Great Bob Edwards Show podcast this weekend-a replay of a documentary he did talking to surgeons who served in Vietnam.
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I really have to work on looking busy. Everyone seems to think they can feel free to interrupt me at will, and it is really starting to get on my nerves.
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“In all criminal prosecutions, the accused shall enjoy the right to a speedy and public trial, by an impartial jury of the State and district wherein the crime shall have been committed, which district shall have been previously ascertained by law, and to be informed of the nature and cause of the accusation, to be confronted with the witnesses against him; to have compulsory process for obtaining witnesses in his favor, and to have the Assistance of Counsel for his defense.”
THAT’s why we should close Guantanamo.
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My IPod was being very cranky last night-cycling on and off. I reset it a couple of times, finally holding the buttons down long enough that it completely rebooted. It appears to be working fine now, but my heart was in my throat briefly. It’s silly to be so emotional over a machine-but it has really become a constant companion, and I can’t really afford a new one right now. I’m glad it’s working, but I’m nervous.
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I meant to do a better job describing yesterday’s game-but my laptop was also freaking out on me, so that’s all I could get down. “Tim” was the name of the Enchanter in “Monty Python and the Holy Grail”, and was also the name of both starting pitchers in yesterday’s game. Hence the enchanter reference.
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Honey Mustard flavor Pringles rule.
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In case you’re a new reader (and really, why wouldn’t you be? I’m so charming…) this symbol (***) symbolizes an abrupt, head snappingly vicious change in theme, tone, or content. I don’t want anyone rupturing an eyeball.
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Dan Carlin’s Common Sense this week was, of course, entertaining and, well, common sensical. The first part was about health care and health care reform, and the second part was about the Pelosi torture question. (Not whether or not she should be tortured, whether or not she was informed about torture due to her presence among the House leadership.) Dan raised an excellent point in the first half-if people are really serious about reducing our debt, they have to talk about cutting defense or cutting Medicare and Social Security. Trimming at the edges (waste, fraud and abuse) doesn’t do it. Dan seems to support single payer, and so do I, for any number of reasons, but Dan clearly urges that major changes are needed, and I wholeheartedly agree.
Will it cost money? Sure. But, as Dan says repeatedly, WE ARE ALREADY SPENDING THAT MONEY. Right now.
He makes an excellent point about Pelosi, and misses one, too. Pelosi argues she was misled when she was briefed by the CIA. Her opponents argue she was not, and thus complicit in whatever crimes were committed. Dan’s good point is that, if she was misled as she says, we need to investigate that as well. It is not acceptable for our elected officials to be lied to by officers of the CIA. What he doesn’t bring up is, assuming she was told, what could she do? This is classified information-she couldn’t go blabbing it to the world.
That was Scooter Libby’s job.
(Rimshot)
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A second, somewhat less serious podcast I enjoy was actually found by my wife-My History Can Beat Up Your Politics. (www.myhistorycanbeatupyourpolitics.com) It’s a low key discussion of current events, usually in reference to some historical precedent or example. For example, when discussing Hillary Clinton becoming Secretary of State, he brings up Seward joining Lincoln’s cabinet as well. He doesn’t appear to have much partisan bias, but I’m sure people will probably find some there if they disagree with him.
Turns out Bruce of MHCBUYP listens to Dan, too. Small world.
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The over/under on when the heat will be turned off in my work area is July 4. I have the over.
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If Tim Redding is still a major leaguer, I guess there is hope for any of us.
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“I’m tired of following my dreams, man. I’m just going to find out where they are going and hook up with them later.”
-Mitch Hedberg
RIP, brother.
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According to To The Best Of Our Knowledge, (www.ttbook.org) , there is a bar in Madison, Wisconsin which features karaoke, except with a LIVE BAND. I’m far too cowardly to even do karaoke, so I certainly wouldn’t do this-my wife would, though, and has the talent to, in Paula Deen’s phrase, knock your socks clean off and into the laundry. (This statement applies even if you are not, technically, wearing socks. That’s how good she is.)(Katie(dontcallmekathleen.blogspot.com), I’m looking at you.)I think I can say without fear of contradiction, though, that this place, and this idea, is simply the coolest thing in the history of things. Can you IMAGINE how fun that would be?
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I can’t believe it took me this long to read John Le Carre. I just started “The Spy Who Came In From The Cold,” and it’s quite good.
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I hope somebody is working on a “Guitar Hero” style piano controller, and a Billy Joel/Elton John version of the game
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“It’s alright-
You can afford to lose a day or two-“
-Billy Joel
Would that it were so, sir.
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IPod Shuffle used to just be the coolest thing-you hit play, and the computer surprises you-coming up with stuff you forgot you owned or forgot you loved. The appeal of that is waning for me, as time goes on. I have gone back to playing albums recently-but shockingly, some don’t appear to have kept their running order in ITunes. And I can’t remember the original sequence a lot of times! Shocking. Further evidence that having a child causes brain damage.
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“I search everywhere for some new inspiration-
But it’s more than cold reality can give.”
-Billy Joel
Amen, brother.
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It is interesting that, in the concert recording that is attached to the 30th Anniversary edition of “The Stranger”, that Billy renders “Miami 2017” as a much more joyful song than on the studio album. I have always thought of it more like a dirge-more wistful.
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So's my life, come to think of it.
Wow. I have never seen this many words and thoughts explode out of you before. Interesting. Working a holiday has quite an effect on you.
ReplyDelete***
I saw that documentary awhile back and it was good. Amazing what they do now with those mobile units.
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YES THAT IS EXACTLY THE REASON TO SHUT DOWN GUANTANAMO!
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I am horrible about my MP3 player... it's my buddy, my pal, my best friend. If I lost it or it died, I might die or get lost too. I understand that totally.
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I liked the Tim reference. :-) I was happy with the game too.
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I've been to many sites where the question is if Pelosi should be tortured or not. I think it needs to be looked at from all angles now. (Nice rim shot! lol)
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Thank wife for the tip on the podcast she found for you. I'd like to check that one out.
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I take it you are roasting with the heat still on? You might want to point out that turning off the heat now will save bucks. They turned ours off over a month ago and we are still cold. Being cold is cheap for them. ;-)
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Love the Mitch Hedberg quote. It's a keeper.
Q: How many surrealists does it take to change a light bulb?
A: Fish.
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They, who are wise, do not allow me to sing under any circumstances. Small children cry.
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Piano Man Hero? lol
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I can't let my MP3 player shuffle. Makes me craZy. Is that really from my kids?
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I love the BJ quotes too. I also think of The Stranger as being sad, not happy at all.
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Great, fun post Michael. It was a real challenge to answer it. hope you don't mind...
Big cheesy grin.
I'm surprised you got through all that.
ReplyDeleteThanks for your attention.
Are you kidding? I can kick ass! lol
ReplyDeleteSeriously now, it was fun.
I'm strongly opposed to single-payer health care, because I don't like monopolies. Especially those enforced by government.
ReplyDeleteLove the idea of Single Payer, Universal Health Care (SPUHC). I even got an opportunity a couple/few years back to really poke at my state legislators about it. My two issues were 1) Choice and 2) Jobs.
ReplyDeleteFirst SPUHC would let the doctors do their jobs of being doctors. How awesome would that be??!! And second, they would actually be able to make money in their practices and at the hospitals because 1) everyone would be insured and 2) there would be ONE insurance company to deal with -- the Gov't, instead of who knows how many right now. This cuts out sooooo much overhead!
You still choose your doctor, your hospital, etc but the bills all go to one place.
Because I'll get three paychecks this month, I was figuring out how much extra $$ I'll be taking home. I already spend over 1/3 of my pay on healthcare plus I have to pay co-pays for doctor visits and prescriptions plus a co-pay and % of costs for procedures and hospital stays. I would gladly give them 40% of my pay in taxes to not have to deal with all that crap... and the bills that show up years later with unknown doctor's names on them and dealing with the absurd assortment of crap any hospital visit.
But I live in MN, home of many large insurance companies. This has the potential to decimate jobs out here. They'd all have health care but they wouldn't have a job. In this economy, it could be their death knell.
Also, I don't believe that you have to deliver the baby if you get pregnant. I think women should have the right to decide what does or does not happen to their bodies. SPUHC would not be able to provide abortions and would put us one more huge giant step toward eliminating the ability to get an abortion regardless of the legality of it.
I don't think it is perfect, but I do believe it is the best option for the whole of our society.
") there would be ONE insurance company to deal with -- the Gov't, instead of who knows how many right now. This cuts out sooooo much overhead!"
ReplyDeleteAnd next this can be applied to banking (one bank, no bothersome decisions), or restaurants (make it all Taco Bell, like in the "Demolition Man" movie), and every other sector of the economy.
That's exactly the point, DMarks. Health Care ISNT like every other sector of the economy.
ReplyDeleteIf you want to eat at Ruth's Chris Steak House, then you go there. You're going to pay more, but you know (or you hope you know) that the food, service, drinks, and amenities are going to be better than Taco Bell.
If you'd rather just have a burrito, then you go to Taco Bell.
But when you're sick, or I'm sick, or (more importantly) Lapin's child is sick, you don't want Taco Bell health care. You want Ruth's Chris health care.
We can't all have Ruth's Chris health care. I understand that.
But right now, we have insurance company bureaucrats making the decisions about what health care we get based on cost, and their profit, not need.
Choices need to be made. These choices should be driven by science, not wealth. That is why we need an impartial third party making these calls, not Aetna, who has a stake in the decision.
You choose to eat out or get a loan or buy a car-YOU DONT CHOOSE TO BE SICK.
And Lapin-I don't think single payer would be all that bad for insurance companies, in the end. A natural ecosystem will form to cover the non covered expenses. So the government plan wont cover (let's say) abortion, or cosmetic surgery, or gastric bypass, or eyeglasses. So Aetna will now sell add on plans to companies, where people won't die if a service is not covered.
In short, DMarks-you think single payer will limit your choices? You don't have choices NOW-insurance companies make the decisions, not doctors. What single payer would do is let doctors be doctors, and let decisions be made on need, not greed.
"In short, DMarks-you think single payer will limit your choices? You don't have choices NOW-insurance companies make the decisions, not doctors. What single payer would do is let doctors be doctors, and let decisions be made on need, not greed."
ReplyDeleteIt would. We'd be subject to the greed of one single company. The government. The only company out there that will shoot you if you do not comply with it.
Right now, you can choose from many insurance companies. Or bypass them entirely and directly pay the doctors.
So you replace many insurance companies "dictating to doctors" with a situation where you have just one insurance company "dictating to doctors."
Getting rid of many choices and replace them with "Big Brother Knows All" of course limits choices.
DMarks, It doesn't become Big Brother Knows All or Big Brother Makes the Decisions. It becomes a case of everyone can go to the doctor to get care. The doctor makes the case for the need for testing or procedures and does it. The government pays for it out of our taxes.
ReplyDeleteAnd Michael, you're right. The insurance companies will adapt. The elective procedures will be what they cover.
For me, this isn't a big deal because I've had military doctors and clinics and hospitals for so long. If I was sick, I went to the doctor. They did what they needed to do to make me better. When I found a doctor I liked, we made our annual appointments and follow ups with that doctor.
Even now, I've found a clinic/hospital system where I still do the same thing. They have about 10-12 doctors at the clinic I go to. I have my regular doc that I love. If I'm sick and need to see someone right now, I call in and get whoever is available that day. I know that I can go to one of three hospitals in the area that know my history and have my records on file.
SPUHC would work much the same way. We'd all still have at least the choices we have now, and even have a world of new choices open up to us because all doctors would be covered by the gov't, except for those elective procedures.
Haven't you ever had to lose your favorite doctor because your work changed healthplans to save money and your doc isn't covered under the new healthplan? Oh wait, you just LOST your choice there, didn't you? You may think you have a choice now, but you really don't. The only ones who actually have a choice right now are the insurance companies.
Let me tell you a personal story. My husband is in healthcare. He works at a rehab and nursing home, where people who are severely injured or ill go for rehabilitation and physical therapy after the hospital but before going home. He actually does the medicare billing and needs assessments. Two of the other employees there had cancer. This year -- mid-year, not during open enrollment -- their insurance company dropped them because their costs were too high because they actually had sick people who needed and used the insurance. Because of the costs for necessary treatments for two people, now no insurance company will cover them. The insurance company will provide an HSA plan for them, where they can put pre-tax dollars to use for healthcare spending. The employer is giving them back an extra $$ amount each pay period to put in to the HSA. The insurance company rep actually told them that they now should go and apply for the state medical insurance plan -- which NONE of them qualify for because they are employed.
So, they aren't getting back enough money to buy their own coverage. They don't qualify for state insurance because they aren't poor enough and are actually working. Right now, those people cannot afford to get sick.
What kind of choice is that?
So now, I had to work through my company and get him on my insurance. Nearly 40% of my pay goes to insurance costs. I still have out of pockets costs too. I'd rather give my money to the govt, know that I was covered, and not have additional unknown costs out of pocket too.
I'm with DMarks on this one.
ReplyDeleteAs Michael so wisely points out, under either system (the current one or the proposed single-payer one), not everyone is getting Ruth's Chris care.
The difference is under the current system SOME people can afford Ruth's Chris' care. As that care becomes more efficient and more routine, it becomes more affordable. That makes it better for EVERYONE in the long term.
If you put the government in charge, nobody gets Ruth Chris' care. We can all sit around and feel great about how fair it all is. Until we notice that we no longer lead the world in medical innovation and that our kids are getting roughly the same medical care we got (as opposed to now, when we get so much more in the way of medical care than our parents did).
Michael, we are closing Guantanamo, aren't we? As soon as we have completed the military tribunals President Obama supports, right? ...
ReplyDeleteThree last thoughts.
ReplyDeleteYou are charming and I like reading your posts.
Pelosi - you are right on the first point. By all means, investigate whether the CIA lied to members of Congress or the administration because they wanted to be the ones to own this partiulcar decision.
As to your second point. As I understand it, Pelosi, a member of the Intelligence Committee, was briefed that both the CIA and the Bush Administration got separate legal opinions that upheld waterboarding. I don't think she disputes this fact. If this information in anyway upset her, I imagine there is proof somewhere that she was concerned (a witness? someone she spoke to? an email? a confidential memo? top secret intelligence committee minutes?).
If you think that she was powerless to do anything because the issue was confidential, wouldn't that logic apply to ANYONE in government who didn't speak out against it - the lawyers, the CIA, and administration memebers?
If we can't hold our elected officials responsible, who do you think we should?
DM-
ReplyDelete"It would. We'd be subject to the greed of one single company. The government. The only company out there that will shoot you if you do not comply with it."
This happens all the time in France, I hear.
"Right now, you can choose from many insurance companies. Or bypass them entirely and directly pay the doctors."
HA! Have you ever priced an MRI?
Jeanne-
"As that care becomes more efficient and more routine, it becomes more affordable."
Can you cite even one example?
"Until we notice that we no longer lead the world in medical innovation and that our kids are getting roughly the same medical care we got (as opposed to now, when we get so much more in the way of medical care than our parents did)."
Except we don't get more care-we get less than France, and Britain, and Canada, and pay more for it.
Did you know that the majority of basic medical research is Federally funded?
Are we innovating at the heroic edges of care? Sure. But there is no reason why we can't have that and cover everybody as well.
"Michael, we are closing Guantanamo, aren't we? As soon as we have completed the military tribunals President Obama supports, right? ..."
Last I heard, the Senate refused to fund the closure.
"If you think that she was powerless to do anything because the issue was confidential, wouldn't that logic apply to ANYONE in government who didn't speak out against it - the lawyers, the CIA, and administration members? If we can't hold our elected officials responsible, who do you think we should?"
I don't know the answer to this. I think the lawyers should be held responsible for malpractice if their work was below the standard of care. I think the Administration should be held responsible for ordering it. But if Congress is told "here's what we're doing, but you can't tell anyone," I'm not sure what they were supposed to do.
We get less care than in Canada, France, etc. which are well known for their many-months waits. The health care ends up rationed, limited.
ReplyDeleteI have a friend in Canada who is screwed over by the Canadian system. I've sent her supplies which are easily available in the US, but are not covered under Canada's "wonderful" plan. Sure, she can escape Canada's insurance company. By leaving the country. Some "choice".
And then there is what happens when the unaccountable Big Brother dictates its choices to people based on its own priorities. The Oregon state health care system has provided an example of how this works:
"Barbara Wagner was notified by letter that the Oregon Health Plan wouldn't cover her prescription. But the letter didn't leave it at that. It also notified her that, although it wouldn't cover her prescription, it would cover assisted suicide." (see this page). Yes, it is more effective for the health care system to kill people rather than help them, isn't it?
In an accountable system controlled by the people (private enterprise), when this happens, you just find another insurance company. When the state, or national government, makes decisions like this (SPUCH monopoly), you have to flee the state or country.
Monopolies take away choices. We need many choices (many payers), not just one. And these many choices should exist within one geographic area, without requiring someone to move to another state or nation to find better alternatives.
Michael,
ReplyDeleteI am going to go out on a limb and suggest that the cost of open-heart surgery, a mammogram, or an MRI is less than it was twenty years ago (inflation adjusted of course). I could be completely wrong. I do know that in my short life I've benefited from cutting edge medical research and availability to specialists.
You say, there's "no reason" we can't continue to innovate at the heroic edge of medicine and still provide basic care to everyone. Sure. With enough money, anything is possible. Where would we get the money to pay for this health insurance? Either it's going to be EXHORBITANTLY expensive (and there is a limit to how much wealth redistribution our society will tolerate) or the health coverage everybody gets will be much less. Taco Bell care, if you will.
Also, that "herioc" edge will one day be the standard. I remember a time when heart bypass surgery was like a death sentence. Now, practically every guy I know over 50 has had that procedure. What is "heroic" today is standard tomorrow. We should be careful of embracing any plan that might jeopordize the heroic.
It's weird that the Democratically controlled Senate refused to fund the closing of Guantanamo. As you and President Obama have pointed out, it's an excellent idea. Wonder what their problem is.
Jeanne: Remember the great quote from P. J. O'Rourke:
ReplyDelete"If you think health care is expensive now, wait until you see what it costs when it's free."
DM-
ReplyDeletehttp://bit.ly/5XdA
A paper from the American Medical Student Association, arguing that waiting times are largely a myth.
I would be interested to know what your friend couldn't get in Canada that was available here. It's absolutely none of my business, so I don't expect you to answer, but I would be willing to guess that something similar to what your friend needed was available to them under the Canadian plan.
The Barbara Wagner case is an
interesting one, to be sure. In summary, her government sponsored plan will not pay for Tarceva, an unbelievably expensive cancer treatment, to extend her life for a few months, while they do cover comfort care/hospice and/or assisted suicide. A horrible choice for anyone to have to make.
Now are you arguing that Aetna, or Blue Cross, or Oxford, would make a different, more compassionate, more enlightened decision? If so, I will resist the urge to mock and suggest that you don't understand health insurance companies very well.
You suggest, again and again, "just find another insurance company". Easy to say. There is not a health insurance company on Earth that will accept Barbara Wagner.
In an ideal world, yes-many payers would be the perfect situation. If you don't like Blue Cross' formulary, you switch to Aetna. Like car insurance-I'm debating switching right now, to see if I can get a better rate.
Thing is, though-I don't die if I have lousy car insurance. I can't switch to another health plan if my company doesn't offer one or if I can't afford one. I can't switch to another health plan if I have a chronic illness.
I don't recall who said it- "Democrats believe we should live in a society where success is determined by hard work and personal merit. Republicans believe we already do."
Jeanne-
ReplyDelete"You say, there's "no reason" we can't continue to innovate at the heroic edge of medicine and still provide basic care to everyone. Sure. With enough money, anything is possible. Where would we get the money to pay for this health insurance?"
That is exactly, precisely the point. We ARE SPENDING THIS MONEY-right now, today, as we speak. We don't need to spend more. The thing is, right now it's going to Aetna and Wellpoint and Oxford and Maxor and making their shareholders rich. It's NOT GOING TO HELPING SICK PEOPLE.
Every time a health insurer denies a claim, they make more money. Period.
Do they risk alienating a customer? Not really. The theory of group health insurance means that it would take a lot of dissatisfied people to lose Microsoft's health plan business.
So as long as you keep the majority content and/or ignorant, you're home free.
Are there problems with government health care? Of course. But they pale in comparison with the problems with the current system.
"Democrats believe we should live in a society where success is determined by hard work and personal merit. Republicans believe we already do."
ReplyDeleteThat doesn't fit the Democratic Party of today, which favors people getting ahead by skin color and gender (affirmative action "quotas") instead of ability.
Ah, yes.
ReplyDeleteWe have left discrimination in the past, then, have we?
Seriously, though-nobody is seriously suggesting that stuff be handed out based on race.
ReplyDeleteBut there's no such thing as a perfect meritocracy, either.
If you hired people purely based on their ability to churn out work, you'd hire all unmarried people without children, because they have no distractions.
You can't do that because it's insane, and you'd be shutting out more than half of your potential employees.
So you make allowances-I'll hire the mom with three kids, and I will take it as a given that she may miss a few more days of work, over time, than a single woman would.
You do this not because you feel all squishy about Moms, and not because you want to hit some invisible quota, but because there is value in having a diversity of perspectives. There are values other than pure achievement-if you want to do work on behalf of the American people, you have to value all Americans.
If you don't like doing that, don't take Federal money.
"Seriously, though-nobody is seriously suggesting that stuff be handed out based on race."
ReplyDeleteMost state universities and a large number of corporations and government entities do hand out jobs, promotions, and admissions based on race. The supporters of these policies do seriously "suggest" this.
See, I don't think that's true. A lot of people want to believe it's true-it fits in with their worldview. But I don't think it is.
ReplyDeleteFor example, the University of Michigan Law School case that the Supreme Court ruled on several years ago.
Admissions aren't "handed out based on race". It's the Chris Rock Rule-nobody gets anything because of their race. But in the case of a tie, they may get a small advantage.
That's not the end of the world from where I sit.
"Given my politics, I am probably not going to like how she rules on many, maybe even most, issues. But almost none of those issues involve racial preferences, which, even if they are a problem, are a small problem for America, affecting fewer people than almost any of the other major policy questions we're debating today. Making race, or racial politics, the central complaint, makes it seem like your biggest policy priority is making sure that not one minority in the land gets anything they don't deserve. But hey, we all get things we don't deserve. I'll go further: almost all of us get something we don't deserve as a result of our race, including white people. Perhaps even especially white people.
ReplyDeleteIf you don't believe it, ask yourself why repeated studies show that resumes with identifiably black names get fewer interview offers than identical white resumes. Being identifiably black hurts your chances worse than having a felony conviction. Even if you want to argue that an identifiably black name is a socio-economic marker for a certain kind of parenting, an argument I find pretty dubious, are you really willing to argue that black kids should be permanently barred from employment because their parents have dubious taste in names? Well, go ahead, I guess, but I'm going to find it hard to take you seriously when you complain about affirmative action because it undermines our fantabulous American meritocracy."
-conservative Megan McArdle about affirmative action.
http://meganmcardle.theatlantic.com/archives/2009/05/the_problem_of_affirmative_act.php
NPR's Peter Segal, on affirmative action and Judge Sotomayor:
ReplyDelete"I don’t know anything about her, and have no opinion on whether should be a good justice, but it really hacks me off the way some people are saying that she must have gotten into Princeton and Yale via some kind of affirmative action program, and therefore she’s not necessarily as accomplished as others with those distinctions, who “earned” them. Okay. (Pause for breath.) I also attended one of those Elite Institutions, and it is true that I probably had a harder time getting admitted as an upper-middle class Jewish kid from the burbs, than if I had been (say) poor and Latino from the Bronx, because the elite institutions have lots of me and not a lot of them, and want to spread the wealth. But of course it is also true that I had every advantage, and they had none, so maybe we should spot those guys a couple of points on their SATs."
http://petersagal.com/wordpress/?p=234