Commentary Magazine


Topic: illness

Christopher Hitchens, Jon Stewart, and More

In his moving article in Vanity Fair about his cancer, Christopher Hitchens disclosed that just before he went on the Daily Show with Jon Stewart, he violently threw up — the result of the illness he had learned about that morning, when he woke unable to breathe, was barely able to cross his hotel room to call for help, and was saved by emergency treatment by doctors who did “quite a lot” of work on his heart and lungs and told him he needed to consult an oncologist immediately.

That evening he nevertheless appeared as scheduled on Stewart’s show (and then at the 92nd Street Y, where he threw up again), unwilling to disappoint his friends or miss the chance to sell his memoir. In the article, he did not describe what he said on The Daily Show, but his appearance there is worth remembering for reasons going beyond his extraordinary fortitude in proceeding with it.

The video is here. At the end, after discussing his work in a camp for revolutionaries in Cuba in the 60s, there was this colloquy:

Stewart: If you had been young today, going through this same sort of [unintelligible], where do you think your alliances would be, where do you think you would have—

Hitchens: Well, I teach at the New School, and I teach English and a lot of journalists and would-be journalists come, and I often hang out with young people who are journalists, and I’m sorry for them, in a way. Because what are they gonna do – I mean, are they going to say ‘I’m a global warming activist’? It’s not quite the same, is it?

Stewart: Isn’t it all the same once you realize that your idealism — you can use it to further your aims, [if] you realize that nothing is nirvana, nothing is perfect?

Hitchens: Oscar Wilde used to say that a map of the world that doesn’t include Utopia isn’t worth looking at. I used to think that was a beautiful statement. I don’t think that at all anymore. I tell you, to be honest, the most idealistic and brave and committed and intelligent young people that I know have joined the armed forces. And they are now guarding us while we sleep in Iraq and Afghanistan and elsewhere. … I never would have expected that would be what I would say about the students I have to teach.

Stewart’s audience, which is often raucous, listened to this in silence.

Hitchens writes in Hitch-22 that these days he thinks about “the shipwrecks and prison islands to which the quest [for Utopia] has led” and that he came to realize that “the only historical revolution with any verve left in it, or any example to offer others, was the American one.” His appearance on the Daily Show was an example not only of his physical courage but also of the intellectual audacity that pervades his book.

RE: ObamaCare Loses Brooks

While I’m certainly glad that someone on the Times op-ed page has come out against ObamaCare, David Brooks could certainly have been a bit more forceful about it. Nothing wishy-washy about Keith Olbermann’s rejection of ObamaCare.

But I was struck by one thing that Brooks wrote: “The fact is, nobody knows how to reduce cost growth within the current system.”

Of course we do.

Allow people to buy insurance across state lines and thus escape unwanted mandates and such economic idiocies as “guaranteed issuance.” If New Yorkers could buy health insurance in Connecticut, their insurance costs would drop by 40 percent overnight. How’s that for reducing costs, Mr. Brooks?

Reform tort law. Texas did exactly that a few years ago and the cost of medical malpractice insurance — which, of course, is passed on to patients — fell by an average of 21 percent, and 7,000 new doctors began practicing in the state, many in under-served areas.

Require that medical-service providers post prices for standard procedures, allowing comparative shopping by doctors and patients alike. Charges for standard procedures can vary dramatically because they aren’t readily ascertained. Once posted, they would tend to converge toward the lower end. Combined with medical savings accounts that incite health-care consumers to look for the lowest prices, the reduction in costs would amount to billions of dollars.

Allow the young to buy high-deductible, low-cost health insurance to protect them from highly unlikely but devastating accidents and illnesses that represent the greatest risks to their health. That would enlarge the insurance pool and decrease the number of uninsured who are shifted onto the bills of those with insurance. That allows lower premiums.

Health-care costs will increase for reasons we can do nothing about, like inflation, an aging population, new and expensive technologies and drugs, and the fact that when we save a patient from dying of one illness, we guarantee that he will later die of another, at further cost. But there are hundreds of billions of dollars wasted in the health-care system today, and we know exactly how to fix that.

The only reason we haven’t is because politicians don’t want it fixed.

The Indispensible Senator

There is little doubt these days that Sen. Joe Lieberman is the most important man in the U.S. Senate. In a must-read Wall Street Journal interview he explains his objections to the public option and to ObamaCare more generally. As to the former, he observes:

It was always about how do we make the system more efficient and less costly, and how do we expand coverage to people who can’t afford it, and how do we adopt some consumer protections from the insurance companies . . . So where did this public option come from?. . . It doesn’t help one poor person get insurance who doesn’t have it now. It doesn’t compel one insurance company to provide insurance to somebody who has an illness. And . . . it doesn’t do anything to reduce the cost of insurance.

But it’s not just the public option. He’s not buying the supposed deficit neutrality of the Democrats’ scheme. He’s not buying that the Medicare cuts are for real or that the current bill will control costs. It sure sounds as though he’s going to vote to filibuster the sort of bill moving through the Senate. In short, Lieberman may be the only man, or at least the most resolute one, standing in the way of an atrocious government takeover of health care.

And on Afghanistan, Lieberman addresses concerns about the 18-month deadline to which many conservatives have objected:

But after probing Defense Secretary Bob Gates in a Senate hearing this week, he’s now more confident. “[Gates] compared it to the so-called ‘overwatch,’ which is really what we did in Iraq. As we felt the Iraqis were prepared to take over in certain areas, we pulled back but we didn’t pull out.” Mr. Lieberman believes this “pull back” is what begins in July 2011, and also felt he got assurances that it would start only in “uncontested” areas—and that there is no deadline for when all 30,000 troops must leave.

He cautions, however, that it’s up to the president to rally the country.

On these and other topics — Iran, the KSM trial, and the Patriot Act – Lieberman is once again front and center, arguing for a robust response to the threats America faces and opposing his Democratic former colleagues. One can argue it is only because the Senate generally depends on 60, not 51 votes, that Lieberman has such extraordinary and unique influence. But in truth, Lieberman has that influence because of the serious arguments he presents, his lack of political cant, and the moral clarity he brings to the debate. He has become the indispensable senator.

Flotsam and Jetsam

The debate has begun: “Republican senators went on the offensive against the Democratic healthcare initiative the morning after the bill moved forward on a procedural vote, blasting the bill as a job-killer and mechanism of ‘excessive government control.’ … ‘We don’t often ignore the wishes of the American people,’ [Mitch] McConnell (R-Ky.) said, noting ‘it’s hard to handicap’ the outcome.”

Sen. Ben Nelson has started things rolling: “Sen. Ben Nelson (D-Neb.), who is uncommitted moving forward, said he has delivered two pages of proposed changes to Majority Leader Harry Reid. … ‘There will be a lot of discussion back and forth about what might get enough votes,’ Nelson said after the vote. ‘There will have to be fairly significant changes for others as well, not just me. Nuance will not be enough.”

Sen. Chuck Schumer says there aren’t any new taxes. Sen. Jon Kyl disagrees: “If you have insurance you get taxed. If you don’t have insurance you get taxed. If you need a lifesaving medical device like a stint or a diabetic pump you get taxed. … The Congressional Budget Office says and the Joint Tax Committee says that these taxes imposed on others will be passed through.”

Republicans are focusing on the controversy over mammography guidelines to make their point about ObamaCare: “GOP lawmakers said the Democratic health care plan, which the Senate allowed to inch forward Saturday night and remains President Barack Obama’s top domestic priority, would set the nation toward massive government control. ‘Do these recommendations make sense from a cost standpoint? Absolutely, from a cost standpoint, they’re right,’ said Rep. Tom Coburn, an Oklahoma Republican who is a medical doctor. ‘From a patient standpoint, they’re atrocious. And that’s the problem with a bureaucracy stepping between a physician and their patient.’”

In case you had any doubt about the three-ring circus: “The five men facing trial in the Sept. 11 attacks will plead not guilty so that they can air their criticisms of U.S. foreign policy, the lawyer for one of the defendants said Sunday. Scott Fenstermaker, the lawyer for accused terrorist Ali Abd al-Aziz Ali, said the men would not deny their role in the 2001 attacks but ‘would explain what happened and why they did it.’”

Another new low for Obama in the Gallup poll.

John McCain on cap-and-trade: “‘Their start has been horrendous,’ McCain said Thursday. ‘Obviously, they’re going nowhere.’ McCain has emerged as a vocal opponent of the climate bill — a major reversal for the self-proclaimed maverick who once made defying his party on global warming a signature issue of his career.”

Bradley Smith: “Harry Reid actually said this debate is about whether Americans will live ‘free from the fear of illness and death,’ and says these things can be prevented by the Pelosi/Reid/Obama approach to healthcare. This must be a really good plan! Of course, you won’t be able to live free from the fear of being thrown in jail for buying the wrong health insurance coverage, but hey, there are trade-offs in life.”

Another bad news item on hiring: “Employers already are squeezed by tight credit, rising health care costs, wary consumers and a higher minimum wage. Now, the surging jobless rate is imposing another cost. It’s forcing higher state taxes on companies to pay for unemployment insurance claims. Some employers say the extra costs make them less likely to hire. That could be a worrisome sign for the economic recovery, because small businesses create about 60 percent of new jobs. Other employers say they’ll cut or freeze pay.” Which suggests that we should be lowering, not raising, taxes and reducing mandates, not increasing them, on business.

Rising Star

The leftwing blogosphere has found its next star. He is an articulate champion of a modern leftist sensibility:

• He says that the war in Iraq has failed to produce democracy and has only created “civil war” that is “getting out of [Bush’s] control.”

• He calls the war in Iraq “unjust” and says it was launched based “on deception and blatant lies.”

• He says that the war has made a mockery of our “slogans of justice, liberty, equality, and humanitarianism”—instead replacing them with “fear, destruction, killing, hunger, and illness.” He goes on to say that “more than 650,000 of the people of Iraq” have died “as a result of the war and its repercussions.”

• He says that the “vast majority” of the American public wants the war to stop and “elected the Democratic Party for this purpose, but the Democrats haven’t made a move worth mentioning,” leading to the “vast majority” of the American electorate “being afflicted with disappointment.”

• Why haven’t the Democrats done what they were supposed to? He has an explanation: “they are the same reasons that led to the failure of former President Kennedy to stop the Vietnam War. Those with real power and influence are those with the most capital. And since the democratic system permits major corporations to back candidates, be they presidential or congressional, there shouldn’t be any cause for astonishment—and there isn’t any—in the Democrats’ failure to stop the war.”

• He bemoans that the White House is focused on Iraq rather than on the real dangers facing all mankind, such as “global warming resulting to a large degree from the emissions of the factories of the major corporations,” “the burden of interest-related debts, insane taxes, and real estate mortgages,” and of course “the abject poverty and tragic hunger in Africa.”

• He is particularly peeved that President Bush “insists on not observing the Kyoto accord.”

• He decries the entire process of “globalization,” which he sees as nothing more than the attempts of “the capitalist system . . . to turn the entire world into a fiefdom of the major corporations.”

• He cites the growing consensus of thinkers who “have declared the approach of the collapse of the American Empire.”

• And he recommends that anyone who wants to know what’s really going on in the world read the works of MIT professor Noam Chomsky and former CIA official Michael Scheuer.

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Fidel’s Favorite

Fidel Castro, who has long been too ill to appear in public, apparently is healthy enough to share his thoughts with us. His most recent contribution to the global political dialogue came yesterday in an editorial in Granma, the Cuban Communist Party’s mouthpiece. He grabbed headlines in America by handicapping its 2008 presidential election—he thinks Hillary Clinton and Barack Obama are “seemingly invincible.” But Fidel’s most interesting thoughts are his evaluations of past American presidents.

Castro’s favorite? That would be “James Carter,” as Cuba’s ailing revolutionary calls him. El Maximo Lider gives a number of reasons why he chose the Georgia Democrat. He notes that Carter “was not an accomplice to the brutal terrorism against Cuba” and that he promoted a maritime agreement with Cuba. Yet he did not mention the most important reason. Castro is most likely so fond of the 39th President because he delegitimized the American embargo of Cuba—but he did not end it.

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The Palestinians, Alone

Some 6,000 Palestinians have been stranded for the past month on the Egyptian side of the border with the Gaza Strip because of the closure of the Rafah border crossing. The terminal was closed after the European monitors who had operated there for the past two years left their jobs following Hamas’s takeover of the Gaza Strip in mid-June. At least 20 of these Palestinian travelers have died either of illness or other causes while waiting on the Egyptian side. Most of them are complaining that the Egyptian authorities are not doing anything to alleviate their suffering. Attempts by Israel to find a solution to this humanitarian crisis have been foiled by both Fatah and Hamas, who turned down an Israeli offer to help the Palestinians return home through the Israeli-controlled border crossing at Kerem Shalom.

Meanwhile, not a single Arab country has come forth to help the marooned Palestinians. Egyptian and Palestinian families living along the border have been hosting some of them, but the majority, including women and children, are forced to sleep in mosques and on sidewalks.

“The Arabs don’t care about us,” Muhammed Haj Jamil, a university student who was on his way home from the Gulf, told me in a phone interview. “The Arabs hate the Palestinians. The Egyptians are treating us as if we were terrorists. Even the Jews treat us better than most Arabs.”

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The “Emergencies” of the Stem-Cell Debate

The Washington Post’s Dana Milbank offers a portrait of the debate on stem-cell research that took place in the Senate over the last two days. He notes the extent to which Senators, especially those working to remove the boundaries governing federal funding of embryo research, focused on sad, often quite touching stories of illness and suffering in their own lives and those of their families and friends.

This makes sense, of course, since the debate was about medical research. But on the other hand, it does raise the question of exactly what case those stories were intended to make. The stem-cell debate is not about whether our country should support medical research—there is an absolute consensus on that point. The federal government spends about $30 billion on such research through the National Institutes of Health each year. The debate is not even about whether to support stem-cell research. The federal government has spent about $3 billion on various forms of stem-cell research since 2001, including more than $130 million on embryonic stem-cell research.

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