Archive for July, 2010

Frank Flanagan

Saturday, July 31st, 2010

When the second world war ended, and the boys began to come home, my parents held parties for all of them who came back to Chicago. Many were friends of my cousin, Bud Kerrison, a B 17 bombardier who served in North Africa. Bud flew 50 missions; the 8th Air Force flying out of England only had to complete 35 missions because their loss rate was higher. His friends, some of whom were from Chicago, had similar military records and had served with him in the same theater. In addition to his Chicago buddies, a bunch of friends from other cities came to the parties and quite a few of them stayed. Why ? Bud had two beautiful sisters and they had a large number of beautiful girlfriends.

Here are Bud and Marion with me in the middle.

There were quite a few marriages that began with my parents’ parties and my mother kept in touch with many of these couples until she died 55 years later. There were a lot of beautiful girls and they all stayed married to the guys they met at the parties.

On of the friends of Bud who stayed on was great big guy named Frank Flanagan. His father was Chief of Detectives in the Philadelphia PD and, as some say, if cut, Frank would bleed blue. At that time, and for years afterward, the Chicago PD was corrupt but, as in any big city department, there were pockets of career officers who maintained the honor of the position and were respected even by the corrupt among them. One such was the father of Pat Neary. She was a beautiful girl with a Irish smile. Her father was an Inspector of the Chicago PD and a great guy. I was about 8 years old then and was fascinated with a tie clasp he wore that had suspended from it a tiny revolver. The tiny pistol worked mechanically and the trigger could be pulled and the cylinder would revolve and the hammer would fall, just as with a real pistol. He told me it even shot tiny bullets but I fear that may have been an embellishment. There are such tiny working guns, so maybe he wasn’t exaggerating after all.

Many of those girls from 1946 stayed beautiful into old age. I haven’t seen Pat in 20 years but she was trim and beautiful with a slight Irish accent the last time I saw her. She had three beautiful daughters.

Marion still looks pretty good at the age of 92. That’s her son Kerry who is 65. She lives alone in a nice condo and goes to the movies with my sister every week.

Anyway, Pat and Frank got married and lived happily ever after, except for one small problem. The Chicago PD pay scale was lousy. They could not afford a house for years and Pat drove an old clunker of a car. My father used to show up with piles of toys for the kids but no one doubted that the purpose of the low salary was to keep the policemen susceptible to bribery. Frank put up with it and there was never a whiff of anything improper about him. The crooks in the department knew this better than anyone else and so a little conspiracy was launched to protect Frank, and probably others like him, from the hustlers. The Mafia had a stranglehold on Chicago and the one place where someone like Frank was least likely to run a foul of organized crime was hit and run accident investigations.

Frank became chief of Hit and Run. A few years later, Life magazine ran a special feature on him as the first crime lab in Chicago law enforcement history began to get results. They developed means of identifying paint chips recovered from accident scenes and then identifying the make, model and year of the car the chip came from. That is no big deal now but it was revolutionary then. The rate at which hit and run crimes were solved became phenomenal. The Life Magazine feature began with a photo of Frank answering the telephone with his signature greeting, “Hit and Run, Flanagan.” He went on to Homicide and thrived as a good Homicide detective.

In 1960, everything changed. The city was hit with a monumental scandal when it was discovered that a burglary ring was run from a police district on the North Side. Corruption had taken over the department and Mayor Daley was faced with a desperate need for a respectable figure to take over the department and clean it up. He found him in a Harvard Professor named Orlando Wilson. Daley was desperate and this gave Wilson enormous power. He could have just about anything he wanted.

In 1960, Chicago mayor Richard J. Daley, in the wake of a major police scandal,[6] established a commission headed by O.W. Wilson to find a new police commissioner.[7] In the end, Daley decided to appoint Wilson himself, as Commissioner.[8] Beginning on March 2, 1960,[4] Wilson served the Superintendent of Police of the Chicago Police Department until 1967 when he retired.
Reforms demanded at the outset by Wilson included establishment of a non-partisan police board to help govern the police force, a strict merit system for promotions within the department, an aggressive, nationwide recruiting drive for hiring new officers, and higher police salaries to attract professionally qualified officers.[8]

Wilson began searching the department for honest and competent men. He found Frank Flanagan in Homicide and made him Chief of Homicide. Among the big homicide cases investigated by Frank was the Richard Speck case, in which Speck raped and murdered 8 student nurses in one night. It was a huge sensation in Chicago for years.

Here is a copy of a Chicago police newspaper (pdf) with a story about Frank and a photo of Pat and his three daughters. Pat is still beautiful there, 18 years after they met at my parents’ party. The two stories about Frank are on pages 4 to 7.

I got stimulated about this after reading a post at Patterico by Jack Dunphy. Dunphy (a pseudonym) wonders what is wrong with Chicago? Crime is out of control and nothing is being done, or at least it seems that way. The details of the sickening situation are here. My brother-in-law is a retired CPD officer. He was retired by the time the situation as described arrived but he was constantly frustrated in the promotion process as affirmative action was in full flower then and only blacks were considered for promotion. If there were not enough blacks applying, some white officers would be considered. The linked article does not mention race but you can be sure it is a huge factor. My brother-in-law finally gave up and stopped taking the sergeants’ exam, a disservice to my sister, but he was sick of watching the list posted every six months.

Frank died a few years ago and, unfortunately, had no sons. He and Pat (still with us but ailing) were the products of a tradition of police families. Maybe if there was a Flanagan on the force, things might be better. In addition to his police service, Frank was the commanding officer of an Army Reserve unit in the city. He retired a full colonel. There aren’t many like him. Among other things, he was a big, hearty, friendly guy and he never lost his Philadelphia accent.

Now we know why Ms Sherrod has disappeared.

Monday, July 26th, 2010

UPDATE #3: Shirley Sherrod’s father was not shot by a klansman.

Grace Miller, Hosie Miller’s wife and Sherrod’s mother, said Friday that she didn’t know if the FBI had opened an investigation into her husband’s killing.

“I hadn’t heard that but, I think it would be a good thing if they did,” Miller said. “But, then again, it won’t bring him back and that was a long time ago.”

Miller, who said that she and Hall were distantly related, never made any attempts to contact the family before his death in 1976.

According to the documents obtained Friday, Grace Miller and her brother-in-law, Walter Miller, tried at least three times to get Hall tried.
On the night of the shooting, Grace Miller swore out a warrant against Hall for assault with intent of murder. Despite the fact that Hosie Miller had since died, that charge went before a grand jury on Oct. 27, 1965 and was dismissed.

On March 24, 1965, the day before Hosie Miller succumbed to his wounds, Walter Miller swore out a murder warrant before James Holt, a justice of the peace, for Hall. That warrant would be presented as an undated special presentment before the grand jury and was also dismissed.

Finally, on Jan. 17, 1966, Walter Miller again tried to bring murder charges against Hall but was unsuccessful.

Eight days later, on Jan. 25, 1966, Grace Miller, with the assistance of famed civil rights attorney C.B. King, filed a wrongful death lawsuit against Hall alleging that Hall shot Miller in the chest while in Miller’s cow pasture off Route 2 in Newton on March 15, 1965. According to court documents Miller was seeking $330,00 to recover present and future lost wages, medical and funeral costs.

So Hall shot Miller over a lawsuit and Hall was a relative of Sherrod’s mother. Doesn’t sound like a Klan case to me.

UPDATE # 2: The coverup of her views is not working. People who criticized Breitbart and defended her are changing their minds and apologizing to Breitbart.

UPDATE: John Derbyshire has a few things to add.

So: while you’re forming opinions on whether Andrew Breitbart did due diligence, whether the NAACP shot themselves in the foot, whether the White House ordered Ms. Sherrod’s firing, whether Bill O’Reilly committed journalistic malfeasance, and the other issues in the case, please don’t lose sight of this key fact: Positions at all levels in the federal bureaucracy — positions dispensing power, patronage, and huge sums of public money — are being filled by radical revolutionary leftists like Shirley Sherrod.

Yesterday, one would have expected, given the furor over Andrew Breitbart posting her speech to an NAACP convention, that Ms Sherrod would be on at least one of the Sunday talk shows. The current media theme is that she is a race hero who had explained how she turned from a racist past to a new understanding that we are all just people, black and white. One might almost say a deification process was underway.

Then she disappeared from public. Why ? If she is going to sue anybody, make her case !

Well, there might just be a problem. Her husband seems to have some odd views.

Charles Sherrod: “We must stop the white man and his Uncle Toms from stealing our elections.”

Oh oh.

Where does Obama find these people ? He seems to be surrounded by them. Is Jeremiah Wright a sort of executive headhunter for the administration ?

Deficits and taxes.

Sunday, July 25th, 2010

I switched back and forth today between This Week and Fox News. That is my usual practice although, without George Will, I have little interest in the This Week discussion period. The Fox regulars would seem, from the complaints of the left, to be garden variety Republicans on economics. Therefore, it is disappointing to see them mouthing the same old Washington nostrums. They seem to agree that deficits are a problem but spending is never mentioned. Not once on Fox News Sunday was cutting spending mentioned. To hear a mention of reducing spending, it was necessary to watch Jake Tapper’s interview of governor Chris Christy on This Week.

Juan Williams, nearly always to the left of the rest of the panel, brought up the old canard (of course) of Clinton era tax rates. Letting the Bush tax cuts expire was simply going back to the Clinton rates and the economy was booming. Fair enough. If that is the case, why not go back to Clinton era spending ? Why not go back to Clinton era government employee numbers ?

Let’s see. The 1999 data is here, and shows that the 1999 budget included:

A more realistic headcount begins with the 1.9 million full-time permanent civilian federal workers who get their paychecks and identification cards from Uncle Sam. Add in the 1.5 million uniformed military personnel and 850,000 U.S. Postal Service workers who were counted in the federal workforce until their department became a quasi-government corporation in 1970, and the total full-time permanent federal workforce was just under 4.3 million in 1996, the last year for which good numbers are available on both the visible and shadow federal workforce.

That should give us a fairly good comparison. How many civilian federal employees are there ? The bureau of labor statistics says 2.0 million. There is a number that would give us some real information.

Table 1. Federal Government civilian employment, except U.S. Postal Service, November 2008
(Employment in thousands)

United States Total Executive departments Defense, total Army

1,909 1,664 652 244

Notice that this is November 2008 data, just before Obama was elected. Notice also that the military is much smaller than in 1998. Notice also that the number of federal employees had only increased by 9,000 in ten years.

What happened after Obama was elected ? Well, the number of federal employees has gone to 2.15 million !. That’s an increase of 250,000 in two years.

Juan, let’s make a deal. We can go back to Clinton tax rates if we lay off 250,000 federal employees.

The Washington line is always to raise taxes to deal with deficits. I wish a well documented, well written book about Harding and Coolidge would be written. Maybe Amity Schlaes could do it. The 1920 recession was more severe than the 1929 contraction. Why don’t we hear about it ?

Because Harding and Coolidge cut government spending in half and advocated a “return to normalcy.” The economy boomed and the recession was over.

A little local color

Wednesday, July 21st, 2010

I moved to the mountains about three weeks ago, after selling my house in Orange County, and am awaiting my escrow close on a new house up here. In the meantime, I am renting a nice older cabin which backs up to the national forest. I was walking Winston this evening when some neighbors stopped by. I learned that, about a half hour before, a bear had walked into the neighbor’s house ( the next one up the road) through an open front door. He had apparently rummaged through the garbage and then decided to seek more nourishment from the source. The home owner jumped up and yelled at the bear, which beat a retreat.

Life in the forest. I got so interested in the story that I forgot Winston’s liver which was cooking on the stove. It looks a bit burned but I am sure he will not mind. His usual daily ration is about a pound of liver or ground beef, mixed with two hands full of dry food. He is a very big Bassett, probably related to his diet.

He didn’t seem to mind. It was eaten in 30 seconds.

Here he is with a nationally known blogger.

I am sure he smells the bears and the coyote pack as he will not go out after dark without me close by. In the morning, he also waits for me to go out with him. The rest of the day, he will potter about the cabin but doesn’t go far. About two weeks ago, I was serenaded by a pack of coyotes about dawn. I have not heard them since Winston has been here. He did chase one a week ago but I managed to call him back. That is an old trick of coyotes. One will appear and tempt a dog to follow or chase. Around the corner is the pack. Coyotes will even send a female in heat to entice a male dog to follow her.

I’ve had a couple of experiences with this in human females and so know better.

A very interesting question

Tuesday, July 20th, 2010

Why were the Russian “illegal” spies repatriated so quickly ? They were exchanged for American agents but why so quickly ? Why not interrogate them for a longer period to be sure we knew what they had been doing. Many newspapers and other one-party media have ridiculed the spies’ accomplishments. Maybe they just weren’t very good and there wasn’t much to learn.

There is, however, another theory.

The speed with which the Obama administration exchanged the recently-arrested Russian “illegals” was astonishing and has led to speculation that the illegals ring may have had potentially embarrassing relationships to current or former US government officials. As a former “illegal” myself, I believe this is plausible.

The cushiest assignment in the world for a Russian intelligence officer would be to the United States, with its clean air and water, excellent medical care, and with none of the anarchy and danger that are common in so much of the world. Ambitious Russian officers would push hard to get these assignments.

For their choice of cover, they’d prefer commercial covers to diplomatic covers. Just as terrorists and nuclear proliferators are wary of meeting our diplomats overseas, American government officials in the US will be wary of meeting a Russian diplomat – they’d suspect he’s a spy. There is no diplomatic immunity for intelligence officers posing as business people, but as we have seen, a captured Russian officer is treated gently and the most likely outcome is exchange.

This is analysis from a former CIA deep cover agent whose workname was “Ishmael Jones.” There is more from this strategic thinker about intelligence.

Why were we in such a hurry to exchange the Russians ? And who were they exchanged for ?

Though one Russian website dubbed today’s transfer “Russia 10 USA 4”, western intelligence sources were claiming tonight that Britain and the US got more out of the spy swap than Russia. They said the four men released by Moscow were more serious individuals than the 10 agents handed over by the US. The four had been in jail and poorly treated.

Britain has a direct interest in Skripal, a former Russian army colonel convicted of passing the identities of Russian agents working undercover in Europe to MI6.

Skripal was sentenced in August 2006 to 13 years in jail for spying for Britain. Russian prosecutors said he had been paid $100,000 by MI6 for the information, which he had been supplying since the 1990s when he was a serving officer.

Two others, Alexander Zaporozhsky and Igor Sutyagin, were convicted of spying for the US. The fourth, Gennady Vasilenko, was sentenced to three years on murky charges of illegal weapons possession. Reasons for his involvement in the swap were not immediately clear.

Well-placed British sources said the exchange was also significant because Russia rarely gives up its citizens, as opposed to Americans or other foreigners, whom it has jailed on spying charges.

One reason given for the extreme reticence among British security and intelligence agencies to talk about the exchanges is fear the Russians would make fresh arrests to use more people as potential collateral. It is possible they were already placing potentially vulnerable people under surveillance now, the sources said, and possible targets may have been warned to lie low.

Hmmm. So the people exchanged were not Americans but Russian double agents. The whole story is peculiar.

The Governing Class

Saturday, July 17th, 2010

We are now at an inflection point in the political history of the United States. The people are being subjected to increasingly arbitrary and ideological rule by a small governing minority. There have been several episodes of similar disconnect in our history. The election of Andrew Jackson, after the “corrupt bargain” of 1824. The Federalists of 1824 had as much fear of a backwoods candidate as the present day Democratic Party fears Sarah Palin. He was uncouth and did not understand the subtleties of governing as did John Quincy Adams, for example.

The present day Democrats celebrate Jackson as an exemplar of the Democratic Party when, in fact, he is the antithesis and would feel comfortable in the tea parties of 2010. James Buchanan is another example of rule by a president who did not support the policies and aspirations of the public. He disdained and opposed the policies of the new Republican Party of the day. He sympathized with the Confederates and, it is widely believed, assisted them in weakening Federal control of US property. He later attempted to defend himself and his record is mixed.

Finally, Woodrow Wilson is a revered figure of the Democratic Party although his well known racism (He segregated the civil service and military) would normally affect his reputation. His government in the World War had many characteristics of Fascism and has been the model for corporate government ever since.

Now, we come to an essay that everyone concerned about the present trend to statism should read. Angelo Codevilla is a retired professor of International Relations and former Foreign Service Officer.

As over-leveraged investment houses began to fail in September 2008, the leaders of the Republican and Democratic parties, of major corporations, and opinion leaders stretching from the National Review magazine (and the Wall Street Journal) on the right to the Nation magazine on the left, agreed that spending some $700 billion to buy the investors’ “toxic assets” was the only alternative to the U.S. economy’s “systemic collapse.” In this, President George W. Bush and his would-be Republican successor John McCain agreed with the Democratic candidate, Barack Obama. Many, if not most, people around them also agreed upon the eventual commitment of some 10 trillion nonexistent dollars in ways unprecedented in America. They explained neither the difference between the assets’ nominal and real values, nor precisely why letting the market find the latter would collapse America. The public objected immediately, by margins of three or four to one.

When this majority discovered that virtually no one in a position of power in either party or with a national voice would take their objections seriously, that decisions about their money were being made in bipartisan backroom deals with interested parties, and that the laws on these matters were being voted by people who had not read them, the term “political class” came into use. Then, after those in power changed their plans from buying toxic assets to buying up equity in banks and major industries but refused to explain why, when they reasserted their right to decide ad hoc on these and so many other matters, supposing them to be beyond the general public’s understanding, the American people started referring to those in and around government as the “ruling class.” And in fact Republican and Democratic office holders and their retinues show a similar presumption to dominate and fewer differences in tastes, habits, opinions, and sources of income among one another than between both and the rest of the country. They think, look, and act as a class.

As to Republicans, here is some evidence of their contempt for the tea parties who do not accept direction from above.

Former Senate majority leader Trent Lott (R-Miss.), now a D.C. lobbyist, warned that a robust bloc of rabble-rousers spells further Senate dysfunction. “We don’t need a lot of Jim DeMint disciples,” Lott said in an interview. “As soon as they get here, we need to co-opt them.” But Lott said he’s not expecting a tea-party sweep. “I still have faith in the visceral judgment of the American people,” he said.

The rest of the essay is worth the time to read it. Nicole Gelinas, in her book, After the Fall, explains how the actual purpose of the TARP fund defeated the chances for an orderly liquidation of the assets that banks held and which no one could set a price for once the mortgage backed securities (MBS) had lost their value.

The consequences of this division between ruled and rulers has incalculable consequences.

Government derives its just powers from the consent of the governed; that is a foundational principle of our republic. To a stunning degree, however, Americans don’t believe that their own government meets that standard. Scott Rasmussen finds that only 23 percent of voters believe that “the federal government today has the consent of the governed.” A remarkable 62 percent of voters say that our government does not enjoy that consent.

How can this be, given our seemingly free and vibrant democracy? I think there are two main reasons, one specific to our present political environment and one more general.

The immediate cause is the fact that the Obama administration and its Congressional allies have embarked on an ambitious, left-wing program that seeks to transform America into a country quite different from what most Americans want. Elections have consequences, as the Democrats never tire of telling us. The problem is that the Democrats, most notably Barack Obama, did not run on the divisive, far-left program they are now trying to implement. Obama postured himself as a rather centrist, post-racial figure. His style as President has been the opposite.

So it is no wonder that most Americans believe they have gotten a government that they didn’t vote for.

I think the more significant cause, however, is the general one–a growing conviction that America is governed by a political class that has its own agenda, involving its own enrichment as well as the endless expansion of its own power, and that this political class is contemptuous of the opinions of ordinary Americans and is determined to impose its will regardless of how Americans vote. I think this perception is in fact true.

Study that chart and see if you can discern the source of Americans’ distrust of the governing class. Republicans fare little better than Democrats as many, including George W Bush, advocated big government in spite of objections from a significant segment of their party members. There is an opportunity for the Republicans to join the wave sweeping the country, but Trent Lott is not a good indicator.

UPDATE: Instapundit has a list of ways to fight back, including ways of communicating if the governing class shuts down the internet and other common means of communication like cell phones.

Jonah Goldberg thinks the left is failing as the rules change. I’m more pessimistic as I wonder if they will let them change without a fight.

Is this 1937 ?

Friday, July 9th, 2010

There is a frightening symmetry going on with the Great Depression. I have previously pointed this out, for example in my review of The House of Morgan by Ron Chernow. Amity Schlaes has written about the aftermath of the crash and how the Depression developed in The Forgotten Man. Both of these books are important to understand what is happening now. Chernow’s book is a bit dated as it was written after the S&L crisis of the 80s. Another, recent book is important. That is After the Fall by Nicole Gelinas.

In graphic form:

Are we at 1937 ? The economy was recovering from the crash but unemployment was still high and banks had been sorted out by the FDIC.. The FDIC is one of the best measures Roosevelt devised. I am a fan of the WPA and the CCC, both of which put men to work on useful tasks. That could never happen today because of the vast web of regulations that have grown up in recent decades, most stimulated by the environmental movement. Donald Luskin, from whose blog that image comes, has some thoughts.

The stock market tells us that last year we avoided a new Great Depression—barely. It was a close call, but we’re not headed for 1932. Now, as stocks correct from their April highs and fears of a “double dip” recession mount, should we be worried about an economic relapse like 1938?

First, the good news. An important milestone was passed last week for stocks. Friday, July 2, was the 997th day since the all-time high in October 2007. That’s how many days the bear market in the Great Depression lasted, starting at the high several weeks before the Great Crash of 1929 and ending on June 1, 1932, one month before Franklin Delano Roosevelt was nominated to run for president. [Ed The bear market had ended before Roosevelt was elected.]

At the bottom in 1932, stocks (as measured by the S&P 500) had lost 86.2% from the 1929 top. Last Friday, stocks were only off 34.7% from the 2007 top. “Only”? To be sure, losing 34.7% is no buggy-ride. But to match the devastation in the Great Depression, the S&P 500 would have to fall 806 points from Friday’s level, or 78.8%.

This comparison is no idle thought experiment. In 2008 and 2009, based on what the stock market was indicating, we really were headed for a new Great Depression. At two crucial junctures in 2008 and 2009, stocks had fallen further than they did in the Great Depression the same number of days after the 1929 top.

In 1920, Harding and Coolidge faced a similar prospect to that which faced Roosevelt. There had been a bear market and a deflationary depression since the end of World War I and the cancellation of war orders. What did they do ? They cut spending and declared “a return to normalcy.” They are often mocked by the left for this but do you know what happened ? The Depression ended in 1921.

The climax came in early March 2009. Then, with the banking system still feared to be insolvent, the hasty passage of a massive deficit-busting “stimulus” bill sent the message that an all-powerful new president and Congress would just as quickly enact their strident antibusiness agenda. At the worst, stocks plunged to show a loss of 56.8% from the 2007 highs. At the comparable point in the Great Depression, stocks were off only 49%.

But a funny thing happened on the way to the new Great Depression. Chairman Ben Bernanke’s Federal Reserve announced a massive program to buy Treasury bonds and mortgage-backed securities to pump liquidity into the banking system. Treasury Secretary Tim Geithner deftly executed “stress tests” enabling the largest banks to be recapitalized in public markets. And one agenda item at a time—socialized health-care, cap-and-trade energy tax, unionization “card check,” mortgage “cramdown”—got diluted, slowed down or stopped.

So, the failure of most of Obama’s agenda saved the economy. OK, I’ve got that.

The most worrisome analogue is the great bear market that began in March 1937. From the top stocks lost 60% of their value, making it the second worst bear market in history. Not ending until April 1942, it was the longest ever.

That’s worrisome because, as the nearby chart demonstrates, over the last year the stock market has followed a path eerily similar to 1937. First, a strong, rapid run to a recovery high—same pace, same magnitude. Then a correction—again, the same. Will we continue on the path that led the correction of 1937 into a collapse in 1938? This question would be nothing more than a technical curiosity for chartists if it weren’t for alarmingly similar economic backdrops between the two periods.

Or, maybe it was a bear market rally.

[A]fter 1937 the economy relapsed into what historians call “the recession within the Depression,” a downturn so severe that in any other context it would qualify as a depression itself.

It was triggered by a set of very specific policy mistakes. The Fed tightened by raising reserve requirements. Consumers were hit with new taxes to pay for the then-new Social Security program. Worried about excessive deficits, Roosevelt cut government spending. At the same time, his administration accelerated antibusiness rhetoric and regulation.

Sound familiar? We’re repeating some of the same mistakes right now, even as fears of a “double dip” recession mount. Antibusiness rhetoric from the Obama administration is at toxic levels, and the pending Dodd-Frank financial reform bill is the harshest regulatory initiative in a generation. Taxes are set to rise, to support new social spending such as health-care reform, and if for no other reason because no one will stop the expiration at the end of this year of the 2003 Bush tax cuts.

Amity Schlaes has some thoughts, too.

Government can spur the private sector. That’s the gist of the argument that’s in the air this summer. This week, for example, President Barack Obama said, “we’ve got much more work to do to spur stronger job growth and to keep the larger recovery moving.” Such spurring is often said to occur in a technical way, when government outlays have a so-called multiplier effect that invigorates other economic participants.

The Obama administration has a second meaning for “to spur.” It is that government entering an industry as a competitor will strengthen that industry and make it more honest. The president has said government entry into the health insurance sector will force the private companies to lower premiums.

But in reality the government isn’t a spur, either kind. It’s a competitor. And when such a big player jumps into a market, it tends to squeeze others out. Even promising industries — the Internet sector, for example — can be hurt.

This is what happened in the 1930s to the Internet equivalent of that era, the utilities industry.

Read the rest. I am still pessimistic about the economy and, as many of my friends know, am taking steps to insulate myself from the worst.

A Nexus Between Medical Journals and Government.

Monday, July 5th, 2010

The Wall Street Journal has one more article on the effect of Obamacare on doctors. A couple of interesting statements bring up some statements on an excellent medical blog I read.

First the WSJ points about Obamacare.

The act will reinforce the worst features of existing third-party payment arrangements in both the private and public sectors — arrangements that already compromise the professional independence and integrity of the medical profession.

Doctors will find themselves subject to more, not less, government regulation and oversight. Moreover, they will become increasingly dependent on unreliable government reimbursement for medical services. Medicare and Medicaid payment, including irrational government payment updates, are preserved (though shaved) and expanded to larger portions of the population.

The Act creates even more bureaucracies with authority over the kinds of health benefits, medical treatments and procedures that Americans get through public and private health insurance. The new law provides no serious relief for tort liability. Not surprisingly, various surveys reveal deep dissatisfaction and demoralization among medical professionals.

I’ve been posting about this for a couple of years and it is no surprise.

Now here is where it gets interesting.

On top of existing payment rules, regulations and guidelines, the new law creates numerous new federal agencies, boards and commissions. There are three that have direct relevance to physicians and the practice of medicine, and the nature and scope of the regulatory regime will be decisive.

Under section 6301, the new law creates a “non-profit” Patient-Centered Outcomes Research Institute. It will be financed through a Patient Centered Outcomes Research Trust Fund, with initial funding starting at $10 million this year, and reaching $150 million annually in Fiscal Year 2013, with additional revenues from insurance fees.

Don’t you think the “Patient Centered” touch is a nice one ?

In effect, the Institute will be examining clinical effectiveness of medical treatments, procedures, drugs and medical devices. Much will depend upon how the findings and recommendations are implemented, and whether the recommendations are accompanied by financial incentives or penalties or regulatory requirements.

Under section 3403, there will be an Independent Payment Advisory Board, with 15 members appointed by the president. The goal of the board is to reduce the per capita growth rate in Medicare spending, and make recommendations for slowing growth in non-federal health programs. It’s hard to imagine any other outcome other than continued payment cuts.

Now, we turn to the blog I mentioned. The author, a cardiologist mostly retired, discusses a recent randomized clinical trial. The way we decide on “clinical effectiveness” in an ideal world is randomized trials. They are the Gold Standard. So how was a recent randomized trial treated in a major medical journal? From the blog.

This week, the Archives of Internal Medicine published four (four!) articles assaulting the legitimacy and the importance of the JUPITER trial, a landmark clinical study published in 2008, which showed that certain apparently healthy patients with normal cholesterol levels had markedly improved cardiovascular outcomes when taking a statin drug.

Superficially, at least, the JUPITER study appears to have been pretty straightforward. Nearly 18,000 men and women from 26 countries who had “normal” cholesterol levels but elevated C-reactive protein (CRP) levels were randomized to receive either the statin drug Crestor, or a placebo. CRP is a non-specific marker of inflammation, and an increased CRP blood level is thought to represent inflammation within the blood vessels, and is a known risk factor for heart attack and stroke. The study was stopped after a little less than two years, when the study’s independent Data Safety Monitoring Board (DSMB) determined that it would be unethical to continue. For, at that point, individuals taking the statin had a 20% reduction in overall mortality, a dramatic reduction in heart attacks, a 50% reduction in stroke, and a 40% reduction in venous thrombosis and pulmonary embolism. All these findings were highly statistically significant.

This is a dazzling result for a randomized trial. Usually, you are looking at small changes and trying to calculate the “p value” to see if it is significant. Why would a journal publish attacks on such a dramatic study ?

If medicine were practiced the way it ought to be – where the doctor takes the available evidence, as imperfect as it always is, and applies it to each of her individual patients – then the incompleteness of answers from the JUPITER trial would present no special problems. After all, doctors never have all the answers when they help patients make decisions. So, in this case the doctor would discuss the pros and cons of statin therapy – the risks, the potential benefits, and all the quite important unknowns – and place the decision in the perspective of what might be gained if the patient instead took pains to control their weight, exercise, diet, smoking, etc. At the end of the day, some patients would insist on avoiding drug therapy at all costs; others would insist on Crestor and nothing else; yet others would choose to try a much cheaper generic statin; and some would even opt (believe it or not) for a trial of lifestyle changes before deciding on statin therapy.

This is the way we all want to practice. “Best Practice” they call it.

But in recent years, and especially now, as we bravely embark on our new healthcare system, this is not how doctors will practice medicine. Instead, they will practice medicine by guidelines. These guidelines (which, in modern medical parlance, is a euphemism for “directives”) are to be handed down from panels of experts, identified and assembled by members of the executive branch of the federal government.

And this makes the stakes very high when it comes to a clinical trial like JUPITER. For guidelines do not permit a range of actions tailored to fit individual patients (consistent with the uncertainties inherent in the results of any clinical trial). Instead, guidelines will seek to take one of two possible positions. That is, under a paradigm of medicine-by-guidelines, the results of clinical trials generally cannot be permitted to remain imperfect or nuanced or subject to individual application, but must be resolved by a central panel of government-issue experts into a binary system – yes (do it) or no (don’t do it). In the case of JUPITER, the guidelines must decide whether or not to recommend Crestor to patients like the ones enrolled in the study, at a potential cost of several billion dollars a year. It should be obvious that the answer which would be more pleasant to the ends of the central authority, and by a large margin, would be: No, don’t adopt the JUPITER results into clinical practice.

Well, we shouldn’t worry because all doctors, and especially well known academics are ethical. Right ?

Right ?

Now comes the interesting part and I think he is absolutely correct.

This, DrRich submits for your consideration, is likely what instigated the almost violently anti-JUPITER issue of the Archives this week. DrRich theorizes that what we’ve got here is a bunch of wannabe federally-sanctioned experts, auditioning for positions on the expert panels. What better way to get the Fed’s attention than to let them know that you are of the appropriate frame of mind to assiduously seek out scientific-sounding arguments to discount the straightforward and compelling, but fiscally unfortunate, results of a well-known clinical trial?

Of the four papers appearing in this week’s Archives, three are more-or-less legitimate academic articles that make reasonable points, but do no harm to the main result of JUPITER. The fourth is a straightforward polemic, which has no place in a peer-reviewed medical journal, and whose very presence, DrRich believes, very strongly suggests that the editors of the Archives themselves must be auditioning for the Fed’s expert panel.

Most doctors resent guidelines unless they are obviously data driven. Most of that data comes from randomized trials.

What we are seeing her is the erosion of the ethics of those who publish and conduct such studies and who use them to establish guidelines. There is another type of guideline, call “consensus guidelines” in which a committee of “experts” debates the best practice. These are the guidelines most doctors distrust. Now we see the corruption of even the randomized trial as a source of data driven guidelines.

Pakistan is an unreliable ally

Saturday, July 3rd, 2010

We have been in Afghanistan for nearly 9 years. We invaded after 2001 and routed the Taliban with a combination of non-Pashtun forces and our own Special Forces and air power. That campaign was a success. Now we are engaged in a nation building and COIN campaign in an area that has never been a nation or even a town. Prior to the Soviet maneuvering which resulted in invasion in 1979, Afghanistan had consisted of a city, Kabul, with a civilized society, and the vast countryside ruled by tribes and hostile to any attempt at central control by Kabul. The rather successful policy by the “central government’ was to leave them alone. Eventually, Soviet forces decided to take control with a series of coups.

The first was in 1971.

The workers started to get organised and became very active in the industrial areas of the country; the demonstrations, which had begun on the campus of the University and in the secondary schools of Kabul, soon spread to the provinces: riots became more and more frequent; the King was openly criticized.

Moscow had a plan ready and in Kabul and army was being infiltrated by the “Parcham” group. A period of transition was necessary before a Marxist government could be established. Someone had to be found, who could, at the same time, be trusted b Moscow and accepted by the Afghan people, in order to replace the King who was gradually loosing his popularity. Only one person met all the requirements, and that was Daoud. After ten years away from the political scene, he was still ambitious and eager to regain power. To achieve this goal, he was to take the King’s place, even if that meant as President of the Republic only. The Russians were in a hurry to put an end to the monarchy, which they considered to be a major obstacle to their objectives.

An agreement was reached in 1971 between two officers belonging to the “Parcham” group (Moscow’s favourite) and Dr. Hassan Sharq who was acting on Daoud’s behalf.

The tragedy of Afghanistan began here but there had never been a real central government. There was Kabul and then the rest of the country. Afghanistan had actually severed relationships with Pakistan in 1961. Pakistan is no friend of a real Afghanistan as an independent country. Afghanistan does have some natural resources and some rudimentary efforts were made to develop them under the Soviets.

The Pashtuns are the dominant tribal group of Afghanistan and Pakistan. This is a major obstacle to any solution of the Afghanistan problem. Pakistan was a political creation at the dissolution of the British control of India. It was poorly done and massive tragedy ensued. Kashmir is one of those mistakes but Pakistan is another in many ways. Perhaps it should have been Pashtunistan except that half the Pashtuns were in Afghanistan, which was about to severe relations with Pakistan.

Pakistan has fomented terrorism in India as part of its Cold War with its neighbor. Much of this is directed at Kashmir but some has been redirected, as in the Mumbai massacre which was originally directed at Kashmir. Pakistan is not a reliable ally.

Countering and Fomenting Insurgencies

In his monograph, Pakistan’s Security Paradox: Countering and Fomenting Insurgencies, Mullick observed what he described as a “duplicitous approach” in Pakistan’s insurgency policy:

* On the one hand, Pakistan has engaged in an effort to counter insurgency (COIN) within its own borders, particularly in the Federally Administered Tribal Areas (FATA).

* On the other hand, Pakistan has been fomenting insurgency (FOIN) across the border in Afghanistan.

* Mullick argued that this policy needs to be considered as part of a coherent Pakistani national security strategy to protect its territorial, economic, and geopolitical interests.

Pakistan is backing the Taliban in Afghanistan and fighting them in Pakistan. Some of this is Pashtun politics.

Mullick argued that Pakistan’s paradoxical COIN/FOIN strategy has undergone several evolutions. Two of these stages hold particular significance for U.S. interests in the region:

* 2001–2008: Pakistan pursued counterinsurgency campaigns against the Pakistan Taliban, Al Qaeda and its affiliates, and separatists in Balochistan. However, Pakistan decided to “selectively target,” and eventually abet, Afghan Taliban, many of whom fled to FATA after the American invasion

* 2009: The Taliban violated a peace deal struck by the government in the Swat Valley and brought their forces within 60 miles of Islamabad. Deciding to regain control over the Valley, Pakistan Army and Special Forces pursued a “hybrid COIN strategy.”

Thus, Pakistan fights when it is threatened but supports the insurgency in Afghanistan, perhaps as a way of redirecting the young militants from its own territory.

Curtis and Tellis questioned whether Pakistan’s shift in emphasis from FOIN to COIN represented a real “paradigm shift” or whether it was merely a transient refinement. Curtis, in particular, objected to the amoral symmetry that Mullick perceives exists between COIN and FOIN in Pakistan’s national security calculus. Pakistan, Tellis further noted, continues to target militant groups selectively, and several prominent networks remain active in Pakistan. These include the Haqqani network based in northern Waziristan, the Hizb-e-Islami Gulbuddin, and the Afghan Taliban. Tellis also emphasized that Pakistan has fomented terrorism in addition to insurgencies and that its efforts with regard to the former have historically been far more effective. To date, there appears to be little change with respect to Pakistan’s support for terrorist groups, such as Lashkar-e-Taiba, which was responsible for the 2008 attacks in Mumbai, India..

Pakistan cannot be trusted and, in fact, may constitute an enemy as it drifts toward militant Islam. Turkey is on the same path. We have to be realistic about what is going on. Our natural ally here is India, a society that has chosen modernity and is pursuing education and commercial development, unlike its neighbor and enemy Pakistan.