2009 - %3, May

Sarkozy's Climate Change Skeptic

| Wed May 27, 2009 3:11 PM EDT

The Financial Times reports environmentalists and other politicos are up in arms over French President Nicolas Sarkozy's desire to appoint geochemist Claude Allegre—a denier of man-made climate change who called Al Gore's Nobel Prize a "political gimmick"—to France's new "super-ministry" of industry and innovation:

Mr Sarkozy wants to bring Mr Allègre, 72, a freethinking, former socialist education minister, into the government in a reshuffle after next month's European parliamentary elections. The president appears to reckon that appointing someone from outside his own centre-right party will help to counter perceptions that he is a polarising, sectarian leader who decides everything himself. Several portfolios are already held by figures from the left and centre.

Alain Juppé, the former centre-right prime minister, said the appointment would send a "terribly bad signal" ahead of international negotiations to secure a successor to the Kyoto treaty on cuts to carbon emissions.

Emphasis mine. I can understand Sarkozy wanting to look like he doesn't eschew a range of viewpoints, but this is a bit like appointing Richard Dawkins to an office of faith-based initiatives. It also doesn't help that Juppé, a member of Sarkozy's own party, thinks it's a stupid way to present yourself as an open-minded leader.

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Tonight on PBS: Hollywood Chinese

| Wed May 27, 2009 3:08 PM EDT

Arthur Dong's documentary on depictions of Chinese people onscreen, “Hollywood Chinese,” will be on PBS tonight as part of the American Masters series. I saw this film last year when it made the festival circuit and enjoyed it, despite having little familiarity with Chinese culture. It had some hilariously outdated film moments, everything from Fu Manchu 'staches to John Wayne in yellowface, plus celebs like Amy Tan and Ang Lee talking about how their heritage has impacted them personally and professionally in Hollywood. Definitely worth a watch, or at least a DVR. You can read my interview with Dong here.

Rod Dreher Generously Acknowledges the Blindingly Obvious

| Wed May 27, 2009 2:40 PM EDT

Conservative blogger and columnist Rod Dreher was initially bothered by Supreme Court nominee Sonia Sotomayor's comment that she "would hope that a wise Latina woman with the richness of her experiences would more often than not reach a better conclusion than a white male who hasn't lived that life."

Then he read the context.

Dreher and other conservatives had been aghast at those 30-odd words ever since Stuart Taylor, Jr. pointed to them in a National Journal column over the weekend. At issue is the accusation that Sotomayor is, in Rush Limbaugh's words, "a reverse racist" who thinks that Latina judges have some special insight that they can and should use that makes them better than white male judges.

Sotomayor, who said those words in a speech at the University of California, Berkeley, in 2001, was actually making a very different point. Sotomayor said that, "Whether born from experience or inherent physiological or cultural differences... our gender and national origins may and will make a difference in our judging." She hoped that, in cases about "race and sex discrimination," a wise Latina's background and experiences might help her produce a better result than a white man who "hasn't lived that life." In context, it's clear Sotomayor is simply acknowledging that personal experiences inevitably affect judges' outlooks and hoping that they affect judges' decisions for the better. Having read the whole speech, Dreher explains what the broader point was:

ba-ROCK and so-toe-my-OR

| Wed May 27, 2009 2:31 PM EDT

Bob Somerby reads two front-page profiles of Sonia Sotomayor and reports back:

In the Times, Sotomayor is a person who is also Hispanic. In the Post’s formal profile, Sotomayor’s ethnicity is the headlined focus. Perhaps unsurprisingly, Goldstein’s focus on ethnicity features a peculiarly trivial, unflattering selection of anecdotes and recollections.

Meanwhile, via Steve Benen, I see that immigration zealot Mark Krikorian is fighting the good fight against pronouncing her name correctly:

So, are we supposed to use the Spanish pronunciation, so-toe-my-OR, or the natural English pronunciation, SO-tuh-my-er, like Niedermeyer? [Following up the next day:] Deferring to people's own pronunciation of their names should obviously be our first inclination, but there ought to be limits. Putting the emphasis on the final syllable of Sotomayor is unnatural in English [...] and insisting on an unnatural pronunciation is something we shouldn't be giving in to.

You know, I'm lousy at pronoucing non-English words.  If you want a nicely rolled R, look elsewhere.  But so-toe-my-OR?  Give me a break.  A five-year-old can do that.  Just like we all got used to pronouncing the president's name ba-ROCK.

This is going to be a long couple of months.

Spy Novels For Journalists

| Wed May 27, 2009 2:14 PM EDT

Alex Berenson is a New York Times reporter by day, bestselling spy novelist by night. Earlier this year, he published his third novel, The Silent Man, featuring his super spy John Wells. I came across the book at the library a couple of weeks ago and discovered that not only is it pretty good, but it's the rare spy novel for media junkies. At one point in the book, Wells assumes the cover of a Lebanese businessman/freedom fighter. To get into character, he tans at Solar Planet, dyes his hair and ODs on fried chicken. Fat and swarthy, Wells procures a fake passport to travel to Moscow to avenge an attack that nearly killed his girlfriend. His alias? Glenn Kramon, which also happens to be the name of Berenson's boss and managing editor of the Times.

I asked the real Kramon whether he knew Berenson had inserted him into the novel. Turns out he's a big fan of Berenson's novels and has read all three. When he first discovered his name in the most recent, Kramon says he "thanked Alex for not making me the villain." Kramon's is not the first name Berenson has appropriated from his Times colleagues. Kramon says his favorite is that of the book's hapless American ambassador to Russia, Walt Purdy, whose name he suspects is a hybrid of investigative reporter Walt Bogdanich and his editor, Matt Purdy. Naturally, the Times names had me wondering who else had popped up in Berenson's novels. Perhaps there's a Maureen Dowd cameo? Alas, Berenson says no. He only poaches names from people he knows, and he's never met Dowd. "I have a hunch that Wells wouldn't like her much, though," he says. "She's not his type."
 

Can the Mayo Clinic Save Healthcare?

| Wed May 27, 2009 1:28 PM EDT

McAllen and El Paso are very similar places: similar people, similiar diets, similar health profiles, both border towns only a few hundred miles apart from each other.  But healthcare costs in McAllen are almost twice what they are in El Paso.  What could possibly account for that?  Atul Gawande visited McAllen to find out, and ended up getting multiple answers from a group of doctors he went to dinner with one night.  Finally he got to the bottom of it:

“Come on,” the general surgeon finally said. “We all know these arguments are bullshit. There is overutilization here, pure and simple.” Doctors, he said, were racking up charges with extra tests, services, and procedures.

The surgeon came to McAllen in the mid-nineties, and since then, he said, “the way to practice medicine has changed completely. Before, it was about how to do a good job. Now it is about ‘How much will you benefit?’ ”

....The Medicare payment data provided the most detail. Between 2001 and 2005, critically ill Medicare patients received almost fifty per cent more specialist visits in McAllen than in El Paso, and were two-thirds more likely to see ten or more specialists in a six-month period....They also received two to three times as many pacemakers, implantable defibrillators, cardiac-bypass operations, carotid endarterectomies, and coronary-artery stents. And Medicare paid for five times as many home-nurse visits. The primary cause of McAllen’s extreme costs was, very simply, the across-the-board overuse of medicine.

....“In El Paso, if you took a random doctor and looked at his tax returns eighty-five per cent of his income would come from the usual practice of medicine,” [a hospital administrator] said. But in McAllen, the administrator thought, that percentage would be a lot less.

He knew of doctors who owned strip malls, orange groves, apartment complexes — or imaging centers, surgery centers, or another part of the hospital they directed patients to. They had “entrepreneurial spirit,” he said.

....About fifteen years ago, it seems, something began to change in McAllen. A few leaders of local institutions took profit growth to be a legitimate ethic in the practice of medicine. Not all the doctors accepted this. But they failed to discourage those who did. So here, along the banks of the Rio Grande, in the Square Dance Capital of the World, a medical community came to treat patients the way subprime-mortgage lenders treated home buyers: as profit centers.

This comes via Ezra Klein, who didn't excerpt anything from the piece because he wanted to encourage everyone to click on the link and read the whole thing.  Obviously I'm not quite so high-minded myself.  Plus there's the fact that I have a dim view of human nature: most of you guys aren't going to click the link no matter how much I tell you to, are you?

But you should!  It really is a good piece.  "Overutilization" is a boring buzzword that Gawande breathes real life into.  If you want to know why American medicine should look more like the Mayo Clinic — and why it would be both better and cheaper if it did — turn off the House reruns and read Gawande instead.  And if you want a different perspective on the same issue, try reading Shannon Brownlee's Overtreated.  It's good too.

(OK, fine, keep watching House.  It's a great show.  Just don't use it as your template for what medical care should look like, OK?)

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Oprah's Kentucky Fried Throwdown

| Wed May 27, 2009 12:56 PM EDT

Oprah's free chicken coupon led to a Kentucky Fried throwdown this week. The Des Moines Register reported a "large, middle aged woman" hollered profanity and spat on the arm of the employee who turned down her free two-piece grilled chicken meal coupon on Tuesday. 

Oprah's threw her unweildy star power behind KFC's newest venture and the response overwhelmed both Oprah.com and Kentucky Fried Chicken, who couldn't meet the demands of the salivating hordes. New York magazine chronicled the agony and the estacy of customers. Some felt discriminated against because they used Linux and couldn't download the coupon (they're people too, O), or are Canadian (no freebies for O Canada). Others pleaded that they needed the nearly unattainable free chicken to feed their children.

Drop in at KFC.com and you'll understand the excitement. The website features happy chicken lovers two-fisting pieces of un-fried poultry while doing the "mix it in your bucket" dance. After redeeming millions of coupons, the company had to call a chicken hiatus and issued an apology and rain checks until chicken supply meets chicken demand.

China and North Korea

| Wed May 27, 2009 12:34 PM EDT

Is there a point at which China will finally tire of the antics of its North Korean neighbor and put its foot down?  Barbara Demick of the LA Times offers up a modest data point today:

North Korea's latest nuclear test raises the question of just how long the bonds forged between old communist allies will endure....Increasingly, China itself is questioning whether the relationship is worth the effort.

Within the Chinese intelligentsia there is a deep divide over how to handle North Korea. The Global Times, a newspaper with close party ties, Tuesday published a survey of 20 of the country's top foreign policy experts. It found them split down the middle — 10 arguing for tough sanctions against North Korea, 10 opposed.

It's not much.  Just a blip.  But I'll bet that even five years ago opinion wouldn't have been split much at all, and if it had it wouldn't have made it into the pages of a newspaper close to the party.  The times may be — slowly, subtly, silently — changing.

An American VAT? Don't Bet On It.

| Wed May 27, 2009 12:31 PM EDT

The Washington Post has an article today arguing that the value added tax (VAT), which is popular in Europe and used in more than 130 countries, is getting a "fresh look" in the United States. Hogwash.

A value added tax is like a sales tax that applies at every stage of the production cycle. The tax is collected from wholesalers and raw materials suppliers, not just retailers, but the end result for consumers is the same, since the businesses pass their tax costs down the supply chain. Other countries have found VAT useful because the costs of collecting it fall largely on businesses, not government, and because its structure discourages the black markets that high sales taxes often create. And economists say VAT doesn't discourage work, savings, or production as much as some other taxes do. But most liberals don't like VAT because, like sales taxes, it's regressive—its burden falls disproportionately to the poor.

According to the Post, Kent Conrad, the Democratic chair of the Senate budget committee, is giving the VAT a look-see because the Dems are hoping to find a way to pay for universal health insurance. Well, it may be "on the table," as Conrad said, but VAT isn't going anywhere soon. When you consider the politics of the situation, it seems pretty clear that the Dems are trying to look like they're considering all the options. But any sort of significant VAT isn't really in the cards. "While we do not want to rule any credible idea in or out as we discuss the way forward with Congress, the VAT tax, in particular, is popular with academics but highly controversial with policymakers," Kenneth Baer, a spokesman for White House Budget Director Peter Orszag, told the Post. That's a long way of saying that VAT is an interesting idea that isn't politically viable right now. Consumption taxes raise the final prices of goods and services. Consumers would definitely notice even a modest VAT when they bought their apple pie, beer, and baseball tickets. Do the Democrats, now at the height of their power, really want to be blamed for instituting a new regressive consumption tax in the middle of a recession? Don't bet on it.

Headline of the Day

| Wed May 27, 2009 12:19 PM EDT

From the LA Times:

Protesters found to be a nuisance

Yes, I suppose they are, aren't they?