The most insidious thing about bondage was how easy it was to grow accustomed to it.
– George R.R. Martin
Clearing Out The Clippings No. 46
It is easy to forget how mysterious and mighty stories are. They do their work in silence, invisibly. They work with the internal materials of the mind and self. They become part of you while changing you. Beware the stories you read or tell; subtly, at night, beneath the waves of consciousness, they are altering your world.
— Ben Okri
Extortion, Paternalism, & Medical Care
It’s actually a bit… unexpected… that I would marry a doctor. Especially a (for now) family practice doctor. I never had “a doctor” growing up. We had a clinic. First come, first serve. I had a dentist and an eye-doctor. The former I remember well, the latter made an absolute mint in Lasik and so he became harder and harder to see and so I would usually see an associate. But no guy I could call “my doctor.” And it was just as well because I never went to the doctor enough to have formed that relationship anyway. The truth is, I avoid the doctor. I try to take medication are rarely as possible. I am the prototypical critic of modern medicine, but married to a doctor. And the latter has, as one might expect, changed my outlook on the medical profession.
Dr. Saunders counters a piece by Virginia Postrel about contraception prescription requirements and they they exist. As it turns out, it involves questions I recently asked him over at Blinded Trials: Namely, what’s the rationale for allowing Plan-B over the counter but not contraception, and could we go more than a year between prescription re-ups? As I asked the question, though, the thought of “extortion” never crossed my mind. But there was a time when it did (well, maybe not “extortion” but “policy based around self-interest”).
I am a clumsy and forgetful sort of guy. I misplace, and break, glasses with regularity. I also wear contacts. Because I lose and break glasses with such regularity, I have to replace them with regularity as well. Generally, you can’t refill a prescription that’s more than a year old. The only reason for this that I could figure was that the eye-doctors wanted the business. They’d talk about how it was for safety and blah-blah-blah, but it was really about their pocketbook! It’s a tempting, and seductive, thing to believe. It provides a bad guy (the Eye Care Establishment!) and provides a cheap soapbox moment.
None of this is to say that I have come around to agreeing with the law. It is unnecessary hassle. Not just because of the required visit, but because I am terrible at those eye-tests and half the time my new prescription is worse than my old. And, for contacts, even a slightly different contact can have all sorts of glare problems or just not turn out as well. The other thing is that the eye tests always send off all sorts of warning bells for glaucoma, which I suppose isn’t their fault but it opens up a can of inconvenience each time when they refer me to somewhere else for visits every three to six months to “monitor the situation” until insurance coverage runs out.
When it comes to the medical profession, they want things “just so” because that is their job. Just like it’s a safety inspector’s job to be obsessed with safety. So of course convenience is going to take a back-seat to the best health care when it’s even moderately close. They know all of the things that can go wrong and to worry about, so they are going to be more attuned to all of the things that can go wrong and need to be worried about. Getting someone in to the eye doctor once a year to run some tests is thus valuable. They might have glaucoma! And if they didn’t, the inconvenience of testing does not compare to catching glaucoma early! Don’t talk to me about inconvenience – glaucoma is awful! And you don’t even have to pay for the testing (until you do, then the balance does start to change).
I still oppose the eye care requirements for a plethora of reasons. On the prescription contraception subject, I simply don’t know. Russell and Clancy are both pretty adamant on the subject, and I am relatively disinclined to suggest that I know better. I am still not entirely sure about the yearly requirements. As Russell points out (and Clancy said when I talked to her about it a while back) it’s pretty standard for any medication. I’m not sure the extent to which it should be, especially when you’ve been taking a medication for a while. But even so, it’s mostly a question of how you balance this with that. And it doesn’t take conspiracy theories to answer why physicians are particularly cautionary and might put a little more weight on making sure things don’t go wrong. That’s their job.
Clearing Out The Clippings, No. 45
The Constitution is becoming, with each passing day, an ever more ironic document as Americans urge elected officials to follow it more closely, even as they themselves continue to support policies and practices which are antithetical to it.
Monday Trivia No. 50
Fourteen U.S. States have a distinction unshared by the remaining thirty-four. Those states are: Alabama, Arkansas, Colorado, Connecticut, Delaware, Iowa, Kansas, Kentucky, Minnesota, Mississippi, Missouri, Ohio, Tennessee, and Wisconsin.
Still Fighting Snow?
I had to mow my lawn today. The grass had grown too tall.
And yesterday when my friends and I drove to Santa Barbara for fish and chips, it was warm enough in the afternoon for guys to wear shorts and pretty women to wear sun dresses as we drank beer and smelled the eucalyptus on the salt air and mused about how we’d use our seven-for-a-dollar avocados.
There are some definite advantages to living in California.
Clearing Out The Clippings, No. 44
The history of man is not simply the conquest of external power; it is first the conquest of those distrusts and fiercenesses, that self-concentration and intensity of animalism, that tie his hands from taking his inheritance. The ape in us still resents association.
– H.G. Wells
Clearing Out The Clippings, No. 43
When you acknowledge as you must, that there is no such thing as perfect food, only the idea of it, then the real purpose of striving toward perfection becomes clear; to make people happy. That’s what cooking is all about.
— Thomas Keller
RhINOceruses, DINOsaurs
Politico has a piece up about the pushback on Bob Kerrey’s candidacy for the Nebraska Senate seat:
The Progressive Change Campaign Committee, a leading booster of liberal candidates and causes, waited just two hours after Kerrey’s announcement this week before slicing up his record and seeking to advance the interests of his nominal primary opponent. “Before leaving Nebraska, Bob Kerrey voted to deregulate Wall Street, voted for NAFTA, and voted for the Iraq war. Since leaving Nebraska, he’s supported cutting Social Security benefits, raising the retirement age, and lowering corporate tax rates. Kerrey will clearly not be a priority for those looking to support populist candidates in 2012 — and Chuck Hassebrook will likely get a lot of attention,” said PCCC co-founder Adam Green.
Democracy for America, Howard Dean’s Vermont-based political action committee, also indicated that Kerrey can’t count on their blessing in his attempt to replace conservative Democratic Sen. Ben Nelson, who is retiring. “We aren’t looking for anyone to replicate Ben Nelson in Nebraska,” said DFA spokeswoman Levana Layendecker. “We’re not interested in supporting Democrats who we can’t count on to support us on the issues we care about like health care and protecting Social Security.”
James Joyner laments this turn of events:
This is just insane. And the Democrats are reasonable on this score compared to the Republicans, where the likes of Jon Huntsman–a popular two-term governor of the most conservative state in the Union–can be not only the most liberal candidate in a huge presidential field but widely excoriated at a Republican In Name Only.
I can at least understand the enmity against a Joe Lieberman or a pre-2008 John McCain, who seemed to go out of their way to go against their party on signature issues, reveling in the press attention it got them.
I think that you have to look at these situations individually. There are all sorts of differences between a presidential nominee and a Senator, and when looking at the latter the most helpful thing to know is not generally who the senator is (press-hungry or very publicly mavericky or whatever) but rather where the senator is from.
I completely understand the attempts to unseat Joe Lieberman. It has little to do with his tut-tutting, though, and a lot more to do with the fact that he was doing it from a perch in Connecticut. The same goes for John McCain and Arizona. In both of these cases, the partisans had real reason to expect better of a senator from that state. Arizona is keen on conservative politicians, and Connecticut on liberal ones. The compromise of having an establishment-bucking maverick-type does not need to be made in these cases. Arizona Republicans can knock McCain off and still have a good shot at their Senate seat. The same goes for Lieberman.
Kerrey, though, is a different story. For a variety of reasons, I am not exactly sure that Kerrey is the right nominee at the right time for that senate seat, but definitely not because he’s too moderate. Rather, because he’s someone that ditched Nebraska (for New York City, even) shortly after leaving his senate seat before. He can easily be portrayed as a creature of Washington who is out of touch with the average Nebraskan. But trying to keep him from getting the nomination because he’s not liberal enough strikes me as… problematic. He’s replacing Ben Nelson, who wasn’t liberal enough. Nebraska is not remarkably likely to elect a candidate who is liberal enough (Exon, the other somewhat recent Democratic Senator, would also qualify as “not liberal enough”).
It’s not about, in my view, how wonderful it is to have moderate senators. Naturally, a moderate would think that moderation is great in a senator. But why should we expect a liberal or a conservative to feel the same way? A liberal or conservative wants someone who will fight for their values. The rubber hits the road, though, when the two likely options are a moderate who will buck your party or a member of the other party. I can understand some of the frustration with Ben Nelson, but you accept Ben Nelson because there’s no Ned Lamont waiting in the wings. Ditto for Olympia Snowe. Without Ben Nelson, there’d be no PPACA.
Of course, this is not always the case. Sometimes you get someone who is the right face at the right time for an ideology that is not remarkably popular in that state. A conservative in Florida had good reason for supporting Marco Rubio, even if Charlie Crist was extremely popular in the state. Ditto for Republicans in Pennsylvania with regard to Toomey and Specter. Or Democrats in Arkansas, who had a good enough candidate in Bill Halter and a poor enough incumbent in Blanche Lincoln that it would have been worth the risk (to the extent that there was any risk – Lincoln lost). It is a common thing for people to believe “my policy preferences make for good politics.” Liberals, conservatives, and moderates often do this. But it often is not so. And you should always be careful taking advice from people who don’t have a vested interest in your ideology (Republicans giving advice to Democrats, vice-versa, and moderates giving advice to either party).
So back to Nebraska. If they can find a candidate who stands a good chance of winning, I think that liberals are right to try to find the best electable candidate they can for their ideology. In this case, though, they appear to be choosing nothing over something. I don’t think it’s just my mild affinity for Bob Kerrey that tells me this is a tactical error.
Many years ago, I took the Kimber/O’Reilly political test, which told me that I was a moderate Democrat in the mold of Kerrey or Florida Senator Bob Graham. I followed Kerrey closely after that. He’s not exactly my champion, but I would probably vote for him for the US Senate. Of course, I am resolved to vote D for the senate regardless. But in Kerrey’s name, I wouldn’t be holding my nose. The same goes for Tester in Montana, or Ashdown in Utah (who, to be fair, won’t win, and maybe that is a case where you nominate someone with the right message so at least then you go down fighting). In other words, I’d vote for these people even if I hadn’t already resolved to vote for the nominee of their party. And, at least in the case of Tester and Kerrey, I don’t think I am alone.
Clearing Out The Clippings, No. 42
The life of the arts, far from being an interruption, a distraction in the life of a nation, is very close to the center of a nation’s purpose, and this is a test of the quality of a nation’s civilization.
— John F. Kennedy