I tell friends from elsewhere that, despite what they may have heard, Hoosiers aren’t a bunch of rubes. Then, I see things like the report that Indiana is passed only by West Virginia in percentage of adult smokers. At 26.1%, we have more smokers than Kentucky. In this day and age, what in the world would possess you to start or continue smoking? Of course, the fact is, while starting smoking is a free choice, once the habit is established, the decision to stop smoking is not a simple matter of choice. Your body is addicted, and your mind is no longer the free agent we contemplate in simplistic economic scenarios. An Indy Star editorial notes the General Assembly’s failure to adopt a smoking ban and the correlation between smoking cessation efforts in states and lower smoking rates in those states.

It occurs to me that some of the arguments made by social conservatives against normalizing homosexuality in our society actually make some sense when applied to smoking. Smoking is a choice, not how you are born. Smoking is harmful behavior. There is a Tobacco Industry agenda to convert young people to make a lifestyle choice. Smoking in mainstream culture may make my kids think it’s o.k., and cause them to choose a harmful lifestyle. So, while I don’t necessarily support criminalizing smoking, I might be open to the idea of getting the behavior into the closet.

I freely admit to not being perfectly dispassionate on this topic. I grew up with smoking and didn’t like it. I’ve seen family members suffer from health problems attributable to smoking. I’ve seen family and friends wanting to quit but being unable.

Smoking is not a self-contained behavior which causes efforts to paint smoking regulation as solely a property rights issue to miss the mark. Property owners aren’t entirely free to discharge toxins even on their own property, particularly if they hold themselves open to the public.

The Indy Star editorial has this to say about reducing the number of smokers:

Numbers likewise don’t lie when it comes to fighting back against this scourge. The CDC report confirms that states with the lowest incidence of smoking are those that spend the most on tobacco cessation and charge the highest cigarette taxes.

They also are more likely to have state and/or city laws forbidding smoking in all indoor public spaces.

Fewer smokers means a healthier population, lower health costs, and maybe a little extra money at the end of the month to pay bills. This is anecdotal, but in my collection practice, I can’t tell you how many people unable to pay their bills seem to smell of fresh cigarettes, suggesting that they are foregoing paying their obligations in favor of buying another pack of smokes.

Today one of my friends, with whom I do not see eye-to-eye politically, posted a complaint about trying Khaleed Sheikh Mohammed in the United States District Court for the Southern District of New York. His complaint was that our criminal justice system was not meant for war criminals. Also in the news are the charges against Nidal Malik Hasan for the Fort Hood murders. There will doubtless be rumblings against the legal process he receives under the United States Code of Military Justice along the lines of “the people he killed didn’t get a lawyer.”

Whenever I hear complaints about bad people receiving due process of law, I’m reminded of the exchange between Roper and More in A Man for All Seasons about how we should give even the Devil the benefit of law, not for his sake, but for our own:

Alice: Arrest him!
More: Why, what has he done?
Margaret: He’s bad!
More: There is no law against that.
Roper: There is! God’s law!
More: Then God can arrest him.
Roper: Sophistication upon sophistication.
More: No, sheer simplicity. The law, Roper, the law. I know what’s legal, not what’s right. And I’ll stick to what’s legal.
Roper: Then you set man’s law above God’s!
More: No, far below; but let me draw your attention to a fact — I’m not God. The currents and eddies of right and wrong, which you find such plain sailing, I can’t navigate. I’m no voyager. But in the thickets of the law, oh, there I’m a forester.I doubt if there’s a man alive who could follow me there, thank God.
Alice: While you talk, he’s gone!
More: And go he should, if he was the Devil himself, until he broke the law!
Roper: So now you’d give the Devil benefit of law!
More: Yes. What would you do? Cut a great road through the law to get after the Devil?
Roper: I’d cut down every law in England to do that!
More: Oh? And when the last law was down, and the Devil turned round on you, where would you hide, Roper, the laws all being flat? This country’s planted thick with laws from coast to coast — man’s laws, not God’s — and if you cut them down — and you’re just the man to do it — do you really think you could stand upright in the winds that would blow then? Yes, I’d give the Devil benefit of law, for my own safety’s sake.

Just a heads up for those interested in such things and who had not yet heard. CBS News will apparently be airing an investigative piece on Rep. Buyer’s Frontier Foundation tonight.

The short version is that the Frontier Foundation, ostensibly a charity to provide scholarships to Hoosier students, got a lot of love from corporate lobbyists with business before the U.S. Congress generally, and Rep. Buyer specifically. Initially, Rep. Buyer claimed not to have much to do with the Foundation. When details emerged that showed that claim to be ridiculous (the Foundation shared office space and employees with his campaign), he changed course and admitted to being deeply involved. Details also emerged that the Foundation mainly raised money through golf outings and wasn’t too keen on actually providing scholarships. Rep. Buyer claimed that he was just trying to amass enough cash to make the Foundation sustainable and was saddened that he was suffering slings and barbs for trying to do a little good in the world while enduring golf trips to nice places.

Update: Oddly, while I think the Frontier Foundation is sketchy, I also thought the CBS editing was unfair. They introduced the segment with a clip of Buyer getting up to leave which made it look like he was running out on the interview, which he wasn’t. They also showed that he voted for various things favoring the industries that contributed to the Foundation. I don’t think it’s that easy. I tend to think that Rep. Buyer would have voted along with Big Tobacco, et al. regardless of contributions to the Foundation.

Update #2TPM Muckraker has a pretty good run down of the interview.

It’s Veteran’s Day, a grim, solemn holiday in my mind. We owe our soldiers, past and present, a debt of gratitude for the service they have provided and the sacrifices they have made. But I suggest that we should use the holiday less to celebrate the sacrifices they have made, admirable as they are; and more to reflect on whether the things purchased through that service and sacrifice are worth the price. When it’s (actual as opposed to rhetorical) freedom and preservation of the country, then definitely. Advancement of lesser policy goals, however, deserve closer scrutiny. Because, it’s not like we’re playing some elaborate game of Risk. We’re sending young men off to die.

In any case, Veteran’s Day always makes me think of World War I poems. So, here are a few:

Flanders Field:

In Flanders fields the poppies blow
Between the crosses, row on row
That mark our place; and in the sky
The larks, still bravely singing, fly
Scarce heard amid the guns below.

We are the Dead. Short days ago
We lived, felt dawn, saw sunset glow,
Loved and were loved, and now we lie
In Flanders fields.

Take up our quarrel with the foe:
To you from failing hands we throw
The torch; be yours to hold it high.
If ye break faith with us who die
We shall not sleep, though poppies grow
In Flanders fields.

How to Die

DARK clouds are smouldering into red
While down the craters morning burns.
The dying soldier shifts his head
To watch the glory that returns;
He lifts his fingers toward the skies
Where holy brightness breaks in flame;
Radiance reflected in his eyes,
And on his lips a whispered name.

You’d think, to hear some people talk,
That lads go West with sobs and curses,
And sullen faces white as chalk,
Hankering for wreaths and tombs and hearses.
But they’ve been taught the way to do it
Like Christian soldiers; not with haste
And shuddering groans; but passing through it
With due regard for decent taste.

The Parable of the Old Man and the Young:

So Abram rose, and clave the wood, and went,
And took the fire with him, and a knife.
And as they sojourned, both of them together,
Isaac the first-born spake, and said, My Father,
Behold the preparations, fire and iron,
But where the lamb for this burnt-offering?
Then Abram bound the youth with belts and straps,
And builded parapets the trenches there,
And stretched forth the knife to slay his son.
When lo! an angel called him out of heaven,
Saying, Lay not thy hand upon the lad,
Neither do anything to him. Behold,
A ram, caught in a thicket by its horns;
Offer the Ram of Pride instead of him.

But the old man would not so, but slew his son,
And half the seed of Europe, one by one.

In a move that made conservative heads explode and liberals more celebratory than the occasion maybe deserved, the U.S. House of Representatives passed a health care reform bill. This leaves a long road ahead requiring a bill to get past Joe Lieberman in the Senate and then requiring a conference vote when the House and Senate versions are merged. But, still, it’s a solid first step.

The final roll call is here. The bill passed 220 – 215. All five Hoosier Democrats voted in favor of passage. Visclosky and Carson were never really in question. Nor were the four Hoosier Republicans: Burton, Buyer, Pence, and Souder – all of them are consistent in marching to the tune set for them by party leadership. But Donnelly, Ellsworth, and Hill were more open questions. Ultimately, they voted with their party as well. The most radical departure from party discipline was actually Joseph Cao (R-LA), a Republican from a very Democratic district who took the seat be virtue of its being vacated by its prior, criminal occupant, William Jefferson.   Thirty-nine Democrats broke ranks and voted against the bill.

The line I’m getting from the conservative blogosphere is that <em>this</em> is what will cause the Republic to fall. (Quoting Star Wars, no less, “So this is how liberty dies . . . with thunderous applause.”) It wasn’t false calls to war, warrantless wiretaps, torture, attempts to suspend habeas corpus, or even expansion of Medicaid that posed such an ominous threat to life, liberty, and the American way. No, it’s the attempt to use government as a tool to rationalize an obviously broken health care system that is the step too far.

I’ve covered this ground before, but briefly, this is why I support government efforts to reform health care:

1. Our system is broken. This is not (as we see perhaps too often) legislation in search of a problem. We spend twice as much as other countries on health care and don’t get more for our money, certainly not twice as much, and possibly less. Current estimates are that something like $700 billion of our current health care expenditures are wasted. And, no, there is no convincing evidence that these expenditures are malpractice related.

2. The market is not well suited to pricing and efficiently distributing health care services. Proponents of free market solutions argue that the current system is not a free market. That’s probably true, but it has more free market elements than other countries that seem to manage to do more with less. And, there don’t seem to be other countries that have had much success with a free market health care system. (Singapore has been suggested as a model with good results and greater than average free market elements. But, from the Wikipedia entry anyway, it sounds like they have a great deal of government intervention with price controls and compulsory savings.) Some problems with market solutions to health care delivery here are that: a) it’s frequently like negotiating with a gun to your head; b) lack of information as to pricing – comparison shopping is all but impossible currently (this one could probably be fixed); and c) lack of information as to what is actually necessary – medicine is complicated and you generally have to rely on the expertise of those who are selling you the product.

3. Costs need to be controlled. Opponents of health care reform say that increased government involvement in health care will bankrupt the country. I suppose it’s possible, but along our current path it seems almost certain. And, the experience in other countries suggests that greater government involvement leads to less, not more, spending on health care. The knock on government financing of health care seems to be more of a matter of faith than evidence. The dogma is that private industry can do everything more efficiently than government and that government screws up everything it touches. (Never mind that we entrust such things as administration of the death penalty and military defense of the nation to this organization that is supposedly hopelessly and inevitably incompetent.) Again, I can point to other countries for examples where health care gets delivered at considerably less cost. Opponents will tell me that other countries’ experiences are not transferable to our own or that the numbers are cooked — but the disparity in spending is so enormous that I cannot believe that the numbers are cooked at that level of magnitude.  The International Federation of Health Plans put together a comparison of prices (pdf) for various health care services internationally. The U.S. price bar for a given service consistently and significantly dwarfs those for other countries. (Start at page 5, two examples: a) well-child visits, $88 – $148 in the U.S. compared to $15 – $38 in Canada, France, Germany, & Spain; b) normal delivery, $2,348 – $4,847 in the U.S. compared to $498 – $1,041 in Canada, France, Germany & Spain and $1,601 Medicare.) By contrast, free marketeers seem unable to point to a place where the market is successful in delivering health care more efficiently, mostly citing to theory. (“In theory, it should work in practice. In practice, it doesn’t.”)

4. My theory is that, unless we are willing to follow the market through to its logical conclusion and simply let people die when they can’t pay for health care, we’re going to get the worst of both worlds with half a loaf of free market health care. People can’t and don’t get preventative care or care early on in their illness when treatment is less expensive. Instead, they wait until things are life threatening and go to the emergency room and get the most expensive treatment at a time when their health condition has progressed to a point where treatment doesn’t do as much to help their quality of life as would have been possible with early treatment.

5. Criticism of lifestyle choices is popular among the opposition. I do not disagree that people should eat better, exercise more, and reduce or eliminate things like smoking and alcohol consumption. However, most what I see in these critiques is not a true effort to figure out how to solve these problems, but an excuse for doing nothing. If we can cast the sick person as morally blameworthy as fat and lazy, we can sit back and cast judgment rather than work to fix the problems. If you want to get at sloth and gluttony, we need to do things like reform the agricultural subsidies, impose urban planning requirements that encourage walking, running, and cycling and perhaps even discouraging use of the automobile. Additionally, we probably need to consider limits on marketing that encourages people to make unhealthy choices over healthy ones. And, probably, we need higher wages so there is more leisure time in which to exercise. I’m uncomfortable with the level of intervention necessary for some of these steps. Certainly you’ll not see too many proposals along these lines from the folks citing sloth and gluttony as the cause of our high health care costs.

Probably there are some more points I should raise, but I guess this is sufficient for a Sunday morning blog post. I think I’ll go eat some more bacon so I can develop heart problems and enjoy some of that sweet, sweet, communist health care.

Casimir Pulaski became a citizen yesterday after President Obama signed a bill being pushed by Dennis Kucinich making Pulaski a U.S. Citizen, 230 years after his death. Pulaski was a Polish noble who came to the U.S. to fight and die for the Revolution. Indiana’s own Pulaski County is named after him and, under IC 1-1-12.5, Indiana recognizes the first Monday in March as “Casimir Pulaski Day.”

I think I spend too much reading the news. It’s really kind of a sideshow to real life in a lot of ways. Reading about the latest health peril for my kids probably tells me less about the risks to my kids than paying attention to what they eat, for example. Reading about Indiana’s latest economic development project is a lot less important than keeping my eye open for new clients. And, really, there is a whole lot less tragedy in my neighborhood than in the newspapers. It probably distorts the way you see the world when you are looking at all the tragedies globally and not seeing the small victories taking place locally.

Probably I won’t stop reading so much news though.

(Image from a painting displayed at the Riverview Community Bank).

Matt Taibbi’s latest pounds on Goldman Sachs international adviser Brian Griffiths speaking at St. Paul’s Cathedral in London:

“The injunction of Jesus to love others as ourselves is an endorsement of self-interest,” Goldman’s Griffiths said Oct. 20, his voice echoing around the gold-mosaic walls of St. Paul’s Cathedral, whose 365-feet-high dome towers over the City, London’s financial district. “We have to tolerate the inequality as a way to achieving greater prosperity and opportunity for all.” (via Bloomberg)

Taiibi’s rant mostly excoriates a particular kind of rich ideologue raised from birth behind walls built by rich ancestors, surrounded by the like minded, and insulated from consequences so that the person never has to let experience intrude upon theory; usually theory that dresses up greed as love and taking as sharing.

Jeff Wiehe, writing for the Journal Gazette, has an interesting story about a woman who died in the county jail after being arrested for DUI. Her BAC was .33 and she apparently had significant problems with alcohol. Much of the story addresses complaints by her family out of Tennessee about her treatment at the jail – they think she should have received more medical treatment; and the manner in which her body was stored – they picked her up from a funeral home garage. The funeral home said her body had been there for about 20 minutes and was placed there specifically so the family could pick it up.

It’s always a fools game to pretend you know enough about a situation from a newspaper article to really judge it appropriately. (Again: not stopping me). But, from what I read, the family’s attitude annoys me. They apparently were not doing the hard work of getting this woman back on the straight and narrow. She was drinking heavily and apparently hadn’t had a paying job in years. That’s no what I’m judging, however. Every family has to go its own way, and just because you share parents doesn’t necessarily make you responsible for a person who has gone off the rails.

But, living in that sort of glass house, you shouldn’t be casting stones at the county government or the people who are charged with cleaning up. Government has about a million demands on its limited dollars. It’s pretty easy to second guess, but how much funding would it take to keep up with all of the psychological and medical demands of every person arrested on drug and alcohol related charges? These are jails, not hospitals and not mental health institutions. And yet, our corrections system ends up being the provider of last resort.

Anyway, from the article, it looks like the family is showing up after the fact and saying “you should’ve done better.” Government having deep pockets, I suspect Allen County will get slapped with a lawsuit of some sort for its trouble.

[Actually, on the topic of expectations that government do everything for everybody without raising taxes, I was suddenly reminded of the Simpson’s episode where Homer was elected to run Springfield’s Sanitation Department]

There looks to be a new blog out there looking at Indiana political issues from a lefty persuasion. Looks solid so far. It’s called “A Loyal Opposition.”