Tag: cabaretic

Much as credit card companies have charged exorbitant interest rates in the period leading up to the passage and enactment of reform, so too have prescription drug companies added more cost to their already prohibitively expensive products.  Afraid that health care regulatory legislation will cut too heavily into their soaring profits, the industry feels no shame, nor any compulsion to give heavily burdened consumers much of a break.  This is a side of the debate that has not gotten the same attention as other areas and one that I have tried to bring to light quite frequently, being that I myself stand to lose quite a bit if out-of-control price increases are not sharply curtailed.  I do not deceive myself into thinking that I am the only one who stands to lose.  Though I do not mind invoking personal experience if it facilitates greater understanding and urgency, I wish it didn’t take the anecdotes of the chronically ill to impress upon a skeptical public the importance of health care reform.          

On the subject of psychotropic medication, something of which I am an amateur expert, I have closely monitored new classes, types, and formulations of prescription drugs in a desire to find the best way possible to treat my condition.  For every new medication that breaks new ground, wins approval by the FDA, and is then prescribed by GPs and psychiatrists across the country, it is a never-ending source of frustration for me to observe the three new offerings which are merely slightly different formulations of existing medications.  This is a covetous process undertaken mainly to reap maximum profit when older scripts are on the verge of losing patent status and thus being offered as generics.  For example, the anti-depressant which is the most recent addition to a family of medications known as SSNRIs has been marketed under the name Pristiq.  Pristiq has a very similar chemical structure and as a result works only slightly differently from an existing drug in the same school, Effexor, that has been around for over ten years.  Sometimes, however, even generics occasionally have limitations.  Though a lower-cost equivalent to Effexor exists, the less-expensive form has been reported to work not nearly as effectively as the name brand formulation.

An article in today’s New York Times reports on Big Pharma’s side of the story.

But drug companies say they are having to raise prices to maintain the profits necessary to invest in research and development of new drugs as the patents on many of their most popular drugs are set to expire over the next few years.

That may be, but before one gets misty-eyed listening to the woe-is-us violin, rest assured that the pharmaceutical industry isn’t exactly hurting for business.  Conveniently they don’t mention the larger picture.  Another example of this kind of infuriating slight-of-hand is the sleep aid Ambien, which has had a sufficient generic alternative for a while.  A relatively new formulation dubbed Ambien CR produces an only a slightly different reaction, mainly by time-releasing the absorption of the drug into the blood stream.  The drug is the same, but the gimmick is different.  Returning to psychiatry, it is either a testament to how little we know about the function of the brain or how unwilling we are to risk radical change that the medications used to treat depression, anxiety, bipolar disorder, and schizophrenia have broken only relatively limited ground in decades.  The best treatment for depression are still a class of powerful anti-depressant known as a MAOI inhibitors, which are close to fifty years old.  They are rarely prescribed, however, because taking them requires strict dietary restrictions that, if not adhered to, can result in serious damage to the body and, in extreme cases, even death.  In treating bipolar disorder, some patients still respond best to Lithium, which has been used in treatment for over a century, but extensively since the Fifties.    

Newer medication often cut down side effects and make the period of adjustment less painful, but do little to increasing the stated objectives of the drug, namely to drag people out of depressive episodes and set them on a course towards health and functionality.  Experimental trials are often plodding affairs proceeding at the pace of a snail, targeting a relatively limited area of the brain, and unwilling to take any unnecessary chances.  Despite this, some medications do pass muster and do end up being taken by who are suffering in the hopes of providing relief.  Even so, the drug makers and those who formulate them sometimes fail to take into account such crucial details as major side effects in a rush to get out the next big thing.  SSNRIs like Effexor, for example, are infamous for producing absolutely awful issues when someone stops taking it.  Though not strictly classified as such, one might even say that such drugs are addictive because the brain acts violently when the medication is discontinued.  These serious matters somehow never find their way onto the commercials on television or the ads inside glossy magazines.  

The difference in cost between name brand and generic drugs is quite vast.  Often it is a matter of several hundred dollars for a one month supply, though it can be as high as a thousand dollars or more.  As one might expect, those with employer-based or individual plans paid for out of pocket have to pay substantially higher co-pays for name brand drugs.  When I had private insurance, the co-pay for generic medications was $10 and for name-brand drugs, it was $60.  Sometimes I had no choice but to take a name-brand medication, which are often treated by insurance companies as something bordering on cosmetic and not essential, when the fact of the matter is that they are highly necessary and highly unavoidable at times.  

Those who don’t have the luxury of private insurance, of course, have it rougher.  Those who have to rely on Medicaid find that they have no choice but to settle for generic medications when a name-brand drug would be a much better fit and work much more effectively.  Medicaid programs vary, but in the state of Alabama, the most expensive medications are only covered if a doctor or specialist one can provide proof that at least two lower-cost alternatives have failed or been insufficient to treat the condition.  Not only must they have failed, one must also work within the confines of a 90 day coverage window.  If a claim to cover a more expensive medication is not filed within 90 days of failing the requisite two medications, then coverage is not granted.  This is ridiculous in lots of ways, mainly that few medications used to treat mental illness work quickly, and many take weeks upon weeks before any psychiatrist or doctor can make a judgment either way.  It’s also ridiculous because it uses a broad brush of convenience, painting all illnesses as basically the same and all treatment regimens as similar.  Some name-brand medications, regardless of the need are not covered at all, since whomever set up the system decided that covering it would unnecessarily drain the General Fund and that it was an unnecessary prescription in the first place.      

Returning to the Times column,

But the drug makers have been proudly citing the agreement they reached with the White House and the Senate Finance Committee chairman to trim $8 billion a year – $80 billion over 10 years – from the nation’s drug bill by giving rebates to older Americans and the government. That provision is likely to be part of the legislation that will reach the Senate floor in coming weeks.

But this year’s price increases would effectively cancel out the savings from at least the first year of the Senate Finance agreement. And some critics say the surge in drug prices could change the dynamics of the entire 10-year deal.

Those who trust Big Pharma do so at their own peril.  

Additionally, The news broke today that, quite unsurprisingly, much misinformation exists surrounding the Public Option™.  As Politico points out,

The debate has placed disproportionate emphasis on the creation of a government insurance plan, raising the expectation that everyone could ditch their employer-provided coverage and enroll in the public option.

But that won’t happen, at least not at the start. The reality is that only about 30 million Americans – 10 percent of the population – would even be eligible.

It could be accessed only through a new insurance marketplace known as an exchange, where consumers would shop for plans. Only certain categories of people could use the exchange: the self-employed, small businesses, lower-income people who qualify for tax credits to purchase insurance and those who are otherwise unable to find affordable private coverage.

This might deflate the hopes of supporters and pacify opponents, but since so much of this debate has been a three-ring-circus based on raw emotion and faulty logic, I sincerely doubt it.  However, as proposed, it is interesting to note that the Public Option™ would be more like Medicaid than anything else.  My hope is that we do not make the same mistakes with the current bill as we do with existing systems it seeks to augment or replace, particularly those in red states who likely would opt-out altogether if provided the opportunity to do so.  Though at least red state residents would presumably have the fall-back of Medicaid, provided they could qualify, the framework is based on ignorance and tunnel-vision of an almost incomprehensible degree.  One cannot simplify the complexities of humanity, nor its diseases, which are as multifarious as its people.  

Returning to the treatment of mental illness, what is often not cited is the disconcerting fact that often African-Americans and Latinos respond much less favorably to medications used to treat the condition.  This is a contentious topic with lots of disagreement, but the argument some advance is that cultural stigma factors in to a very large degree.  If minorities feel shamed or guilty about seeking help for psychiatric needs, they are much less likely to engage in medical research.  Furthermore, many believe that therapy is a more viable option than medication.  Often it is difficult to make any kind of pronouncement when the truth is obscured by so many different interrelated factors.  And though one can easily make a case for mental illness, one could also make a case that minority and low-income residents might be less inclined to visit a doctor for a more run-of-the-mill ailments as well.    

The lifetime prevalence of major depression in the United States is estimated to be 16.2 percent, with considerable social and role impairment evident in the majority of patients. Previous studies found only minor differences in depression rates among African Americans, Latinos and whites. But various studies have found patients from lower social economic groups often have less access to mental health care, are less likely to be prescribed and to fill prescriptions for new antidepressants and are less likely to receive care beyond medications when compared to whites.  

This fear and anxiety so many have that resembles to these eyes a case of St. Vitus Dance may not have any basis in reality.  Doesn’t matter how good the system is if no one uses it.  God forbid everyone in this country have a high standard of living and good health.  As the article points out, minorities and low-income citizens often have the highest need for quality care and are apt to put off seeking help until the pain becomes intolerable.  That these are the people most likely to be eligible for enrollment in the government-run (gasp) option, those now building it from the ground up would do well to consider its target audience.  We speak out of our own privilege when we assume that somehow the Public Option™ will directly affect us for better or for worse, when the poor and less fortunate will be the ones who either reap its rewards or suffer from its limitations.  While it is true that middle class individuals and the reasonably affluent have struggled under the yoke of skyrocketing health care costs, I recall going in that I assumed the changes needed and intended were meant to appeal to our tired, our poor, our huddled masses yearning to breathe free.  Somewhere along the way this became all about us.        

Flying under the radar to a large extent is Congress’ attempt to reform and regulate our country’s financial system.  The yeas and nays are quite predictably divided along party lines and several powerful entities who stand to lose from reform have, of course, loudly registered their complaints.  Thus far, the going has been slow, in part due to internal Democratic party squabbling and a failure to find consensus among high ranking committee members of different parties.  Despite this, it is far more likely that something soundly sweeping and resolute will arrive from fiduciary legislation than the hyper-politicized, emotionally overwrought, and contentious Health Care bill now currently dwelling in a state of hopeful limbo.  This is in part due to the fact that the struggle to reform monetary policy doesn’t hold nearly the same degree of attention in the eyes of the public.  Yet, as would be expected, allegations have surfaced claiming that certain crucial legislators actively involved in the process have deep pockets and a willingness to court conflict of interest-bearing accounts.          

We often refer to corruption as though it is some relatively recent development unique to our times.  This is part of our compulsion to assume that we live in the worst of all possible worlds and that the past promised a purity never to be regained in the modern age.  Not so, not so.  Looking behind us a few decades, if not a few centuries, will reveal a wealth of similarities between these days and others.  Though the scope of lobbyist influence and dubiously ethical campaign contributions are the latest bone of contention and face of evil, the basic concept has never changed.  In particular, the story of the Second Bank of the United States and its dissolution can prove to be instructive.  Established following the War of 1812 to shore up the value of the dollar, curb inflation, and to manage the nation’s massive debt incurred after the conclusion of a conflict with no clear winner or loser, the Bank of the United States achieved its stated purpose, but like so many financial fixes it also provided short term success and long term woe.  

After the war, despite the debt, the United States also experienced an economic boom, due to the devastation of the Napoleonic Wars. In particular, because of the damage to Europe’s agricultural sector, the U.S. agricultural sector underwent an expansion. The Bank aided this boom through its lending, which encouraged speculation in land. This lending allowed almost anyone to borrow money and speculate in land, sometimes doubling or even tripling the prices of land. The land sales for 1819, alone, totaled some 55 million acres (220,000 km²). With such a boom, hardly anyone noticed the widespread fraud occurring at the Bank as well as the economic bubble that had been created.[3]

–Source:  Wikipedia.

It should be noted that the Bank of the United States was not a national bank owned and managed by the United States of America.  It is fortunate that the term “socialism” was not coined until a few years later, else its opponents lob that charge in its direction.  It was, instead, a privately held banking corporation that happened to be the repository of the entirety of federal tax revenues.  As one might concede, the massive amount of control, influence, and capital it had over the federal government as a result sent Jacksonian Democrats into a tirade.  However, the bank’s National Republican supporters stood firm.  That genius public speaker, living legend, and intransigent Jackson opponent Senator Daniel Webster of Massachusetts was on retainer as the bank’s legal counsel and was also Director of its Boston branch probably made absolutely no impact upon the proceedings, nor did the fact likely influence his allegiance.  That several other Congressional leaders periodically received large loans from the bank in exchange for their votes, since extending the bank’s charter required periodic congressional resolution was also an inconsequential, trifling matter.    

Eventual Chief Justice and Dred Scott decision maker Roger Taney served as Attorney General and Secretary of the Treasury under Andrew Jackson before winning confirmation.  His own recollections of the workings of the Bank are as pertinent and revealing now as they were then.  In particular, Taney noted how a congressman sworn to oppose the institution one day cast a rather surprising vote in its favor the next.  As it turned out, the Bank granted him a loan of $20,000 on generous terms, no small sum for the 1830’s.  Instead of coming down harshly on the congressman, Taney takes a more philosophical stance, attempting to understand the power of rationalization and the inner workings of the mind rather than overt moralizing.    

Now I do not mean to say that he was directly bribed to give his vote.  From the character he sustained and from what I know of him I think he would have resented anything that he regarded as an attempt to corrupt him.  But he wanted the money, and felt grateful for the favor, and perhaps thought that an institution which was so useful to him, and had behaved with such kindness, could not be injurious or dangerous to the public, and that it would be as well to continue it.  Men when under the influence of interest or passion often delude themselves thoughtlessly, and do not always acknowledge even to themselves the motives upon which they really act…It was one of the dangerous arising from the mammoth money power, that its very duties as collecting and disbursing agent brought it constantly in contact with members of Congress and other public functionaries and made it acquainted with their wants and enabled it to place them under obligations and create a feeling of dependence and even gratitude without the direct and offensive offer of a bribe.  

 

-Source:  Dorman B. Eaton

The North American Review, Vol. 135, No. 310 (Sep., 1882), pp. 197-219

To backtrack a few decades, one needs to understand the mistakes of the First Bank of the United States and how its failure influenced the construction and formulation of the Second.  Then, as now, economists were split as to the ways to revive the economy and shore up the system to prevent future failures.  Recessions, as evidenced by our current one, have a multitude of causes and a combination of events in tandem are what dictate severity.  Predictably, economists are often split along ideological faults since political allegiance dictates where one assigns blame.  It is another instance of wishful thinking on our part to assume that some school of thought or occupation deeply rooted in politics and indebted to allegiance might either rise above or be utterly unaffected by partisanship.  What few can argue, however, are the facts.      

In the summer of 1818, the national bank managers realized the bank’s massive over-extension, and instituted a policy of contraction and the calling in of loans. This recalling of loans simultaneously curtailed land sales and slowed the U.S. production boom due to the recovery of Europe. The result was the Panic of 1819…[4]

-Source:  Wikipedia

Most economists agree that this was the first instance where a market based economy in this country began its inevitable cycle of boom and bust.  What transpired as a result of this Panic were that many people lost substantial sums of money, unemployment soared, and it took years for the country to dig its way out.  Returning to the present day, each time a recession or severe economic downturn hits, there is always a renewed push among some to favor specie (gold or precious metals) over paper currency.  Recently, Ron Paul and many Libertarians proposed a return to the Gold Standard and to a solid backing of debt rather than the speculative system now in place.  This same distrust of monetary policy led President Jackson and his followers to be initially suspicious of the Second Bank and when instance after instance of corruption and quid pro quo came to light, he vowed to kill it, and through force of will and stubbornness, he inevitably did.  

A sweeping example of uncompromising executive power, Jackson’s act also ushered in the pervasive and persistent notion of populism, whereby the desires of the monied elite were pitted against those of the exploited masses.  The President’s supporters initially cheered the decision to dissolve the Bank as a victory for the average citizen.  His opponents grumbled amongst themselves and made the first efforts to form their own party, one which would be known as the Whigs.  However, it needs noting that the only thing truly unifying them together was hatred of a common enemy in the form of Jackson.  The never-healed, nor resolved deep fissures within the Whigs proved to be their undoing, and the party had relatively modest success on a national stage, eventually dissolving and being absorbed into the new Republican party around the time of the Civil War.      

An unforeseen consequence of the demise of the Bank was a destabilization of the entire financial system which contributed to another Panic, this one beginning in 1837.  Some scholars assert that had the Bank been allowed to stay in existence, what became a five year recession would not have occurred in the first place.  Others believe that the decision had a minimal impact and that other trends and causes were to blame.  Still, the lesson to be learned from this is that, despite the undeniable scope of unethical conduct perpetrated by politicians, making a change too sweeping without a firm sense and understanding of how to skillfully and lastingly rebuild a house of cards on sounder ground is bound to have negative consequences.  Financial systems in our modern economy are beholden to trends, currents, cross-currents, and influences that are both complex and completely in flux at all times.  We have seen recently the destruction of unilateral decisions made impulsively and how their detrimental impact lasts well beyond the tenure of person who put them into place.    

Establishing sufficient regulation and sufficient safeguards have serious limitations because of the way the system is structured.  The value of almost every commodity is up for debate and one need only consult the exchange rate between foreign currencies to observe that.  At this moment, the value of the U.S. dollar is changing value slightly, but nonetheless notably from second to second, minute to minute, hour to hour.  Provided our markets and other world markets happen to be actively trading, this is to be expected.  No amount of well-meaning legislation will prevent another recession, unless it proposes a credible way to address human fallibility.  However, this does not excuse complicity with the very entities reformers and regulators seek to hold accountable for their actions, either.  What this does mean is that financial reform needs to start with an educated guess that will undeniably have to be revised over time.  Greed finds a way to reassert itself, but so do the flaws in a supremely complicated system beholden to influencing events no one can predict ahead of time.  Some will guess correctly and some will guess incorrectly, but the best strategy is to be adaptive rather than punitive.

For a time, finding a middle ground with stated opponents was the concept of the hour, advanced by a young, idealistic President who seemed to really believe that a Washington, DC, set in its ways was ready to come to the table in a spirit of fellowship.  I seek not to be the latest to declare the effective end of a noble experiment or to register my frustrations at the true believers of the pratice, but rather to encourage the concept where, as Thomas Jefferson wrote, reason is left free to combat it.  Like so many revolutionary ideas, finding that which unites is not a passive endeavor and requires a equal proportion of self-reflection and sweat.  Indeed, it is this same effort that must be undertaken by each of us if we are to develop effective vaccines to combat racism, classism, sexism, and other infectious diseases, while knowing full well that they will mutate with time.  If only research and development could be a term-limited matter, but alas, it is not and may never be.        

Much partisan and ideological nastiness comes from simple misunderstanding, one which assumes that surface differences define the whole.  A country as large in area and diverse in population as ours could hardly be expected to adopt or develop a kind of overall uniformity.  Even countries a tenth the size of ours possess a variety of dialects, religious identifications, customs, and means of expression.  Face value is skin deep.  

As Politico’s Glenn Thrush writes,

Rep. Heath Shuler (D-N.C.) has bucked Nancy Pelosi on nearly every vote – including health care – and is said to dwell deep in the Pelosi doghouse.

But he had nothing but kind words for the speaker during an appearance in his district this week – telling a meeting of high school students she was “the most misunderstood person in Washington,” according to the Asheville Citizen-Times.

“She’s very misunderstood,” the congressman said. “She’s a devout Catholic. Don’t get in a Bible discussion with her.”

Religious expression in the South is a very public matter, as are open confessions of faith.  Indeed, I do not cringe internally or grow uncomfortable when I hear scriptural references invoked to underscore larger points or become offended by those who profess their faith in Christ, but I know some from North of the Mason-Dixon line who do.  Regarding my own greater understanding, had I not deliberately befriended others who had grown up with different cultural expectations and practices, I would not have been able to correctly understand their notable discomfort and might even have assumed that Northerners as a bloc were strictly secular or that they all spoke and believed with one voice.  One such a strongly held misconception exists among some in the South, asserting if one takes a certain controversial stance, like say, the right of a woman to choose to terminate her pregnancy, one cannot possibly be religious or possess any spiritual grounding whatsoever.        

Abraham Lincoln pointed out this irony in his Second Inaugural Address, given shortly before the end of the Civil War.  Who better to address this issue than a man born in a border state, Kentucky, which held divided loyalties during the conflict.  Though Lincoln himself led the eventually victorious Union forces, several of his wife’s close relatives were Southern sympathizers and many took up arms in the service of the Confederacy.  This left Mrs. Lincoln open to charges that she was either a Confederate spy or a traitor, charges that while unfounded, were nonetheless easy to make.  The Washington of their time was also a city of split personalities, indebted to both Eastern and Southern culture.  Lincoln’s remarks that muddy day in March have application to any protracted struggle where both sides of a conflict claim sole ownership over the moral high ground and direction of the debate.      

Neither anticipated that the cause of the conflict might cease with or even before the conflict itself should cease. Each looked for an easier triumph, and a result less fundamental and astounding. Both read the same Bible and pray to the same God, and each invokes His aid against the other.

Sixty years prior, our third President had emerged victorious in what had been the first, but certainly not the last contentious election for the highest office in the land.  As a child of the Enlightenment, he advanced a school of thought common to those times whereby a belief in logic and rationality could by themselves suffice to end religious intolerance and resulting persecution.  Though the theocracy so many fear has never taken firm root in American soil, Thomas Jefferson’s focus was on a virulent strain of this same repressive attitude that might find firmer footing and a breeding ground on our shores.  In his first Inaugural Address, which I have quoted earlier in passing, Jefferson sought to unify a nation which had, within just four Presidential election cycles, become a two-party nation in flagrant disregard of the wishes of its creators.  

Let us, then, fellow-citizens, unite with one heart and one mind. Let us restore to social intercourse that harmony and affection without which liberty and even life itself are but dreary things. And let us reflect that, having banished from our land that religious intolerance under which mankind so long bled and suffered, we have yet gained little if we countenance a political intolerance as despotic, as wicked, and capable of as bitter and bloody persecutions.

As for these times, we are justified in registering reservations and in so doing, refusing to be railroaded or ignored.  We are well within our rights to apply steady pressure and fight for our causes.  However, if we wish to make the Democratic party a more perfect union, rather than the disorganized, dysfunctional family it often resembles, it will require more than sloganeering, sweeping pronouncements, and digging in for the inevitable siege.  Behold, a Blue Dog sticking up for the oft-reviled Speaker of the House!  Will wonders never cease?  A slightly different way of looking at supposedly unresolvable differences led a member of our party from a different school of thought to assert strongly and unequivocally that, though the packaging and wrapping may be different, commonality exists.  That which one is accustomed need not blind us to see friends and allies not immediately like us or, worse yet, to confuse, as Jefferson wrote, differences of opinion which are not differences of principle.  The shovel-ready projects in front of us require us to do more than propose and purchase the needed tools.  We must also dig into the earth, for it is only then that we can move mountains.  

This holiday, which denotes the eleventh day of the eleventh month was once called Armistice Day, as it marked the end of hostilities during World War I.  It is unfortunate, in my opinion, that our collective memory of that conflict grows fainter and fainter with each passing year, since it marked the exact instant we grew from a second-tier promising newcomer on the world stage to a heavy hitter.  The European continent had threatened to blow itself up for centuries before then, but with a combination of ultra-nationalism and mechanized slaughter, millions upon millions of people perished in open combat.  Our entrance into the war and world theater turned the tide but the original zeal that characterized the war’s outset had become a kind of demoralizing weariness that our fresh troops and tools of the trade exploited to win a resounding victory.  Our industries revived Europe, making us wealthy in the process, and though much of this wealth was lost in The Great Depression, precedent had been set.  When Europe blew itself apart once more in World War II, their loss was our gain.          

A year ago today I was at Mount Vernon, enjoying a day off at George Washington’s home, taking in the iconic and beautiful view of the Potomac river.  Along with the steady stream of tourists like myself were servicemen and women from every branch of the Armed Forces.  A ceremony at our first President’s tomb commemorating the bravery of all who had served was to be held mid-day and, deciding I’d watch it for a while, I began moving in the direction of the Washington burial plot.  What ringed the tomb was often more interesting than the main attraction.  Case in point, the burial site of the estate’s slaves, which had been given posthumous mention, though the names, dates of birth, dates of death, and individual stories had long since been lost to posterity.  I mused a bit that this was how most Americans living today felt about the Great War.    

The scene struck a discordant note with me in another way.  It’s the same on-one-hand, but on-the-other-hand kind of conflicting emotional response that underlies my thinking about war and those who engage in it.  If I am to follow the teachings of my faith, war is never an option to be considered for even half a second.  Indeed, if it were up to me, I’d gladly abolish it from the face of the earth.  However, I never want to seem as though I am ungrateful or unappreciative of those who put themselves in one hellish nightmare situation after another as a means of a career and with the ultimate goal to protect us.  It is this same discomforting soft shoe tap dance that I take on when I pause to give reverence to the memories of those who established and strengthened our nation, while recognizing too that they were indebted to a practice I consider deplorable.

I would never describe hypocrisy as a kind of necessary element in our society, but a “do as I say, not as I do” quotient that seems to be commonplace in our lives does merit recognition.  For example, quite recently a friend of mine who had lived in France for several months was describing to me the cultural differences in attitude towards sex in our culture versus theirs.  Here, we are indebted to a hearty Puritanism which shames those who engage and scolds those who make no attempt to conceal.  Yet, we still think nothing of eagerly consenting to casual sex and our media and advertising reflect this.  As it was explained to me, in France, sex is everywhere, no one feels as though a highly public display is the least bit out of place or vulgar, no one feels guilty at its existence, but they are much less inclined towards hooking up with complete strangers or faintly known acquaintances than we are.  It is certainly interesting to contemplate whether we’d sacrifice the right to one-night-stands or the promise of frequent escapades if after doing so we would henceforth face no repercussions of guilt and strident criticism for daring to see sexuality as something more than a weakness of willpower and a deficit of character.  One wonders if we would sacrifice achieving something with nearly inevitable consequences attached for the sake of not getting what we want whenever we want it.  The trade off, of course, being we would no longer have to feel dirty or ashamed for having base desires.    

I mention this paradox in particular because the national past-time these days might be the sport of calling “gotcha”, particularly in politics.  The latest philandering politician is revealed for the charlatan he is and our reactions and responses are full of fury and righteous indignation.  “How dare he!”  Granted, one party does seem to act as though it has a monopoly on conventional morality, but if it were my decision to make, I’d drop that distinction altogether, else it continue to backfire.  Yet, this doesn’t mean we ought to take a more European approach, whereby one assumes instantly that politicians will be corrupt and will cheat, so why expect anything otherwise.  Still, we ought to take a more realistic approach towards our own flaws and the flaws of our leaders instead of adhering to this standard of exacting perfection which has created many a workaholic and many a sanctimonious personal statement.  To the best of my reckoning, we must be either a sadistic or a masochistic society at our core.  Perhaps we are both.        

It is easy for us to make snap judgments.  I have certainly been guilty of it myself.  Taken to an extreme, I can easily stretch the pacifist doctrine of the peace church of which I am a member. I can imply that military combat of any sort is such an abomination that everyone who engages in it is beholden to great evil and deserves precisely what he or she gets as a result.  This would be an unfair, gratuitous characterization to make.  Though I do certainly find war and warfare distasteful, I prefer to couch my critique of the practice in terms of the psychological and emotional impact upon those who serve and in so doing speak with compassion regarding those civilians in non-combat roles who get caught in the middle and have to live with the consequences.  Likewise, I would be remiss if I dismissed the role George Washington played in the formation of our Union if I reduced him to an unrepentant slaveholder and member of a planter elite who held down the struggling Virginia yeoman farmer.  Moreover, I could denigrate the reputation of Woodrow Wilson, whose leadership led to our victory in the First World War, by pointing to his unapologetic beliefs in white supremacy and segregation.  I could mine the lives of almost everyone, my own included, and find something distasteful but somewhere along the line we need to remember that hating the sin does not meant we ought to hate the sinner, too.  

The conflict swirling around us at this moment is just as indebted to paradox as the sort which existed during the lives of any of these notable figures in our history.  John Meacham wrote,

…[T]he mere fact of political and cultural divisions—however serious and heartfelt the issues separating American from American can be—is not itself a cause for great alarm and lamentation.  Such splits in the nation do make public life meaner and less attractive and might, in some circumstances, produce cataclysmic results.  But strong Presidential leadership can lift the country above conflict and see it through.

This is what we are all seeking.  While I am not disappointed by President Obama, I see a slow, deliberative approach to policy that is alternately thoughtful and exasperating.  I certainly appreciate his contemplative, intellectual approach, and can respect it even when I disagree with its application.  One of the paradoxical tensions that typify the office of Chief Executive or any leadership role, for that matter, is the balance between power and philosophy.  Meacham again writes,

…Politicians generally value power over strict intellectual consistency, which leads a president’s supporters to nod sagely at their leader’s creative flexibility and drives his opponents to sputter furiously about their nemesis’s hypocrisy.  

If ever was a national sin, hypocrisy is it.  It is the trump card in the decks of many players and it is used so frequently that one can hardly keep track of the latest offender.  If it were not everywhere and in everyone, it would not be such a familiar weapon.  Even if one has to split-hairs to do it, one can always locate hypocritical statements or behaviors.  Politics can often be an exercise in pettiness, and the latest bickering between Republicans, Democratic, liberals, center-left moderates, conservatives, and center-right moderates have morphed into this same counter-productive swamp of finger-pointing.  It is this attitude which keeps voters home and leads to further polarization.  Securing Democratic seats and a healthy majority in next year’s elections will require rejuvenation of the base but also inspiring moderate and independent voters to even bother to turn out to the polls.  What this also means is that we ought to learn how to forgive ourselves for our shortcomings and recognize the humanity in our opponents as well.  A scorched-earth strategy works for the short term, but it also guarantees a ferocity in counter-attacks and leads to long-term consequences only visible in hindsight.  By all means, fight for what one believes, but eschewing tact and diplomacy is the quickest way to both live by the sword and die by it.  I’m not suggesting toughness or steel-spines ought to be discarded, but rather that we all have weaknesses of low hanging fruit that make for an easy target, and the instant we eviscerate our opponent by robbing their trees, we should soon expect a vicious counter-attack in our own arbor.        

The political news streaming out of Washington, at least as reported by the major outlets, already casts a large, ominous shadow promising nothing but inevitable disappointment and tension headaches.  By strong implication, the ultimate effect produced no matter what health care bill is passed by both chambers and then signed into law will be that of bitterest disappointment.  The irony, however, is that no matter the outcome, whatever results from negotiation and finds its way onto President Obama’s desk will be deemed either insufficient or detrimental in the minds of both liberals, moderates, and conservatives alike.  I suppose I was of the silly opinion that success had many fathers while failure was an orphan.  That a bill so desperately needed could be so reviled, rather than revered upon enactment, (and, need I mention, years before it will even be fully implemented and tested for effectiveness) speaks to how we seem to judge winning and losing these days.

As Paul Simon wrote,

Laugh about it

Shout about it,

When you’ve got to choose,

Every way you look at it, you lose.

Regardless of one’s political allegiance, the Health Care Reform bill will be rightly deemed beneficial or detrimental when it is more or less fully integrated into the existing system.  It is at that point, which might be as long as five whole years from now that we will be able to make a credible judgment for ourselves as to whether or not it works.  Until then, we are merely gaming on probabilities and resorting to that eternal bane of every cagey politician:  speculating about hypotheticals.  Although hammering out the intent of the bill is highly necessary, our fiercest criticisms should be saved for much later down the road.  My thoughts now pivot to the words of the Civil War historian Shelby Foote, who, when discussing his opinion as to the root cause of that divisive conflict, stated,

“We failed to do the thing we have a true genius for, compromise.  Americans like to think of themselves as uncompromising but it’s the basis of our democracy, our government is founded on it; it failed.”

To highlight another current issue, some are already pronouncing the stimulus package either an outright failure or a disappointment, but the truth of the matter is that its impact is simply not as bombastic and instantly transformative as many of us were expecting.  A vast majority of the funds have not yet even been dispersed or spent and many others are tied up in bureaucratic red tape.  The lesson to be learned is that government works very slowly, it is heavily indebted to the status quo, and that no matter what promises of change are made, one must work within the established parameters of the system.  This does not mean, however, that in seeking massive reform that we had unrealistic expectations going into it.  Ideals are the only way that anything gets formulated and brought to the floor.  

Change will come to Washington, but the pace is not proportional to our anticipation of it.  We live in a lightning-quick, impulsive, short-attention span world fed by media but this is absolutely nothing like the world in which our elected representatives dwell.  Most people I know find C-SPAN to be an effective anti-insomnia cure and not edge-of-one’s-seat entertainment.  One of my friends chose to study international politics rather than American politics because in other countries, one was apt to see scenes of excitement and upheaval on a frequent basis:  coup d’etats, violence in the streets, huge rallies, transparent espionage, and moments of high drama.  In recent memory, with the notable exception of the 1960’s, one rarely observes such things here, and even then the unrest didn’t reach the fevered pitch of say, the Prague Spring.  By contrast, we are indebted to the example of our English forebearers whose one and only revolution produced a short-term attempt at Parliamentary democracy, an equally short-lived de facto military dictatorship, and then a prompt re-establishment of the monarchy, albeit with a few democratic concessions granted to English citizens.  Our own revolution did not, quite unlike the French, take on a radical component that attempted to sweep aside almost all established conventions in the process.                  

Some are quick to pronounce Americans as either center-right or center-left, but I think center by itself would suffice.  Most people, if asked, would probably identify themselves as moderate.  We are a centrist nation, by in large, and one which looks upon both unabashed liberal strains and conservative strains with a great degree of suspicion.  Our fear of radicalism and/or reactionary elements is hardwired into our DNA.  Most Americans are not inclined to march in the streets or to take on activist roles.  Being left alone to their own devices might be the attitude of a vast majority.  Regarding health care, what will probably be signed into law will be a slightly left-leaning proposal that contains concessionary measures to moderates while preserving a few key demands of liberals.  Love it or hate it, this is just how Democracy functions within a pluralistic society.  When Mussolini took control of Italy as a dictator, the saying goes, the trains ran on time like never before, but then again, the barrel of a gun has a persuasive power that an attack ad never does.    

Lest one think otherwise, I don’t want to seem as though I’m happy with accepting crumbs when promised a lavish dinner.  Certain elements of the House bill really trouble me, particularly the anti-abortion amendment tacked onto it as a means of placating anti-choice legislators.  Still, the place for changing minds and disseminating ideological stances is ours, not theirs.  The role of the politician is, as stated, to best represent the beliefs of his/her constituency.  If our stated duty is enlightening and educating the ignorant, then we might take this huge flap over health care as a reference point of where we need to allocate our resources and the strategies we propose to use to accomplish it.  We are not immune to the need for reform, either, and though we might make a living off of rocking other peoples’ boats, we need someone to rock our own every so often, too.    

When it comes down to brass tacks, people in positions of authority seem often to be indebted to one of two sorts of leadership styles.  Some are devotees of the process school, whereby one embraces wholly a highly regimented and specific system, and in so doing does not deviate from it for any reason.  Process managers doggedly cling to a prefabricated strategy until resolutions and goals are finally reached.  Other people are of the idea/visionary school, and for them the big picture and a more creative means to an end are far more important.  While process people are frequently exasperating to idea people and vice versa, what is often forgotten is that there is a need for both of them in the big tent.  However, when the organizational structure of a political party is overwhelmingly dominated by process politicians, the discrepancy between the two is not only jarring and highly visible, it is also demoralizing and insipid.    

Many of us would prefer a more dynamic leader in charge of both the House and the Senate.  I am among the many who appreciate a scrappy fighter who loves hand-to-hand combat and will not be bullied or cajoled into submission by anyone.  Within the Democratic party a few names fit that profile, but their overall limitations in leadership capacities keep them from reaching a wide audience.  For whatever reason, both Nancy Pelosi and Harry Reid—perhaps Reid more than his House colleague—are beholden to process and the minutia of their jobs more than inspirational speeches, long range planning, or dramatic legislative success.  In contrast with President Obama, who is the consummate big idea politician, they both look tepid and dull by contrast.  When the base clamors for red meat, they are instead provided with bloodless Democratic leadership.  Thus, it is any wonder that approval ratings for Congress and for both the Speaker of the House and the Senate Majority Leader are exceptionally low?  Nor is it any wonder that Harry Reid is facing the fight of his life in 2010 and that Nancy Pelosi has proved a huge disappointment to those who, like me, welcomed the arrival of the first female Speaker?  

Having read the news today, I did note that with the passage of the House’s version of Health Care Reform Pelosi was forced to twist some arms and hurt some feelings, one notices this is hardly a role she relishes and one she performs only when absolutely necessary.  She and Reid both seem to prefer behind-closed-doors private negotiation and shrink from direct confrontation.  If I believed in that sort of methodology or in its inerrant ability to achieve results, I would be less skeptical, but I know that a balance between recklessly throwing forearms and elbows and sweet talk is what usually translates to legislative success and does not create enemies in the process.  Forgive me for believing that political people-pleasers might consider alternate careers as well as those who try to be everything to everyone.  Compromise ought to be empowering, not debasing.              

What we might want to ask ourselves is why so many process legislators exist in the Democratic party in the first place.  One explanation is that they were forced to take the path of least resistance while out of power for twelve years and in so doing concede ideological territory to the Republican majority.  Post-1994, the party was at its weakest point in decades and hardly fired up and ready to go.  Back then, Barack Obama was an obscure law professor who had yet to run for a single elected office.  Though certainly no one at that point would have ever speculated in print or in conversation as to whether or not the Democratic party was dead, to many of us, it did certainly feel that way.  Democrats shifted to a prevent defense kind of strategy, whereby they sought to stem the  bleeding and in so doing, ensure that the liberal stalwarts and left-leaning centrists did not get voted out.  What this did, however, is concede the middle to the Republicans, who continued to make steady, solid gains with moderates and independents.  Years of failure and failed policy cannot be easily overcome by two successful election cycles.  To be sure, ideology and party identification calcifies slowly but once set, it is difficult to melt away.    

Although this is now 2009, you’d scarcely notice it if you examined the conventional wisdom of the, need I state the obvious here, majority party.  It’s one thing to play like one is behind, but it’s quite another thing to not act like one deserves to be number one.  At the moment, the Republican party may be in tatters, but one cannot deny that there is a certain defiant spirit to the right-wing base at the moment that I never saw in the aftermath of 1994, nor even in 2002.  That it took a charismatic, genius public speaker with an inspirational message combined with highly incompetent incumbent President to bring that perfect storm to Category 5 status reveals some very key limitations within our goals and expectations.  Electing a President promising transformational reform is not sufficient.  We must also elect stronger, better, more effective Representatives and Senators, too.  We know, now more than ever, that a President can propose anything, but he or she cannot vote and cannot through force of will break up logjams or counter the inertia of committee and counter-productive partisan posturing.                        

Process is beholden to policy wonkery and, rest assured, I do not deny the importance of knowing the existing framework, also.  The best Senators, for example, are masters of that chamber’s rules and in so doing utilize their encyclopedia knowledge of said fact to push legislation in the direction they feel is best.  However, process can also result in stubborn inflexibility and a wanton disregard towards changing course when what is being tried clearly is not working.  Process individuals often feel utterly rudderless and lost when their carefully formulated theories prove insufficient or ill-equipped in a changing environment.  Complacency in any form is anathema to any movement or any organization.  What some fail to understand is that reform is a constant process with no end because those who oppose reform constantly redraw the battle lines to suit their own desires.  My own hope is that we may have recognized finally that letting things get this bad for so long provides us with challenges so large and so looming that even getting the minimum passed and enacted provides a supreme challenge.  Had we not buried our head in the sand all these years, our plates and portions would be of much more manageable size.  Above all, we cannot and must not ever assume for an instant that victory is owed to us based on moral high ground or that any battle can be won so conclusively that we have nothing else to do but swap combat stories and reminisce about the good old days.        

This morning I spoke at meeting to deliver a vocal ministry that, once it had fully formed in my consciousness, I knew would likely not be received with accolades.  Because I believe that the only way to keep forward progress and to foster growth is to at times make light of hard truths, I did not sugarcoat my message.  Having been raised in a Christ-centered tradition that was decidedly not Quaker, I recall many sermons over the years designed to call out the congregation when they had gone astray.  As such, I am a firm believer that criticism can be constructive and is not uniformly destructive in nature, even when the words themselves make waves and challenge assumptions.  This may have been my background, but I came to understand that it was not the reference point that many fellow Friends in attendance understood.  I fault them not for this.      

Perhaps I should qualify that I use as my guide the words, wisdom, and intent of Jesus.  They are, as I understand them, rarely, if ever, composed of feel-good platitudes or self-congratulatory statements.  Some of them were highly inflammatory in their day and when one contemplates the sum of their impact, one can hardly fail to recognize why Jesus was eventually crucified.  He had quite a knack for enraging the powers that be and making absolutely no attempt to smooth over his lessons and teachings with anything resembling tact or diplomacy.  Though we, in my humble opinion, ought to consider him a hero, he was a rabble-rouser in his day and in our time, those who threaten the establishment enough usually pay for it with their very lives.  Jesus did not coddle anyone and neither do I.    

When lone gunmen brutally slaughter innocent citizens on our shores, the first thing everyone runs to diagnose is motive.  Wild speculation rages as the first few confused details trickle out, which eventually are firmed up as substantive information becomes public.  The media framing implies, but can’t bring itself to mention directly, whether the psychological cost of warfare might be a deeply destructive force that erodes the emotional health of those who serve.  That, in turn, points a finger at our reliance on war as an economic tool and a political necessity.  Politicians and military contractors both push a robust military option and insist upon on the existence of many triggers eager to be squeezed.  Socialist might be the right-wing insult of the hour, but pacifist follows closely behind on the scale of damning conservative indictments.  

Two days have passed since the 2009 election cycle ended and the second-guessing and arm-chair quarterbacking has quite predictably arrived.  Everyone has a theory or a unique explanation and each is in the camp of either imminent demise or nonchalant shrugs.  I suppose I lean much more to the latter than to the former.  I have no alarmist, chilling words of caution to impart to any Democratic candidate up for re-election or election in a year’s time.  When some are questioning whether we should let up on the gas pedal, I advocate strongly for pressing down firmly and keeping it there.  We have a right to push our agenda just as strongly as Republicans pushed theirs when they were the majority, and skittish popular opinion will always exist in times where discomfort reigns and its end is not clearly visible.  That’s how humans are, particularly when they have been led to believe that good times are a birthright.  

A few of the mainstream usual suspects are already billing last night’s elections as some rebirth of the Republican party.  While many lessons can be pulled from the results, sometimes the simplest answer is the correct one.  To put it plainly–Democrats need to run better candidates next time.  Both Jon Corzine and Creigh Deeds had serious flaws as campaigners, attempted to undercut their opponent rather than provide voters a reason to vote for them on their own merits, inspired neither loyalty nor enthusiasm among Democratic voters, and the relatively low turnout of both contests reveals it.  This might be a radical idea in American politics, but last year’s Presidential election showed that if a strong candidate with a compelling message runs then enthusiasm runs high and the results are tremendously successful, to say the least, at the ballot box.  To wit, Barack Obama was the first candidate I’ve ever voted for without needing to restrain the impulse to hold my nose while engaged at the polls.    

Out here in the grassroots liberal blogosphere, I see a lot of issue advocacy:  sign this petition, promote this legislation, block this vote, speak out against this person, advance this cause, and so on.  Rarely do I ever observe a means to draft worthy office seekers for upcoming races.  I’m sure there are any number of qualified candidates out there who would be fantastic leaders and inspirational figures.  Some complete unknown today could start at a low level and eventually work his or her way up to high elective office.  I mention this in part because I know transformational visionaries are found on this site and others like it; I’ve read their essays and their comments, so I know they exist.  However, so long as they resist a call to government service or refuse to throw their hat into the ring, we will be often forced to back the lesser of two evils and deal with the long-term consequences of bad policy and losing election nights.

Obama’s coattails might not have a massive reach beyond the immediate, but perhaps instead of relying on one impressive figure as a means to sweep less compelling candidates into office we ought to perceive of the President’s historic election as a different kind of bellwether, one that compels others into service.  Perhaps it is its own kind of mandate, one that tells us in no uncertain terms that leadership is not a passive endeavor.  Lest some people discount their own gifts, American history is full of successful politicians and leaders who were much more than the sum of their parts.  Thomas Jefferson’s angelic, erudite prose shaped much of the backbone that formed the American experiment in democracy, but he was a sub-par public speaker at best and a frequently shy, underwhelming, socially awkward presence in person.  Andrew Jackson lacked rhetorical polish to such an extent that his opponents often rendered him illiterate and barely qualified to hold the office, but his shortcomings in eloquence were more than countered by a force of will and leadership strength which insured that much of his stated agenda was implemented in the course of two terms in office.  These are but two examples pulled from the past and I can invoke the names of many more if need be.            

The reasons not to be involved, to be sure, are legion and indeed I cannot fault anyone for his or her reservations.  Successful politics requires a certain kind of personality type and skill set, one that demands a thick skin, a compulsion to shift position for the sake of expediency, a constantly uneasy relationship with moneyed interests, an occasional need to head directly to the jugular of one’s opponents, and the nimble dexterity to say what one means in diplomatic language which is perfectly clear to all but not incendiary in tone.  To be sure, some have neither the skill, nor the stomach for what can be an odd combination of narcissistic and debasing.  Yet, as long as we keep saying, “I don’t know why ANYONE would be in that dirty business”, we will get exactly that which we do not need and we will continue to elect weak legislators.  I sometimes think that perhaps the antidote would be found in teaching courses to our young adults entitled “Politics 101”, which would focus on the real job responsibilities required of those called to service more than a high-minded synopsis of the system and its multitudinous peculiarities.            

Political junkies and sports fans both like to examine numerical data from almost every conceivable perspective.  Sometimes statistics exist in both areas simply for the love of statistics.  To be sure, for example, I know this morning that someone is taking yesterday’s results from one particular race, examining the raw data on a precinct-by-precinct basis and in so doing is coming up with some new fascinating means of analysis.  What is produced is often either minutia or pleasantly inconsequential, but it does serve as food for thought, in any case.  The same people who brought you such specialized stats as passing efficiency against teams in the NFC West or the number of interceptions thrown by a quarterback over the age of thirty-five are about to unleash their latest bit of creative color analysis and like you, I will read it with rapt attention.  This is political science, after all, but in observing the particulars it might be more helpful to put a bit more effort behind that which cannot be defined in voting numbers and overall turnout.  Before internalized polling, before debates, before party primaries, before party identification, before a ranking of important issues from most important to least important, before any early measurable indicator comes the individual decision:  Do I run or not?

Oh sure, I know that it’s not as simple as will alone.  The recent mayoral race in New York City reveals that one can spend $100 million of one’s personal fortune and still barely eke out a win.  Being a national player requires friends in high places, powerful boosters, an experienced inner circle and staff, and the organizational structure to get the whole process off the ground.  Even so, one must crawl before one walks, and almost everyone who isn’t independently wealthy has to toil in the relative obscurity of the minor leagues before getting called up to the big time.  Those who do run need to ask themselves if they are called to serve purely to court the adoration of the crowds or whether they owe their devotion to some higher purpose.  So long as we consider politics a thankless profession, the Barack Obamas of the world that are printed on the ballot sheet ready to be marked up or displayed before us on a computer screen will be few and far between.  I for one would like to see a blogger or two in future making his or her first tentative steps towards changing the system on the inside.  We’ll continue to work on the outside, if they’ll do their part from within.  

The current squabbling over whether or not abortion would be government funded in some kind of back door fashion accentuates how conflicted we are as a nation regarding the procedure.  When many private plans cover the procedure, I find most unfair to expect somehow that government coverage would not include the same provision in the spirit of strict parity.   If some are holding government to some kind of moral higher standard than the sainted private sector, then I guess I can’t understand why anti-choice legislators are attempting to impose their will upon a supposedly evil, fallen entity whose name is government in ways that they are unwilling to extend to business, whose radiant goodness is known to all.  This discrepancy continues to show how much of a shill certain politicians have become for the rich, the powerful, and the well connected at the expense of sense and even their own stated convictions.  

This morning’s Politico attributes the death of centrism in the Republican party to the overwhelmingly insatiable demands of the far-right riffraff.   The sans-culottes throngs certainly have pitched some pretty parades over the past few months, haven’t they?  Heads have, metaphorically speaking, rolled and more are almost certain to take their place underneath the unforgiving guillotine.  Yet, to insist that this was a movement spearheaded by the party itself would not be correct.  This summer the GOP establishment tried to harness the energy of the rabble and found that it marched to no one’s orders but its own.  

“I don’t give a crap about party,” said Jennifer Bernstone, a tea party organizer for Central New York 912, which helped to lead the anti-Scozzafava charge. “Grass-roots activists don’t care about party.”

Says Everett Wilkinson, a tea party organizer in Florida: “We are not going to allow our [movement] to be stolen by the GOP or by any political party.”