Saturday, November 21, 2015

Amidst political hysteria, lets get one fact straight

The Paris attack mastermind, Abdelhamid Abaaoud
 and most of the attackers were French or Belgian,
 not Syrian.

As European citizens, they could travel freely around Europe.   They had no need to sneak in with refugees.    Rumors got started about refugees when a Syrian passport was found at one of the scenes, but it is unclear whether this was a faked or stolen passport or whether one the men was Syrian.   We know that most of them were not Syrian.

It is possible that terrorists could pose as refugees and get into Europe because of their open borders and close proximity -- but not into the U.S.    Our investigative vetting is far more rigorous and takes up to two years.   But those who were French and Belgian citizens could have simply taken a flight into the U.S. without any vetting at all -- unless they were on a terrorist no-fly list, which at least some of them were.   The point is:   if they were going to try to attack the U.S., the refugee route would be the worst possible way for them to try to get here.

Let's calm the anti-refugee hysteria and honor American values, remembering Emma Lazarus's words immortalized on our Statue of Liberty:   "Give me your huddled masses, yearning to be free."


Eliminate tv ads for Rx medicines

The American Medical Association is calling for a ban on direct-to-consumer advertisements for prescription drugs and medical devices.

This is a move I whole-heartedly support -- both as a consumer fed up with sitting through endless tv ads for Cialis -- and as a physician who knows the effect this practice has on medical costs.

These advertising costs, which are figured into the price of medicines drug companies charge, have increased to $4.5 billion in the past two years.   One estimate a few years ago, even prior to this increase, reported that the industry spends more on advertising than it does on research for new medicines.   And yet they justify high prices because of their research, never mentioning the cost of advertising.

In addition to the advertising costs, they engender other costs.   Consider the extra time it takes a doctor to have to explain to his patient why the latest ad he saw on TV last night is not appropriate for his illness, or that the new drug may be good but it is no better than the old one which costs one-tenth as much.   And then there is the added cost of the new drugs that are unnecessarily prescribed by some doctors rather than take the time to explain why he does not -- or because he knows the patient will likely just go to another doctor who will prescribe what the tv ads push.

The medical profession should never have acquiesced to changing the old prohibition against advertising, just as the profession should never have turned its management over to business professionals.   Because now that's what we've got -- another big business that puts profits ahead of compassion and sensible health care.


Friday, November 20, 2015

"All we have to fear . . . is fear itself." FDR

At a time of national fear and dread that our country was under attack and might not survive, President Franklin Delano Roosevelt delivered his most memorable one line that we need to hear today.

"All we have to fear, is fear itself."

FRD's message was reassuring, calming:    We can do this.   We must not let fear distract us and defeat us.  We will be successful.


Indiana governor rejects two refugee families

Picture of Syrian refugees . . . waiting.
                                                                                              photo from Reuter's
Five Syrian babies, three of them triplets (L to C), are seen lying in blankets among their relatives following the arrival of refugees and migrants on board the passenger ferries Blue Star Patmos and Eleftherios Venizelos from the islands of Lesbos and C
Indiana's Republican governor Mike Pence, along with so many other governors ordered state agencies to halt refugee resettlement activities.

The Chicago Tribune reports that a Syrian family, consisting of two parents and their five year old son, pictured below, that had been scheduled to arrive in Indiana on Thursday, has instead been warmly accepted to make their home in Connecticut, whose governor Dannel Mallow personally greeted them on their arrival.  This young family has been thoroughly vetted and has been living in Jordan for three years, waiting for resettlement in the United States.
Syrian refugees find rare path to Chicago

The re-settlement in Connecticut was arranged by Exodus Refugee Immigration, which has been notified by the Indiana officials not to send any more refugees to their state.

A second family had been placed by Catholic Charities in Indiana and scheduled to arrive in December.   They will now be settled in another welcoming state yet to be named.

Governor Pence also made headline news last spring when he signed Indiana's Religious Freedom bill that would have allegedly allowed discrimination against GLBT people, although Pence denied that was its intent.  However, the immediate backlash from national corporations and convention planners was such a dire threat to Indiana's economy that the legislature quickly revised the law.

That debacle ended Pence's consideration as a major 2016 candidate for the Republican presidential nomination.    Although, when we now see what the choices are for the GOP nomination, this might not have been such a liability after all.

The demagoguery rampant among the Republican presidential candidates, led by Donald Trump, is as astonishing as it is disturbing.     Yesterday, he even seemed on three different occasions to respond to questions about a data base of Muslims in this country that would require all Muslims to register and carry an ID card with their religion on it.    Now on more reflection and consultation with his advisers, Trump may back away from that position.   As of last night, his campaign had declined to clarify his position.   If in fact he is saying he would have such a registry, that is a chilling echo of Nazi Germany's requiring Jews to wear a yellow Star of David in the years leading up to the Holocaust.

We need to have FDR sit down with one of his fireside chats that were so reassuring during World War II -- and say to us that famous line:
"All we have to fear is fear itself."  


Thursday, November 19, 2015

Utah judge removes himself from the gay adoption case

Judge Scott Johansen, the Utah judge who refused to grant adoption to the lesbian couple (see ShrinkRap, Nov. 13, 2015), then later responded to protests by delaying the removal of the foster-care baby from their home, has finally taken the appropriate step:   He has removed himself from the case and will be replaced by another judge.

That was a  wise  smart decision on his part. (Second thought:  changed "wise" to "smart"not sure he has any wisdom.)  His bias, rationalized by willful misinformation, was simply unacceptable in 2015 following the landmark SCOTUS decision that marriage equality is the law throughout the United States.

Perhaps this helped Johansen to make that smart decision to step aside:  There was talk of impeachment circulating in Utah.


"Now they are scared of three year old orphans," says President Obama

Athena Image

President Barack Obama responded to Republicans who want us to shut out Syrian refugees.  He said Republicans "think they're so tough. . . . At first, they were too scared of the press being too tough on them in the debates. Now they are scared of three year old orphans. That doesn't seem so tough to me." 

The latter was a reference to Chris Christie's saying that not even refugee children should be allowed into the United States.   Obama also said that Republicans advocating the acceptance of Syrian refugees who are Christian, but not those who are Muslim, was "offensive."   He didn't name them, but that was Jeb Bush and Ted Cruz.

The president added: "I cannot think of a more potent recruitment tool for ISIL than some of the rhetoric that's been coming out of here during the course of this debate."

Obama is absolutely right.  The right-wing, both here and in France, are just playing right into the hands of the Islamic State's plan:   turn us against each other, alienate Muslims in Western countries, and provoke a massive invasion of their caliphate.

However, Mike Huckabee and Ted Cruz, who court evangelical groups, may have misjudged their base on this issue.  A number of evangelical Christian groups, as well as Roman Catholic groups, are only increasing their determination to help refugees.

And President Obama has threatened to veto legislation that stops our refugee programs.


Wednesday, November 18, 2015

The French will still take in 20,000 refugees next year

Adding more to shame those cowardly Republicans who insist that we not take in the 10,000 promised refugees in the U.S. next year, French President Hollande has announced that France will honor its pledge to take 20,000 refugees in the next year.


"Refugees are the most thoroughly screened people who travel into the United States"

With all the fear-mongering coming from Republican presidential candidates and governors, we need a good lesson in the facts.    Here is the reality, as described by Curt Goehring, Executive Director, Center for the Victims of Torture.

"[T]he process for a refugee to be resettled into the United States is extremely rigorous. Before being considered for third country resettlement, most refugees must first register with the UN High Commissioner for Refugees (UNHCR). In making a referral for resettlement, the UNHCR first conducts an in-depth assessment and background check.

"Only those who pass the screenings and have been determined to be among the most vulnerable populations and not a security risk are referred on to the U.S. Next, the U.S conducts meticulous security screenings, which include biographic and identity investigations; FBI biometric checks of fingerprints and photographs; in-depth, in-person interviews by Department of Homeland Security officers; medical screenings; and other checks by U.S. domestic and international intelligence agencies including the National Counterterrorism Center and National Security Council.

"Refugees are the most thoroughly screened people who travel into the United States.

"Therefore, I am outraged to see people use the Paris attacks as a way to perpetuate the lie that refugees are terrorists and should not be allowed into host countries. We work with refugees every day. They are not terrorists; they are fleeing indiscriminate or targeted violence directed against civilians for political purposes. Their lives have been destroyed by acts of terrorism - whether state sponsored or by extremist groups. This is a time to stand with victims of this horrifying violence, not foster malicious falsehoods.

"We understand the impulse to react. But these are times that require us to keep human dignity at the heart of our individual response. And these are times to emphasize that human rights and the rule of law must be at the core of government response."
*     *     *

Are you listening Jeb Bush, John Kasich, Ted Cruz, Mike Huckabee, Donald Trump, Chris Christie, Bobby Jindal?   Are you proud to be pandering to the worst in us?

Instead, I am proud that President Obama and the three Democratic candidates are calling upon us to be better than that, to stick to our American values of compassion and generosity.

Hillary Clinton called the "hateful rhetoric from the GOP . . . a new low."   Martin O'Malley repeated his call for us to accept 65,000 refugees, saying, "There are women, there are children dying. . . .  They are fleeing the same sort of carnage that was unleashed on the people of France. . . . I don't think it's too much to ask of us that we do our part here."

And Bernie Sanders:  "We will not be terrorized or live in fear . . . .  we will not succumb to Islamophobia. . . . We will do what we do best and that is be Americans – fighting racism, fighting xenophobia, fighting fear."


Tuesday, November 17, 2015

Pharmaceutical price gouging

Solvadi, the most commonly used medicine to treat Hepatatis C, costs $1,000 per pill, which adds up to about $87,000 for the necessary 12 weeks of treatment.

But independent chemists have determined that the actual cost to manufacture the pills for a 12 week treatment is only $136.    That leaves a difference of $86,864 -- per patient treatment -- to cover research and development.

It's true that even the older medicines to treat Hepatitis C were expensive, and there is evidence that Solvadi is a better drug.   Some would say that the value of a cure is priceless, compared to death or the lifetime costs to keep a patient alive with end-stage liver disease.   But why should drug companies and their stockholders and CEOs get wealthy at sick people's expense?

There is a basic moral issue involved here, when it comes to the health of a nation.    Should that be left up to the marketplace?    Should a drug that can make thdifference between life and death be subjected to the same economic forces as  a new smart phone?

Clearly, I favor humanitarian solutions over market solutions.   But there are many questions that need to be solved by ethicists and economists, as well as by politicians, and ultimately by the voters of this nation.


Here's how the radical jihadists win

They win by making us afraid in our daily lives, doing ordinary things.   And now, out of the fear that they will attack us here at home, we have governors and pandering politicians saying we will not take in any refugees from Syria.

Ian Millhiser at ThinkProgress, however, points out that legal authority to admit refugees into the country is given to the president by the Constitution and by the Refugee Act of 1980.  It was made even more explicit in 2012 by a SCOTUS decision in Arizona v. United States.

The fact is that Syrian refugees are not our enemy;  rather, we have a common enemy in ISIS.    Any refugees that are brought to this country are being very carefully vettedThe majority of them are children and women who have been through unimaginable trauma.

In addition, this is not the way a would-be terrorist would choose to try to come into our country.  It takes too long, and the vetting would pick them up.

Unfortunately, this fear that a terrorist might sneak in among them is fertile ground for those demagogues who fan the flames of xenophobia.   Republican presidential candidates are spouting some of the most uninformed, outright lies about all this.   They are abandoning American values.    Jeb Bush and Ted Cruz are calling for "Christian refugess" to be admitted, but not Muslims.

Shame on them.


We are not at war with Islam

In 1941 Japan attacked U.S. territory in Hawaii, and we declared war.   We knew who we were fighting and where -- even though it was all over the Pacific Ocean and along the eastern border of Asia (not to mention the simultaneous war in Europe).

But the point is, we were in a declared war with other defined nations.   Now we are at war with "terrorists" of many stripes without clearcut national identities.    Nor is it simply a war with "radical Islam," a most unfortunate term that Hillary Clinton was wise to avoid being drawn into using in the last debate.

We are not at war with any extremist branch of Islam, even though the attackers praise Allah as they carry out their atrocities.    At best, we could say that we are at war with "radical jihadists," who have taken as their jihid, their mission, to avenge what they consider violations of their lands, their laws, and their culture.

But as far as anyone can speak for a religion, Islamic scholars and imams denounce all this killing.   To those who claim that Islam is a violent religion, I say:   Have you read the Bible?   There are some pretty violent things in there too, including child sacrifice, slavery, eye-for-an-eye retaliations, and stonings.   In the history of Christianity, we have the Inquisitions and the Crusades, as well as the overthrow of the governments we didn't like -- or where we simply wanted their land or their oil.

In both religions' texts, there are also admonitions to love and to help your neighbors and those in need.    Either book can be quoted by those looking for justification for their own purposes, including violence.

To say that we are at war with Islam is to malign millions of gentle, caring, loving, and sharing people who want to live peacefully with us.


Monday, November 16, 2015

GOP debate #4: Rubio winner; Kasich, Bush losers

A HuffPost/YouGov poll of Republican-leaning voters who watched the fourth debate, or at least watched some video clips of it, had some definite messages for the candidates.

Rubio was the clear debate winner according to 31%, with Bush 3%, Fiorino 3%, and Kasich 0% the clear losers.   While Trump still came in fourth, only 10% gave him the win -- a definite demotion for him.

As to who helped, and who hurt, his campaign, voters said this:
Rubio helped himself by a net +40%, and Kasich hurt himself with a net score of minus 45%.   He comes across as whiny, cranky, and unappealing -- even though to moderate voters he should be the best of them all on policy issues and actual accomplishments.   But only 3% had an improved opinion, while 48% had a worse opinion, of Kasich.  With Bush it was 10% improved, 34% worse.

Because Bush needed badly to turn around his sliding streak, his minus 3% was almost as devastating.

Sunday, November 15, 2015

Democratic debate #2

Again, the Democratic candidates proved themselves to be more knowledgeable, more specific, and to have better (in my opiniion) policies than the Republicans.

There are small differences among the three, but those differences are mostly in the pragmatics of how you get things done -- and less about ideology and values and goals.

My guess is that Bernie Sanders probably improved his standing a bit.   Clinton was put on the defensive for past positions on the Middle East and on connections to Wall Street.  But she held he own pretty well.    O'Malley was also there and neither helped nor hurts himself.


Stephen Colbert on Trump and Carson

Quote from Stephen Colbert on Friday's "The Late Show," discussing recent polls showing Ben Carson pulling slightly ahead of Donald Trump:

"Evidently people have been looking at Trump and thinking 'Maybe we shouldn't elect a man who shouts crazy things.    Maybe we should elect a man who whispers crazy things.'"

Growing panic that Trump or Carson might win

The Washington Post political writers Philip Rucker and Robert Costa began their article with this:
"Less than three months before the kick-off Iowa caucuses, there is growing anxiety bordering on panic among Republican elites about the dominance and durability of Donald Trump and Ben Carson and widespread bewilderment over how to defeat them."
Everyone was waiting for Trump and Carson to self-destruct, but that keeps not happening.   Focus groups on how to attack them haven't come up with any good strategy.

Trump's responses to attacks have been so withering that they backfire.  And Carson's appeal is more spiritual than political.   Donors are still sitting on their checkbooks, waiting to see how this plays out, hoping a front-runner will emerge.  There's even talk of a Romney making a late entry into the campaign.

On top of that, Democrats are beginning to worry a bit too.   Although Hillary Clinton seems unbeatable at this point -- as they say, what if she hits a banana peel and Trump or Carson is the Republican choice and actually gets elected?

Now I'm worried too.