Health & Care

I had a series of shabbes conversations on health care today. What astounds me is the often callus regard physicians have for their patients sentiments. They agree that the highest level of care should be provided to every patient, but that excessive wait times (5 hours in the emergency room) and curt explanations are just a fact of life. Deal with it. Often, doctors claim to be exceedingly busy and unable to spend the necessary time to explain their diagnosis to patients and do general hand holding. My instrumental counterclaim is that more time hand holding will yield fewer malpractice suits. My friend's response was, don't sue so much and your health care premiums won't go up so fast. This is obviously silly, as the the cost of malpractice suits is 1) negligible to the entire cost of health care in America and 2) shouldered far more by doctors than patients. The reply strikes me as exceedingly arrogant, however, and reveals a certain bravado amongst physicians.

What really bothered me, however, was my inability to give a non-instrumental argument as to why health CARE is important. Why am I owed an explanation? I come in which a life threatening illness that almost kills me. Doctor enters, grunts, writes a prescription, and leaves. Five days later I am totally healthy but without a whit of understanding as to why. Has the doctor shirked her responsibility? Is she blameworthy? I feel like I could offer some souped-up Kantian 'respect' argument, but somehow that feels forced. Are we entitled to care, above and beyond health?

11221, you are so predictable like that

Netflix has this cool feature that lets you see the top 100 movie rentals across the country. Of course shlock like "The Pursuit of Happiness" and "The Bucket List" are on it. But then you can get a list of the top 25 rentals in your area. Ann Arbor is a bit more posh than the rest of the country so we get Season 5 of "The Office" and "Annie Hall." I know those titles, though. Where are they uber-hip, where do all the cool kids hang out? So I googled "Williamsburg, NY zip code" pulled 11221 and punched up the list. What do I get? A documentary of Hasidic Jews, a 1983 PBS documentary on Style, "Masculine/Feminine" and nine foreign titles (two of which are Ingmar Bergman).

Oh 11221, it's good to know that you so are predictably trendy.

I want to see any movie

which, according to the NYT, is rated R for, "drug use, swearing and the repeated violation of Commandments 3, 5 and 7 to 10."

It would be funny if the MPAA characterized moral breaches in movies according to the Rambam's minyan hamitzvot. That would be a very Coen brothers thing to do.

Kinda Annoyed

Here is Obama's Rosh Hashana message:



Here is his Nowruz message:



I just don't appreciate that he uses the same tone to address the (unfortunate) Palestinian problem as the Iranian dictatorship. As if I am not perfectly aware of the suffering that the Palestinians endure. I just don't believe that if only we, the Jewish people, looked back on our cherished heritage* and our outspoken condemnation of oppression that somehow the Palestinian problem would be solved. It takes two to tango. Harumph.

* I think it is possible that the first Jewish intellectual to give the line from Yishaya "or lagoyim" discursive currency was Jesus. See Matt. 5.14 "You are a light unto the world. A city built on a hill." I find it weird when people quote that line as distinctively Jewish.

Trust

Why do Republicans not trust government to promote social welfare, but defer to the government on matters of security and law & order? Why do Democrats trust government to promote social welfare, but mistrustful of the government on matters of security and law & order?

Security and order is a matter of trust. There exists a local power differential and the body on the low end must trust that the superior will not take advantage of its position. The police officer can pull me over, rip me from my car, beat me like a nag, and arrest me for resisting arrest. It is going to be difficult for me to make a sufficiently persuasive claim to seek recompense--the burden is on me. I just have to trust the officer and the government in turn. Now you might have a good story as to why that trust is warranted (bureaucrats want to retain power, elected officials don't want to lose office, the gov't primary role is to maintain security, not meddling in health care), but we can talk about trust in that context.

Health care, however, is not an issue of trust. The government might screw up, because that is what big bureaucracies are wont to do, but it is not a failure of trust, it is a feature of institutional design. That is why I find it so odd that the language of trust is bandied about regarding health care, it just seems out of place.

Fifth Annual Zev Day. 7/28. Be There.

Well, I guess Zev Day has a much longer history, but I have only been aware of the festivities for five years.

What's the deal with organ trafficking anyway?

I had a good spat with (R.) Dan and Shmuel over facebook about the uses and disadvantages of organ trafficking. They raise important concerns regarding a persons ability to consent (well, that might be putting words in their mouths), lowering of costs of organs and generally saving people's lives. I worry about people's ability to consent and exploitation of the poor.

If people are 'fairly' compensated for their organs, why shouldn't they be allowed to sell them on the market?

What This Means

There are a plethora of reports alleging election fraud in Iran. The best I have read thus far comes from Juan Cole, whom I do not normally agree with. Al Jazeera is being really weird and anti-liberal in its coverage, generally maintaining a neutral to skeptical tone regarding the fraud.

The election indicates is that there is distance between the policies of the government and Ayatollah and the wishes of the people, but the fact that the results will likely stand demonstrates that the people are still unable to affect that policies of the Iranian government. Despite the media frenzy over the protests, comparisons to Tiananmen and all, the scale appears to be on the order of thousands, a relatively small showing for protests in the Middle East. The result is not a tragedy because the delegate to the office of the presidency will or will not change, but because of what it indicates about the willingness of Iran's oligarchy to change its policy, even on something as small as a figure head (let alone it's nuclear program). Given that policy change, let alone regime change, appears unlikely Israel will likely bomb Iran*. This is a disaster...

Update (6/15): OK, NYT is reporting protests of ~half a million. That's a real, ol' timey, Mid-East protest. None of this "thousands in the street" crap. I have no idea what's going to happen from here, but at least it shows some spunk.



*Again, this is a descriptive not a prescriptive claim.

Three Questions

Whenever reading political theory always ask three questions:
1. What is the premise?
2. What is the account/mechanism?
3. What is the payoff?

So for Hobbes it would be something like:
1. People have a projectivist epistemology which causes acrimony. We must solve that by bringing people together under one rule.
2. Consent is employed to transfer 'natural rights' to one body.
3. A perfectly consensual and represented politics.

There are still some bugs in this and my account of Hobbes might not be perfect, but I think it is a good rubric. A surprising number of articles do a hack job of #2 and don't address #3 at all. So, for instance, if you ever read something that outlines a problem and resolves it by magic pixie dust, dragon fire or power excised by the industrial bourgeoisie always be skeptical.

Kol Yisrael Arevim

I post this because it is getting some traction in the blogosphere, and because it finely articulates why I struggle with Zionism and kol yisrael arevim.



For a moment I will engage my mother, who will no doubt respond along these lines: So they are stupid?! There are lots of stupid people in the world. Why let stupid people alter your identity?! The problem is that according to normative religious/cultural principles I actually share a community with these people. Why can't I construct a community which cleaves along the lines of smart/stupid as opposed to Jewish/non-Jewish (granted my life is far more heavily weighted the former already)? Why would I want to share anything with bigots?

The best rebuttal I can offer at this moment is that maybe God wants us to take responsibility for stupid people. Maybe that's the point of community. Living together in a diverse environment in order to understand the baseness and transcendence of the human spirit. I think it was St. Thomas who argues this, but how can we appreciate the beautiful without the ugly?

Gogol the Optimist

I am working on a proposal to write a paper about Emerson and Gogol. I mentioned this to my dad and told me a story illustrating how nuts Gogol was. Apparently, he was obsessed with the numbers 2 and 4 resulting in his suicide at the age of 42.

I burst out laughing--I always sensed he was a glass half full kind of guy. A true Russian optimist.

Can One Appeal to Merit?

I attended a workshop over the last month with one of the professors here where we discussed her forthcoming book which articulates a non-ideal philosophical argument for racial integration, specifically affirmative action. Throughout the seminar I was confused as to why she did not address the question of merit head on--if one works hard and excels (those are two different items) isn't one entitled to a position at an Ivy or elite firm (or at least more entitled than someone without that merit)? How do the values of integration (democratic norms along with social justice ones) address the claims of merit?

Turns out she doesn't really think such an appeal exists, at least to a strong version of the claim. Sure, she concedes, you are going to have a hard time remaining an elite school if you open up enrollment to a lottery, but merit, in itself does not really constitute a claim. Merit will excel on its own, but it is not a ethical value by itself; an instrumental not a deontic value (that might be stating it a bit too strongly--she did intimate that at a large firm passing up someone more qualified for a cousin of yours might be an ill). So if you don't believe that merit is an appropriate claim, anti-affirmative action arguments really fall down.

Just prima facie, there seems to be some appeal to justice wrapped up in merit, something like Aristotle's equals to equals where one's capacity ought to equal the challenge of the position, but I am not sure. Furthermore, it would be hard to argue that every promotion ensures a correspondence between merit and responsibility. Anyhow, it was kind of a mind blowing moment.

Why Now?

There seem to be indications that the Republican party is ready to block Sotomayor's confirmation. I am not really sure how it is going to do this. Its party discipline is on the decline, and I can't imagine that Collins or Snowe will block her (especially considering that they confirmed her in 1998). Neither do the Republicans have the votes, nor do they have the motive to raise hell over her nomination. From initial reports she writes narrow decisions and is not an outspoken pro-choicer. Furthermore, a battle against the first Latino SC judge won't play politically.

Given all that, why nominate her now? Obama has excellent public approval and a lot of goodwill. If you believe, as I do, that Sotomayor will sail through the confirmation, why not choose someone more controversial now and save the safe bet for later? Is he saving capital for health care later this year?

Barack Hussein and Hosni Mubarack

Are they really so different?

But No Horsetrading

One of the odd things about Sen. Specter's announcement is that it does not appear as if he bargained for any committees. The Dems got a +1 and really did not have to trade anything away except a "player to be named" i.e. not to contest him in 2010. It will be interesting to see if he gets any committee chairmanships.

In light of this Snowe remarked: the party's message has been, “Either you're with us or you’re against us.”

The GOP's in trouble. The harder you whip, the harder you fall.

West Wing: The Obama Administration

When I began watching the West Wing I found it a bit implausible that so much could happen in one season. A war, budget fiasco, infidelity scandal, air strike on a hostile nation all in one year?! Come on. Well, I formally rescind my skepticism. Here is my list of episodes for the first 100 days of the Obama administration:

1. Inauguration & oath misfire
2. TARP
3. Confirmation-gate(s)
4. pseudo State of the Union
5. Closing GitMo, torture memos
6. Pirates!
7. Mexican drug war
8. North Korean ICBM test
9. Swine-flu

Update: 10. Specter switches parties
11. Bo the dog (would probably be wrapped up into another episode)
12. Pakistan (two episodes)
13. Nuclear North Korea
14. Sotomayor (like Glen Close and Justice Mendoza rolled into one)
15. GM and Chrysler bankruptcy

Only a 100 days in and already we'd be shaping up for a very entertaining season. I wonder what the season finale will be (G-d forbid life imitate art).

Kalonomos Cohn's New Blog

My friend, Kalonomos Cohn, who is still not on facebook, has started a philosophical blog. It is a bit heavy, but is highly recommended.

Presidential Trends

Republicans: Iraq::Democrats: ?

Well, Bush 41 invaded Iraq, Clinton invaded Somalia, Bush 43 invaded Iraq and Obama ... crap.

My favorite pirate quote: “Every country will be treated the way it treats us,” Abdullahi Lami, one of the pirates holding a Greek ship anchored in the pirate den of Gaan, a central Somali town, was quoted by The Associated Press as saying in a telephone interview.

Does that mean if we give them flowers and chocolate that they will give us flowers and chocolate?!! They are freaking pirates, they are never going to be nice ... unless ...

On a personal note, I am walking a narrow plank thin line between thinking pirates are pretty cool and being gravely concerned with the new pirate scourge on the high seas. OK, maybe I'm not doing such a good job...

The Limits of Time

It doesn't seem like I got much done today. I woke up at 6:40, went to the gym, minyan, home, showered, made lunch and then stalled until 11a. I was in class from 11 until 6, Penn & Inklings from 7-8 (which counts as work as far as the life of the mind) and then back to the department from 9-12, but only working 2 of those three hours. So what is that? 7+1+2, ten hours of work. Not as bad as what I feared. So what would a really productive day look like?

Let's say you get back from minyan at 8:30 and you give yourself an hour to turn around (Email, NYT, shower, make lunch, FB). Work from 9:30-6:30 an hour and a half for dinner and then another four hours at the department. That's 13 hours, which is about the upper limit over any non-small stretch of time. The day seems like more than 13 hours can be squeezed out of it, but I just don't think it can, absent serious quality of life compromises.

If you were crazy and had your meals served to you at your desk you could probably get six hours of sleep, an hour for turn around (wake up, shower, get into the apartment, take clothes off), an hour commute and a half an hour for davenning leaves 24-8.5, fifteen and a half. So the margin between productive and paralysis is only 2.5 per day. There just really ought to be more time.

Purim Plato

I saw Robert Mankoff speak yesterday at the Institute for the Humanities Brown Bag Lunch. He was funny but, like all other White People in the croud, I love New Yorker cartoons, so it was a lot of preaching humor to the laugh machine choir.

During his monologue he claimed that Plato and Aristotle warn against the vices of humor. This was our interaction during the Q&A session:

Me: But when you read Plato it is obvious that he is not always serious. For instance in the Republic Socrates chides poets for speaking in a voice other than their own, but then you realize that Plato is speaking through the voice of Socrates.
Mankoff: That's what I get at the University of Michigan*.
Me: I think that is funny.
Mankoff: And I think you are full of shit.

For the moment I don't want to contest his notion of humor (which I think leaves out such things as puns), but want to understand what he means by "full of shit." It reminded me of when Jose and I were walking down the Champs-Élysées and I was ranting about some ridiculous idea when he accused me of the same thing. I remarked in turn: I am not quite sure what you mean by "full of shit." If you mean to say, "My Zev, you are sounding very Zev-like today" then I may take your meaning.

Are "we" full of shit? Is that, maybe, what we are supposed to be? Let the pedantic comments roll.

* I wanted to correct him and say Chicago, but I (fortunately) thought better of it.