Latest 9/11 Victim: our Justice System

Greenwald makes a pretty convincing case that Bush/Obama’s “justice system” for accused terrorists is merely for display purposes only.

If you’re accused of being a Terrorist, there’s not one set procedure used to determine your guilt; instead, the Government has a roving bazaar of various processes which it, in its sole discretion, picks for you based on ensuring that it will win. Even worse, Holder repeatedly assured Senators that the administration would continue to imprison 9/11 defendants even in the very unlikely case that they were acquitted, citing what they previously suggested was their Orwellian authority of so-called “post-acquittal detention powers.” Is there any better definition of a “show trial” than one in which the defendant has no chance of ever being released even if acquitted, because the Government will simply thereafter assert the power to hold him indefinitely without charges?

9/11 didn’t “change everything”; we let the Bush administration do that. Al-Qaeda had no ability to rewrite the rules of what happens to an arbitrary individual pulled off the street by the U.S. government. They couldn’t force us to torture captives, or to view detainment as its own justification or proof of wrongdoing. We tore down our own principles of justice and due process.

The cost of rebuilding them is to take the (real) risk of acquitting some individuals truly guilty of horrible crimes. While we won’t get that from Obama or any politician facing reelection, here’s to the hope that America’s willingness to sacrifice principles for revenge will die with Khalid Sheikh Mohammed.

More Cannabis Research Around the Corner?

Today almost no credible evidence suggests that cannabis belongs on Schedule I of the Controlled Substances Act, alongside drugs like heroin. This position has stifled medical research of the drug and its component chemicals for 39 years, making research extremely expensive and arbitrarily difficult to secure compared to that of much more harmful drugs.

A few organizations have spent enormous amounts of money going through the formal petition process in good faith to reschedule cannabis, and each petition has been met with blatant obstructionism; lengthy delays, arbitrary dismissals, last-minute over-rulings. The current petition hasn’t been acted on since its submission seven and a half years ago.

Two signs suggest we may soon see a relaxation of the unjustified limitations imposed on researchers.

1. One of the last influential and independent voices claiming that the drug had no medicinal properties (ignoring an absurd amount of evidence) was the American Medical Association. Today they finally fixed that. They make a very reasonable request:

Our American Medical Association (AMA) urges that marijuana’s status as a federal Schedule I controlled substance be reviewed with the goal of facilitating the conduct of clinical research and development of cannabinoid-based medicines. This should not be viewed as an endorsement of state-based medical cannabis programs, the legalization of marijuana, or that scientific evidence on the therapeutic use of cannabis meets the current standards for a prescription drug product. [AMA statement pdf]

Sativex vs Old Timey Meds!2. Sativex is an oral spray pharmaceutical made from the whole cannabis plant; it should look suspiciously familiar to these medicinal extracts used around the turn of the century. Already approved in Canada, it’s breezing through U.S. phase III clinical trials for M.S. treatment, with FDA approval potentially a couple years away (barring political shenanigans). Upon approval, whole-plant cannabinoids–not just the isolated THC in dronabinol–can finally be easily studied for the treatment of other ailments.

If a cannabis extract proves to be as effective and safe as many scientists expect, I think it’s likely the public will demand more research in this area via some alteration of the Controlled Substances Act. My bet is that politics will keep marijuana in Schedule I, and (a generic name for) Sativex will be placed in Schedule III. This would ease research considerably while ensuring GW Pharmaceuticals enjoyed a healthy monopoly for years to come.

As for why cannabinoid research is so damned important, see GW Pharm’s site.

Reasonable People May Not Show

(Obviously started in August)

In the age of Glenn Beck, the town hall meeting paradigm is just the anonymous web forum with no moderator. The people interested in genuine discussion won’t go near it, and “socialist!” is the new “yr gay”. To this extent the tea party folks have certainly been successful at churning out viral YouTube clips, but for better or for worse, no one should get the impression that public meeting attendees are necessarily representative of a constituency.

I see a lot of conservative bloggers and commenters making the mistake of watching these clips and pronouncing that it’s evidence of a silent majority that will surely stand up and “throw the bums out” in 2010. HotAirPundit highlighted a Houston area meeting featuring an obnoxious birther and an angry crowd awaiting outside and concludes, “Something tells me he will get voted out.” Gene Green, the Democrat representative, took office with almost 75% of the vote, but I guess he could always wind up in some scandal and be replaced (probably with another Democrat).

This isn’t to say I’m necessarily behind the proposed reforms; reading McArdle hasn’t given me a lot of confidence in us being able to cut costs using similar actions at the state level, but I feel some brand of insurance reform is inevitable at this point and hope there are people behind this acting in good faith. Democrats are basically putting themselves on the chopping block with this so they may have more persuasive information than I have access to.

Morning Edition is not the O’Reilly Factor

NPR Morning Edition host Steve Inskeep is often an excellent interviewer, but his behavior in this “interview” with Republican chairman Michael Steele was awful (and many commenters seem to agree). This morning I only heard the last 30 seconds or so and it was painful. I tried to listen again and could only stand a minute or so.

Yes Steele’s op-ed is ridiculous — “trust Republicans to defend Medicare!”, even NRO bloggers label it pandering — but Inskeep is clearly too close to this issue to conduct the interview respectfully. If Steele said contradictory/false statements, I was completely distracted by Inskeep’s badgering.

NPR needs an editor who’s willing to cut segments like this, not feature them on the home page!

Update: After listening again, what bothered me as much as Inskeep’s tone was his questions. He seemed to have an agenda to box in Steele as an anti-government ideologue (he is, but this isn’t particularly enlightening) and make the point that, since Steele agrees that Medicare is useful, that his opposition to another government plan is illegitimate. Much of the interview seemed like a jab at air.

Cases for Competition, not Insurance

An Andrew Sullivan reader needed a (seemingly) straightforward outpatient procedure. Her bill was almost 300% of the estimate. She complains that “the price of health care procedures is nothing but a dart thrown at numbers on a dart board.”

Of course the provider has acted in bad faith, but I think the entire insurance system is the real culprit. Providers over-bill because a) someone else is paying (in her case they knew she was insured) and b) they know they’ll get away with it (who are insurance companies going to complain to?). A mechanic will have you sign off on some percentage above the written estimate, and clearly itemize your charges; because the competition will also. If you get ripped off, you won’t come back and you’ll try your best to make sure others won’t either. Also, it’s my hunch that medical providers who see you walk in the door as a future fight with an insurer (who might not pay them)–rather than as a direct customer–probably aren’t going to be as motivated to make you happy.

Another Sullivan reader is baffled trying to predict the cost of a child delivery…also due to an incredibly complex insurance system.

Of course it’s not practical for everyone to know the cost of most medical procedures, but in the system we have now, almost no one does, and that’s a great environment to produce costs that rise past their real value.

Update: Even more evidence that prices are screwed up by the insurance system.

Health reform is absolutely necessary, and I support efforts to prevent insurers from ripping off customers and making care more accessible to those who need it, but HR3200 means mandatory insurance for even smaller and more common procedures, which seems exactly the wrong direction to go if our goal is to control costs and encourage competition among providers.

Although undoubtedly there’s a level of anti-government propaganda in this piece, Stossel’s “Sick in America” is something every proponent of more insurance should watch:

Medical innovation is worth the cost

Here’s a pretty inspiring interview with inventor Dean Kamen, who says the focus on long term costs of the health care system (and fears of rationing) is all wrong, and that we should put more money into innovations that more than payoff later.

I’m sure in 1920 if you asked actuaries to say what percentage of our GDP are we going to spend taking care of people with polio, they’d say: “They get polio, it goes to their lungs, they sit in iron lung machines, they could live a whole lifetime with three people watching over them. We can’t support them all.”

But what did it cost to deal with everybody with polio? Oh, $2 apiece.

Simple cures for diseases like diabetes (high cost in aggregate) and Alzheimer’s might be just down the road and would radically change the cost of care. So how do we pump up innovation? In this Ezra Klein article, MIT economist Amy Finkelstein says, “If you cover people with insurance it increases their demand for health care and that will create a larger market for innovations. That’s certainly what I found happened with Medicare.” (No evidence provided but she does have a lot of publications on Medicare and insurance markets.)

So even if costs rise (and long-term costs appear scary today), the increased coverage that some kind of HC reform (private or public) would provide is likely to raise demand and spur more innovation, not less, increasing our chances of finding treatments that will lower costs in the long run? It’s an interesting hypothesis anyway.

On Cash for Clunkers

I have to agree with USA Today’s editorial on Cash for Clunkers (via), but they don’t even mention opportunity cost. Even with the minor fuel economy savings, “helping” people into loan payments further redirects money away from local economies and family savings. I feel for the auto workers, but the auto industry has enjoyed riding the wave of the housing bubble (buyers relying on home appreciation to offset auto depreciation) and the wave has crashed.

So this seems like a bad deal for buyers, local businesses, the environment, and the taxpayers who’ll pay for it.

Anti-new car propaganda:

Extreme libertarian Challenge

Radley Balko is a thoughtful libertarian blogger who provides particularly awesome coverage of criminal justice system misconduct. You should read it. In Reason magazine he’s issued a challenge for “lefty bloggers” to define their limits “on the size, cost, and influence of the federal government.” I think this has the potential to be an interesting exercise, but in another way it feels kinda cheap. A few lefties will bite, say dumb things, and libertarians will jump all over them in the comments and we’ll have really pushed the debate forward… I don’t consider myself “lefty”, but I guess I do find the conversation of how to provide a safety net and upward mobility for the poor more important than a debate over what level of taxation on the clearly rich represents “tyranny”. Continue reading