Monthly Archives: April 2007

Assigning Blame

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Following up yesterday’s post on the “causes” of the Virginia Tech massacre — I was disappointed to see that Arianna Huffington wrote this:

Reports that Cho had been taking antidepressants once again turn the spotlight on the uneasy question of what role these powerful medications might have played in yet another campus massacre.

It’s the same bloody-morning-after question I’ve been asking since 1998, when we learned 15-year old Oregon school shooter Kip Kinkel, who opened fire in his school cafeteria, had been on Prozac. Nearly ten years — and numerous school-shooters-on-prescription-meds — later, we’re still waiting for answers….

… Eli Lilly, the maker of Prozac, has vehemently denied numerous claims that the drug causes violent or suicidal reactions. But the company’s own documents admit that “nervousness, anxiety, insomnia, inner restlessness (akathisia), suicidal thoughts, self mutilation, manic behavior” are among the “usual adverse effects” of the medication. And a clinical trial found that Prozac caused mania in 6 percent of the children studied.

Can there be any doubt that Cho was exhibiting many of these adverse effects during his reign of terror in Blacksburg? His rambling, multi-media diatribe seems like a textbook example of manic behavior. The question is, was his manic behavior purely the result of a sick mind or was drug-induced psychosis part of the toxic psychological mix?

We don’t know. But we do know that one school shooter after another was on prescription drugs. Kip Kinkel was taking Prozac. Columbine killer Eric Harris was taking Luvox. Red Lake Indian Reservation shooter Jeff Weise was taking Prozac. James Wilson, who shot 2 elementary school kids in Greenwood, South Carolina, was taking anti-depressants. Conyers, Georgia school shooter T.J. Solomon was on ritalin. Is this just a coincidence?

A “coincidence” that people with behavioral problems are prescribed drugs? Huffington seems to think that these were perfectly well-adjusted children until some pharmaceutical salesman got hold of them. I doubt that’s the case. It’s more likely that these kids were given drugs after they developed some behavioral pathologies, in hopes that the drugs would help. Apparently, they didn’t. It is unfortunately the case that Prozac doesn’t do squat for, say, attachment disorder or other personality disorders, which might well have been behind all of the atrocities Arianna cites. It is also unfortunately the case that the only treatment for some problems is long and intensive (and expensive) work with a therapist. It’s easier to hand out pills

We can only speculate what was going on with Seung-Hui Cho, but schizophrenia certainly would account for all of his actions and behaviors. It’s typical for schizophrenics to be perfectly bright and normal children until they hit late adolescence or early adulthood — college years, in other words — when the symptoms begin to manifest. In rare cases symptoms are not apparent until the late 20s or early 30s. John Nash (the subject of “A Beautiful Mind“) fell apart during his graduate school years. The “Unibomber,” Ted Kaczynski, also began to struggle with his symptoms while in graduate school. At the moment it’s thought that schizophrenia is caused by a combination of genetic and environmental causes; it appears some people are born with some brain miswiring that makes them susceptible to developing the disease.

Instead of incessantly looking for scapegoats like Prozac, what we need is a massive overhaul in the way our nation, society, and health system deals with psychiatric disease.

I agree with Joan Walsh that we humans tend to look for patterns or causes in order to reassure ourselves that episodes like the Virginia Tech massacre are not completely random. Well, in a sense, it wasn’t completely random; it happened because a young man with a serious psychiatric disorder wasn’t getting proper treatment and supervision. It just didn’t happen because of cultural rot or video games or even Bill Clinton. Walsh also wrote,

Several of the “lessons” people tried to draw were particularly heinous and bogus, of course. No matter what Michelle Malkin says, the answer to gun violence isn’t more guns. I already wrote about right-wing crackpots’ efforts to blame the victims for not fighting back, and I still can’t believe such cruelty didn’t get more coverage. Instead, on Sunday we got more noxious garbage on ABC’s “This Week,” as Newt Gingrich blamed liberalism for the massacre.

On one level, this wasn’t a surprise. In 1994 the then-House speaker blamed liberalism when Susan Smith murdered her two children in North Carolina, and said the only way to prevent such tragedies was to “vote Republican.” He blamed liberals, again, for the 1999 Columbine killings. What surprises me is not what Gingrich says, but the very fact that the serial adulterer from Georgia is still on Sunday news shows lecturing the nation on morality. Aren’t there enough interesting, respectable, credible Republican leaders to make the rounds?

And can you imagine if a major Democratic Party figure, who was once third in line for the White House and who might run for president again, was saying such idiotic and hateful things about Republicans? Can you imagine if, say, Al Gore blamed the Bush administration, or the conservative movement generally, for the Virginia Tech massacre? He would be howled into political exile by braying right-wingers, but it’s an acceptable part of mainstream discourse to blame liberalism for the nation’s most jarring tragedies. And mainstream media elites wonder why they’re losing their audience. (Tangent, or not: Was there a better symbol of the media elite’s growing irrelevance than the choice of Rich Little to entertain them — and mirror their obsolescence — at the White House Correspondents Association dinner Saturday night, after Stephen Colbert’s brave, bracing, hilarious performance last year?)

(Aside: I actually feel sorry for Rich Little. He’s an elderly fellow who was a big star in the 1970s. Now he probably feels publicly humiliated, and he’s going to be remembered as the old guy who bombed at the press dinner.)

Update: Cho’s commitment papers.

Iraq Bill Out of Conference

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Outstanding —

The House-Senate Conference Committee has just approved the Iraq Accountability Act, which includes the troop readiness standards and benchmarks for the Iraqi government found in the bill that passed the House, as well as a mandatory date to begin redeployment. If the President cannot certify progress by the Iraqi government, redeployment must start by July of this year, with a goal of being completed within 180 days. If the President can certify progress by July, redeployment must begin by October 1 of this year, with a goal of completion within 180 days. Speaker Pelosi and Senate Majority Leader Harry Reid issued the following statement on the Conference Committee approval:

    Pelosi and Reid Call on President to Support New Direction in Iraq

    “The agreement reached between the House and the Senate rejects the President’s failed policies in Iraq and his open-ended commitment to keep American troops there indefinitely and forges a new direction for a responsible end to the war.

    “If the President follows through on his veto threat, he will be the one who has failed to provide our troops and our veterans with the resources they need and it will be the President who has rejected the benchmarks he announced in January to measure success in Iraq. The bill ensures our troops are combat-ready before they are deployed to Iraq, provides our troops the resources and health care they deserve in Iraq and here at home, and responsibly winds down this war.

    “Iraqis must take the tough and necessary steps to secure their nation and to forge political reconciliation. Secretary of Defense Robert Gates understands the value of timelines in motivating the Iraqi Government to accomplish these goals. The President should carefully consider the views of his Secretary of Defense in making a judgment on this legislation.

    “An overwhelming majority of Americans, bipartisan majorities in both houses of Congress, military experts and the Iraq Study Group believe that a responsible end to the war best advances our national security needs. It is now up to the President to make a decision: continue to stay his failed course or join us to give our troops a strategy for success.”

Mandatory redeployment, children. Now let’s hope it passes quickly.

The Associated Press reported earlier today,

Defying a fresh veto threat, the Democratic-controlled Congress will pass legislation within days requiring the start of a troop withdrawal from Iraq by Oct. 1, Senate Majority Leader Harry Reid said Monday.

The legislation also sets a goal of a complete pullout by April 1, 2008, he said.

In remarks prepared for delivery, Reid said that under the legislation the troops that remain after next April 1 could only train Iraqi security units, protect U.S forces and conduct “targeted counter-terror operations.”

Bush reaffirms rejecting timetable

Reid spoke a few hours after Bush said he will reject any legislation along the lines of what Democrats will pass. “I will strongly reject an artificial timetable (for) withdrawal and/or Washington politicians trying to tell those who wear the uniform how to do their job,” the president said.

Bush made his comments to reporters in the Oval Office as he met with senior military leaders, including his top general in Iraq, Gen. David Petraeus.

Taken together, Reid’s speech and Bush’s comments inaugurated a week of extraordinary confrontation between the president and the new Democratic-controlled Congress over a war that has taken the lives of more than 3,200 U.S. troops.

Nine U.S. soldiers were killed in Iraq today by a single suicide bomber.

Reid isn’t backing down. He said today that Bush is “in denial.”

“No more will Congress turn a blind eye to the Bush administration’s incompetence and dishonesty,” Senate Majority Leader Harry Reid (news, bio, voting record) said in a speech in which he accused the president of living in a state of denial about events in Iraq more than four years after the U.S.-led invasion. …

… In his remarks, Reid criticized Bush and called Vice President Dick Cheney the president’s “chief attack dog,” lacking in credibility.

He likened the president to Lyndon Johnson, saying the former president ordered troop escalations in Vietnam in an attempt “to save his political legacy,” only to watch U.S. casualties climb steadily.

Bush, he said, “is the only person who fails to face this war’s reality — and that failure is devastating not just for Iraq’s future, but for ours.”

The Right is throwing everything they have at him, including David Broder of the Washington Post. Think Project explains,

David Broder, the sagely insightful “dean” of the Washington press corps, attacked Senate Majority Leader Harry Reid (D-NV) today over his claim that the war in Iraq is lost.

Speaking on XM radio, Broder said that Reid should “learn to engage mind before mouth opens,” and suggested that Reid’s Senate allies “have a little caucus and decide how much further they want to carry Harry Reid” and his “bumbling performance.”

Asked if Harry Reid is “an embarrassment,” Broder said, “I think so,” since “every six weeks or so there’s another episode where he has to apologize for the way in which he has bungled the Democratic case.”

Well, somebody’s a public embarrassment, but I don’t think it’s Harry Reid.

Greg Sargent writes that, some reports to the contrary, Harry Reid has not backed off from or apologized for his “war is lost” comment from last week. See also Atrios.

That Dog Won’t Hunt

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You might have heard that New Gringrich blamed the Virginia Tech tragedy on liberals. I don’t know why anyone would be surprised at this. The pseudo conservative Right has been blaming liberals for everything wrong with the world for years. Essentially they took the old John Birch liturgy and substituted “liberal” for “Communist.” And they got away with this for a long time.

However, the Right was in total control of the federal government for the past few years, and during that time the world became more screwed up than it ever was, I wonder how well “it’s all liberals’ fault” still works. That might have been persuasive to some back when Democrats had had a majority in Congress for many years. Now it just sounds pathetic.

Also, from Think Progress:

In a new video, the the right-wing American Family Association attributes the tragedy at Virginia Tech to: a lack of prayer in school, a lack of the Bible in school, a lack of spanking kids, a lack of physical punishment in school, abortion, condoms, Bill Clinton, internet pornography, free speech, the entertainment industry, “satanic” music, and liberal culture in general.

An op ed in today’s Wall Street Journal also blames liberalism for the Virginia Tech shootings. Unlike the rantings of Gingrich and the AFA, this argument has a shred of truth. Not the whole truth, but some truth. Jonathan Kellerman writes about the anti-asylum movement of the 1970s that shut down many large psychiatric facilities and made it more difficult for people to be committed against their will.

Kellerman blames some off-the-wall theory floating around in psychiatric circles that “madness could be a reasonable reaction to an unjust society” and even that mental illness did not exist. As I remember at the time, the real impetus to closing many hospitals was the perception they had become little more than warehouses for people who might be better off in some kind of supervised living situation. Yes, some people who wanted to close the hospitals had seen “One Flew Over the Cuckoo’s Nest” a few too many times. Others thought that patients might benefit from something like a halfway house arrangement until they were well enough to take care of themselves, instead of being locked up in a hospital. I think in some cases that’s a valid argument.

The problem was that this plan was only carried through halfway. Hospitals were closed, but the patients in them were not given the less-restrictive alternative they had been promised. They were just turned loose. Many ended up homeless or in jail. A few were a genuine danger to themselves and others.

The other part of the equation, involuntary commitment, is a bit dicier. Certainly involuntary commitment used to be abused. On the other hand, people who are psychotic or delusional are hardly in a position to make informed decisions about themselves.

In my long sorry life I’ve heard of a number of atrocities committed by disturbed people who had been denied adequate medical treatment. One that comes to mind is the murder of a New Jersey boy in 1997. The murderer was a 15-year-old whose parents had attempted to place in a hospital just days before. The parents were afraid the youth was a danger to himself, and possibly to others. The hospital psychiatric screening unit and a family court judge disagreed, and the judge told the family to get outpatient help. Shortly after this the youth sexually molested and then strangled an 11-year-old who was selling candy in the neighborhood.

The famous Andrea Yates who drowned her five children while in a psychotic state had been in and out of psychiatric facilities and the care of various shrinks for years before this tragedy. One limiting factor to her treatment was how much her medical insurance would pay. And, yes, her husband also made some boneheaded decisions, but in the days leading up to the tragedy he also had made some effort to get more aggressive treatment for her, without success.

But the bottom line is that as a nation, as a society, we have not shown much interest in resolving the issue of what to do about people with psychiatric illnesses. If Seung-Hui Cho had not killed himself, right now the nation would be arguing itself hoarse over the insanity defense. Instead, people are mostly ignoring Cho’s obvious mental disturbance and instead are using the tragedy to promote their (usually unrelated) political and social agenda.

I’m not sure what to do about the psychotics among us, either. But I do suspect the solution will require (1) much improved access to psychiatric health care as part of an overhaul of health care generally, and (2) better public education about psychiatric illness.

Our Troops Are Bush’s Hostages

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Paul Krugman says President Bush is holding our troops hostage.

There are two ways to describe the confrontation between Congress and the Bush administration over funding for the Iraq surge. You can pretend that it’s a normal political dispute. Or you can see it for what it really is: a hostage situation, in which a beleaguered President Bush, barricaded in the White House, is threatening dire consequences for innocent bystanders — the troops — if his demands aren’t met. …

… Mr. Bush isn’t really trying to win the argument on the merits. He’s just betting that the people outside the barricade care more than he does about the fate of those innocent bystanders.

This is an outstanding column that I urge you to read all the way through. Here’s a bit more:

What’s at stake right now is the latest Iraq “supplemental.” Since the beginning, the administration has refused to put funding for the war in its regular budgets. Instead, it keeps saying, in effect: “Whoops! Whaddya know, we’re running out of money. Give us another $87 billion.”

At one level, this is like the behavior of an irresponsible adolescent who repeatedly runs through his allowance, each time calling his parents to tell them he’s broke and needs extra cash.

What I haven’t seen sufficiently emphasized, however, is the disdain this practice shows for the welfare of the troops, whom the administration puts in harm’s way without first ensuring that they’ll have the necessary resources.

As long as a G.O.P.-controlled Congress could be counted on to rubber-stamp the administration’s requests, you could say that this wasn’t a real problem, that the administration’s refusal to put Iraq funding in the regular budget was just part of its usual reliance on fiscal smoke and mirrors. But this time Mr. Bush decided to surge additional troops into Iraq after an election in which the public overwhelmingly rejected his war — and then dared Congress to deny him the necessary funds. As I said, it’s an act of hostage-taking.

There’s been a lot of rhetoric about Bush and Congress playing a game of “chicken” over Iraq. I’ve witnessed also a ton of debate — public and private — on the Left about strategy and the virtues of passing a tough bill rather than a weak bill. Although the final bill is still in conference, rumor has it that the bill Congress will send Bush probably will have a “nonbinding” timetable as opposed to a firm one. This has got many who oppose the war wringing their hands about spineless Dems, which has become a habit on the Left. I’ve done plenty of it, too.

But I think, just this once, it doesn’t matter much. The important thing is to get Bush a bill that contains as many conditions on the Decider’s unfettered power as Congress can pass reasonably quickly. This means, like it or not, a bill that can get the votes of most of the conservative, Blue Dog Democrats and at least some Republicans. Because whatever bill Congress sends to Bush will be vetoed. A weak bill, a strong bill; doesn’t matter. It will be vetoed, because George Bush has a pathological aversion to being told what to do.

If Congress does send Bush a weak bill he would be smart to sign it. But his ego is on the line, so he won’t be smart. He’ll be stubborn. You can count on it.

Some are arguing today that since Bush will veto the bill, Dem leadership should be putting pressure on the softer Dems and antiwar Republicans to get on board with a strong bill. I’m fine with that, but only if this can be accomplished reasonably quickly. The worst thing Congress can do now is have a long-drawn-out fight over the wording of the bill. This would give the hawks plenty of time to saturate the nation with a propaganda campaign about “divided” Democrats wasting time providing critical supplies to our troops.

This is a public relations war, and much of the public isn’t going to pay attention to the fine print. What they’ll notice is Dems coming together quickly and decisively to send Bush a bill putting limits on the war. Or they’ll notice Dems fighting among themselves for weeks on end, unable to send Bush a bill putting limits on the war.

On the other hand, if Congress sends Bush a relatively weak bill, and he vetoes it, the Dems can rightfully say that Bush won’t compromise and isn’t interested in working with Congress to find a resolution to the Iraq problem. They could fan out around the country and tell constituents that the troops are hostage to Bush’s ego, and I think people would agree.

I’ve heard it argued that the antiwar Dems should hold out for the toughest possible bill, leaning on the “softer” Dems to comply, so that the public will perceive Dems to be strong. If Dems send a weak bill to Bush, the theory is, the public will lose respect for Dems. Maybe. But I think what would make Dems look even weaker is if they have to fight for several weeks to get the votes for a stronger bill, while Bush and his surrogates strut about the country saying that the Dems don’t know what they want, and that they’re just piddling around playing political games while the troops need their appropriation.

The worst thing that could happen is if the House-Senate conference puts together a tough bill that can’t pass, forcing them to crank out a series of incrementally weaker bills until they write one that can get a majority on board. That’s what would make the Dems look really weak. The GOP would have a fine time exploiting congressional pussyfooting.

Time is of the essence, as the lawyers might say. Whatever bill goes to Bush needs to go no later than next week, IMO. I’d love it if the Dems could send Bush a bill with a binding timetable, but not if it’s going to take several weeks and multiple passes to get to Bush’s desk.

Remember, there’s no rule that says Congress has to send Bush an even weaker bill next time. Some of the hand-wringers are making that assumption, but that’s not necessarily how it’s going to play out. IMO Dem leadership is just as likely to go to the public and say, well, we tried to work with him, but he won’t budge. So now we’ll have to get tough.

The fact is that nothing with any strings attached whatsoever will become law until there’s enough support for it to override Bush’s veto, and we’re still a long way away from that. Instead of endlessly carping at Harry Reid, Nancy Pelosi and David Obey, I wish the antiwar hotheads would apply pressure on the Blue Dogs and Republicans to help build a veto-proof majority for a bill that puts limits on Bush’s power. That would be (dare I say it?) useful, rather than self-indulgent.

We lefties can be our own worst enemies sometimes. I agree with what Swopa of Needlenose wrote here —

Personally, I don’t care if Bush doesn’t veto the bill, because that just sets him up for another measure to enforce the “advisory” language he’s already accepted. Here’s what I wrote a month ago:

    This is not going to be the last vote on the war, because as we all know, the war’s toll and the public’s revulsion towards it aren’t going to go away. Rather than tear ourselves apart trying to get everything we want on the first vote, progressive Dems are being smart to take what’s being offered — then, they should come back a minute after this vote and start asking for more. This should be the beginning of the snowball, the camel’s nose under the tent, a slippery slope, whatever cliche you want to use… and it’s time to stop settling for noble, principled defeats and learn how to win instead.

That logic is the same regardless of whether the bill Pelosi and Reid finish with includes mandatory timelines or merely “goals.”

In that same post, I wrote, “Kudos to Speaker Pelosi and the progressive Democrats in the House who recognized that the PR difference between even a small step toward ending the war and failing to pass anything will be enormous.” The aftermath of the initial votes has already demonstrated this, as Dems have become associated in the public’s mind with backing an end to the war.

For anti-war progressives to turn their back on the bill that comes out of the conference committee because the language isn’t strong enough would be essentially asking to give back what Democrats have gained in defining public opinion — and it would fly in the face of the reality that ordinary Americans aren’t parsing the differences in phrasing the way activists are. Sometimes, you just have to be smart enough to recognize that you’re winning, and not talk yourself out of what got you there.

The real fight is going to begin after the veto. What’s going on now is just ritual.

In related news: Davis Espo writes for the Associated Press:

With a veto fight looming, Senate Majority Leader Harry Reid said Monday that President Bush is in a state of denial over Iraq, “and the new Congress will show him the way” to a change in war policy.

Reid, D-Nev., said the Democratic-controlled House and Senate will soon pass a war funding bill that includes “a fair and reasonable timetable” for the withdrawal of U.S. combat troops. In a speech prepared for delivery, he challenged Bush to present an alternative if, as expected, he vetoes the measure.

This is smart, but the “Congress will show him the way” rhetoric only works if Congress can get a bill to Bush quickly. I can’t emphasize that enough.

This is from an editorial in today’s New York Times:

President Bush is taking every opportunity to rail against the troop withdrawal deadlines in the war-spending bills that Congress is readying for passage. He warns that Congressional attempts to set deadlines will harm the troops in Iraq, because a political fight over timetables will delay money needed for the frontlines.

The assertion is completely contrived. Mr. Bush voiced no such misgivings last year, when the Republican-led Congress took until June to complete a war financing bill. The $103 billion Mr. Bush wants— and Congress is ready to provide — is for spending through the end of September. It’s not needed in a lump sum or on any particular date in the near future. In the end, the real obstacle to getting the money promptly to the troops will be the veto that the president has threatened to issue on the final bill. …

…Ideally, all nonemergency government spending — which obviously includes the Iraq war at this point — would be included in the annual federal budget. But ever since he started the war in 2003, Mr. Bush has maneuvered to pay for it via separate emergency measures. That ploy created a false impression of urgency, which made lawmakers who questioned the spending seem irresponsible. The effect was to short-circuit real debate about the war. Now that Democrats are using the bill precisely to raise questions — and pose answers — Mr. Bush is desperate to derail it.

If you want to see what a real spineless wimp does look like, don’t look at Harry Reid. Look at Doug Schoen, a political consultant (of course) who flaps about in today’s Boston Globe that

The 2008 election is the Democrats’ to lose. Attempting to usurp the powers of the commander of the chief — or risking the charge that Democrats have abandoned troops in the field — is one of the few ways the party could jeopardize its seemingly impregnable position. The best chance to end the war is to make sure the next president is a Democrat.

Bleep that. Congress isn’t attempting to “usurp” any powers the Constitution gives it, and I think more and more of the public is hungry to see Bush taken down a few pegs.

Finally — I regret I don’t have time today to demolish this piece by piece, but Michael Chertoff has an op ed in today’s Washington Post that argues the Iraq War really is essential to national security. He evokes September 11 in the first sentence. No, really. Y’all don’t need me to tell you how bleeped up this is.

Haley Barbour, Baby Killer

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Gov. Haley Barbour of Mississippi hates abortion. On March 23 he signed a bill that would criminalize all abortions in Mississippi as soon as Roe v. Wade is overturned. After the nomination of Sam Alito to the Supreme Court, Barbour announced his support a bill that allowed abortion only to save a woman’s life but made no exceptions in cases of rape or incest. (He would prefer a bill that made a rape and incest exception, but said he would sign the bill without it.)

Sharon Lerner wrote in The Nation (February 7, 2005):

As you read this piece about abortion in Mississippi thirty-two years after the right to have an abortion was affirmed by the Supreme Court, the government of Mississippi is marking the anniversary of Roe v. Wade in another way. Governor Haley Barbour has issued an official proclamation declaring the seven days leading up to the anniversary “a week of prayer regarding the sanctity of human life.” Barbour also authorized the placement of tiny white crosses on the lawn of the state Capitol “in memory of the unborn children who die each day in America,” according to the decree.

You get the picture. However, in Mississippi there’s much less concern for the lives of children after they are born.

I mentioned this in the last post — in an article to be published in tomorrow’s New York Times, Erik Eckholm writes that infant mortality rates in some of the southern states are going up.

To the shock of Mississippi officials, who in 2004 had seen the infant mortality rate — defined as deaths by the age of 1 year per thousand live births — fall to 9.7, the rate jumped sharply in 2005, to 11.4. The national average in 2003, the last year for which data have been compiled, was 6.9. Smaller rises also occurred in 2005 in Alabama, North Carolina and Tennessee. Louisiana and South Carolina saw rises in 2004 and have not yet reported on 2005.

Whether the rises continue or not, federal officials say, rates have stagnated in the Deep South at levels well above the national average.

Here’s more —

Most striking, here and throughout the country, is the large racial disparity. In Mississippi, infant deaths among blacks rose to 17 per thousand births in 2005 from 14.2 per thousand in 2004, while those among whites rose to 6.6 per thousand from 6.1. (The national average in 2003 was 5.7 for whites and 14.0 for blacks.)

The overall jump in Mississippi meant that 65 more babies died in 2005 than in the previous year, for a total of 481. …

…Poverty has climbed in Mississippi in recent years, and things are tougher in other ways for poor women, with cuts in cash welfare and changes in the medical safety net.

Here’s where Gov. Barbour comes in.

In 2004, Gov. Haley Barbour came to office promising not to raise taxes and to cut Medicaid. Face-to-face meetings were required for annual re-enrollment in Medicaid and CHIP, the children’s health insurance program; locations and hours for enrollment changed, and documentation requirements became more stringent.

As a result, the number of non-elderly people, mainly children, covered by the Medicaid and CHIP programs declined by 54,000 in the 2005 and 2006 fiscal years. According to the Mississippi Health Advocacy Program in Jackson, some eligible pregnant women were deterred by the new procedures from enrolling.

One former Medicaid official, Maria Morris, who resigned last year as head of an office that informed the public about eligibility, said that under the Barbour administration, her program was severely curtailed.

“The philosophy was to reduce the rolls and our activities were contrary to that policy,” she said. …

… The state Health Department has cut back its system of clinics, in part because of budget shortfalls and a shortage of nurses. Some clinics that used to be open several days a week are now open once a week and some offer no prenatal care.

The department has also suffered management turmoil and reductions in field staff, problems so severe that the state Legislature recently voted to replace the director.

Oleta Fitzgerald, southern regional director for the Children’s Defense Fund, said: “When you see drops in the welfare rolls, when you see drops in Medicaid and children’s insurance, you see a recipe for disaster. Somebody’s not eating, somebody’s not going to the doctor and unborn children suffer.”

Questions: Is Gov. Haley Barbour one of the most craven hypocrites on the planet? Or is he just oblivious to the suffering he is causing? And does the fact that many of Mississippi’s black citizens are living in third-world conditions even register with him?

More Late-Term Confusion

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Time and time again I am struck by how little people know about abortion law and practice in the U.S. This includes most people with firm opinions on abortion. For example, earlier this week I noticed one right-wing blog after another celebrating the end of “late-term abortions,” by which they obviously mean abortion of a viable fetus, presumably for frivolous reasons. Example:

Most Americans, even those who are pro-choice, understand how sick this procedure was. If a late term pregnancy was so harmful to the mother’s health, then the mother should just deliver the baby and give the baby a chance to survive. But this procedure wasn’t really about saving the life of the mother. It was about killing an unwanted baby. …

… Some lefties are angry at Justice Kennedy, claiming that he’s abandoned them, and now they’re lamenting the fact that killing a late term unborn baby by sucking its brains out is no longer legal. Of course, they disguise partial birth abortion as “women’s rights,” which is a bunch of hooey.

Here’s a feminist whose first comment was “We’re f***ed.” Sure, lady, if you mean that you can’t go to an abortionist when you’re 6+ months pregnant and have your unborn baby almost completely delivered except for his head and have his brains sucked out while he’s still alive because you just don’t feel like being pregnant any longer, then yes, I suppose you’re f***ed. Be sure to check out the comments on this feminist’s blog as well. These wacko women are beside themselves about the fact that they can’t kill their babies in this manner any longer.

But elective late-term abortions were already illegal in most states. Roe v. Wade allows states to ban abortions once the fetus has reached the gestation age at which it is potentially viable, about 23 weeks[*], except when the life and health of the mother are at risk. There are laws on the books in most states to that effect. Some of the states that don’t have such laws in effect are those which tried to enact a law without the “life and health” exception, and the law got tangled up in court challenges.

[* Recently an infant survived that was believed to have been born at 21 weeks gestation. This made international news because she was the first baby ever known to have survived after a gestation period of fewer than 23 weeks.]

A PDF document at the Alan Guttmacher web site provides an overview of abortion law in the states as of April 1, 2007. It’s a three-page document, and pages 1 and 2 are a table that provides basic information on the abortion laws of each state. If you doubt what I say about elective late-term abortion already being illegal, just take a look.

The “Partial Birth” Abortion Act of 2003, while burdened with several miscarriages of fact and logic, makes no provisions for the lateness of the procedure, just the nature of the procedure. The real battle begun by this week’s SCOTUS ruling is not over “late term” abortions, but “mid term” abortions, meaning second-trimester abortions performed before a fetus is possibly viable.

Roughly 10 percent of all abortions in the U.S. are performed after the first trimester and before 20 weeks’ gestation, or about two thirds of the way through the second trimester. Some of these are performed for medical reasons, and some are elective. However, when a pregnancy is terminated before 20 weeks’ gestation, the fetus will die, no matter how the abortion is performed. No exceptions. So when people start raving about changing procedures so that “the baby has a chance to live,” they are confused.

The fact is, there is little agreement about what it was that was just banned. Depending on how the “partial birth” act is interpreted, it might ban no abortions at all, but only stipulate that abortions be performed by different means. Or, it might ban most abortions after the first trimester. And I won’t be the least bit surprised if some states “interpret” the act in a way that shuts off access to abortion entirely.

So what was just banned, exactly?

About the only point everyone seems agreed on is that the act bans a second trimester (notice emphasis) procedure called “intact D&E” (sometimes referred to as dilation and extraction, or D&X) in which all but the fetal head is extracted, then the fetal skull is pierced or crushed so it can easily pass through the birth canal. However, the far more common practice in second trimester abortions is dilation and evacuation , also called standard D&E, in which surgical instruments are used to dismember the fetus in the womb, and body parts are pulled out through the birth canal.

Exactly why one procedure is more icky than the other eludes me. However, my understanding is that some physicians prefer intact D&E (or D&X) procedures because with the standard D&E physicians must fish around for all the little fetus pieces, thus increasing risk of injury or infection to the woman. In some cases a woman whose life or health is really on the line might be at less risk with an intact D&E rather than a standard D&E.

There is one other abortion method generally used in the late second trimester called “induction.” In this procedure chemicals are introduced into the womb to cause fetal death, and then labor is induced. So far I haven’t heard anyone argue that induction is covered by the “partial birth” ban, but I also doubt many Fetus People have heard of it. My understanding is that induction is the most common method used in genuinely late-term abortions, of which I’ll speak a bit later in this post.

Analysis of this week’s Supreme Court decision written by people who seem to understand these distinctions say that the “partial birth” act actually bans only the “intact D&E,” also called D&X, procedure. It does not ban standard D&E or induction abortions, they say. Nor does it change the gestational limits of abortion, so abortions will be no more or less “late term” as they were before. And if you read this section of the Supreme Court’s deliberations, this view appears to be correct; the justices interpret the Act to ban D&X, but not standard D&E, procedures.

National Right to Life has its own views (emphasis added).

“Partial-birth abortion” is a legal term of art, defined by Congress as a matter of federal law, as quoted above.

Although supporters and opponents of the new law differ dramatically in their perceptions of what methods the law covers (as discussed below), neither side believes that the legal definition of “partial-birth abortion” is synonymous with the shifting and conflicting descriptions attached in various literature to such pseudo-medical jargon terms as “dilation and extraction,” “intact dilation and evacuation,” or “intact dilation and extraction.”

In short, it is simply inaccurate for journalists to equate the legal term “partial-birth abortion” with these nebulous jargon terms.

For the record, The American College of Obstetricians and Gynecologists says,

Despite the fact that the safety advantages of intact dilatation and evacuation (intact D&E) procedures are widely recognized—in medical texts, peer-reviewed studies, clinical practice, and in mainstream, medical care in the United States—the US Supreme Court today upheld the Partial-Birth Abortion Ban Act of 2003.

The “partial birth” claptrap was coined by the Fetus People as a propaganda tactic, and they define it to please themselves. If in the next few weeks or months they don’t decide that the “partial birth” act also covers standard D&E, I will eat my keyboard. Because if the “PAB” Act truly bans only intact D&E/D&X abortion, those celebrating the end of “late term” abortions may be in for a shock. Very likely the same number of abortions will still be performed, and as early or late as they were before.

In today’s New York Times, a Cambridge fellow named David Garrow also tells us, soothingly, that hardly anything will actually change.

The Carhart decision is an extremely limited upholding of the federal ban, one that promises to affect very few abortion providers and only a tiny percentage of their patients. The most recent and reliable national statistics, from the Guttmacher Institute, show that only about 30 American doctors ever use the “intact dilation and evacuation” method that has now been criminalized. Only some 2,200 of the 1.3 million abortions performed annually in the United States involve the banned procedure.

Moreover, Justice Kennedy explicitly and insistently limited the reach of the new prohibition. He emphasized that the ban covers only the relatively rare intact dilation and evacuation method, and does not in any way apply to standard dilation and evacuation, the most common method for late-term abortions, in which fetal tissue is removed from the womb piecemeal. Reiterating the standard he embraced 15 years ago in Planned Parenthood v. Casey, Justice Kennedy stated that the ban would impose an undue burden if it covered standard dilation and evacuation and thus would be unconstitutional. …

… Writing on behalf of the four dissenters, Justice Ruth Bader Ginsburg correctly emphasized that under Justice Kennedy’s holding, “the law saves not a single fetus from destruction, for it targets only a method of performing abortion.”

Also in today’s New York Times, Gina Kolata writes,

The Supreme Court decision on Wednesday to uphold a ban on a type of abortion, has huge political implications but, as a practical matter, is unlikely to have much of an effect.

The reason, said Dr. Isaac Schiff, chairman of the department of obstetrics and gynecology at Massachusetts General Hospital in Boston, is that there are safe and readily available alternatives to the banned method, which the law calls partial birth abortion.

“This law by itself, if it were the only law passed, would be a nonoccurrence,” Dr. Schiff said.

I’m not arguing here that we should be complacent, because there is copious medical testimony from ACOG and others that under some circumstances the alternative methods could put some women at increased risk. And you know the Fetus People are not going to be content with the “PBA” law. They will push ahead to legislate more restrictions. This was just a beginning.

On the other hand, I do think we need to be careful about making predictions of wholesale slaughter of women resulting from the “PBA” ban. There may not be a statistically significant result, in which case the Fetus People will be emboldened, and we who think women are not brood animals might be less credible when they try to extend the ban to other procedures.

Now, about real late-term abortions —

Organizations working to criminalize abortion have done a great job conflating the terms “late term” and “partial birth,” and I infer most wingnuts think they’re the same thing. This has led to fuzzy headed assumptions (such as the one quoted at the top of this post) that women routinely waltz into abortion clinics in the last trimester of pregnancy and demand abortions because they are having a bad hair day. But I’ve seen no authoritative data saying that elective third-trimester abortions are being performed by licensed medical personnel anywhere in the U.S., including those few states that haven’t expressly banned them.

And it’s very rare for a viable fetus to have to be sacrificed to save a mother. I understand third-trimester abortions are most commonly done when the fetus is already dead or has no hope of survival, but I don’t have a source to prove that. On the other hand, “rare” is not “never,” and if you (or your wife, or daughter, or sister, or mother) are one of the rare exceptions, is that OK? And how weird is it to justify sacrificing the life of even one woman for some twisted principle misnamed the “right to life”?

Eleanor Clift writes of third-trimester abortions:

Late-term abortions account for only .08 percent of the 1.3 million abortions that take place in this country every year. Most of that .08 percent are done to protect the life of the mother, so they are not affected by the Court’s ruling. This is a tiny, tiny sliver of a much larger issue. Politicians of either party seeking the center on an issue with such moral ramifications should be able to agree on ways to reduce abortions without criminalizing a medical procedure—and putting doctors, and potentially, women, in jail.

But today wingnuts everywhere no doubt still believe that “late term” abortions are banned. And this takes us to why NARAL is one of the most worthless advocacy organizations ever invented. For years newspaper and television reporters have sloppily used “late-term abortion” as a synonym for whatever it is the wingnuts call “partial-birth abortion.” And for years I’ve been yelling at television screens “MID-term, you twit!” to no avail. NARAL really should have been working hard to educate journalists about the distinctions. I see no evidence they ever did so. Instead, journalists have been getting all of their “information” from abortion criminalization groups and repeating their propagandistic language.

There have been some excellent critiques of NARAL on firedoglake this past week, including this one by Brendan and this one by Phoenix Woman. If you are upset by this week’s SCOTUS ruling, whatever you do don’t donate money to the national NARAL organization. Volunteer or donate money to a local NARAL chapter or, even better, Planned Parenthood.

Back in the 1970s I thought NARAL was making a big mistake not to issue a clear statement in support of banning elective third trimester abortions, as Roe v. Wade allowed, by any means. NARAL was concerned about the famous slippery slope, but I think making a clear distinction about elective post-viability abortions would have defused much rightie propaganda that has hurt the cause of reproductive rights and health lo these many years.

The fact is — and having given birth to two babies myself, I say this with authority — if a woman does not want to be pregnant, she needs to terminate that pregnancy way before the third trimester begins. Because at that point you’re about as pregnant as anybody ever gets. The hormones are raging, the ankles are swollen, you may have gained most of your pregnancy weight, and your “innie” belly button has popped out and become an “outie.” (I’m explaining this to guys; frankly, I doubt many women have ever willingly carried a pregnancy to the sixth month and suddenly decided to end it.) And by then, however the pregnancy is terminated — childbirth or otherwise — it’s a big honking medical deal that is riskier than a first-trimester abortion. A legal gestational limit on elective abortion set somewhere between 20 and 23 weeks would simply reflect good medical practice. But that’s my sermon.

One more thing — in an article to be published in tomorrow’s New York Times, Erik Eckholm writes that infant mortality rates in some of the southern states are going up.

To the shock of Mississippi officials, who in 2004 had seen the infant mortality rate — defined as deaths by the age of 1 year per thousand live births — fall to 9.7, the rate jumped sharply in 2005, to 11.4. The national average in 2003, the last year for which data have been compiled, was 6.9. Smaller rises also occurred in 2005 in Alabama, North Carolina and Tennessee. Louisiana and South Carolina saw rises in 2004 and have not yet reported on 2005.

Whether the rises continue or not, federal officials say, rates have stagnated in the Deep South at levels well above the national average.

By contrast, many developed nations and some states in the U.S. in recent years have an infant mortality rate of less than 5 per 1,000 live births. Clearly, infants are dying in the South who would not have died had they been born in, say, Massachusetts. Righties love to argue that because of some discrepancies of how infant mortality is calculated by various nations, comparisons between the U.S. and other nations is meaningless (this is bogus, but I’ll leave that alone for now). But when you’ve got a rate of 11.4 in Mississippi and 4.9 in California, I’d say there’s something wrong with Mississippi.

But right now I will predict that the state legislatures of these southern states will put little effort in the coming months into improving the health of pregnant women and small children, and will instead work overtime thinking up new ways to restrict abortion. Anyone wanna bet?

Update: Something the Fetus People say never happens.

Hysteria, Thy Name Is Wingnut

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Some rightie bloggers have their knickers in a knot because the Canadian Broadcast Corporation (apparently; none of them link to the original article, but this guy provides a screen shot) used what was probably a stock photo of factory smokestacks to illustrate a global warming article.

Why is this scandalous? Apparently the CBC has used the same stock photo in other stories — possibly they own it — and they tweak the colors and crop it different ways to make it work with the story. But the photo isn’t anything but an eye catcher, something graphic to break up text. From what I can tell the CBC never put a caption on it and aren’t claiming it stands for anything in particular except factory smokestacks in a generic sense.

Some people need another hobby.

The site linked above says “Set aside for a moment the journalistic misrepresentation on display in using a photo depicting air pollution to illustrate a story on the costs of meeting Kyoto mandated C02 reductions… ” Right, factory emissions don’t have anything to do with C02 … oh, wait …

Reid to Bush: Bring It On

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The carnage in Iraq continues. Shashank Bengali, Laith Hammoudi and Nancy A. Youssef write for McClatchy Newspapers:

At least 173 people died in Baghdad on Wednesday in a series of major explosions, making the day the capital’s deadliest since the onset nine weeks ago of a much-touted U.S.-Iraqi security plan.
The violence capped a dreadful seven days that began with a stunning suicide attack in the Iraqi parliament building in the heavily fortified Green Zone. At least 363 people have died in Baghdad in the past week.

And Polly Toynbee writes for The Guardian:

It’s been a good week for death. In Iraq, 200 people were blown to bits in what witnesses called “a swimming pool of blood” with “pieces of flesh all over the place”. Remember that the dead are only part of the story: add to each of the war’s hundreds of thousands of civilian corpses all those burned and crippled survivors, far beyond Iraqi medical facilities’ ability to cope, breadwinners and babies lost. Few families are untouched by the sheer scale of slaughter.

Naturally, today officials at the Pentagon said that violence in Iraq is diminishing. Of course, this depends on what you mean by “violence” and “diminish.” And “Iraq.”

Just to show how secure the Pentagon is in its assessment — National Journal reports (subscriber only material, so I don’t have a link):

Pentagon lawyers abruptly blocked mid-level active-duty military officers from speaking Thursday during a closed-door House Armed Services Oversight and Investigations Subcommittee briefing about their personal experiences working with Iraqi security forces.

The Pentagon’s last-minute refusal to allow the officers’ presentations surprised panel members and congressional aides, who are in the middle of an investigation into the effort to train and organize Iraqi forces.

Clearly, the Pentagon is proud of what it is accomplishing in Iraq.

Also on Wednesday, President Bush met with congressional Democrats to discuss the “emergency” supplemental appropriations bill, which Democrats in Congress are calling the Iraq Accountability Act. Greg Sargent provides a peek at what happened:

A source familiar with the meeting — at which no compromise of any kind was reached, though Speaker Nancy Pelosi said publicly today that it had been “productive” — shares a few interesting tidbits. First, the source says, Bush bristled and was taken aback when Senate Majority Leader Harry Reid compared the current situation to Vietnam; he also appeared irked by those who said the war couldn’t be won.

Second, according to the source, Reid told Bush that he understood that the White House would come after Congressional Dems after the veto of the bill with everything they had; Reid vowed to respond every bit as aggressively.

“Reid talked about a recent conversation he had with a retired general where they talked about the similarities between the current situation and Vietnam,” the source relates. “He talked about how the President and Secretary of Defense [during Vietnam] knew that the war was lost but continued to press on at the cost of thousands of additional lives lost.”

“The analogy to Vietnam appeared to touch a nerve with the President. He appeared a little sensitive to it,” the source continued. “And he clearly didn’t like to hear people in the room say that the war couldn’t be won militarily.”

More: “Reid made it clear to the President that he understood that the President and Vice President after the veto would come after him and Speaker Pelosi with everything they have. Reid said that he and Pelosi would respond just as aggressively. He said he was convinced that they were on the right side of the issue.”

Yesterday’s Dan Froomkin post:

There were no pyrotechnics, but according to multiple reports Senate Majority Leader Harry Reid compared Iraq to Vietnam at one point in a closed door meeting with Bush. Specifically, Reid suggested that Bush was pursuing a lost cause at the cost of American troops in order to protect his legacy.

Bush’s reaction: He was “visibly angered” says the New York Times; he “bristled” according to the Associated Press. And he “denied this forcefully, after which Mr. Reid touched his arm in a gesture of friendliness,” write the Wall Street Journal.

Meanwhile, the Iraq Accountability Act makes its way toward completion. Last night some Republican House members attempted to to strip provisions in the Act holding the Iraqi government accountable and providing for a “responsible redeployment from Iraq” (nice phrase, that) before the bill goes to conference committee for reconciliation with the Senate version. This attempt failed.

Although the Act is still a work in progress, after slogging through a number of news stories I get the impression that the House might defer to the Senate regarding the timetable language. The Senate bill has a non-binding goal of March 31, 2008 for withdrawing U.S. troops from Iraq. The House version has a firm deadline of September 2008.

The war at home is over public opinion, and all signs are that the Dems are winning for once.

Dan Froomkin wrote on Tuesday:

President Bush’s public campaign to push back against Congressional demands for withdrawal from Iraq is becoming highly reminiscent of his failed effort two years ago to win support for a radical overhaul of Social Security.

The meticulously choreographed settings, the carefully controlled audiences, the mind-numbing repetition of hoary talking points (with a particular emphasis on stoking fears) — it’s like deja vu.

And so is the result: A public that is apparently more turned off to Bush’s ideas the more he talks about them.

As it was last time, Bush’s Bubble may be the central problem. Bush seems to think that through sheer force of will — and repetition — he will convince people that his cause is just — in spite of all the evidence to the contrary. And why does he think that? Quite possibly, because virtually everyone he talks to — and virtually everyone he sees — is already in his camp.

Via Atrios — here’s one of those famous Bush “town hall” meetings in front of a group of hand-picked drooling idiots with scripted questions. Bush says insightful things like “death is terrible.” Don’t watch on a full stomach. Continue reading →