, but it could be true. Or perhaps there is something else embarrassing on the birth certificate that he does not want released. I have no idea what else could be on there, but maybe there is something -- maybe it lists religion, for example.

Whether a ploy, to cover up some other information, or because there really is a problem with the birth certificate, none of it really matters. I think every president should be required to present their birth certificate prior to taking the oath of office. Probably Obama really is an American, but there could be some future case that is less certain. Shouldn't this be standard operating procedure?

I refrain from making too big an issue out of it because I believe it is futile -- unless a court makes Obama show his birth certificate, he is not going to; and if he doesn't have to show it, the vast majority of people are going to believe him. That said, I can't see why he should not have to present the birth certificate; and, although the evidence indeed seems to point to his being born in Hawaii, I will remain uncertain until I see better proof.

On the subject of his religion -- another matter of great dispute in spite of strong evidence in one direction -- I discovered this weekend that my parents both believe he is a Muslim. I don't, but I don't think he is really a Christian, either. It seems pretty clear that he attended Jeremiah Wright's church in order to get street cred in Chicago rather than because he had a sincere religious attachment to the church. The fact that he could pretend not to know Wright's radical viewpoint in spite of having been in the church for 20 years shows how seriously he must have taken the message. And then he could say that it was impossible to disown Wright, only to disown him a week later after Wright made another incendiary speech. No, Obama was no follower of Wright in a spiritual sense. He has all the earmarks of an atheistic liberal intellectual. Mind you, I don't particularly care what religion he is -- he could be a Southern Baptist, a Muslim, or a Buddhist, and I would still disagree with almost all of his policies. But I think it's a charade that few people accept to say that he is a Christian.

Sunday, July 19, 2009

ATM fees

I often get gas at a station called Wawa, which is undoubtedly one of the dumbest names I've eve heard for a store. On top of the pumps, the store has been running ads for their no-fee ATMs. One of them shows a man saying, "I saved $175 last year," and the other shows a woman saying, "I saved $24.50 last month." The ad states at the bottom that this is based on an typical ATM surcharge of $1.75.

I'm all for saving money on ATMs, but these amounts are ridiculous. $24.50 in one month? That's 14 withdrawals, or nearly once every two days. I can't imagine a circumstance in which you would need to withdraw cash every other day. Some people may get paid as frequently as once a week, so I could see an argument for that many withdrawals (I don't even average that much), but why every other day? Even the other example, $175 per year, is pretty bad -- 100 withdrawals means more often than once every 4 days, or about twice a week. If there is a reason that you would need to make that many withdrawals, I'd like to hear it.

My bank, by the way, does what I regard as the sensible thing and reimburses customers for up to a certain dollar amount each month. That makes perfect sense: they are saving money from not having individuals coming to one of their tellers or using one of their ATMs, so it is reasonable to encourage the customer in that line of behaviour. In my case, I would use it anyway, since the bank is out of state. My wife and I got tired of changing bank accounts every time we moved, so we just picked one with a generous ATM policy and make all our deposits by mail (or, recently, by computer).

Thursday, July 16, 2009

Miniwheats

My whole family likes Miniwheats. Tanya introduced me to them back when we first got married, and I am hooked. Now, original Shredded Wheat is one of the more disgusting culinary inventions that I know of. It's just a brick of knitted wheat-based fibers that look like they are ready to be made into a burlap sack, and taste that way. They tried to improve on this at one point by making a cereal called Miniwheats -- not the same as the present version, and I don't even think you can find them anymore. These were simply smaller bricks of unflavoured wheat fiber, each one still too big to fit in one's mouth. Then someone at Kellogg's got a brilliant idea: why don't we make them so small that you can actually spoon them into your mouth like other cereal. Genius!

They called the new cereal "Bite-sized Miniwheats." And then they went totally crazy and put sugar on them. I don't know why this took so long, since every other cereal is full of sugar. These were "Frosted Bite-sized Miniwheats" -- today simply Miniwheats. The great thing about this cereal is that it tastes quite sweet for the amount of sugar on it, because all the sugar is on the outside where you can taste it (and, if you're like me, you make sure that the sugar side always goes directly on the tongue). Coating is an easy way to get flavour without all the bad things (calories) that go with it. Another food that takes advantage of coating is salted nuts, which are not nearly as full of salt as you might think. Soups are the exact opposite: all the flavouring gets mixed thoroughly, so you have to have a lot of anything to experience its flavour. That's why soups are full of salt -- usually over 100% of your RDA, sometimes 200%. Even low-salt soups are still pretty salty compared to other foods, but they don't taste that way.

Recently they have added some additional Miniwheat flavours, such as strawberry and blueberry. I actually like these quite a bit, but I had to laugh at the official flavours: it's not just "blueberry," it's "blueberry muffin." As though the cereal has anything in common with blueberry muffins other than the blueberries. It's obviously a marketing ploy, and one that works, too, at least on my kids. Alex was telling me how much he loved the cereal. "At first, Mom just said it was blueberry," he explained. "And I didn't want that. But then I read the box and saw that it was blueberry muffin!"

Thursday, July 9, 2009

Microwave popcorn

I just bought some microwave popcorn. I got the one that says, "No Diacetyl Added," because the last thing I want is popcorn with extra diacetyl. Yuck! I'm surprised the government hasn't banned it yet.

By the way, uh, what is diacetyl?

Ah, yes, consulting Wikipedia, I find that diacetyl -- also known as "biacetyl" -- is the chemically known to scientists as butanedione. It is a byproduct of fermentation, and, as such, occurs naturally in alcoholic beverages; it is also present in butter, and is therefore used as flavouring in artificial butter products. Apparently, people who work in factories that manufacture artificial butter flavouring can get a nasty lung disease from inhaling this chemical over a period of years.

The only consumer ever to be diagnosed with the same lung disease ate two bags of microwave popcorn per day for ten years; the air in his kitchen had levels of diacetyl comparable to that in factories. I can therefore eat diacetyl-laced popcorn (and other products) in perfect serenity. The funny thing is that this popcorn is the decadent stuff -- butter popcorn, not butter-flavoured -- so I don't know why they would need to add artificial flavouring anyway. But I guess if roast beef needs to have beef flavouring added, butter needs to have butter flavouring added.

Palin's resignation, explained

An article in the Wall Street Journal today goes a long way to explaining Sarah Palin's resignation in terms that not only make sense, but actually agree with why she said she did it. She was being harassed by so many Freedom of Information Act requests and trivial ethics investigations (according to one article I read, she had been acquitted on all 15 of them so far) that she didn't have time to do her job. Resigning was therefore the best thing for Alaska, even though she knew it would hurt her politically.

I can't prove this is correct, of course, but it fits both with the facts and with what she said in her resignation speech; and, by Ockham's Razor, it seems like the best explanation until someone can prove something different. Even otherwise supportive conservatives have been critical of her decision to step down, and Rich Lowry goes so far as to say that her stated reason -- it was for the good of Alaska -- is absurd. Mr. Lowry should be ashamed of himself, not for being critical of her decision, but for giving no credence to her own reason. Granted, that reason may not have been apparent, but you would expect at least the benefit of the doubt from someone who claims to support the conservative movement. It seems that Palin has divided America into two categories: those who think she is the best thing since peanut butter, and those who can't stand her. (I fall into the former category.) No one has a moderate view.

Palin's biggest failing seems to have been that her speech was awful. I didn't see it, but I believe those who say it was. One wonders why she didn't make her reasons more explicit, but I'm sure people would have found things to criticize even then -- why shouldn't she fight? Why back down from the challenge? But if we believe her, it wasn't about backing down or fighting; it was about doing what was best for Alaska. I suspect she will have more to say about it in the future, and this gives me hope that she isn't resigning for completely personal reasons (which would suggest retirement from politics in general).

Wednesday, July 8, 2009

Mark Sanford

I can see why Republicans want to get rid of Mark Sanford: he's an embarrassment. But I can't see why Democrats would have any objection to what he did. After all, it was just about sex. (And love, and marriage, and faithfulness, and some other things, but nothing about government.)

I can see, however, why Sanford would not resign. A better question would be, why would he? If he resigns, he admits that he screwed up in a big way, and his political career is over. If he doesn't, maybe his career is over, but maybe it isn't. Already his story has been pushed off the front page by Sarah Palin's resignation, and who knows what else will happen between now and 2010 or 2012. People have a way of forgetting things. I don't mean anyone will forget his affair entirely, but its importance will surely diminish over time. By 2012, Republicans might be begging Sanford to run for president. They might not, I admit; I'm just saying it is a possibility. If he finishes out his term honourably, he could go out reasonably popular; and if there are major problems, such as the recession continuing for several years, people may start to regard his governorship as a golden age and his affair a trivial matter compared with urgent matters of state. In either case, what does he gain by stepping down? He has already done all the damage to his marriage that he possibly could, and his political career is going nowhere if he resigns.

Tuesday, July 7, 2009

Safety first?

The primary school across the street has a sign up that reads, "Have a safe summer." Now, I've got nothing against safety, but is that the best thing they could wish you? How about a happy summer, or a good summer, or a fulfilling summer? Somewhere along the line, safety became the highest good (especially for children), and everything else is a matter of personal choice. The state won't do anything to keep kids in traditional two-family households, but God forbid if you should fail to strap them into a carseat until they are 7 years old, or let them jump on a trampoline without proper safety precautions, or try to let them play with any of a vast array of toys that have been recalled because they pose some sort of safety risk.

Just to be clear: I don't think the government should be in the business of telling families how to raise kids. If parents want to get divorced, I think it is unfortunate, but I don't oppose government sanctioning of it. What I don't understand is why that should be so uncontroversial, yet hardly anyone blinks when the government tries to regulate things that affect children far less than divorce. The death of a child is always a tragedy, but it will always happen, regardless of what kind of precautions we take. The question is, where do we set a limit on a child's safety, the limit beyond which parents are not allowed to transgress? Is it enough to say that everyone agrees that safety is important, whereas moral concerns are a matter of opinion? In a way, I think that this is actually the cause of our society's safety obsession: because we aren't allowed to say anything about morality, our child-protecting sensibilities have all been displaced onto physical safety issues. But clearly not everyone views safety the same way -- if we did, we wouldn't need laws about it. If a child seat decreases the chance of a child's death by .001%, should we require all children to use them? Why not require that houses be built without stairs, that families with toddlers be forbidden to have knives, and let's get rid of those dangerous bathtubs while we're at it -- the kids can all get sponge baths to be on the safe side. If we could demonstrate that eliminating stairs would improve safety more than car seats, would people insist on it? Of course not, because it seems like an absurd intrusion into people's lives. In my view, however, car seat laws are no less absurd. Parents take chances with their kids all the time; any one of a hundred things could cause serious injury or death, but we leave it to them to decide which risks are worth taking.

The ironic thing is that some aspects of parenting are demonstrably more damaging to children than lack of child seats: for example, being raised by divorced parents. Oh, they may be less likely to die (by some tiny fraction of a percent), but they will be very likely to grow up less well adjusted, less educated, and earn less than their non-carseat-using peers whose parents remain married. If anyone were to put the matter as a straight either-or -- would you rather take this chance of a child's death in a car accident, or this enormously greater chance of a child's maldevelopement through a disrupted home life -- any sane person would take the physical risk. Again, I don't favour telling parents not to get divorced. In my view, the state exists (in civil matters, anyway) to regulate agreements among people, not to tell people what agreements they have to make. To me, however, this is all the more evidence that the state should stay far away from telling parents how to raise their children, even on what may seem to some self-absorbed individuals as the uncontroversial question of personal safety. Not because safety is unimportant, or because we should take no notice at all of child abuse; but because there are higher goods than safety, and because we have gotten to the point of regulating more and more trivial things that can easily be left to individual discretion without any risk of a mass destruction of life.

Monday, July 6, 2009

Sarah Palin's resignation

If people think that resigning from the governorship hurt Palin's chances for the presidency in 2012, I agree with them. That was my first thought when I heard about her resignation. If people think that Sarah Palin resigned from the governorship in order to run for president in 2012, however, I think they're nuts. With all the abuse she (and especially her family) has taken in the last year, I don't find it in the least bit remarkable that she would want out of public office. I am disappointed, I admit: she is the most remarkable conservative politician I have ever seen, with the possible exception of Ronald Reagan, and I had high hopes for her future. I'm not convinced that she's out of politics forever, but this move certainly puts a future presidential run further into the future. But why assume that that is her goal? Journalists don't seem to understand that Sarah Palin is a person before she is a politician. She hasn't been training for political office since high school; things just happened that pushed (or pulled) her in that direction. I think I would have a hard time turning down a chance at the national political spotlight, but I don't have five children, including one special needs child; and, of course, my family has not been through the hell that hers has.

I wish Sarah Palin the best in whatever she chooses to do, and if that means something other than politics, that's okay with me. My only regret will be the sad lesson that it is possible to drive a normal person out of politics by shameless personal attacks. When people wonder why all politicians are egotists, they should consider what has happened to Sarah Palin and ask themselves: who else but egotists could put up with all of it? It's especially sad for Palin because she didn't ask for it. She wasn't groomed, like Al Gore, for the presidency from the time she was little. She became a hit on the national scene because she connected naturally with voters, not because she had a carefully built-up image to present. It's easy to apply superlatives to the latest thing that has happened, but I don't think I'm guilty of presentism when I say that the venom directed against Sarah Palin was unprecedented in its intensity, and that it has been the saddest display of liberalism in my lifetime. Liberals like to say that conservatives are the party of hate, but they are always having to stretch the evidence to make their point -- it may not sound like hate, but it is if you understand the code -- or even to invent lies (remember the fake story about someone shouting "kill him" at a Palin rally last year?). What liberals did to Palin is a far clearer demonstration of their own hate than anything they could put on conservatives, angry white males, or poor white trash. They are a bitter bunch, liberals, and I can only pray that people will come to recognize their posturing as the apostles of goodness for what it is.