Wednesday, June 17, 2009

"Lightning" Amazing Street Performance

From the comments..."best use of the Segway EVER."
Philip Glass never looked and sounded so good in a street performance.
Agree. Thanks, Abbas!

Monday, June 15, 2009

Physician Focus - Money-Driven Medicine Special

In this clip from the documentary version of Maggie Mahar's truly excellent book Money Driven Medicine, two doctors discuss one of the principle problems facing health care in America, the shortage of primary care physicians (PCP) and the reluctance of those entering the medical profession to track in that direction.

The Money Driven Medicine website is okay but needs a lot of work. So does the propaganda machine. This message is too important to remain in the hands of artists. It's time to put this film into as many places as possible as the health care debate is under way.

I wish I could tell my readers where to order this dvd but I have yet to find out. I have contacted the source and am waiting for a reply.

Sunday, June 14, 2009

Iran's Presidential Election Followup

Last week's presidential election in Iran was both a disappointment and a wake-up call for anyone expecting the incumbent to have a close call or lose to his opponents. Despite whatever negative diplomatic spin official Washington tries to put on the outcome, Mahmoud Ahmadinezhad won in a landslide. Even eyewitnesses and disinterested journalists observing in person may disagree with why and how it happened so the next important question is how will the world outside Iran respond, and specifically, what will be the official and unofficial responses from America?

I put up a background post last week collecting a few links to a few Iranian expats in their deep hope that Iran might select a more moderate leader than the populist demagogue who won reelection. In a different post four years ago I collected a string of links collecting various opinions of observers at that time. Though the issues are complicated I came away with the impression that this man's election was something of a national embarrassment with apathy to blame on the part of people who should know better.

I'm not smart enough to say why Ahmadinejad won with such a lopsided victory but a list of guesses might include a groundswell of populist sentiment that he offers hope for improvements in the lives of a growing number of people trapped in a stressed economy. International sanctions, high inflation and tight credit from the global financial meltdown may be included. And I read somewhere that despite sitting on the world's richest oil reserves, Iran still has no refineries and imports gasoline. If true, this last item strikes me as bizarre.

This photo and comments from an Iranian blog offers a glimpse into the dynamics of the election.

In this picture you see a youngish girl with a modernish appearance selling Ahmadinejad. This is very hard to believe as I have never seen any Iranian girl with her features wearing that kind of make up and highlights. Iranian girls are very smart in knowing what to wear to enhance their beauties. They are extremely aware of not becoming a tableau! This one simply does not know this style of make up is wrong for her features: she would be regarded as tableau and that is very embarrassing by Iranian standards. We all know what has happened to our young girls wanting a bit of freedom with their appearance. Not a single Iranian girl got away with her appearance without being at least cautioned once.

This girl and the driver are both from the Revolutionary Guards (Sepah Pasdaran). She is Khahar(sister) Zynab and he is Baradar(brother) Mohsen. They are just doing a bit of 'taghiyeh' (holey lie) to get Ahmadinejad reelected. They seem to be having some fun doing it too. After the elections she will be back looking like this.

That was June 3. On June 13, as results of the election came clear, he posted this grim little post:
Iranian Elections
Once again the Iranians were fooled to the polls only and only for one purpose: to show the world that the regime has legitimacy.

The election is over but there seems to be a level of ferment in the population that was missing four years ago. I will be watching next how widespread this year's protests will be commemorating the student massacre of 1988. See last year's post Student Protest in Iran (Additional material).

I don't know how to puzzle together these upcoming events with the results of the election. Perhaps someone else can offer some ideas. My instinct is that Mr. Ahmadi Nezhad may clever enough as a politician to spin many people in the street toward his support but not necessarily students who are a notoriously hard to manipulate bunch in countries all over the world, including ours.

This is a video from last year.

Thursday, June 11, 2009

More Health Care Scare

Copied from Fact

More Health Care Scare
Could a public insurance plan spell the end of private insurance companies?

A new ad from Conservatives for Patients' Rights says that a public health insurance plan now being proposed in Congress "could crush all your other choices, driving them out of existence, resulting in 119 million off their current insurance coverage."

That's misleading. The 119 million figure comes from an analysis of a plan that would mirror Medicare and be open to every individual and business that wanted it. But that's not the type of public plan President Obama has proposed. Nor is such a plan gaining acceptance on Capitol Hill.

The author of the study says that while some have backed the Medicare-like proposal, using the 119 million number "overstates the impact of what now is being considered."

The ad also falsely cites the New York Times as the source of a statement that what's being proposed would leave no consumer choices and "government in control of your health care." The Times didn't say that at all. The newspaper was just quoting claims made by insurance companies and members of Congress.

The group Conservatives for Patients' Rights is spending money on the airwaves again, this time warning Americans that the ability to buy health coverage through a public plan — an idea being debated on Capitol Hill — would leave them with "no choices in health insurance." We wrote about one of CPR's ads in April. The new TV spot is a step up from the last effort, but still misleading.

The ad, which began airing this week on CNN and Fox News, asks viewers to "imagine" that a bulldozer is "the massive, government-run insurance plan some in Congress want."
Citing a study by the Lewin Group, it says: "This government-run plan could crush all your other choices, driving them out of existence, resulting in 119 million off their current insurance coverage."

CPR Ad: "Bulldozer"

CPR Ad "Bulldozer"

There are hundreds of choices in health care plans today. But imagine this is the massive, government-run insurance plan some in Congress want. This government-run plan could crush all your other choices, driving them out of existence, resulting in 119 million off their current insurance coverage, leaving no choices in health insurance and government in control of your health care.

CPR Chairman Rick Scott: It's not too late. Protect your health care choice. Tell Congress to say no to a government-run plan.


The study does include the 119 million number, but "this government-run plan" that the ad refers to is one of six possibilities the Lewin Group analyzed, and the most extreme version of a public plan at that. The type of public plan necessary to cause 119 million people to move from private insurance to a considerably cheaper public option doesn't appear to be gaining traction in Congress. And it isn't what President Obama has proposed. It's certainly true, as the ad says, that "some" legislators have backed a Medicare-like public plan that could undercut private insurers, but casual viewers could easily miss that qualification. As John Sheils, senior vice president of the Lewin Group, says of using the 119 million figure, "In a sense it overstates the impact of what now is being considered on the Hill. But at the same time, it would be really disingenuous for people to say, well, we never meant to do that."

The Lewin Group is part of a subsidiary of UnitedHealth Group, which owns the insurer United Healthcare. It says it operates with "editorial independence," and we've often referred to its studies. This report, published April 6, looked at several options for a public plan, including one that would pay health care providers at Medicare-level rates (i.e., a plan that would pay doctors and hospitals less and have much cheaper premiums than private insurance) and be open to all individuals and all businesses. The Lewin Group said such a plan "would enroll about 131.2 million people (includes some uninsured who become covered). The number of people with private health insurance would decline by about 119.1 million people." Attracted to a less costly insurance plan – premiums would be about 30 percent less than those offered by private insurers – businesses, and individuals, would make the switch first, then some private insurers could go out of business, not the other way around, as the ad says. But the study looked at several variations in how a public plan could be structured – at the low end, one type of plan would cause only 10.4 million to move off their current coverage.

The report prominently notes that
the type of public plan President Obama proposed on the campaign trail would be available only to individuals, the self-employed and small employers – not to everyone and therefore, wouldn't pull anywhere near as many people off private insurance. The Lewin Group estimated that if payment rates were like Medicare, a detail Obama didn't specify in his campaign proposal, 42.9 million would enroll in Obama's type of public plan and 32 million would move off of private coverage. The numbers are lower for plans using different payment rates to medical providers.

The study finds that the more like Medicare a public plan is, the cheaper it would be and the more people and businesses it would attract. Medicare reimbursement rates are significantly lower than what private insurers pay health care providers. Conversely, a public plan that was modeled on private insurance – an idea being pushed by Sen. Charles E. Schumer of New York
wouldn't be that enticing and wouldn't cause much of a shift in the way workers are covered. "That’s an area you might get 10 to 12 million," moving off private insurance, Sheils says.

Sen. Ted Kennedy, meanwhile, has drafted a health care proposal with a public plan that would pay providers at Medicare rates plus 10 percent. The Lewin Group study didn't specifically look at that option, but it did analyze the effects of a plan paying rates midway between Medicare and private coverage. That would be close to Kennedy's idea. (The Lewin Group study notes that Medicare payments to hospitals are 30 percent less than what private insurers pay and payments to doctors are 20 percent less.) Under the midpoint scenario, the number with private insurance would drop by between 21.5 million and 67.5 million, depending on who would be allowed to buy into the public plan.

Conservatives for Patients' Right's ad doesn't make clear that the government would have to institute the most generous public plan in order to have the estimated 119 million move off of their current plans, according to the study.

One final point on the Lewin study: The ad may well give some the impression that the 119 million people that are "off their current insurance coverage" are simply losing their insurance plans altogether. That's not the case, as all would still have coverage through their employer, who decided to switch to the cheaper, public alternative.

It's also worth noting that this number comes from one analysis, and some researchers haven't predicted such a damaging effect on the private insurance market from the introduction of a public plan. A 2008 report by the Urban Institute said in general terms: "We think that a public plan would not drive out private competitors. ... Private plans that offer better services and greater access to providers, even at a somewhat higher cost than the public plans, would survive the competition in this environment. It is also conceivable that private plans offering a lower cost option—for example, lower premiums than the public plan, say by exploiting care management innovations, and network and payment rate limitations—could stake out a separate competitive niche in some markets." The authors said there were constraints on the ability of the government to set very low payment rates.

New York Times Didn't Actually Say That

The ad goes on to say the public plan would "leav[e] no choices in health insurance and government in control of your healthcare," while citing the May 5 New York Times. But that's not the Times' analysis of what a public plan would do.

We've seen this type of newspaper endorsement technique before in political ads, where the credibility of a publication is used to bolster the claims. In this case, the Times didn't say that a public plan would leave "government in control of your healthcare." Rather, a May 5 article by reporter Robert Pear said that this was the view held by Republicans and insurance companies.

New York Times, May 5: But insurance companies and Republican lawmakers say a government-run plan could drive private insurers out of business and eventually lead to a single-payer system run by the government.

The article also mentioned a quote from Democratic Rep. Jan Schakowsky of Illinois, who said that a public plan could "put the private insurance industry out of business" because of the public plan's "superiority.”

Interestingly, the May 5 article is about Schumer's proposal to make a public plan closely resemble private ones. As Sheils told us, if that type of public plan is established, it would mean 10 million to 12 million wouldn't keep their current insurance, according to Sheils' analysis – not the 119 million figure the ad touts.

– by Lori Robertson
Sheils, John and Randy Haught. “The Cost and Coverage Impacts of a Public Plan: Alternative Design Options.” Lewin Group, 6 April 2009.

Pear, Robert. “Schumer Points to a Middle Ground on Government-Run Health Insurance.” New York Times, 5 May 2009.

Sheils, John. Interview with, 11 June 2009.

Holahan, John and Linda Blumberg. "Can a Public Insurance Plan Increase Competition and Lower the Costs of Health Reform?" Urban Institute, 2008.

Related Articles

Tuesday, June 09, 2009


Blogging will be light until June 23.
I have too many care giving assignments to do more than read comments and stay current.

Monday, June 08, 2009

Canadian Health Care Myths

Via Common Deams/ Denver Post / Ron Beasley

As America comes to grips with the reality that changes are desperately needed within its health care infrastructure, it might prove useful to first debunk some myths about the Canadian system.

Myth: Taxes in Canada are extremely high, mostly because of national health care.

In actuality, taxes are nearly equal on both sides of the border. Overall, Canada's taxes are slightly higher than those in the U.S. However, Canadians are afforded many benefits for their tax dollars, even beyond health care (e.g., tax credits, family allowance, cheaper higher education), so the end result is a wash. At the end of the day, the average after-tax income of Canadian workers is equal to about 82 percent of their gross pay. In the U.S., that average is 81.9 percent.

Myth: Canada's health care system is a cumbersome bureaucracy.

The U.S. has the most bureaucratic health care system in the world. More than 31 percent of every dollar spent on health care in the U.S. goes to paperwork, overhead, CEO salaries, profits, etc. The provincial single-payer system in Canada operates with just a 1 percent overhead. Think about it. It is not necessary to spend a huge amount of money to decide who gets care and who doesn't when everybody is covered.

Myth: The Canadian system is significantly more expensive than that of the U.S.

Ten percent of Canada's GDP is spent on health care for 100 percent of the population. The U.S. spends 17 percent of its GDP but 15 percent of its population has no coverage whatsoever and millions of others have inadequate coverage. In essence, the U.S. system is considerably more expensive than Canada's. Part of the reason for this is uninsured and underinsured people in the U.S. still get sick and eventually seek care. People who cannot afford care wait until advanced stages of an illness to see a doctor and then do so through emergency rooms, which cost considerably more than primary care services.

What the American taxpayer may not realize is that such care costs about $45 billion per year, and someone has to pay it. This is why insurance premiums increase every year for insured patients while co-pays and deductibles also rise rapidly.

Myth: Canada's government decides who gets health care and when they get it.

While HMOs and other private medical insurers in the U.S. do indeed make such decisions, the only people in Canada to do so are physicians. In Canada, the government has absolutely no say in who gets care or how they get it. Medical decisions are left entirely up to doctors, as they should be.

There are no requirements for pre-authorization whatsoever. If your family doctor says you need an MRI, you get one. In the U.S., if an insurance administrator says you are not getting an MRI, you don't get one no matter what your doctor thinks - unless, of course, you have the money to cover the cost.

Myth: There are long waits for care, which compromise access to care.

There are no waits for urgent or primary care in Canada. There are reasonable waits for most specialists' care, and much longer waits for elective surgery. Yes, there are those instances where a patient can wait up to a month for radiation therapy for breast cancer or prostate cancer, for example. However, the wait has nothing to do with money per se, but everything to do with the lack of radiation therapists. Despite such waits, however, it is noteworthy that Canada boasts lower incident and mortality rates than the U.S. for all cancers combined, according to the U.S. Cancer Statistics Working Group and the Canadian Cancer Society. Moreover, fewer Canadians (11.3 percent) than Americans (14.4 percent) admit unmet health care needs.

Myth: Canadians are paying out of pocket to come to the U.S. for medical care.

Most patients who come from Canada to the U.S. for health care are those whose costs are covered by the Canadian governments. If a Canadian goes outside of the country to get services that are deemed medically necessary, not experimental, and are not available at home for whatever reason (e.g., shortage or absence of high tech medical equipment; a longer wait for service than is medically prudent; or lack of physician expertise), the provincial government where you live fully funds your care. Those patients who do come to the U.S. for care and pay out of pocket are those who perceive their care to be more urgent than it likely is.

Myth: Canada is a socialized health care system in which the government runs hospitals and where doctors work for the government.

Princeton University health economist Uwe Reinhardt says single-payer systems are not "socialized medicine" but "social insurance" systems because doctors work in the private sector while their pay comes from a public source. Most physicians in Canada are self-employed. They are not employees of the government nor are they accountable to the government. Doctors are accountable to their patients only. More than 90 percent of physicians in Canada are paid on a fee-for-service basis. Claims are submitted to a single provincial health care plan for reimbursement, whereas in the U.S., claims are submitted to a multitude of insurance providers. Moreover, Canadian hospitals are controlled by private boards and/or regional health authorities rather than being part of or run by the government.

Myth: There aren't enough doctors in Canada.

From a purely statistical standpoint, there are enough physicians in Canada to meet the health care needs of its people. But most doctors practice in large urban areas, leaving rural areas with bona fide shortages. This situation is no different than that being experienced in the U.S. Simply training and employing more doctors is not likely to have any significant impact on this specific problem. Whatever issues there are with having an adequate number of doctors in any one geographical area, they have nothing to do with the single-payer system.

And these are just some of the myths about the Canadian health care system. While emulating the Canadian system will likely not fix U.S. health care, it probably isn't the big bad "socialist" bogeyman it has been made out to be.

It is not a perfect system, but it has its merits. For people like my 55-year-old Aunt Betty, who has been waiting for 14 months for knee-replacement surgery due to a long history of arthritis, it is the superior system. Her $35,000-plus surgery is finally scheduled for next month. She has been in pain, and her quality of life has been compromised. However, there is a light at the end of the tunnel. Aunt Betty - who lives on a fixed income and could never afford private health insurance, much less the cost of the surgery and requisite follow-up care - will soon sport a new, high-tech knee. Waiting 14 months for the procedure is easy when the alternative is living in pain for the rest of your life.

Looking at Lebanon After Yesterday's Elections

Lebanese politics is a form of representative democracy, but nothing like what Americans imagine when they read those words. I have been following events in that part of the world since before I started blogging and it seems the more I learn the less I know. Americans hear the term Hisbollah and rarely stop to think that it is neither a country nor a tribe, and most have no idea that it's geographic location is inside Lebanon. It is puzzling, then, that there can be a war between Israel and Hisbollah that does not involve the whole of Lebanon. This is because various political interests there are not under a single control and command center. Each group has its own militia which protects and retains whatever power is possible under the Lebanese constitution.

Via the Arabist I just watched a four part documentary about the Gemayyel clan which as Maronite Christians is the dominant family which controls the presidency of Lebanon by constitutional authority.

That sentence calls for an explanation.

Lebanon's constitution is modeled around what is called a consociational principle. When I first came across that word several years ago I thought it was a typographical error. Nothing in my schooling had referred to anything consociational so I had to look it up. In plain language it refers to a political system insuring that certain interests that could be pushed out of power if mathematical results of voting are left unchecked are afforded constitutional protection. Variations of this idea are also practiced in Switzerland and the Netherlands.

When we speak carelessly of "democracy" we forget that one of the downsides of the idea is what political scientists call the "tyranny of the majority." We like to say that everyone has to go along with whatever the majority decides, but in many instances that is impossible, not because the minority won't "just go along" but because by doing so they would be violating deeply held beliefs that if abandoned would mean they would simply vanish. In America we deal with this problem by allowing certain groups to be exempt from whatever the majority holds. The Amish, for example, are not expected to pay taxes or allow their children to be recruited into the military. Various religious groups routinely are allowed to observe certain days as holidays, often paid. Sometimes these exceptions are mandated by law. More often they are simply extensions of cultural courtesy.

When the Lebanese constitution was drawn up a background of bloodshed and bad feelings made "cultural courtesy" an unrealistic ideal. So by law certain components of the political control of the country were designated for various groups. The president will always be a Christian (which in Lebanon means a Maronite Christian), Speaker of Parliament will be a Shiite Muslim, Prime Minister will be a Sunni Muslim, and other parts of the government will be similarly divided, including not only these three main sectarian groups but Druze and others as well. (Druze refers to a Muslim offshoot group that can be though of as "Muslim unitarians.") For this reason the presence of Palestinian refugees is tolerated, even though they have little or no political influence, and Hisbollah, which is a remnant (and revolutionary) Sunni group, is also able to control part of the country. (For Americans, one of the bright spots of yesterday's elections in Lebanon was that Hesbollah did not do as well as they had hoped. Nevertheless, the group is very much a reality in the Lebanese political scheme of things.)

Short sentence. Long explanation.

Anyway, for the reader who had half an hour and is willing to click through four different videos I recommend this series.
I learned more in half an hour of watching than I have been able to grasp after five years of reading and studying. It helps that I have put in that five years, of course, but even without knowing that much background an uninitiated American can get a lot out of the series. Disclosure: Yes, this is an Al Jezeera production, so for those who have already decided that anything from that source is taboo, I suppose you may simply keep moving in your bigoted ignorance. For everyone else, here is Part One.

Sunday, June 07, 2009

Iran's Presidential Election is Next Week

Results of next week's presidential election are important to US-Iran relations and determining what Washington's next moves will be in that part of the world. Although Iran's form of government is not what Americans understand as a model representative democracy, it is not nearly as autocratic as most of us imagine. The pronouncements of Mahmoud Ahmadinejad, inflammatory as they are, do not represent the best qualities of that country's electorate and although the clerical authorities have the power to countermand anything he says, at some level they, too, have their fingers on a popular pulse that may not always reflect the brightest and best that Iran offers. (No American should have to be reminded that convoluted politics, demagoguery, conflicts of interest and old-fashioned blind negligence is endemic to all political systems. Other systems may be corrupt but our own is far from perfect.)

Following Iran's elections four years ago I took a close look at the results. My interest was piqued by the close ties between big shots in Baghdad and their Shiite friends in Tehran. American troops in Iraq were purported to be there to fight Al Qaeda, not to threaten Iran. (There was no Al Qaeda in Iraq previously, but that is beside the point.) But there was something odd to me about what I was reading. If Iran and Iraq had been in a protracted and very bloody war that lasted eight years, what was all this buddy-buddy stuff happening now?

In Iran election comments the day before Independence Day, 2005, I gathered a string of commentary from Iranian writers and others regarding the results of their recent election of Ahmadi Nezhad (his name later to morph into the now familiar Amnadinejad), former mayor of Tehran and a populist of the brightest stripes, as the national president. Looking over the list I had two impressions..

First, most of them expressed surprise that the guy had done well enough to be elected. Rarely do the great unwashed to whom voices like his appeal get organized or energized well enough to put someone like that into office. (We see it happen with regularity in grindingly poor countries -- I'm thinking Haiti, Venezuela, many so-called "developing" countries, a misnomer if there ever was one -- but not as often in places where ecomomic conditions pull the safety net up well enough that those at the bottom do not suffer as much. With its oil wealth and large parts of the population awash in comfortable (if frowned upon by the clerics) manifestations of modern culture, Iran was not supposed to be in that category.

Second, after being surprised, several of the commentators interpreted his election as a positive change toward political improvement. More participation in elections, even on the part of voters who may have elected the wrong man, was a good sign. Actually that was a bland excuse for a bad outcome that had more to do with apathy on the part of those who knew better. I came away with the feeling that those whose apathy had allowed this rube to be put into office would not let it happen again. Next time those who had been so careless would not let it happen again. (I recall how embarrassed a lot of people in Georgia were upon the election of Lester Maddox, the famous segregationist, as governor of the state in the late Sixties. Mortified, they were, but too late.)

Within months of Ahmadihejad's election there were indications that some people were having regrets, even in the Clerical group that supercedes the secular government in its authority. Check out a post from December 2006, the following year, Iran elections update -- Updated again...

Iran's moderate former President Akbar Hashemi Rafsanjani has won election to Iran's powerful clerical body, the Assembly of Experts, results show.

With more than half the votes counted, Mr Rafsanjani, who was defeated in the 2005 presidential election, had a clear lead at the top of the list.

The election - and simultaneous local polls - was seen as a test of support for President Mahmoud Ahmadinejad.

Well the next presidential elections are next week and we will see if my impressions were accurate. Ahmadi Nezhad has had four years to consolidate his power and polish his image and is running for re-election, but he is not without opponents. We all know from the recent incident with journalist Roxana Saberi that the authorities there are not as old-school tough as many would have us believe, and despite stereotypes their system that can be pliable on occasion.

Here are some links I came across this morning about next week's presidential election in Iran.

Kamran at View from Iran posts Yes, I will vote

In less than ten days, millions of Iranians will go to the polls to participate in what might be the most important election since the revolution thirty years ago. I want to vote because I believe that it is a fundamental right to use every democratic tool we have to try to influence change in our beloved land. This is especially true even when the options are not our dream options. The government of President Ahmadinejad has show and created a situation, nationally and internationally, that can easily get out of control and have disastrous effects for the country and the people we love.

I don’t believe in these people and do not think any of the candidates can solve the enormous challenges we face, but I am still voting. During the past thirty years, our rights as Iranian citizens have been constantly under attack. This has been true despite many promises of protection and invitations to engage in the building of our society.

I am voting with the hope that not only the hardline government will change, but that we will build a more democratic society where women’s rights, a free press, free speech, and human rights are not a dream. Last 4 years proved our right can be in more danger than we could even imagine.

Being part of this initiative was unthinkable for me just four years ago. Four years of right-wing Ahmadinejad has put Iran on a downward path. I believe that Iranian expats should play a more constructive role and not keep waiting for some magical transformation of power.

Let’s make a change. Let’s vote.

One entire paragraph of his post was hyperlinked to Vote for Iran, a site dedicated to the election aimed at Iranians who are being urged to vote for change. Where have we heard that line before?

The 12th of June Iranian presidential election can become a historical moment for our country. Iranian people can make a choice. For many years the basic right of our nation have been violated time after time: our civil rights, freedom of speech, and free press. The Iranian people can make a choice. The miserable situation that Iran is in, nationally and internationally as well as politically and economically can change for the better. Sending the government of President Ahmadinejad home on election day and voting for a reform candidate (Mousavi or Karroubi) can send the message that Iranians are ready to join the world community.

* The Iranian diaspora can play an important role to influence change in Iran.
* Together, we make up a loose-knit community of 4 to 5 million Iranians all around the world. Our vote can make a difference.
* Every vote counts.
* You can gather friends and go to vote together.
* You can call family and loved ones in Iran and encourage them to vote as well.
* Each one of us should participate in this election.
* Let’s make change happen!
* Let’s vote for a better Iran.

Check out the link. It's as good as anything in US politics, complete with pictures and videos supporting the effort to vote for change. I don't sense any specific candidate is running as an opponent, but the message is by default that anything is better than what they now have.

Our Twelve-Year Chinese Cycle editorial from Tehran

Twelve years ago, in 1997, in less than six months people voted a candidate into office who was little known in society at large. Those few months were enough for them to size him up and to get to know him. The gains of {Mohammad Khatami}'s first administration was perhaps not so significant to the third generation of post-revolution Iranians; after all they were simple demands, but for my generation they were consequential. We still had the bitter taste of the years of repression and contraction under our tongues. The prescription of Freedom had been filled in such a rush as to be forgotten easily. We went through a period of terror. The only colors that could be seen in public were black, brown or dark blue. The air was stifling.

Suddenly, our hearts started to warm up. Our fears lessened. Tranquility showed it face to us. We had a smiling president to behold. We distanced ourselves from bitterness, violence and anger. Courage began to make a show. And there was something called hope in our hearts.

We were ordinary people whose demands were minimal. It was the story of life in its ordinariness through and through. We had left our ambitious demands for the future, for them to be met at a slower pace. We cherished the realization of our simple demands. We weren't politicians. We were ordinary people. Perhaps the reader would dismiss my arguments as "raw sentimentalism," but I was a small witness to a change in the nature of governance with the last election that put us at the end of a line whose end was nowhere in sight, a line that wouldn't move an inch. The new president promised a society filled with joy and happiness. There was agitation, disquiet and intensity in his delivery.

From its very inception, the presidential election of 2003 was doomed to bring ominous results. We, ordinary people, strove to prevent this from happening and we couldn't. Those who called for a radical change in the order of things disappeared from view and left hopelessness behind. When we shouted the name of the reformist candidate on the streets of Tehran, we weren't thinking of a single person but a huge wave. It was at nine o'clock on the night of the election that we learned of our defeat. On that night, tears washed our disbelief and anger.

Hopelessness has a way to creep in. You realize it when it has already done its job. A film director, a researcher and writer who become disinterested have lost hope. They flare up with the slightest provocation. They won't tolerate more insults.

When indifference sets in, one must become apprehensive. When childish achievements become norm, they re-appear as jokes in emails and among the public. With every joke the process of self-deprecation intensifies.

Close to four years have elapsed and we have burrowed into our cocoons more and more. We have become sadder. Writers wrote less. There were less literary awards to go around because nothing of significance appeared in bookstores. Many books were not given permission to publish and collected dust. Our cinema, which had at some point been prized for its distinguishing marks, didn't produce any important works. Trite comedies like The Outcasts I & II, make by a paramilitary member with a terrible reputation, broke all kinds of records at the box office while a well-respected director gathered all his anger and shouted it When We Are All Asleep. All those who were asleep never saw the film. Those who were champions of an alternative cinema went into hiding. This hopelessness slowly enveloped us. Hopelessness will not disappear when you have more films, TV series, and hackneyed comedies. Books are not bought if their quantity in print increases. Newspapers and magazines that had something significant to say fizzled out. And many other developments over the past four years that I won't have time to enumerate. Our voices have never been stifled completely. We are not living in a vacuum; we are just hanging in mid-air.

Twelve years have passed since the election of the smiling president. The Chinese calendar has a twelve-year cycle. I can only hope that our unpredictability as a nation can stop the runaway train of the dour president. We ordinary citizen have no passports to leave the country.


"Setade Ma" (Our Campaign) is an online volunteer movement of concerned Iranians who want to play a role in deciding the future of Iran. You can join us from your house in this cyber space. We want to advocate civic participation by encouraging Iranians to vote tin he upcoming Presidential Elections, 12 June 2009. Setade Ma is focusing on a big phone campaign that was launched 4 weeks before the election and we are hoping to grow among people and to make our votes have an impact on the results of the Election.

"ستاد ما" یک حرکت خودجوش مردمی است و از همه کسانی که می خواهند در تعیین سرنوشت کشورشان سهیم باشند دعوت به همکاری می کند. شما هم در خانه خودتان به ستاد ما بپیوندید و با تلفن دوستانتان را تشویق به رای دادن کنید. تعداد داوطلبان ستاد به شکل هرمی به سرعت زیاد می‌شود که تاثیر گذاری آن را مرتبا بالا می‌برد. این روش در انتخابات مهم دنیا جواب داده و اگر هر یک از ما ۵ نفر را جذب ستاد کنیم این ستاد آنقدر بزرگ میشود که بتوانیم نتیجه انتخابات را تغییر دهیم، همانطور که در خرداد ۷۶ نتیجه انتخابات را تغییر دادیم.


The young contributors from Iran to Mid East Youth talk about all kinds of topics, but their recent focus has been on the upcoming elections and what changes that might come about. Check out the post headlines and spend a few minutes evaluating what young people on line are saying.

Finally, this is a press release from Vote for Iran dated June 3.

In just a few days, Iranians will go to the polls to elect a new president. This has been an historic campaign with unprecedented use of new media for campaigning and communicating with voters inside and outside Iran. Chances are, this election will also feature the highest turnout of Iranians living abroad. Vote for Iran ( is a project to communicate with Iranians in diaspora. It has no ties with the government of Iran.

What was unthinkable just four years ago is a reality today. People like us, who disagree with the Islamic state and are great supporters of human rights, recognize the need to participate in the presidential elections in Iran. Four years ago, we were not actively promoting the electoral process in Iran. Four years ago, we did not imagine bringing family and friends with us to the embassy to cast our votes. This election is different, though, and that is why we have created Vote for Iran (

The 12th of June Iranian presidential election can become a historical moment for our country. Iranian people can make a choice. For many years the basic rights of our nation have been violated time after time: our civil rights, freedom of speech, and free press. The miserable situation that Iran is in – nationally and internationally as well as politically and economically – can change for the better. Sending the government of President Ahmadinejad home on election day and voting for a reform candidate (Mousavi or Karroubi) can send the message that Iranians are ready to join the world community.

Domestic issues are the key to presidential elections both in Iran and the United States. Almost four years ago, Ahmadinejad was elected to respond to corruption in politics. He promised honesty and more equitable sharing of Iran’s oil wealth. Despite a plethora of domestic issues including runaway inflation and the high jobless rate, this year Iranians will be sending a message about whether or not the country will engage with the West.

Saturday, June 06, 2009

Mark Lynch on the Cairo Speech

The Aardvark has been on my blogroll for a long time.He is a man of many words but also very smart. When he says something is worth quoting, believe it.

Israelis and Palestinians. I'm still struggling to grapple with this truly astonishing portion of his speech. I don't think I have ever heard any American politician, much less President, so eloquently, empathetically, and directly equate the suffering and aspirations of Israelis and Palestinians. This is the one part which I have to quote:

Around the world, the Jewish people were persecuted for centuries, and anti-Semitism in Europe culminated in an unprecedented Holocaust. Tomorrow, I will visit Buchenwald, which was part of a network of camps where Jews were enslaved, tortured, shot and gassed to death by the Third Reich. Six million Jews were killed - more than the entire Jewish population of Israel today. Denying that fact is baseless, ignorant, and hateful. Threatening Israel with destruction - or repeating vile stereotypes about Jews - is deeply wrong, and only serves to evoke in the minds of Israelis this most painful of memories while preventing the peace that the people of this region deserve.

On the other hand, it is also undeniable that the Palestinian people - Muslims and Christians - have suffered in pursuit of a homeland. For more than sixty years they have endured the pain of dislocation. Many wait in refugee camps in the West Bank, Gaza, and neighboring lands for a life of peace and security that they have never been able to lead. They endure the daily humiliations - large and small - that come with occupation. So let there be no doubt: the situation for the Palestinian people is intolerable. America will not turn our backs on the legitimate Palestinian aspiration for dignity, opportunity, and a state of their own.

For decades, there has been a stalemate: two peoples with legitimate aspirations, each with a painful history that makes compromise elusive. It is easy to point fingers - for Palestinians to point to the displacement brought by Israel's founding, and for Israelis to point to the constant hostility and attacks throughout its history from within its borders as well as beyond. But if we see this conflict only from one side or the other, then we will be blind to the truth: the only resolution is for the aspirations of both sides to be met through two states, where Israelis and Palestinians each live in peace and security.

This is quite possibly the most powerful statement of America's stake in the Israeli-Palestinian conflict and the urgent need for justice on both sides that I have ever heard. He posed sharp challenges to Israelis and Palestinians alike, directly addressing the realities of Palestinian life under occupation and the humanitarian crisis in Gaza while also empathizing with Israeli fears. He positioned the U.S. as the even-handed broker it needs to be: "America will align our policies with those who pursue peace, and say in public what we say in private to Israelis and Palestinians and Arabs." Left unsaid, but clearly in the background, was the fact that he has been matching those words with deeds by forcefully taking on the issue of Israeli settlements in the West Bank.

He also offered a powerful analogy to the American civil rights campaign and other global experiences to argue that "that violence is a dead end. It is a sign of neither courage nor power to shoot rockets at sleeping children, or to blow up old women on a bus. That is not how moral authority is claimed; that is how it is surrendered." I really like this analogy, which he extended well beyond America's shores. Some Palestinians will likely complain, though, that their own attempts at non-violent activism too often get crushed beneath Israeli bulldozers. How will the U.S. and the international community support such non-violent action and redeem such moral authority?

Friday, June 05, 2009

Health Care Insurance Commentary

Found at Old Jews Telling Jokes...
This is a dirty joke, so those who are offended by dirty jokes should skip this video.◄

Greg Djerejian on Obama's Cairo Speech

Belgravia Dispatch emerges from an extended hiatus for a don't-miss commentary. Djerejian is a very smart man with diplomacy in his DNA. If he says something is okay I feel better already. And Obama has not even arrived at the putative excuse for a trip abroad, an appearance in France to commemorate D-Day. This Administration's ability to orchestrate diplomacy is poetic to a Shakespearean degree.

Take a few minutes from your busy day to read this post slowly and entirely.

...all told, and given the overall political realities this President faces, I found it a reasonably adroit balancing act, with one main message: that he was very serious about patiently and deliberately pursuing a peace process (and so, for example, final status issues can be broached well later after much seed-work), in sharp contrast to the deep bungling of this portfolio by the previous Administration. And if some might feel rumblings of discomfort that discussion of ‘shooting rockets at sleeping children’ was too crudely aimed as a moral criticism of only one side (regarding Obama’s point about the surrender of moral authority), overall again, and given the growing tension of late between Tel Aviv and Washington, the middle-ground Obama forged was ultimately more an umpire-like demand, delivered in reasonably soothing, pragmatic, almost professorial tones, that both sides better adhere to the Road Map. We might have done well worse than that, at least as a start.

Thursday, June 04, 2009

Glimpses of Peter Oakley (geriatric 1927)

The recent experience of Susan Boyle's overnight explosive success was overwhelming and last I heard she is convalescing somewhere, on the edge of a nervous breakdown. I was reminded of Peter Oakley whom I followed with enthusiasm when he first made the scene at You Tube. Readers not familiar with him can dig around in the archives or go directly to You Tube to learn about him, but his story stands in vivid contrast to that of Susan Boyle.

At this point he has been uploading You Tube videos for two and a half years and is up to 187 clips. This most recent release takes him to a Harley-Davidson club where for the first time in his eighty-plus years he rides a Harley. There was a time when I caught every release, especially when he lost his anonymity and later was the prime mover behind a musical group, The Zimmers, made up of himself and a lively group of other old people producing an album.

After a while I had to place him on the shelf as yet another of the many subjects that I wish I could keep close watch on but life (and I'm sure he would not be offended a bit by this) is really too short to do everything you want to do. I just now allowed myself to get lost about an hour among his recent videos, but I had to stop to put up this post. The reader should note when you look at his channel page that he seems to have upwards of six or seven thousand regular fans. I find that very impressive as well as reassuring. Peter Oakley represents gracious civility at its most polished. And it's wonderful to see so many people besides me have come to appreciate someone with that quality. It should be noted that the majority of his fans are young people. Peter is the Grandad of You Tube.

MedPAC -- Technocrats only a Policy Wonk can Love

Like children at an Easter egg hunt, our elected representatives have been looking for the bestest egg of all, the one with real chocolate candy instead of one or two gummy bears. After sniffing around aimlessly for months, someone finally pointed them in the right direction.

...the Medicare Payment Advisory Commission’s (MedPac’s) recommendations could serve as a brilliant blue print for overhauling Medicare...

Until now, most reform advocates have ignored MedPac. The reports that the independent advisory panel issues in March and June of each year are long. They are dense with detail. And they are very, very smart. The commissioners understand that health care quality could be higher if we spent less on care.

They have digested the Dartmouth research revealing that when patients in some parts of the country receive more aggressive and more expensive care, outcomes often are worse. They realize that doctors and hospitals should be rewarded for the quality of the care they provide, not the quantity. As HealthBeat has reported, they know that the fee schedule that Medicare now follows favors specialists while underpaying primary care physicians, and they have suggested re-distributing Medicare’s dollars “in a budget neutral way”-- hiking fees for primary care while lowering fees for some specialists’ services. They have pointed out that some very lucrative procedures appear to be done too often, in part because they pay so well. The Commission has advised targeting these procedures and comp ring them to alternative treatments—just in case a less expensive approach might turn out to be more effective (and not as risky for the patient), as pricier, more aggressive treatments.

Finally, MedPac notes that some hospitals actually make a profit on Medicare’s payments. This is because these hospitals are more efficient: patients typically spend fewer days in the hospital and see fewer specialists. There are fewer readmissions, And generally, outcomes are better. MedPac suggests that when private insurers pay hospitals more, they may simply be rewarding less efficient hospitals for lower quality care. (And of course, private insurers pass those higher payments along to their customers in the form of higher premiums.)

MedPac goes beyond looking at how we pay providers. Investigating Medicare Advantage, it has described the care that private insurers are providing as somewhere between “disappointing” and “depressing.” Taking a look at the boom in hospital construction, MedPac noted, in its March 2008 report that “much of the added capacity is located in suburban areas and in particular specialties, raising the possibility that health care costs will increase without significantly improving access to services in lower income areas”.

Whippin' Up the Base Until it Forms Stiff Peaks

No way to capture the full experience of visiting this blog.
It's like taking your grandchildren to Chuck-E-Cheese.
You'll never know what it's like til you do it.
And don't skip the comments thread.

Launch! Healogica--Clinical Trials Recrutiment service

Ever wonder how people getting treated by "experimental" drugs or procedures get selected?
I often wonder, should I become stricken with some arcane condition, how I would find out ALL my options, including some that may not be on my doctor's punch list.

Via The Health Care Blog we get this....

Healogica was one of the companies that presented at Launch! at the Health 2.0 Meets Ix conference in Boston in April. I felt that the quality of the Launch! companies as so strong that they all deserved to be featured to more than the 200 people in the room who saw it. So on the spur of the moment I offered all of them a spot on THCB to get them a little more visibility. And now there’s a flood of three minute videos headed our way.

First up is an innovative clinical trial recruitment service called Healogica. And yes it’s new (which is the point of Launch). Watch the short video below to get an idea and investigate further over at Healogica

Healogica Demo from Health 2.0 on Vimeo.

Health Care Fantasy -- The Public Option

When I studied the actual plans for health care reform in the Congressional pipeline I was disappointed. It is clear that the insurance industry is so firmly entrenched in Washington politics that any noises from the single-payer people are as unnoticed as sneezes at a football game. I came away resigned to the idea that single-payer (obviously the quickest, most cost-effective way to reduce costs) will have to wait until American health care gets so financially obese that even the most selfish of Washington politicians can no longer be in denial. Something like how the UAW, after driving two of their three cash cows into bankruptcy, finally "got it."

The only bright spot I found was something called the "public option," a government sponsored insurance alternative to private insurance. The insurance industry is terrified of any such plan, of course, because even at its most fiscally irresponsible, any government plan would easily undercut the private sector because there would be no need to pay executive bonuses, profits to share-holders or, of course, taxes.

And that's just a change in paperwork. Imagine how much could be saved if the government actually got into the business of DOING health care on a more widespread basis than the already vast network of military medical professionals and the Veterans Administration's hospitals and local private-sector affiliates.

This morning Maggie Mahar posted news of a hopeful signal from the White House. Her headline was President Obama: “I strongly believe that Americans should have the choice of a public health insurance option”.

In a letter to Senators Ted Kennedy and Max Baucus that the White House just released this afternoon, President Obama spelled out his vision for health care reform, making it clear that he wants a public sector alternative to private insurance: “operating alongside private plans. This will give them a better range of choices, make the health care market more competitive, and keep insurance companies honest.”
In his letter, the President also stressed that “reform cannot mean focusing on expanded coverage alone. Indeed, without a serious, sustained effort to reduce the growth rate of health care costs, affordable health care coverage will remain out of reach. So we must attack the root causes of the inflation in health care.” He then points to the large multi-specialty medical centers, where doctors work on salary, that HealthBeat has pointed to as models for learning how to provide more effective care at a lower cost: “ That means promoting the best practices, not simply the most expensive. We should ask why places like the Mayo Clinic in Minnesota, the Cleveland Clinic in Ohio, and other institutions can offer the highest quality care at costs well below the national norm. We need to learn from their successes and replicate those best practices across our country. That's how we can achieve reform that preserves and strengthens what's best about our health care system, while fixing what is broken.”

Go read the rest of her post. She will write a fuller commentary later.

Meantime, I was hit with a fantasy and left the following comment at her blog.

As Pacino might say, "HOO-Waaaah!!"

This is great news. After witnessing the casual manner by which the president tossed a few other things into the pile, then pulled back and let Washington politics have its way, I was afraid he might do the same with health care reform. Maybe not.

When I studied the actual proposals in the pipeline at the Kaiser comparison site I came away with the impression that the insurance industry had everyone in Washington by the family jewels. Proposals to "insure" every citizen, no matter how poor or currently ineligible, with tax money underwriting the whole enterprise, has the insurance companies salivating. Why should they care who they insure as long as Uncle Sugar picks up the tab? Actuarial tables don't lie, and the more public they are the better insurance companies look. ("Hey, all we're doing is figuring out a financially reasonable way to cover everybody. We don't make the charges. All we do is manage this grand new risk pool. Don't pick on US!")

I imagine a well-run, cost effective public plan, operated out of community clinics, VA hospitals and military dispensaries with paid professionals (yes, even PCP's and specialists). Such a system could still outsource lab tests, imaging, even CT's, and still deliver top-quality health care at a fraction of the costs of the current health care land yacht version of a gas hog.

The professionals would be in the loop for any new best practices as they develop and the drug companies could be brought to heel at the same time.

Compared to most community health care non-systems, the VA and military systems are models of fiscal excellence. It's been forty-five years since I was drafted to become an x-ray tech in the Army Medical Service Corps and I saw how that worked from the inside. I'm sure today's system is radically different and far better, but the basic idea was excellent: professionals were paid according to grade (officer ranks) but that was only the base. Added to that might be "professional" pay + "overseas duty" pay + "hazardous duty" pay + whatever it might take to recruit and retain needed services. No, it wasn't fee for service because that doesn't make any sense when patients have no means or "private insurance" for fees.

This is all a flight of fancy on my part. I expect nothing of the sort will come to pass, but I had to get it out of my system. It comes from seeing too many Michael Moore films. Now back to your regular scheduled programs.

Addendum, a few minutes later...

Little did I know as all this was coming together that a similar discussion was already under way at The Health Care Blog.

Should We Open the VA to All Comers?

Perhaps the idea is not as far-fetched as I imagined.

Wednesday, June 03, 2009

Art against the Iraq war - Bitter Fruits

This is from Leila Abu-Saba's blog.

Laura McCallum, a sculptor and teacher in Brooklyn, NY, began a project six years ago to draw a tiny image in honor of each American killed in the Iraq war. The scroll now has 4,259 images on it, and takes up an enormous hallway.
Laura stood up with me at my marriage to David MacLeod, and more recently traveled with me to Lebanon and Syria in 2008.

I have no comment. The piece speaks for itself.

Monday, June 01, 2009

Dr. George Tiller (1941-2009)

Dr. George Tiller was assassinated yesterday at the church where he and his wife attended. He was one of a handful of physicians known to provide what has come to be called "late term abortions." Nothing I write here is likely to change anyone's mind about abortion, but I want to make a few notes for future reference.

Sarah Robinson's response,
written in the first hours of D. Tiller's death, was both clear and swift. Recommended reading.

1. Tiller was one of the great heroes in the fight for a woman's right to choose safe, legal abortion. Late-term abortions are a terrible business for everyone concerned. Despite anti-abortion distortions to the contrary, they are very rare -- and almost never chosen for anything but the most heartbreaking of reasons, usually having to do with the life of the mother or the viability of the fetus. It's a life-changing choice for everyone concerned, and not one anybody takes lightly.

By all accounts, Tiller dealt with these horrific situations with dignity, compassion, and grace, helping women and their families deal with the loss and grief that always come with being faced with such a traumatic decision. He didn't just tend to their physical condition; he tended to their psychological and spiritual well-being, too. Most of us will be backed into life-or-death corners regarding serious medical conditions (a family member's, or our own) at some point in our lives. In those times, we are fortunate when we can find doctors with that kind of ability to understand the nuances, and help us deal with the ambiguities, and come to terms with the hard decisions we must make. Tiller was, according to his patients, one of those doctors.

2. The Terrorists Win. Tiller was one of just three doctors in the entire US who performed late-term abortions. Now, there are just two. Which means that 36 years of anti-choice terrorism is now just two assassinations away from completely ending late-term abortion in America. Violence has won out -- over the will of the people, over the courts, over the horrific logic of medical necessity. And whenever terrorists win, democracy has lost -- and is lost.

Much more at the link.
Someone in the comments thread questioned her assertion that he was one of three doctors performing late term abortions. Her reply was more circumspect.

Odds are good that there are more than one or two, but anybody else who does it doesn't do many, and isn't advertising the fact to anyone (for reasons that are all too obvious). A lot of doctors will perform controversial procedures for their regular patients, but not for other people. And unfortunately, most women don't know where their doctors draw those lines until they're hard up against them. The doctors won't talk about it even if asked.

The Wikipedia article already has a few details.

George Tiller was killed on May 31, 2009, shot to death during worship services at Reformation Lutheran Church in Wichita where he was serving as an usher.
After threatening two others who tried to prevent his departure, the gunman fled in a car. Witnesses described the vehicle as a powder-blue 1993 Ford Taurus, registered to 51-year-old Scott Roeder of Merriam, in Johnson County.

Scott Philip Roeder (born February 25, 1958) was arrested some 170 miles away in suburban Kansas City three hours after the shooting, Wichita Deputy Police Chief Tom Stolz said. The suspect had been a member of the anti-government Freemen group and was convicted in 1996 on explosives charges after police officers discovered fuse cord, a pound of gunpowder and nine-volt batteries in the trunk his car, but an appeals court overturned this conviction in 1997, ruling that the search of Roeder's car had been illegal.

The reader can do his own research about the Montana Freemen. I'm not interested.

Most conversations I hear about abortions are steeped in ignorance and extreme points of view. I know from reading that abortion statistics are nothing like what most people understand. They know there are many (even though actual numbers and sources are rarely cited) and they leap immediately to the grim details of post-viability procedures, referring to scissors, sucking out brains, etc. Words like baby-killers, murder and genocide are used carelessly with references to living newborns tossed into garbage cans to die.

A search for actual details is revealing.

In 2003, from data collected in those areas that sufficiently reported gestational age, it was found that 6.2% of abortions were conducted from 13 to 15 weeks, 4.2% from 16 to 20 weeks, and 1.4% at or after 21 weeks. Because the Centers for Disease Control and Prevention's annual study on abortion statistics does not calculate the exact gestational age for abortions performed past the 20th week, there are no precise data for the number of abortions performed after viability. In 1997, the Guttmacher Institute estimated the number of abortions in the U.S. past 24 weeks to be 0.08%, or approximately 1,032 per year.

This is from the Guttmacher Institute.

  • Nearly half of all pregnancies to American women are unintended; four in 10 of these end in abortion.

  • About half of American women have experienced an unintended pregnancy, and at current rates more than one-third (35%) will have had an abortion by age 45.

  • Overall unintended pregnancy rates have stagnated over the past decade, yet unintended pregnancy increased by 29% among poor women while decreasing 20% among higher-income women.

  • In 2005, 1.21 million abortions were performed, down from 1.31 million abortions in 2000.

  • Nine in 10 abortions occur in the first 12 weeks of pregnancy.

  • A broad cross section of U.S. women have abortions:
    • 56% of women having abortions are in their 20s;
    • 61% have one or more children;
    • 67% have never married;
    • 57% are economically disadvantaged;
    • 88% live in a metropolitan area; and
    • 78% report a religious affiliation.

"For a long time, nearly 90% of abortions in the U.S. have taken place in the first trimester, but in recent years, women having an abortion have been able to do so earlier and earlier in the first trimester. Currently, more than six in 10 abortions occur within the first eight weeks of pregnancy, and almost three in 10 take place at six weeks or earlier,” says Rachel Jones, lead researcher on the new survey. “Medication abortion, which provides women with an additional option early in pregnancy, clearly reinforces this very positive trend.”

"The United States has one of the highest abortion rates in the developed world, with women from every socioeconomic, racial, ethnic, religious and age-group obtaining abortions," says Lawrence Finer, associate director for domestic research at the Guttmacher Institute. "We study abortion so we can learn more about how well current efforts to improve contraceptive use and reduce unintended pregnancy are working, the circumstances under which women have difficulty accessing abortion and, ultimately, how to reduce the need for abortion."

"Evidence from around the world shows that placing restrictions on abortion to make it harder to obtain has much more to do with making it less safe than making it rarer, " says Susan Cohen, director of government affairs at the Guttmacher Institute. "Yet in the United States, abortion opponents take credit for the mounting state and federal restrictions on abortion, rather than working to reduce unintended pregnancy to begin with."

One of the curious twists of the anti-abortion movement in America is that most of the same people seeking to reduce the number of abortions are also reluctant to promote better sex education and easier access to contraceptives. And the groups most in need of better understanding of reproduction and the proper use of contraceptives are the very groups denied both. Voices seeking common ground ("reduce the number of abortions") have a hard time getting past the biggest challenge of all, that all abortions terminate pregnancies and the way to reduce the number of abortions is to reduce the number of unintended pregnancies.

The unfortunate vocabulary that has come to be used in the debate (pro-life, pro-choice, pro-abortion, anti-abortion, anti-choice, pro-death, etc.) inflames all discussions and drives many to the extreme illustrations. In the same way that the torture debate goes off the rails with the ticking-bomb scenario, abortion discussions quickly slip from one extreme to the other. "Pro-life" advocates have come to the extreme position that "at the moment of conception" a future taxpayer, neighbor or heir has been brought into existence and anyone seeking to eliminate that embryo is guilty of murder. Moreover, the woman that the embryo now inhabits has at once forfeited all rights to do anything that would endanger that future child's growth or development.

In vitro fertilization, a widely-used reproductive technique used by couples trying to get pregnant, routinely produces multiple fertilized eggs, selecting up to four for implantation, one of which can be expected to survive. In the event that three or four appear to be holding on, the newly-pregnant mother is usually advised to allow the doctor to "deselect" the number down to twins or just one. I have yet to hear anyone referring to this procedure as a variant of abortion which, by the strict definition of "at the moment of conception" it is.

As I said at the opening, I doubt anything I write here will change any minds. But maybe by treating this man's murder as the evidence of a national sickness that it is I can get someone to think more clearly. I recall being in a college classroom the morning after Dr. King was assassinated when a student who was glad to see him dead said "I don't see why we have to make him a martyr." I pointed out to him that no one was making King a martyr. The fact that he was dead, killed for what he stood for, accomplished that. Likewise, Dr. Tiller -- whether or not the reader wants to accept it -- is now a martyr, killed for what he stood for. And anyone who thinks his death will advance the cause of those who are glad to see him dead does not understand history.


Hilzoy put up several good posts in response to Dr. Tiller's killing.

Dr. George Tiller

...also these links... (Read this one if you don't have time for them all.)

Operation Rescue

Terror Should Not Pay