Sad that this needs to be said. Even sadder that so few Republicans are saying it.

President George W. Bush is rightly remembered as a failed president because of Iraq, Katrina, and more.

I’ve always thought he was a pretty decent man who deserved credit for several things. Foremost was his personal triumph of PEPFAR, which saved millions of lives around the world. There was also his support for mental health parity and his support for religious tolerance after 9/11.

We’ll never know what would have happened had 9/11 not erupted on his watch. I suspect that he would have had a different, more worthy presidency. (h/t Fusion–more here.)

The Students Professors Must Reach

Even though I have been a professor for decades, my favorite teaching story comes from my wife, who was in the business for only a few years. She taught writing at a community college, mostly to working class people, recent immigrants and second language students looking to develop their career and/or life. For homework one week, she asked her students to write a hortatory essay. She graded the essays and handed them out at the end of a class.

A 19-year old male student stormed up to her desk. In his hand was clutched his essay, which had received a failing grade.

“This OFFENDS me! This is not fair!” He boomed.

My wife looked at his paper and said “Remember how in class I said you had to tell readers what your essay was about at the beginning? You never did that so it wasn’t clear what you were trying to say”.

“That’s not the point!” He insisted.

“Remember how we talked about not introducing new points at the end of an essay?” my wife said. “Your last sentence starts a new argument that doesn’t follow from anything else you wrote and you didn’t have the space to develop.”

“THAT’S NOT THE POINT!!” He repeated.

My wife looked at him and said gently “Maybe the point is that you tried really hard and you got a bad grade anyway and that’s really disappointing.”

“Yes”, he said quietly, and burst into tears.

Met with unexpected compassion, the self-righteous bully dissolved, revealing the vulnerable, self-doubting young person beneath. After he stopped crying and pulled himself together, he was able to listen to what my wife was trying to teach him. Knowing that his professor cared about him, he persisted in the course and ended it a better writer than he had started.

One of the blind spots of professors is that almost all of them were excellent students. School was typically a series of triumphs from kindergarten on. This can make professors unaware of how scary and frustrating college can be for young people, especially those who came from under-resourced schools that didn’t prepare them well for the experience. It’s pretty easy to teach the young people who are well-prepared for college, are confident that they have every right to be there and have faith that they will succeed in their educational goals. The real challenge for faculty — the one that separates the best teachers from the average ones — is connecting with and supporting the students who are none of those things.

What’s the matter with Kentucky?

My liberal friends are anxiously reading Alec MacGillis’s, “Who Turned My Blue State Red,” in the Sunday New York Times about growing Republican strength in poor communities. Alec brilliantly explores why eastern Kentucky and similar locales support Republican politicians pledged to cut Medicaid, Food Stamps, and disability programs that specifically benefit these very communities.

MacGillis notes two key points. The first is depressingly familiar: low voter turnout among the specific people most harmed by Republican policies.

The people who most rely on the safety-net programs secured by Democrats are, by and large, not voting against their own interests by electing Republicans. Rather, they are not voting, period.

MacGillis presents reams of figures that document the simple fact that nonvoters are much more likely than voters to be uninsured, to be unbanked, to have serious unmet economic needs.

The second point is more interesting and more comprehensible at a human level:

The people in these communities who are voting Republican in larger proportions are those who are a notch or two up the economic ladder… And their growing allegiance to the Republicans is, in part, a reaction against what they perceive, among those below them on the economic ladder.

These Republican voters are not particularly lashing out at supposed others, be they immigrants or black residents of the inner city. Rather, these voters are reacting to their own neighbors and perhaps friends and relatives, who rely on food stamps, Medicaid, or disability payments and who don’t seem fully deserving.

I’m not sure what lesson this provides, from the standpoint of either politics or policy. Supporters of expanded social provision must find better ways to engage poor people, to get out their votes. We can also find more opportunities for fruitful alliances across economic and ideological lines. Over the next several years, I am confident that Medicaid will be expanded across the South, despite widespread opposition. There’s too much money at stake for too many people for the battle to continue much longer after President Obama leaves office. Some tightening of particular programs may help, too. On balance, it’s probably a good thing that federal disability programs have tightened some of their procedures in evaluating mental health and musculoskeletal conditions that have shown the greatest increase in recent years.

Whatever the political or policy lessons, Alec’s essay captures a basic human reality, aptly summarized in the title of Paul Thorn’s great country song: “I don’t like half the folks I love.” 


Viewed from afar, one might think that categories such as “deserving poor” or “disabled” are reasonably clear-cut. Viewed up-close, things seem much more fuzzy. Many people who rely on public aid straddle the boundaries between deserving and undeserving, disabled and able-bodied. Many of us know people who receive various public benefits, and who might not need to rely on these programs if they made better choices, if they learned how to not talk back at work, if they had a better handle on various self-destructive behaviors, if they were more willing to take that crappy job and forego disability benefits, etc.

It’s easy, even viewing our own friends and relatives, to confuse cause and effect regarding more intimate barriers. A sad reality of psychiatric disorders is that the very symptoms which inflict mental pain on the sufferer can make themselves felt to others in ways that undermine empathy and personal relationships.

Across the Thanksgiving dinner table, you see these human frailties and failures more intensely and with greater granularity than the labor economist could possibly see running cold data at the Census Bureau. But operating at high altitude, the labor economist sees structural issues you can’t see from eye level.

There have always been vulnerable people, whose troubles arise from an impossible-to-untangle mixture of bad luck, destructive behaviors, and difficult personal circumstance. That economist can’t see why your imperfect cousin can’t seem to get it together to hold a basic job. She can see that your cousin is being squeezed out by an unforgiving musical-chairs economy. Every year, in the backwaters of America, that economy seems to put out fewer and fewer chairs.

An integrated registry of real hazards

Donald Trump has the attention span of a gnat, so it’s not surprising he forgot what he meant about the registry of Moslems.  The other Republicans are flailing about trying to find a coherent system for protecting Americans, but most of them have been irretrievably stupefied by years on a public payroll and lack any management skills.
That’s not all: a government database?? We can’t depend on incompetent, lazy, government civil servant nincompoops and their jack-booted thugs to manage and  use such a thing. (Honestly, when these RINOs go to bed and wake up, I think they just forget everything and have to figure it out again from scratch!) Here’s where we absolutely need privatization and outsourcing, and Visa plus any of the specialist outfits we hired to do Iraq for us are totally ready to step up. The database needs to be a private sector enterprise with appropriate profit incentives and guarantees, plus exemption from civil liability (honest businessmen occasionally make well-meaning mistakes, but only a heartless Commie like Elizabeth Warren would think they should be punished for them).
Finally, we need to be smart about what perils we focus on, and Moslems are not even in the top four risks.  Here are the most dangerous creatures loose among us, along with some operational definitions therefor, so we can get them correctly labeled once and for all.  One integrated national database of the following threats, searchable by anyone who can be trusted to look in it, biometrically checkable, will save a lot of wasteful duplication. Continue Reading…

Weekend Film Recommendation: A Cat in Paris (Une Vie de Chat)


I like to recommend films for kids every now and then, and I want to get back to that this week. Accordingly, allow me to point you to a charming 2010 Oscar-nominated French animated film originally titled Une Vie de Chat that was subsequently re-voiced using English language actors as A Cat in Paris.

The titular cat of the film is Dino, who lives a double life. By day he is the beloved pet of a little girl named Zoe. But at night he makes a daring (and amusing) journey across the neighborhood to the flat of Nico, who is a (what else?) cat burglar. The two conduct daring robberies until dawn, when Dino races back to Zoe’s bed. Zoe very much needs Dino because she has been so traumatized by the murder of her policeman father that she has lost the ability to speak. This frustrates her grieving mother Jeanne, who is a senior police detective. Jeanne is trying to track down her husband’s fearsome killer as well as the burglar who is stealing precious jewels across the city. She has no idea that the two mysteries will become completely interwoven. The stage is set for suspense and excitement, as well as the possibility of healing both for Zoe and Jeanne.

The snazzy, jazzy animation is somewhat impressionistic but not so much that children will be confused. Nico’s movements and figure show that he is at heart as much a cat as Dino. Through some artful drawing and script writing, Jeanne, initially seeming to be on the steely side, is revealed in a scene where she practices martial arts to have a bit of the cat in her as well, albeit hidden under emotional scar tissue. This feline connection ties Dino, Zoe, Nico and Jeanne together thematically and artistically in a way that makes the resolution of the story highly satisfying (even if you are more of a dog person).

I watched this movie with three little boys who enjoyed it as an exciting story, but I think I would recommend it even more for little girls. The struggles to understand each other that mothers and daughters can have are well brought out, and Jeanne (voiced by the great Marcia Gay-Harden in the English language verson) is a terrific role model as a wounded but also strong and brave woman. Jeanne chides her daughter at times but when the chips are down, she protects her with inspiring ferocity.

Roses to Jean-Loup Felicioli and Alain Gagnol for their artistry and for their ability to craft a film that parents and children can enjoy together. A Cat in Paris delivers drama, excitement, sweetness and laughter in a pleasing combination that will put a smile on your little one’s face and quite probably yours as well.

Medicaid beats other insurance for children with special health care needs

A new study by Kreider and colleagues is out in JAMA Pediatrics which compares parents’ experiences with various forms of insurance coverage. On ten of fourteen measures, Medicaid looks better than private insurance coverage and compares favorably with CHIP coverage, too.

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The findings provide valuable corrective to people who unfairly criticize and overlook its many strengths for low-income people and the disabled. Yet it’s more concerning when we think about qualified health plans on the new state marketplaces. I worry that these will fall far short of what Medicaid offers to low-income people and those with special needs. With so many knife fights over ACA, the public conversation hasn’t intensively focused on children with special health care needs. It’s time to pay more attention.

More from me here, at

“As we have no real racial problem, we are not desirous of importing one”

I don’t know whether President Obama is doing everything right in addressing the ISIS/Daesh threat. I depart from some liberal friends on police use of metadata and other security matters. I am, however, reassured by the President’s calm solidity, which presents such a contrast with pandering and posturing politicians looking to score political points in the aftermath of an atrocity.

I don’t know what to say about presidential candidates and governors who would take in only Christian refugees in the wake of the agony in Syria and the Paris attacks. The United States faces a quite-manageable security threat from the refugees we have agreed to admit. Hiding in plain sight, our simplest anti-terrorism policy is our most effective: Embrace people from every religion and community, and ensure their equality and success in American life. It would be a huge mistake, not to mention an equally huge betrayal of our national ideals, to back away from that.

In any event, the openly-expressed anti-Muslim sentiments directed against refugees in recent days bring back memories, and not good ones.

No room at the Inn

No room at the Inn

Debating e-Cigarettes

Recently, two dueling groups of public health experts wrote open letters to the World Health Organization regarding e-cigarettes. The first group saw e-cigarettes as a potentially valuable public health tool, the second group was much more skeptical. At the Stanford Health Policy Forum, we invited signatories from each side to debate e-cigarettes and the result was an extraordinarily thoughtful and civil exchange.

Killing Baby Hitler

When Kevin Drum and Jeb Bush agree about something, one of two grossly implausible events must have occurred: either Kevin is wrong or Jeb is right. Since Jeb’s wrong-headedness is more reliable than even Kevin’s good sense, a devout Bayesian in this situation will start out suspecting that Kevin has made one of his rare mistakes.

Some time ago – sorry, real life has been interfering with my blogging – the New York Times asked what seemed like a remarkably silly question: “If you could go back and kill Hitler as a baby, would you do it?”

Answers: 42% Yes, 30% No, 28% Not sure.

The Huffington Post picked this up and asked it of JEB! by email. Bush (sensibly) ducked it until he was asked on camera, at which point he emitted a characteristically inarticulate grunt of affirmation. “Hell yeah, I would! You gotta step up, man.”

Kevin was more thoughtful but equally decisive:  “I’m not an especially bloodthirsty guy, but hell yes, I’d do it. Sure, maybe World War II would happen anyway, though that’s hardly inevitable. Maybe the Holocaust too. But even a reasonable chance of stopping either one of them would be well worth the life of a baby who would otherwise grow up to be a monster. What am I missing here? I wouldn’t even hesitate.”

I’m pleased to report another success for the Rev. Mr. Bayes. In my judgment (which I would be glad to pronounce ex cathedra if someone would just build me a cathedral) both Bush and Drum are obviously and catastrophically wrong.

Forget about time-travel paradoxes, forget about the risk that something even worse would happen, and assume that your powers of foresight are perfect. You still shouldn’t kill Baby Hitler, for the simple reason that the Baby Hitler you’d be killing wouldn’t have done anything wrong, and intentionally killing innocent people is wrong, the same way torture and slavery are wrong. End of discussion.

Logically, of course, the Right-to-Life crowd should be up in arms about Bush’s expressed willing to intentionally take innocent life. And logically, of course, Bush himself couldn’t really hold his expressed position on abortion and also his expressed opinion about baby-killing. But, of course, logic has nothing to do with it.

Continue Reading…