Tacit knowledge Dep’t

I’m not sure why people are criticizing Dr. Jack Cassell, a Florida urologist, for telling patients who voted for Obama to seek care elsewhere.

After all, doesn’t it stand to reason that the very best urological treatment would come from a physician who is himself a prick?

Perhaps Dr. Cassell could form a joint practice with a proctologist.

Author: Mark Kleiman

Professor of Public Policy at the NYU Marron Institute for Urban Management and editor of the Journal of Drug Policy Analysis. Teaches about the methods of policy analysis about drug abuse control and crime control policy, working out the implications of two principles: that swift and certain sanctions don't have to be severe to be effective, and that well-designed threats usually don't have to be carried out. Books: Drugs and Drug Policy: What Everyone Needs to Know (with Jonathan Caulkins and Angela Hawken) When Brute Force Fails: How to Have Less Crime and Less Punishment (Princeton, 2009; named one of the "books of the year" by The Economist Against Excess: Drug Policy for Results (Basic, 1993) Marijuana: Costs of Abuse, Costs of Control (Greenwood, 1989) UCLA Homepage Curriculum Vitae Contact: Markarkleiman-at-gmail.com

14 thoughts on “Tacit knowledge Dep’t”

  1. A diarist on DailyKOS nailed this issue today. In Florida (or Alabama or other Deep South states), it's code for No Blacks. And it's likely to be defended (by Fox) as an issue of freedom of speech and freedom of association.

  2. Where's the eye roll smiley when you need it? EVERYTHING you people dislike is racism. This is, in fact, an issue of freedom of speech and of association.

  3. Brett Bellmore says:

    "Where’s the eye roll smiley when you need it? EVERYTHING you people dislike is racism. This is, in fact, an issue of freedom of speech and of association."

    You forgot to invoke 'states rights'.

  4. "This is, in fact, an issue of freedom of speech and of association."

    It's the Free Market (TM), too! Yes, yes, why yes it's the Free Market allocating the Best Care to all! See, Markets DO work!

  5. "You forgot to invoke ’states rights’."

    I didn't forget. It has nothing to do with state rights. It has nothing to do with race, either, and rather blatantly so. It does have to do with politics, and he's as entitled to ask people who support a law he doesn't like to look elsewhere for a doctor, as people looking for a doctor are entitled to hire one whose politics THEY like.

    How could it possibly be "racist"? At least half of the people supporting this bill have got to be white. It makes about as much sense to call him a racist if he said he didn't want to care for patients who like anchovies on their pizzas!

    "Racist": It's your all-purpose epithet, you guys don't even pretend it means anything anymore.

  6. This doctor's so full of sh!t his eyes are brown (see the interview on the frint page at Balloon Juice; he's flat ignorant about the Affordable Care Act). But I see no reason to call him a racist.

  7. I don't think one has to find the doc's position racist to find it offensive. There was a time when providers of services to the public were supposed to do so without regard to race, religion, creed … including political creed. It's a very scary development to have to pass a political test to get medical care.

    Not that it's all that new. When Saskatchewan initiated public health care (single payer etc) in the early 1960s, the Saskatchewan medical association went on strike (i.e. refused to care for people) for a long bitter time. They eventually decided they wanted to eat, so they resumed work – and the general effect of medicare in Canada was to greatly increase physicians' incomes, since they didn't have any bad accounts or pro bono work any more.

  8. I don't know where you live Brett, but in the South there is a lot of coding and fusion of race with many things that don't seem superficially to be "about" race. Is this doctor overtly racist? No, I doubt it. But I don't think for a minute he would do this if he thought his peers and best friends were among those who voted for Obama.

    I personally would find a different doctor and would ask any primary care physician making a referral for a different name. It's a nasty trait, to use the position of providing an essential service as a way to club you over the head with political and personal biases.

  9. Once you break out the secret decoder ring, the hope of communication is over. "Coding" is just a rhetorical technique for being able to claim somebody is 'saying' something they didn't say.

  10. Brett, I don't think that's true. I mean, it is and it isn't.

    Racism is deeply unconscious as well as conscious. Even people who are admitted racists don't really understand why they feel the way they do. We've made so much progress after the civil rights movement that is generally a total taboo to be openly racist. Yet does that mean that people aren't?

    The tricky thing is figuring out where racism really exists. And you're right – on an individual basis it is very difficult to know whether someone is truly acting from racial hostility. But this stuff has been studied over and over, theories have been built – some with more authority than others. It's all very dicey but that doesn't make any of it untrue.

    To a certain extent, mainly for practical purposes, people end up relying on intuition. Women need to be careful about certain "types" of men. The same goes for any minority community that might have to deal with racial hostility, or gays and sexual violence, etc. And it's all based on very subtle *code*. None of it is anything that would really hold up in court. I agree we all need to be careful not to draw conclusions where we shouldn't, but we can't dismiss the subtle "tells" of prejudice either.

    Conservatives just have to face the fact that a lot of their politics is very attractive to bigots. That doesn't mean it necessarily is in principle. But spend some time at Fox nation or somewhere similar and the blatant racism is palpable. So was this guy a racist? There are some contextual elements that put him in the "at-risk" category. I think it's a worthwhile discussion.

  11. I think 'liberals' really need to face the fact that a lot of their politics are merely attractive to a different sort of bigot, whom they're more comfortable with. Which would be why you find so many liberals who hold really poisonous opinions of gun owners, start hearing banjo music the moment they see a Confederate battle flag on a pickup bumper, conflate anybody who's opposed to post viability abortion with Operation Rescue, are so ready to believe Tea Party members are dangerous yahoos… That sort of thing IS bigotry, you know. It's just the liberal form of it. It's on display all the time.

    Now, to be fair, I'll concede that "coding" does take place, to some extent, all over the political spectrum. But it's still the death of communication to so casually accuse people of it. It should be a last resort, only when you can demonstrate that the overt behavior of the person is more consistent with the 'coded' message you're attributing to them, than the words they're actually uttering are. Otherwise there's no way to communicate a message somebody looking for 'coding' doesn't want to hear. Or, more to the point, avoid their 'hearing' a message you didn't really communicate. It becomes a way of confirming your own prejudices about the other side, beyond any possibility of falsification.

    Hell, isn't bigotry about treating people as mere instances of a group, and attributing to them the characteristics you believe appropriate to the group, instead of treating them as individuals in their own right? Resort to talk of "coding" can BE bigotry, itself, if it's not based on particularized evidence in individual cases.

    So, in the individual case we're discussing, we've got a doctor who says people who support Obama care should seek their medical care elsewhere. And this is supposedly coded 'racism' despite the fact that "people who support Obama care" is a much larger group than "blacks", and so would be a really, really lousy proxy for the latter.

    I say, you can't call that coding unless you've got some evidence to back it up. Calling that racism, right off the starting block, is just a liberal reflex, that's turning "racist!" into the liberal version of "Poopy head!", communicating nothing more to the people who hear it than that you don't like somebody. The process of stripping "racist" of all actual meaning is so far along at this point, I'm not sure you could even reverse it if you tried. You've ruined the word for political discourse, by gross overuse. Liberals would probably be quicker to realize that, were the notion that people who oppose their politics are racists not one of the most common bigotries of the left…

  12. You make some interesting points, Brett. I do think it diminishes language when we use terms incorrectly, as sort of pummeling devices. Calling this man racist, with no actual evidence of it, certainly is a disservice to actual racists.

    And you're absolutely right that there is a lot of snobbery on the left towards rural, or conservative culture. However, this concern is hyper-inflated by the right, and exploited politically. The whole wine and cheese liberal thing. Calling it bigotry is a bit of a stretch. Speaking of diminishment, this is a complicated story that goes back – well, probably since the dawn of civilization, as soon as you had different classes of labor. It's about philosophy and cosmopolitanism, education and economic structure.

    I think a strong case can be made that the confederate flag is an ugly symbol, that gun owners who want zero regulation are irresponsible, that anti-abortion legislation takes away women's rights, and that a large number of Tea Partiers are racist (all of the birthers might be placed in this category, with emphasis on those speaking on stage). So, some who hold these views may also feel a sort of class bigotry. But how many of them *are compelled by their bigotry* to hold these beliefs?

    The dangerous thing about racism or other prejudice (and I want to say "real bigotry") is that it drives political beliefs. So if you think homeless people are scum you oppose services to help them. If you think women are inferior to men you oppose giving them equal rights. Or you're a homophobe, or a racist, etc. These are also historically groups historically discriminated against, and so (and I realize this is a liberal perspective) there is a legacy social order that needs to be pushed against.

    I'm trying to think of ways in which liberal bigotry towards rural traditionalism drives political oppression. As a liberal, I think liberal policy goals are actually trying to help any real victims. But often what is perceived as "oppression" (again, talk about language diminishment) is in fact the inconvenience of not being able to be the dominant cultural form. This would be laws against Christianism where you can't hang crosses in courtrooms, or heterosexism when gay marriage is allowed and antigay discrimination is outlawed. The gun issue seems odd because what most gun control advocates want to regulate is pretty reasonable – with a targeted social outcome. But a certain type of gun enthusiast has invented this big conspiratorial fantasy about needing guns for protection against the government (please), and seems utterly revanchist. I think there is a somewhat principled case against affirmative action, but it is hardly targeted towards any one class of man.

    So in all of those examples, bigotry didn't seem to be driving any of it. It might be an unfortunate response to some of the political objections, but that's after the fact. Each of those issues originates as a specific policy goal that has nothing to do with bigotry. I can't think of any class-bigoted liberal that takes a position on anything *because* of bigotry. If you can give me an example I'd be interested.

    Yet with what I would call *real* bigotry (at least in the sense that there are actual policy implications), it is the original driver of policy. One's views of women, minorities and gays are actively shaping their political beliefs. As I argued before, this is often unconscious, but it is no less troubling from a human rights standpoint. This is why I think its important to have the discussion and take possible cases seriously.

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