A Katrina Health Care System

By ATUL GAWANDE

Published: May 26, 2007

This is my third week as a guest columnist. Let’s take a look at the health care news that’s transpired in that time.

First, DaimlerChrylser sold off 80 percent of its Chrysler division for three pebbles and a piece of string. O.K., the cash payment was actually $1.35 billion. But for an 82-year-old company that built more than two million cars and trucks last year, took in $47 billion in revenue, and owns 64 million square feet of factory real estate in North American alone, that’s almost nothing. Yet analysts say that it was a great deal for Daimler. Why? Because the buyer, Cerberus Capital Management, agreed to absorb Chrysler’s $18 billion in health and pension liability costs.

Stop and think about this for a minute. The deal meant that the costs of our job-based health insurance system — costs adding $1,500 to each car Chrysler builds here, but almost nothing to those built in Canada or Europe — have so broken the automaker’s ability to compete that giving it away became the smartest thing Daimler could do. Chrysler’s mistake was to hang around long enough to collect retirees and an older-than-average work force. As a result, it now has less market value than Men’s Wearhouse, Hasbro, the Cheesecake Factory, NutriSystem, Foot Locker and Pottery Barn. Oprah is worth more than Chrysler. This is not good.

Meanwhile, officials at West Jefferson Medical Center outside New Orleans reported that the number of indigent patients admitted there has tripled since Hurricane Katrina. The uninsured are now 30 percent of their emergency room patients. Officials in Houston hospitals are reporting similar numbers. Conditions seem worse rather than better. Katrina caused a vicious spiral. Large numbers of people lost their jobs and, with them, their health coverage. Charity Hospital, the one state-funded hospital in New Orleans, closed. The few open hospital emergency rooms in the area have had to handle the load, but it’s put the hospitals in financial crisis. Four hundred physicians filed a lawsuit against the state seeking payment for uncompensated care, and massive numbers of doctors and nurses have left the area.

In Washington, a conference held by the American College of Emergency Physicians revealed that New Orleans may have it worst, but emergency rooms everywhere are drowning in patients. Mandated to care for the uninsured, they are increasingly unprofitable. So although the influx of patients has grown, 500 emergency rooms have closed in the last decade. The result: 91 percent report overcrowding — meaning wait times for the acutely ill of more than an hour or waiting rooms filled more than six hours per day. Almost half report this occurring daily.

A few days later, the Commonwealth Fund released one of the most detailed studies ever done comparing care in the U.S., Australia, Canada, Germany, New Zealand and Britain. We’ve known for awhile that health care here is more expensive than anywhere and that our life expectancy is somehow shorter. But the particulars were the surprise.

On the good side, the study found that once we get into a doctor’s office, American patients are as likely as patients anywhere to get the right care, especially for prevention. Only Germans have a shorter wait for surgery when it’s needed. And 85 percent of Americans are happy with the care they get.

But we also proved to be the least likely to have a regular doctor — and starkly less likely to have had the same doctor for five years. We have the hardest time finding care on nights or weekends outside of an E.R. And we are the most likely (after Canadians) to wait six days or more for an appointment when we need medical attention. Half of Americans also reported forgoing medical care because of cost in the last two years, twice the proportion elsewhere.

None of this news, however, did more than lift a few eyebrows. So this is the picture of American health care you get after watching for a few weeks: it’s full of holes, it’s slowly bankrupting us and we’re kind of used to it.

That leaves two possibilities: (1) We’ve given up on the country; or (2) We’re just waiting for someone else to be in charge.

I’m pulling for No. 2.

Atul Gawande, a surgeon at Brigham and Women’s Hospital in Boston and a New Yorker staff writer, is the author of the new book “Better.” He is a guest columnist this month.

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Arrested While Grieving

By BOB HERBERT

Published: May 26, 2007

No one is paying much attention, but parts of New York City are like a police state for young men, women and children who happen to be black or Hispanic. They are routinely stopped, searched, harassed, intimidated, humiliated and, in many cases, arrested for no good reason.

Most black elected officials have joined their white colleagues and the media in turning a blind eye to this continuing outrage. And many black cops have joined their white colleagues in the systematic mistreatment.

Last Monday in the Bushwick section of Brooklyn, about three dozen grieving young people on their way to a wake for a teenage friend who had been murdered were surrounded by the police, cursed at, handcuffed and ordered into paddy wagons. They were taken to the 83rd precinct stationhouse, where several were thrown into jail.

Leana Matia, an 18-year-old student at John Jay College, was one of those taken into custody. “We were walking toward the train station to take the L train when all these cops just swooped in on us,” she said. “They cursed us out and pushed the guys. And then they handcuffed us. We kept asking, ‘What are you doing?’ ”

Children as young as 13 were among those swept up by the cops. Two of them, including 16-year-old Lamel Carter, were the children of police officers. Some of the youngsters were carrying notes from school saying that they were allowed to be absent to attend the wake. There is no evidence that I’ve been able to find — other than uncorroborated statements by the police — that the teenagers were misbehaving in any way.

Everyone was searched, but nothing unlawful was found — no weapons, no marijuana or other drugs. Some of the kids were told at the scene that they were being seized because they had assembled unlawfully. “I didn’t know what unlawful assembly was,” said Kumar Singh, 18, who was among those arrested.

According to the police, the youngsters at the scene were on a rampage, yelling and blocking traffic. That does not seem to be the truth.

I spoke individually to several of the youngsters, to the principal of Bushwick Community High School (where a number of the kids are students), to a parent who was at the scene, and others. Nowhere was there even a hint of the chaos described by the police. Every account that I was able to find described a large group of youngsters, very sad and downcast about the loss of their friend, walking peacefully toward the station.

Kathleen Williams, whose son and two nieces were rounded up, was at the scene. She said there was no disturbance at all, and that when she tried to ask the police why the kids were being picked up, she was told to be quiet or she would be arrested, too.

Capt. Scott Henderson of the 83rd Precinct told me that the police had developed a “plan” to deal with youngsters going to the wake because they suspected that the murder was gang-related and there had already been some retaliation. He said he had personally witnessed the youngsters in Bushwick behaving badly and gave the order to arrest them.

Many of the kids were wearing white T-shirts with a picture of the dead teenager and the letters “R.I.P.” on them. The cops cited the T-shirts as evidence of gang membership.

Thirty-two of the youngsters were arrested. Most were charged with unlawful assembly and disorderly conduct. Several were held in jail overnight.

Police Commissioner Ray Kelly did not exactly give the arrests a ringing endorsement. He said, in a prepared statement, “A police captain who witnessed the activity made a good-faith judgment in ordering the arrests.”

A spokesman for the Brooklyn district attorney, Charles Hynes, said, “It wouldn’t be unusual for a lot of this stuff to get dismissed.”

The principal of Bushwick Community High, Tira Randall, said, “My kids come in here on a daily basis with stories about harassment by the police. They’re not making these stories up.”

New York City cops stopped and, in many cases, searched individuals more than a half million times last year. Those stops are not happening on Park Avenue or Fifth Avenue in Manhattan. Thousands upon thousands of them amount to simple harassment of young black and Hispanic males and females who have done absolutely nothing wrong, but feel helpless to object.

It is long past time for this harassment of ethnic minorities by the police to cease. Why it has been tolerated this long, I have no idea.

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Shiite Cleric Resurfaces With Anti-U.S. Sermon

By JOHN F. BURNS

Published: May 25, 2007

BAGHDAD, May 25 — The populist Shiite cleric Moktada al-Sadr appeared in public for the first time in months on Friday, delivering a fiercely anti-American sermon and offering himself in a new guise as a nationalist intent on bridging the divide between Iraq’s warring communities of Shiites and Sunnis.

Flanked by bodyguards and hailed by weeping loyalists, the 33-year-old Mr.

Sadr made his reappearance at the mosque in Kufa, a Shiite holy city 100 miles south of Baghdad, where he made his last public appearance in October. In the months since, American officials say Mr. Sadr had taken refuge in Iran.

The Kufa mosque has been the cleric’s favorite redoubt since he emerged early in the Iraqi conflict as the leader of the Mahdi Army, a powerful anti-American militia that has made Mr. Sadr a crucial player in the struggle for power in Iraq.

“No, no, no to Satan! No, no, no to America! No, no, no to occupation! No, no, no to Israel!” Mr. Sadr told about 1,000 worshippers, frequently mopping his brow in the 110-degree heat of Iraq’s early summer.

He renewed earlier demands for a timetable for an American troop withdrawal, saying the Iraqi government “should not extend the occupation even for a single day.” But he avoided setting a deadline, perhaps because of widespread fears among Iraqi Shiites that the country’s new Shiite-dominated army and police were far from ready to stand alone against the Qaeda groups and Baathist diehards who have driven the Sunni insurgency.

Mr. Sadr coupled his call for an American pullout with an offer of a new alliance with Iraq’s minority Sunnis, thousands of whom have been killed or driven from their homes over the past year by Shiite death squads. Many of these have been offshoots of the Mahdi Army, who have struck in revenge for a relentless Sunni insurgent campaign of bombings aimed at Shiite civilians gathering at markets, mosques, weddings and other gatherings.

In this, too, Mr. Sadr found a new opening for an attack on the Americans, saying “the invader has separated us,” Shiites and Sunnis, and that “unity is power and division is weakness.” Casting aside for the moment his oft-stated claim to be the only Shiite leader capable of offering Shiites protection against Sunni insurgents, he said he was “extending his hand” to Sunnis, and to Iraqi Christians, a small and scattered community that has seen thousands of families join the wave of Iraqis seeking refuge from the war by fleeing abroad.

He said he had ordered the Mahdi Army not to attack Sunnis, and to end clashes with the Iraqi army and police, which he described, in reference to the Shiite predominance in their ranks, as “our brothers.” But his strongest appeal was for a new alliance between Shiites, Sunnis and Christians. “I want to say now that the blood of Sunnis is forbidden to everyone, they are our brothers in religion and in nationality,” he said.

“And let our Christian brothers know that Islam is a friend to our minorities and to other faiths, and seeks dialogue with them.”

According to American officials familiar with intelligence reports, Mr. Sadr fled Iraq in January for sanctuary in Iran, which has been a major source of arms and finance for the Mahdi Army. The Americans, who said earlier this week that Mr. Sadr had slipped back into Iraq about a week ago, suggested that the cleric, in fear of arrest or assassination, may have sought refuge in Iran ahead of the American troop buildup ordered in January by President Bush.

The cleric has matched his rare public appearances in the four years since the American-led invasion with an elusive politics, juggling alliances and enmities in a way that has made him a formidable but unpredictable force.

The pattern was evident again on Friday, when he left political opponents guessing as to why he chose to resurface in Iraq now, just as the influx of nearly 30,000 additional American troops is moving to its peak and American commanders are reviewing long-deferred plans for a broad sweep into Sadr City, the vast Baghdad slum that has been the base for much of Mr. Sadr’s political support.

One theory that has gained widespread currency is Baghdad is that Mr. Sadr, during his absence in Iran, saw his power in Iraq eroding. In his months away — always denied by his spokesmen in Iraq, who insisted today that he had remained in Iraq all along — Shiites in Sadr City and elsewhere have suffered ceaseless suicide bombings, some of them claiming scores of victims. Inevitably, the cleric’s absence led to talk among Shiites of his having chosen personal safety over his responsibilities to the people he claims to lead.

Allied to this has been the gradual dismemberment of key parts of the Mahdi Army as American and Iraqi forces have staged raid after raid on Mahdi Army cells, especially in Sadr City. The raids have had an opaque dimension, politically, with American commanders and senior officials in the government of Prime Minister Nuri Kamal al-Maliki, who is a political ally of Mr. Sadr’s, claiming that most if not all of the dozens of “terrorist leaders” killed and captured in the raids have been from “rogue” and “criminal” groups that have broken with Mr. Sadr.

These claims have had the benefit for Mr. Maliki of avoiding the appearance of declaring war on a political partner, Mr. Sadr, whose 30-member parliamentary bloc provided Mr. Maliki with the margin of votes he needed to become prime minister a year ago. For Mr. Sadr, the formula has had a face-saving quality, and, American commanders say, has helped eliminate elements of the Mahdi Army that were beyond the cleric’s control and posed the threat of future challenges to his leadership.

Other elements in the shifting political landscape in Iraq may have helped bring Mr. Sadr back. With mounting pressures in Congress and public opinion in the United States for an American troop withdrawal, Iraq’s feuding political parties have begun to look beyond the time when the American military presence will be the decisive element in the quest for political power. Mr. Sadr, some Iraqi politicians believe, may have seen this as the moment to make his claim as a nationalist leader, something he has made moves towards before, only to have the attacks on Sunni civilians by Mahdi Army death squads define him, at least in minds of many Sunnis, as a mercilessly sectarian figure.At about the same time he was delivering his sermon, Iraqi special forces killed a top leader of the Mahdi Army in the southern city of Basra, according to Reuters.

Abu Qader and at least one aide were shot after leaving Mr. Sadr’s office in the center of the city, the British military said. British troops have stepped up operations against Shiite militias as they prepare to hand over Basra to Iraqi security forces later this year.

Mr. Sadr’s appearance came as the American military announced today that six more soldiers had died in Iraq, five on Thursday and one on Tuesday, according to Reuters. April was the worst month this year for the American military since the invasion, with 104 soldiers killed. About 90 have been killed in May so far.

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CAMPAIGNING FOR HISTORY Reflections on the American Presidency in a Political Season (a blog from the New York Times)

May 24, 2007, 6:22 pm

Repairing the Damage Done

By Jules Witcover

WASHINGTON — More than three decades ago, Nixon White House Counsel John Dean called the Watergate cover-up “a cancer on the presidency.” Another one exists today, posing a challenge for the next president to restore the office as a credible voice in foreign policy.

President Bush’s detour in Iraq off the multilateral track adhered to throughout the Cold War years has caused a deep drop in American prestige abroad, requiring extensive repair by his successor regardless of which party wins in 2008.

While Bush’s invasion and occupation of Iraq has been the immediate trigger for the decline of American influence, just as significant was his original failure to capitalize on the terrorist attacks of 9/11 to mobilize a truly collective global response.

The outpouring of empathy for the United States in the wake of those events was quickly short-circuited by the invasion. In diverting the American military from its legitimate focus against the real perpetrators of the attacks, Bush left the primary job undone in Afghanistan, in order to chase a more ambitious dream of superpower dominance.

A decade earlier, neoconservative theorists in the Republican Party saw in the collapse of the Soviet Union an invitation for America to assume a vastly more assertive, unilateral role in imposing its power and political ideology elsewhere.

Among these theorists at the Pentagon was Paul Wolfowitz, deputy undersecretary to Secretary of Defense Dick Cheney, who worried that with the demise of Soviet communism the strongest rationale for a muscular national defense was gone. Yet serious threats remained, from nuclear ambitions in North Korea and the determination in Iran and Iraq to assure control of their vast oil resources essential to American power.

Under Wolfowitz, a quest was undertaken for a strategy justifying continued American military hegemony. As James Mann wrote in his revealing 2004 book, “The Rise of the Vulcans: The History of Bush’s War Cabinet,” Wolfowitz assigned his chief assistant, I. Lewis “Scooter” Libby, to have a draft prepared that “set forth a new vision for a world dominated by a lone American superpower, actively working to make sure that no rival or group of rivals would ever emerge.”

Libby gave the assignment to another Wolfowitz aide named Zalmay Khalilzad, little known then outside defense circles. He ultimately became the American ambassador to occupied Iraq after the overthrow of Saddam Hussein and the establishment of a new American-sponsored regime in Baghdad, and subsequently ambassador to the United Nations.

A leak of the Khalilzad draft, according to Mann, caused embarrassment and was rewritten, but the finished product became a rough blueprint for the radical new American foreign policy that flowered in the George W. Bush administration.

The draft envisioned a world in which American military power alone would rival or replace the collective security that had marked U.S. containment policy through the Cold War. It even hypothesized, Mann wrote, the possible future need for “preempting an impending attack with nuclear chemical and biological weapons” — the rationale eventually dusted off for the Iraq invasion.

A side incentive for developing the new strategy was pressure from congressional Democrats for a substantial “peace dividend” after the Cold War’s end. To counter such diversions of defense spending for neglected domestic needs, the Pentagon theorists needed a persuasive argument for a lusty military budget.

When Khalilzad’s draft kicked up criticism that it smacked of hostility to other nations, Libby toned down the language in what became the Defense Policy Guidance of 1992, but the essential message remained. By keeping America militarily all-powerful, other countries would be deterred from attempting to match its strength.

When Bill Clinton took over the White House after the 1992 election, he didn’t, according to Mann, seriously challenge the basic force concept, focusing more on domestic matters. The neoconservative theorists, out of power, nevertheless fretted about Congressional projections of static or shrinking defense budgets.

In 1997, they banded together as the Project for the New American Century to build on the 1992 policy statement. A subsequent paper called for more defense spending to preserve “the current Pax Americana … through the coming transformation of war made possible by the new techniques,” including nuclear weapons, in the hands of new, often regional threats.

The group noted critically that the Pentagon’s Quadrennial Defense Review of 1997 “assumed that [North Korea’s] Kim Jong Il and [Iraq’s] Saddam Hussein each could begin a war—perhaps even while employing chemical, biological or even nuclear weapons—and the United States would make no effort to unseat either ruler.”

The paper observed that “past Pentagon war games have given little or no consideration to the force requirements necessary not only to defeat an attack but to remove these regimes from power and conduct post-combat stability operations …

“The current American peace will be short-lived if the United States becomes vulnerable to rogue powers with small, inexpensive arsenals of ballistic missiles and nuclear warheads or other weapons of mass destruction. We cannot allow North Korea, Iran, Iraq or similar states to undermine American leadership, intimidate American allies or threaten the American homeland itself. The blessings of the American peace, purchased at fearful cost and a century of effort, should not be so trivially squandered.”

According to Gary Schmitt, a co-chairman of the project, George W. Bush, governor of Texas at the time, was neither a member of the group nor as far as Schmitt knows aware at the time of its findings. But among the participants were Wolfowitz and Libby, architects of the basic concept of a muscular defense including preemption of threats of weapons of mass destruction.

Did Bush as president come on his own to embrace the precepts of the project or was he sold on them by Cheney, Wolfowitz, Libby and others of the circle known as “the Vulcans”? Either way, events of the post-9/11 years have confirmed that those precepts were at the core of the radical foreign policy that have imperiled his presidency and American leadership across the globe.

Among the first challenges for Bush’s successor in 2009 will be to demonstrate dramatically that he or she has learned the hard lesson of that go-it-alone foreign policy, which in the end forced America to go hat-in-hand to the international community. The new president must waste no time putting America back on the track of multilateralism and collective security.

With very good luck and a return to diplomacy, the United States could be out of Iraq by that time, giving the next president, Republican or Democratic, a free hand to restore the reputation of the American presidency in the eyes of friends and foes abroad, and at home as well..

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Jules Witcover, a political columnist for 30 years, has written a dozen books about American politics, including “No Way to Pick A President” and “The Year the Dream Died.” His most recent book is “Very Strange Bedfellows: The Short and Unhappy Marriage of Richard Nixon and Spiro Agnew.”

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EXODUS The Flight of Millions From Iraq Threatens the Entire Region

by Stephen Glain

From The Nation:

VOLUME 284, NUMBER 23

In Damascus one recent evening, Ahlam Al Jaburi entered thefoyer of her apartment in tears. She had risen at 5:30 AM that day to be first in line at the office of the United Nations High Commissioner for Refugees (UNHCR) in what she hoped would be her second interview since she first requested asylum in December. Even by the grisly standards of postinvasion Iraq, Jaburi has a strong case. In July 2005, while working with US military officers investigating the claims of war victims in the Bagh dad suburb of Khadimiya, the 41-year-old computer spe cialist was kidnapped by three men while hailing a cab to get to work. “They called me a spy for the Americans and wanted information on their base,” Jaburi says between long silences, interrupted only by the mechanical hum of a glowing fluorescent tube. “They threatened to kill me, but I had nothing to tell them.” Her only concession to her tormentors was a plea that they not toss her body into the Tigris River.

Jaburi, a Sunni Muslim, was kept blindfolded and regularly beaten for eight days before her elder brother negotiated her release through a third party. The family paid a ransom of $50,000, which it drew from the sanduk ashira, a “tribal box” managed by local sheiks. As she was released, Jaburi, whose given name means “dream” in Arabic, was ordered to leave Iraq with her family.

Despite her service with US authorities in Baghdad, Jaburi was turned away from the US Embassy in Damascus when she requested asylum in America. After ten hours of waiting for her interview, enduring sporadic fits of pushing and shoving from other asylum seekers, she was forced to return home after the office closed for the day.

The latest malignant outgrowth of Bush’s war in Iraq is, according to Refugees International president Ken Bacon, “the fastest-growing refugee crisis in the world.” Like debris from a maritime disaster, the remains of Iraq’s shattered lives are washing up at border crossings, accumulating at immigration centers and settling into tenement housing. The exodus, particularly in its first stages, has included members of Iraq’s oncelegendary class of skilled white-collar elites—doctors, engineers, scientists and educators. Without Iraq’s professionals, it will take a generation to rebuild the country into a self-reliant state with a functioning economy.

“All of the doctors I know have decided to not go back,” says a Sunni Iraqi pathologist and hospital administrator in Amman who, fearing for his family’s security back home, would not give his name. “It will take a decade just to train new physicians. The insurgency has turned the country into an empty vessel, drained of talent.”

What began as a thin stream of Iraqi merchants and investors seeking a safe place to do business has become a flood of some 2 million refugees—though it could be twice that amount—concentrated largely in Jordan and Syria. Many are destitute, and they place enormous strain on a region that is already highly combustible, both politically and economically. Once welcomed as fellow Arabs in distress, they are in - creasingly blamed for a scorching rise in inflation, crime and prostitution. Heads of state and politicians warn that they will import Iraq-style sectarian strife—political fearmongering, many believe, that could become self-fulfilling at a time when the Bush Administration appears to be lining up its Sunni allies for a confrontation with Iran.

“We have thousands and thousands of Iraqis spilling in from Iraq, and the government is worried that they may bring their conflict to Jordan,” says Taher Masri, a respected former prime minister. “In Parliament a few weeks ago, members were condemning Iran for trying to convert Jordanians to Shiism. My driver just asked me if Shiites were a greater danger than Israelis.”

Dispossession accounts for much of the Middle East’s colonial inheritance, from the Ottoman Turks’ genocidal eviction of Armenians to the Palestinian exodus that followed the creation of Israel with British complicity. If history is any guide—and it usually is in the Middle East—where refugees go, trouble follows. The Iraqi exodus could do more to reshape the geography and geopolitics of the region than anything gamed out in neoconservative think tanks, which tend to see the matter as an abstraction. For Jordan and Syria, themselves the bastard progeny of imperial coupling, the problem is very real—and deadly serious.

“Jordan is scared to death of the spillover from Iraq,” says Rhanda Habibe, Amman bureau chief for Agence France-Presse and the doyenne of the Jordanian press corps. “The Arab world is dividing into two groups, with Egypt, Saudi Arabia, the US and Jordan on one side and Iran, Hamas and Hezbollah on the other. If there is civil war in Iraq or a civil war in the West Bank, it could all spin out of control and suck us into it.”

Though there are an estimated 1.2 million Iraqi refugees in Syria, compared with some 750,000 in Jordan, the strain is felt deepest in the Hashemite Kingdom. Tiny and resource poor, Jordan is a culture dish for the Middle East’s myriad schisms, scored as it is by rich and poor, Muslim and Christian, secular and fundamentalist. Jordan lumbers under the weight of a large ethnic Palestinian population—40 to 60 percent of the total—much of which is still living in camps. The Palestinians in Jordan have coexisted uneasily with indigenous “East Bankers” since the two sides went to war in 1970. The regime is burdened by its alliance with the deeply unpopular US government and its peace accord with Israel. It is also a mendicant state, unable to survive without generous aid from the United States and its Arab neighbors. In February, for ex ample, Jordan avoided a budget crisis only after Saudi Arabia, under stiff pressure from Washington, pledged $500 million in aid.

Aside from strong-arming the Saudis, however, the White House has taken a back seat in the refugee crisis. Ellen Sauerbrey, the Assistant Secretary of State for Population, Refugees and Migration, has pushed Amman and Damascus to accommodate Iraqi exiles while doing little to open America’s own borders to them. Testifying before Congress four months ago, Sauerbrey—who has no experience with refu- gees and who was appointed by Bush during a Congressional recess last year to avoid a floor fight over her strong opposition to abortion rights—confined US resettlement efforts to a single paragraph of her opening remarks. It took a measure led by Senator Edward Kennedy to shame the government into granting asylum to 7,000 Iraqi war refugees (among them, Ahlam Al Jaburi, whose persistence finally paid off this past April when she was awarded a promise of asylum).

With the US playing only a passive role in the crisis, Arab leaders are dealing with the problem as they see fit. Both Amman and Baghdad—the former worried about its capacity to absorb so many Iraqis, the latter covetous of its professional elites—are determined to reverse the migration. For a while, according to recent arrivals, Shiite men were being turned away at the Iraqi- Jordanian border, some with stamps in their passports that prohibited them from returning for five years. Now, they say, any adult male between the age of 18 and 36 stands a good chance of being re fused entry. Amman recently an nounced it would admit only Iraqis bearing a special passport, soon to be issued by the Baghdad government on highly re - stricted terms.

Rafed, a refugee and aid worker, says UN officials are being pressured by Amman and Baghdad to stop registering Iraqi exiles, which gives them some measure of protection against forcible return. “There is an agreement to send us back, especially the intellectuals and professionals,” says Rafed, who would not give his full name because he works closely with the UN. “This crisis is an embarrassment to both regimes.”

Rafed is a linguist with a degree from the University of Baghdad. Before fleeing Iraq he translated for US forces and worked with internally displaced persons throughout the country. (The IDPs, totaling close to 2 million, are a widely overlooked by - product of the war. More than one in ten Iraqis is now unmoored.) By May 2006 Rafed was getting death threats for “working with the unbelievers.” He varied his route to work each day and carried a handgun for protection, but having lost four of his cousins to the insurgency, one by decapitation, he decided to flee.

A Shiite, Rafed acknowledges some discrimination under Saddam Hussein, but he is nostalgic for the stability of the late dictator’s rule. Before the US invasion, Rafed was engaged to a Sunni girl, but the relationship crumbled under pressure from both families. Stress has made him a diabetic, he says.

Like many of his fellow exiles, Rafed blames foreign elements for the conflict: Salafists (Sunni extremists) from Saudi Arabia and Afghanistan, agents from Iran and, of course, the United States. It was the Americans under viceroy Paul Bremer, the refugees say, who established a confessional style of government, with political parties defined by sect and ethnicity. “The Salafists started executing Shiites,” says Rafed, “and then the Mahdi Army began to retaliate. Then, after the 2005 elections,

the Sunnis felt threatened and abandoned politics and entered the insurgency. It was 90 percent political.”

Some also blame Jordan’s king, Abdullah II. In December 2004 the king warned of a “Shiite crescent” raking across the Arab world from its Persian pivot. Coming from a monarchy with a reputation as America’s handmaiden—Abdullah’s father, King Hussein, was on the CIA’s payroll—Abdullah’s remark was widely received as a proxy war whoop aimed at Iran and was quickly repeated by Egyptian President Hosni Mubarak.

Not long afterward, reports circulated that Iranian agents were proselytizing in Jordan’s impoverished south, provoking a démarche from Amman. Earlier this year, a Jordanian cleric during Friday prayers condemned Shiites as apostates, and parents reported that teachers were lecturing students about the evils of Shiism. In an apparent move to cool things down, Abdullah invited a Shiite imam to preach at the King Hussein Mosque, a first for Jordan.

Having dutifully channeled for Washington, America’s man in Amman was clearly in over his head. “When you have teachers condemning Shiites in class, that’s bad,” says Joost Hiltermann, Middle East project director for the Brussels-based International Crisis Group. “When immigration officials are asking if visitors are Shiite or Sunni at the airport, that’s bad. And when clerics are calling for violence against Shiites, that’s bad too, particularly when you consider that clerics are controlled by the government.”

In contrast with Jordan, Syria continues to welcome Iraq’s dispossessed. In part, that’s because Damascus has the resources to accommodate them. Unlike Jordan, the country is endowed with water and oil and a population more than three times that of its smaller neighbor to the south. Damascus also still prides itself on being the fountainhead of Arab nationalism and as a haven for refugees and dissident groups.

Such conceit is not cost-free. Syria too is stalked by ethnic and sectarian tensions, with a restive Kurdish minority and a majority Sunni population ruled by the Assad family dictatorship. President Bashar al-Assad is clearly betting that his au thority is sound enough for him to play the role of beneficent sheik. For now, at least, it appears to be a safe wager. The Americans are pinned down in Iraq, and Syria is riding the crest of an economic boom with the unwitting help of Washington. In December 2003 the United States imposed economic sanctions on Damascus for assisting militant groups like Hamas and Hezbollah, but as US Treasury officials cracked down on Syrian accounts held overseas, depositors simply repatriated their funds. The result was a liquidity glut that irrigated an economy long parched for capital.

“All the dirty funds are coming back to Syria,” says Jihad Yazigi, editor in chief of The Syria Report , an online economic bulletin. “And you can thank these US sanctions.”

In the current standoff, however, there is little margin for error, and the 41-year-old Assad is still relatively new at the game. It was the Palestinian refugee crisis, after all, that led to civil wars in Jordan and Lebanon, the latter of which was quelled by a Syrian intervention that paved the way for Syria’s long and painful occupation of the country. Assad has to keep a wary eye on Aleppo, Damascus’s rival city to the north, which has a growing Salafist movement. When the Grand Mufti of Syria died in 2004, Assad waited two years before replacing him with Sheik Ahmed Hassoun, who as the mufti in Aleppo had skillfully kept a lid on sectarian tensions. As Syria’s exile population swells—in Aleppo as well as in Damascus—so does the prospect of confrontation.

If anything, says Laith Kubba, a former spokesman for the Iraqi government, the United States should thank the Syrian government for not turning its back on the Iraqis. “I would be happier to see Iraqi professionals staying in Jordan and Syria, preserving their skills,” says Kubba, who is now a senior director at the National Endowment for Democracy. “Sending them back only consumes or wastes them in the civil war.”

No one knows that better than Khulood Alzaidi, an aid worker who was forced to flee Iraq for Jordan in 2005 after receiving death threats slipped under the door of her home in the southern city of Kut. Poised and soft-spoken, the dark-skinned Alzaidi has kept the threatening letters as proof of her vulnerability. But her quest for asylum in the West is ensnared in a bramble of politics and red tape. She has no residency permit and has been picked up by security services and ordered to leave the country. Like her fellow émigrés, she dreads the prospect of being forcibly returned to the sectarian holocaust that is Iraq.

“I have nowhere to go,” she says. “The Jordanians want us out, and the Americans won’t take us in.”

Unlike the vast majority of her fellow exiles, Alzaidi has met the man most closely associated with her plight. On No - vember 17, 2003, the 27-year-old Shiite was one of a dozen or so Iraqi women who were guests of President George W. Bush at the White House. The event was held to honor the group’s work on behalf of women in postwar Iraq, and was organized by Fern Holland, the feminist activist who less than a year later would be murdered by insurgents there.

On the day of Alzaidi’s meeting with the President, she was ushered into the Oval Office along with the rest of the group, where they stood before a phalanx of reporters and a galaxy of flashing strobe lights. According to Alzaidi, Bush centered himself directly to her left. He assured the delegation that the United States would not abandon Iraq and that his decision to invade the country would be vindicated despite the chaos and rising death toll (by then, Iraq’s sectarian violence had been escalating for several months).

“I saw the blood of Iraqis in his face,” Alzaidi says from a friend’s apartment. “This was the man who turned our lives up side down.” Alzaidi says she nearly cried from rage, but restrained herself out of respect for the President.

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A LETTER TO PAUL WOLFOWITZ ON HOW HIS DEPARTURE FROM THE WORLD BANK WILL BE DEALT WITH IN HIS OBITUARY

By Calvin Trillin

From The Nation:

VOLUME 284, NUMBER 23


The second paragraph will spell it out
In chapter, Wolfie, and in sordid verse.
Your lawyer worked in vain, and, by the way,
The paragraph it follows will be worse.

That paragraph will be about the war
For which you served as cocksure philosophe.
It’s even harder there to claim clean hands,
For graft stains fade, but blood just won’t come off.

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Sick Justice

From The Nation:

VOLUME 284, NUMBER 23

The frantic race to then–Attorney General John Ashcroft’s bedside on March 10, 2004, sounds more Hollywood than history: Acting AG James Comey’s foot-to-the-floor drive to head of then–White House counsel Alberto Gonzales and Chief of Staff Andrew Card; FBI Director Robert Mueller’s startling imperative to his agents to defy any attempt by Gonzo and Card to throw Comey out; the sedated and badly ailing Ashcroft rousing himself from his sickbed to defend the Constitution; the resignation threats by Comey and Mueller. As Washington lore, the episode joins Richard Nixon’s Saturday Night Massacre and Thaddeus Stevens’s being carried on a stretcher to vote in the impeachment trial of Andrew Johnson. And behind all this, the President pushing a wiretap program so blatantly illegal that his own top Justice appointees were threatening to resign.

The histrionics of that night, recounted by Comey to the Senate Judiciary Committee after three years, further erode Alberto Gonzales’s already fatally compromised capacity to run the Justice Department. And they expose an internal Administration conflict between hyper-politicized operatives like Card, Gonzales and Karl Rove and Justice professionals like Comey—Bush appointees who nonetheless understood that their oath was to the Constitution. But there is also a risk that the drama of this good guys/bad guys confrontation—with Comey protecting his boss the way Michael Corleone took it on the chin for the Don at that lonely, dark hospital in The Godfather—is obscuring the real story: just how many ways the Bush Administration was finding to break the law, and just how high the chain of complicity ran: According to Comey’s testimony, for two years the White House had endorsed still unspecified secret wiretaps by the National Security Agency without a warrant or authorization from the Foreign Intelligence Surveillance Court. In other words, for two years the NSA and telephone companies had been committing a federal crime with the full endorsement of the Oval Office.

In spring 2004, when Ashcroft, Comey and every other responsible official in the Justice Department had reviewed the program and declared that the taps blatantly violated the surveillance law, Card, Gonzales and Bush himself all indicated their intention to go forward anyhow. In plain English, that is a conspiracy.

If Comey’s memory is accurate, the President himself called the wife of the critically ill Ashcroft and asked her to let Gonzales and Card visit his bedside. When they arrived they tried to persuade the sedated Ashcroft to approve the illegal taps. But Ashcroft had already signed over his AG authority to Comey, who consequently carried the title Acting Attorney General. As George town University law professor Marty Lederman has noted, this means that Bush, Gonzo and Card were seeking the signature of an Ashcroft “who was not only incapacitated but not even acting in an official capacity.” What was the point? Writing in the blog of Yale law professor Jack Balkin, Lederman, a former adviser to the Ashcroft Justice Department’s Office of Legal Counsel, suggests a chilling motive: “Obviously, they did so in order that they could present a fraudulent certification, of someone who was not at the time acting as AG, to the NSA and/or to the telecom companies.” That is how determined the President was to continue an illegal program. Add fraud to the charge sheet.

§ As recently as February 2006, Gonzales testified in a sworn statement to Congress that there was no substantive dissent within the Justice Department over the warrantless wiretap program. This is not a casual misrepresentation: Had Gonzo told the truth, it would have moved Congress to ask questions. Add perjury to the charge sheet.

And the lies continue. When NBC reporter Kelly O’Donnell asked Bush at a press conference whether he ordered Card and Gonzales to the hospital that night, the President changed the subject: “I’m not going to talk about it. It’s a very sensitive program.”

Which program, Mr. President—the wiretaps you had been told were illegal, or the program of strong-arming sedated and sick officials who don’t see things your way? It must be said that John Ashcroft’s genuine courage when confronted in the hospital by Card and Gonzales does not absolve him of responsibility for creating the conditions in which illegality flourished. As Bush’s first Attorney General, he promoted the climate of secrecy that removed essential checks and balances on the Administration, indulging the Oval Office’s contention—backed up by John Yoo’s memos on the Geneva Conventions and in Dick Cheney’s speeches—that the law is only what the President says it is.

And while Comey’s and Mueller’s resignation threats sounded dramatic, there was no Saturday Night Massacre; Ashcroft, Comey and Mueller did not resign, instead settling on a compromise permitting the illegal program to go ahead with modest modification. Like their foreign-policy equivalents Colin Powell and George Tenet, these Justice officials persisted in the delusion that an Administration addicted to executive unaccountability and secrecy would be better off with themselves in it. The focus on Gonzales’s responsibility in the Ashcroft hospital affair should not be a distraction from the need for an aggressive Congressional investigation of the NSA wiretap program itself—as it existed before the sickbed saga, and as it continues to this day. At the Judiciary Committee hearing senators were understandably reluctant to push Comey on the point, given his cooperation and spectacular revelations. But national security classification and executive privilege do not apply to the grotesquely illegal. It is time for subpoenas and public disclosure.

As we go to press, Gonzales hangs by a thread, with more and more Republicans joining Democrats in calling for his resignation. And a no-confidence vote is pending. The ongoing tale of politically motivated US Attorney firings deepens every week; now it appears that as many as twenty-six of the nation’s federal prosecutors may have been reviewed on the grounds of insufficient enthusiasm for the White House agenda. That Gonzales systematically lied to Congress about his knowledge and role in the firings isn’t even a question. What Comey’s account makes so devastatingly clear, though, is that Gonzo’s lies are just the signature of far deeper rot. Combining the US Attorney scandal and the Comey disclosures, Gonzales stands revealed as an unambiguous conspirator against the Constitution. As does his boss. The President’s arrogant dismissal of Comey’s shocking testimony implies that, to Bush, even public gestures of conscience are to be treated as state secrets.

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Immigrants and Politics

By PAUL KRUGMAN

Published: May 25, 2007

A piece of advice for progressives trying to figure out where they stand on immigration reform: it’s the political economy, stupid. Analyzing the direct economic gains and losses from proposed reform isn’t enough. You also have to think about how the reform would affect the future political environment.

To see what I mean — and why the proposed immigration bill, despite good intentions, could well make things worse — let’s take a look back at America’s last era of mass immigration.

My own grandparents came to this country during that era, which ended with the imposition of severe immigration restrictions in the 1920s. Needless to say, I’m very glad they made it in before Congress slammed the door. And today’s would-be immigrants are just as deserving as Emma Lazarus’s “huddled masses, yearning to breathe free.”

Moreover, as supporters of immigrant rights rightly remind us, everything today’s immigrant-bashers say — that immigrants are insufficiently skilled, that they’re too culturally alien, and, implied though rarely stated explicitly, that they’re not white enough — was said a century ago about Italians, Poles and Jews.

Yet then as now there were some good reasons to be concerned about the effects of immigration.

There’s a highly technical controversy going on among economists about the effects of recent immigration on wages. However that dispute turns out, it’s clear that the earlier wave of immigration increased inequality and depressed the wages of the less skilled. For example, a recent study by Jeffrey Williamson, a Harvard economic historian, suggests that in 1913 the real wages of unskilled U.S. workers were around 10 percent lower than they would have been without mass immigration. But the straight economics was the least of it. Much more important was the way immigration diluted democracy.

In 1910, almost 14 percent of voting-age males in the United States were non-naturalized immigrants. (Women didn’t get the vote until 1920.) Add in the disenfranchised blacks of the Jim Crow South, and what you had in America was a sort of minor-key apartheid system, with about a quarter of the population — in general, the poorest and most in need of help — denied any political voice.

That dilution of democracy helped prevent any effective response to the excesses and injustices of the Gilded Age, because those who might have demanded that politicians support labor rights, progressive taxation and a basic social safety net didn’t have the right to vote. Conversely, the restrictions on immigration imposed in the 1920s had the unintended effect of paving the way for the New Deal and sustaining its achievements, by creating a fully enfranchised working class.

But now we’re living in the second Gilded Age. And as before, one of the things making antiworker, unequalizing policies politically possible is the fact that millions of the worst-paid workers in this country can’t vote. What progressives should care about, above all, is that immigration reform stop our drift into a new system of de facto apartheid.

Now, the proposed immigration reform does the right thing in principle by creating a path to citizenship for those already here. We’re not going to expel 11 million illegal immigrants, so the only way to avoid having those immigrants be a permanent disenfranchised class is to bring them into the body politic.

And I can’t share the outrage of those who say that illegal immigrants broke the law by coming here. Is that any worse than what my grandfather did by staying in America, when he was supposed to return to Russia to serve in the czar’s army?

But the bill creates a path to citizenship so torturous that most immigrants probably won’t even try to legalize themselves. Meanwhile, the bill creates a guest worker program, which is exactly what we don’t want to do. Yes, it would raise the income of the guest workers themselves, and in narrow financial terms guest workers are a good deal for the host nation — because they don’t bring their families, they impose few costs on taxpayers. But it formally creates exactly the kind of apartheid system we want to avoid.

Progressive supporters of the proposed bill defend the guest worker program as a necessary evil, the price that must be paid for business support. Right now, however, the price looks too high and the reward too small: this bill could all too easily end up actually expanding the class of disenfranchised workers.

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The Catholic Boom

By DAVID BROOKS

Published: May 25, 2007

The pope and many others speak for the thoroughly religious. Christopher Hitchens has the latest best seller on behalf of the antireligious. But who speaks for the quasi-religious?

Quasi-religious people attend services, but they’re bored much of the time. They read the Bible, but find large parts of it odd and irrelevant. They find themselves inextricably bound to their faith, but think some of the people who define it are nuts.

Whatever the state of their ambivalent souls, quasi-religious people often drive history. Abraham Lincoln knew scripture line by line but never quite shared the faith that mesmerized him. Quasi-religious Protestants, drifting anxiously from the certainties of their old religion, built Victorian England. Quasi-religious Jews, climbing up from ancestral orthodoxy, helped shape 20th-century American culture.

And now we are in the midst of an economic boom among quasi-religious Catholics. A generation ago, Catholic incomes and economic prospects were well below the national average. They had much lower college completion rates than mainline Protestants. But the past few decades have seen enormous Catholic social mobility.

According to Lisa Keister, a sociologist at Duke, non-Hispanic white Catholics have watched their personal wealth shoot upward. They have erased the gap that used to separate them from mainline Protestants.

Or, as Keister writes in a journal article, “Preliminary evidence indicates that whites who were raised in Catholic families are no longer asset-poor and may even be among the wealthiest groups of adults in the United States today.”

How have they done it?

Well, they started from their traditional Catholic cultural base. That meant, in the 1950s and early ’60s, a strong emphasis on neighborhood cohesion and family, and a strong preference for obedience and solidarity over autonomy and rebellion.

Then over the decades, the authority of the church weakened and young Catholics assimilated. Catholic values began to converge with Protestant values. Catholic adults were more likely to use contraceptives and fertility rates plummeted. They raised their children to value autonomy more and obedience less.

The process created a crisis for the church, as it struggled to maintain authority over its American flock. But the shift was an economic boon to Catholics themselves. They found themselves in a quasi-religious sweet spot.

On the one hand, modern Catholics have retained many of the traditional patterns of their ancestors — high marriage rates, high family stability rates, low divorce rates. Catholic investors save a lot and favor low-risk investment portfolios. On the other hand, they have also become more individualistic, more future-oriented and less bound by neighborhood and extended family. They are now much better educated than their parents or grandparents, and much better educated than their family histories would lead you to predict.

More or less successfully, the children of white, ethnic, blue-collar neighborhoods have managed to adapt the Catholic communal heritage to the dynamism of a global economy. If this country was entirely Catholic, we wouldn’t be having a big debate over stagnant wages and low social mobility. The problems would scarcely exist. Populists and various politicians can talk about the prosperity-destroying menace of immigration and foreign trade. But modern Catholics have created a hybrid culture that trumps it.

In fact, if you really wanted to supercharge the nation, you’d fill it with college students who constantly attend church, but who are skeptical of everything they hear there. For there are at least two things we know about flourishing in a modern society.

First, college students who attend religious services regularly do better than those that don’t. As Margarita Mooney, a Princeton sociologist, has demonstrated in her research, they work harder and are more engaged with campus life. Second, students who come from denominations that encourage dissent are more successful, on average, than students from denominations that don’t.

This embodies the social gospel annex to the quasi-religious creed: Always try to be the least believing member of one of the more observant sects. Participate in organized religion, but be a friendly dissident inside. Ensconce yourself in traditional moral practice, but champion piecemeal modernization. Submit to the wisdom of the ages, but with one eye open.

The problem is nobody is ever going to write a book sketching out the full quasi-religious recipe for life. The message “God is Great” appeals to billions. Hitchens rides the best-seller list with “God is Not Great.” Nobody wants to read a book called “God is Right Most of the Time.”

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Risky Bets on Winning Tax Fights

By FLOYD NORRIS

Published: May 25, 2007

Death may still be certain, but taxes are something else entirely.

Disclosures are now appearing in quarterly reports from American public companies, showing that companies are betting billions on tax breaks that may not work out.

The disclosures also show that some companies keep fighting over taxes for decades. While most companies say they have cleaned up tax disputes from the 1990s and even up to 2002 or 2003, others are far slower. Some are still fighting over audits that began in the 1980s — leaving the companies at risk of paying billions in taxes and penalties.

Exxon Mobil may be the slowest of the settlers. It reports that it is still facing audits from the Internal Revenue Service for tax years back to 1989, and in Malaysia all the way back to 1983. All told, the company reports that $3.7 billion is being held in reserve to cover tax benefits the company claimed on its returns but deemed doubtful enough that it did not include them in profit reports to shareholders.

The new rule from the Financial Accounting Standards Board is supposed to make all companies account for taxes in the same way, something that has not happened in the past, when accounting rules were vague and practices seem to have varied greatly.

Getting into compliance now has caused some companies to cut their book values by hundreds of millions of dollars, and others to raise their values by similar amounts.

The part of the rule that was perhaps most anticipated by investors and tax authorities was a requirement that companies warn shareholders of expected changes in tax reserves within the next year.

The prospect of that warning scared a lot of companies, which worried that a statement that a company expected $100 million of reserves to be freed up when an audit was completed could spur the I.R.S. to get tougher in the audit. The companies begged the standards board to delay the effective date of the rule, but in vain.

There have been some disclosures. Altria, the tobacco company, says “it is reasonably possible that within the next 12 months certain U.S. state and foreign examinations will be resolved,” providing $105 million in profits for the company. Those profits would come if the taxing authorities allowed tax benefits that the company claimed but did not report to investors, presumably because it thought there was a risk they would not be approved.

But many companies found ways to talk without saying anything. “The disclosures have been handed over to the lawyers,” said Harvey L. Pitt, a former chairman of the Securities and Exchange Commission (and a nonpracticing lawyer), “and the lawyers are obfuscating.” He spoke this week at a conference on the rule sponsored by Siegel & Associates, a consulting firm.

Consider a couple of disclosures. Here’s one from JPMorgan Chase: “It is difficult to project how unrecognized tax benefits will change over the next twelve months, but it is reasonably possible that they could change significantly.”

Here’s another from Occidental Petroleum: “It is reasonably possible that Occidental’s existing liabilities for uncertain tax benefits may increase or decrease within the next twelve months primarily due to the progression of audits in process or the expiration of statutes of limitation. Occidental cannot reasonably estimate a range of potential changes in such benefits due to the unresolved nature of the various audits.”

Under the rule, companies are supposed to report in their profits any tax benefit claimed on tax returns if there is at least a 51 percent chance that the tax authorities will agree.

That standard — called “more likely than not” in tax jargon — is a pretty generous one. Some companies previously posted tax benefits they thought would probably be approved, a higher standard. Book values for those companies actually increased under the new standard. But over all, more companies cut book values than raised them, said Sampriti Ganguli, managing director of the Tax Director Roundtable, a group of corporate executives.

The leader in claiming tax benefits that it fears may not be accepted appears to be Merck, at $7.4 billion, according to a survey by David Zion, an analyst at Credit Suisse. General Electric and AT&T also reported figures over $6 billion If those tax positions are ultimately upheld, reported profits will rise by those amounts. If they are rejected, profits will not suffer unless the tax authorities reject benefits that the companies expected to be approved and reported as profit. But cash flows will be hurt.

A big question now for many companies is whether the I.R.S. will change its policies and ask to see more internal corporate documents on how the numbers were calculated, and then use the figures in audits. The I.R.S. has said it is thinking about changing its policy, Saul M. Rosen, Citigroup’s tax director, said at the Siegel conference. “Is it fair,” he asked, “for an agent to know what level of reserves a company has set up for a particular issue, or where a taxpayer thinks his position may have a weak point?”

If the I.R.S. finds itself embarrassed by companies reporting billions in profits after audits are settled in their favor, Mr. Rosen’s question may become the next big battleground in tax policy.

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The All-Spin Zone

--by Stanley Fish

When Aristotle comes to the topic of style and persuasion in Book 3 of his “Rhetoric,” he draws back in distaste from a subject he considers “vulgar” and “unworthy.” The only reason I am talking about this stuff, he says, is because men are so susceptible to artfully devised appearances. In the best of all possible worlds we would “fight our case with no help beyond the bare facts,” for after all, “nothing should matter except the proof of those facts.”

Unfortunately, Aristotle laments, both our political institutions and the citizens who populate them are “corrupted” by passion and partisan zeal, with the result that the manner of delivery counts more than the thought that is being delivered. It is therefore necessary to catalog the devices by means of which audiences are “charmed” rather than truly enlightened. We must know these base arts, Aristotle asserts, so that we will not be defenseless against those who deploy them in an effort to deceive us and turn us away from the truth.

Aristotle’s “Rhetoric” may be the first, but is certainly not the last treatise that performs the double task of instructing us in the ways of deception and explaining (regretfully) why such instruction is necessary. The Romans Cicero and Quintilian took up the same task, and they were followed by countless manuals of rhetoric produced in the Middle Ages, the Renaissance, the 18th and 19th centuries and down to the present day. A short version of the genre – George Orwell’s “Politics and the English Language” – has been particularly influential and is still often cited 60 years after its publication.

And now in 2007 comes “unSpun,” by Brooks Jackson and Kathleen Hall Jamieson. The book’s subtitle tells it all: “Finding Facts in a World of Disinformation.” Once again (for the umpteen-thousandth time) we are given a report on the sorry state of things linguistic – “We live in a world of spin” – and a promise that help is on the way, in this case in the form of a few brief precepts employed as section headings: “Check Primary Sources,” “Know What Counts,” “Know Who’s Talking,” “Cross-check Everything That Matters,” “Be Skeptical, But Not Cynical.” The idea is that while “we humans aren’t wired to think very rationally” and are prone to “letting language do our thinking for us,” we can nevertheless become “more aware of how and when language is steering us toward a conclusion.” In this way, Brooks and Jamieson promise, we can learn “how to avoid the psychological pitfalls that lead us to ignore facts or believe bad information.

***************

Stanley Fish is the Davidson-Kahn Distinguished University Professor and a professor of law at Florida International University, in Miami, and dean emeritus of the College of Liberal Arts and Sciences at the University of Illinois at Chicago. Mr. Fish has also taught at the University of California at Berkeley, Johns Hopkins and Duke University. He is the author of 10 books.

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Pirates and Sanctions

By NICHOLAS D. KRISTOF

Published: May 24, 2007

DONGGUAN, China

This is a city you’ve probably never heard of, yet it has a population of 10 million people who fill your dressers and closets. By one count, 40 percent of the sports shoes sold in the U.S. come from Dongguan.

Just one neighborhood within Dongguan, Dalang, has become the Sweater Capital of the World. Dalang makes more than 300 million sweaters a year, of which 200 million are exported to the U.S.

Keep towns like this in mind when American protectionists demand sanctions, after the latest round of talks ending yesterday made little progress. Some irresponsible Democrats in Congress would have you believe that China’s economic success is simply the result of currency manipulation, unfair regulations and pirating American movies.

It’s true that China’s currency is seriously undervalued. But places like Dongguan have thrived largely because of values we like to think of as American: ingenuity, diligence, entrepreneurship and respect for markets.

The people in Dalang, the Sweater Capital, used to be farmers, until a Hong Kong investor opened a sweater factory at the dawn of the 1980’s. After a few years, the workers began to quit and open their own factories, and both the bosses and the staff work dizzyingly hard. One factory worker here in Guangdong Province told me that she works 12-hour shifts, seven days a week, 365 days a year, not even taking time off for Chinese New Year. She chooses to work these hours to gain a better life for her son. If protectionists want somebody to criticize for China’s trade success, blame that woman and millions like her.

Remember that China isn’t like 1980s Japan, which had a sustained huge surplus with nearly everybody. China’s global surplus has surged in the last five years, but traditionally its global trade position has been close to a balance, and it still has a trade deficit with many countries.

China imports components, does the low-wage assembly, and then exports the finished products to the U.S. — so the whole value appears in the Chinese trade surplus with the U.S., even though on average 65 percent of the value was imported into China. When a Chinese-made Barbie doll sells in the U.S. for $9.99, only 35 cents goes to China.

Sure, China pirates movies and software — but the U.S. was even worse at this stage of development (when we used to infuriate England by stealing its literary properties without paying royalties). Pirated DVDs are sold openly on the streets of Manhattan, while sellers in China can be far more creative. A couple of days ago, I dropped into a small DVD shop in Beijing to check its wares. Everything seemed legal.

Then the two saleswomen asked if I wanted to see American movies — and tugged at a bookshelf, which rolled forward on wheels. Behind was a door; one of the saleswomen whisked me into a secret room full of pirated DVDs. That’s piracy — but also capitalism at its harshest and hungriest. There are plenty of reasons to put pressure on China, including its imprisonment of journalists and its disgraceful role in supplying the weaponry used to commit genocide in Darfur. But whining about the efficiency of Chinese capitalism is beneath us.

All that said, the Chinese development model is running out of steam.

Labor shortages are growing and pushing up wage costs. Factories are having to spend more money to improve worker safety and curb pollution. The environment is such a disaster that 16 of the world’s most polluted cities are now in China.

China will also be forced to appreciate its undervalued currency, further pushing up costs. The “China price” will no longer be the world’s lowest, and millions of jobs making T-shirts and stuffed toys will move to lower-wage countries like Vietnam and Bangladesh.

So if China is going to continue its historic rise, it will have to move up the technology ladder and shift to domestic consumption as its economic engine. Yet the share of consumption in China’s economy has fallen significantly since 2000.

So as one who has been profoundly optimistic about China for the last 25 years, I think it’s time to sober up. President Hu Jintao is China’s least visionary leader since Hua Guofeng 30 years ago, and China has the burden of unusually weak leadership as it navigates a transition to a new economic model as well as a political transition to a more open society.

I’m betting China will pull it off, but I don’t think the world appreciates the risks and challenges ahead.

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Rethinking Old Age

By ATUL GAWANDE

Published: May 24, 2007

At some point in life, you can’t live on your own anymore. We don’t like thinking about it, but after retirement age, about half of us eventually move into a nursing home, usually around age 80. It remains your most likely final address outside of a hospital.

To the extent that there is much public discussion about this phase of life, it’s about getting more control over our deaths (with living wills and the like). But we don’t much talk about getting more control over our lives in such places. It’s as if we’ve given up on the idea. And that’s a problem.

This week, I visited a woman who just moved into a nursing home. She is 89 years old with congestive heart failure, disabling arthritis, and after a series of falls, little choice but to leave her condominium. Usually, it’s the children who push for a change, but in this case, she was the one who did. “I fell twice in one week, and I told my daughter I don’t belong at home anymore,” she said.

She moved in a month ago. She picked the facility herself. It has excellent ratings, friendly staff, and her daughter lives nearby. She’s glad to be in a safe place — if there’s anything a decent nursing home is built for, it is safety. But she is struggling.

The trouble is — and it’s a possibility we’ve mostly ignored for the very old — she expects more from life than safety. “I know I can’t do what I used to,” she said, “but this feels like a hospital, not a home.” And that is in fact the near-universal reality.

Nursing home priorities are matters like avoiding bedsores and maintaining weight — important goals, but they are means, not ends. She left an airy apartment she furnished herself for a small beige hospital-like room with a stranger for a roommate. Her belongings were stripped down to what she could fit into the one cupboard and shelf they gave her. Basic matters, like when she goes to bed, wakes up, dresses, and eats were put under the rigid schedule of institutional life. Her main activities have become bingo, movies, and other forms of group entertainment. Is it any wonder most people dread nursing homes?

The things she misses most, she told me, are her friendships, her privacy, and the purpose in her days. She’s not alone. Surveys of nursing home residents reveal chronic boredom, loneliness, and lack of meaning — results not fundamentally different from prisoners, actually.

Certainly, nursing homes have come a long way from the fire-trap warehouses they used to be. But it seems we’ve settled on a belief that a life of worth and engagement is not possible once you lose independence.

There has been, however, a small band of renegades who disagree. They’ve created alternatives with names like the Green House Project, the Pioneer Network, and the Eden Alternative — all aiming to replace institutions for the disabled elderly with genuine homes. Bill Thomas, for example, is a geriatrician who calls himself a “nursing home abolitionist” and built the first Green Houses in Tupelo, Miss. These are houses for no more than 10 residents, equipped with a kitchen and living room at its center, not a nurse’s station, and personal furnishings. The bedrooms are private. Residents help one another with cooking and other work as they are able. Staff members provide not just nursing care but also mentoring for engaging in daily life, even for Alzheimer’s patients. And the homes meet all federal safety guidelines and work within state-reimbursement levels.

They have been a great success. Dr. Thomas is now building Green Houses in every state in the country with funds from the Robert Wood Johnson Foundation. Such experiments, however, represent only a tiny fraction of the 18,000 nursing homes nationwide.

“The No. 1 problem I see,” Dr. Thomas told me, “is that people believe what we have in old age is as good as we can expect.” As a result, families don’t press nursing homes with hard questions like, “How do you plan to change in the next year?” But we should, if we want to hope for something more than safety in our old age.

“This is my last hurrah,” the woman I met said. “This room is where I’ll die. But it won’t be anytime soon.” And indeed, physically she’s done well. All she needs now is a life worth living for.

Atul Gawande, a surgeon at Brigham and Women’s Hospital in Boston and a New Yorker staff writer, is the author of the new book “Better.” He is a guest columnist this month.

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The Golden Rule in the Human Jungle

By Mark Buchanan

News of the past few days and weeks suggests a rather dismal view of humanity. Israelis and Palestinians are again firing rockets at each other. On the streets of Karachi, just over a week ago, Pakistani security forces stood by while 42 people were killed and many more injured at a rally for Iftikhar Mohammad Chaudhry, deposed Chief Justice of the Supreme Court and opponent of President Pervez Musharraf. In the United States, a company compiling data on consumers is making money by helping criminals steal the savings of thousands of retired Americans.

Violence, corruption and greed. What kind of people are we?

But counter all of that with this – a young man in Cleveland has pledged $1 million of his own money to establish scholarships for disadvantaged children. His name is Braylon Edwards, and, O.K., he’s an emerging star for the Cleveland Browns who makes more money in a year than most of us will in a lifetime, but still. He could have bought a yacht and a fleet of sparkling Humvees. Instead, he invested in the future of hundreds of people he doesn’t even know.

“To secure a positive future for our country,” an ESPN article quoted Edwards as saying, “we have to start with these kids. We have to support them.”

So maybe the news is more dismal than it needs to be. But a glance at my previous columns shows that I’ve fallen into a similar pattern, writing on racial prejudice, genocide and entrenched political polarization, while not mentioning the more positive sides of the social atom. Cynicism can be pushed too far, because pure and untainted human altruism really exists – and it’s something to which we should learn to pay a lot more attention.

In a classic experiment of modern behavioral science – one that is now familiar to many people – an experimenter gives one of two people some cash, say $50, and asks them to offer some of it (any amount they choose) to another person, who can either accept or reject the offer. If the second person accepts, the cash is shared out accordingly; if he or she rejects it, no one gets to keep anything.

If we were all self-interested and greedy, then the second person would always accept the offer, as getting something is clearly better than getting nothing. And the first person, knowing this, would offer as little as possible. But that’s most certainly not what happens.

Experiments across many cultures show that people playing this “ultimatum game” typically offer anything from 25 to 50 percent of the money, and reject offers less than around 25 percent, often saying they wanted to punish the person for making an unfair offer.

An important point that people often overlook about these experiments (and others like them) is that they’ve been performed very carefully, with participants remaining completely anonymous, and playing only once. Everything is set up so no one can have any hope of building a good reputation or of getting any kind of payback in the future in kind for their actions today.

So this really does seem to be pure altruism, and we do care about fairness, at least most of us.

That’s not to say, of course, that we’re not often self-interested, or that human kindness isn’t frequently strategic and aimed at currying favor in the future. The point is that it’s not always like that. People give to charity, tip waiters in countries they’ll never again visit, dive into rivers to save other people or even animals – or set aside $1 million to send poor kids to school – not because they hope to get something but, sometimes, out of the goodness of their hearts.

Social researchers have begun referring to this human tendency with the technical term “strong reciprocity,” which refers to a willingness to cooperate, and also to punish those who don’t cooperate, even when no gain is possible. And there’s an interesting theory as to why we’re like this.

In theoretical studies, economists and anthropologists have been exploring how self-interest and cooperation might have played out in our ancestral groups of hunter-gatherers. In interactions among individuals, it’s natural to suppose that purely self-interested people would tend to come out ahead, as they’d never get caught out helping others without getting help in return and would also be able to cheat any naïve altruists that come along.

But it is also natural to suppose that when neighboring groups compete with one another, the group with more altruists would have an advantage, as it would be better able to manage collective tasks – things like farming and hunting, providing for defense or caring for the sick – than a group of more selfish people.

So you can imagine a basic tension in the ancient world between individual interactions that favor self-interest and personal preservation, and group interactions that favor individual altruism. Detailed simulations suggest that if the group competition is strong enough, cooperators will persist because of their intense value to group cohesion. But there’s slightly more to the story, too.

Further work shows that groups really thrive if the altruists are of a special sort – not just people who are willing to cooperate with others, but who are also willing to punish those who they see failing to cooperate.

This work is only suggestive, but it raises the interesting idea that it’s a long history of often brutal competition among groups that has turned most of us into willing cooperators, or, more accurately, strong reciprocators. We’re not Homo economicus, as Herbert Gintis of the University of Amherst puts it, but Homo reciprocans – an organism biologically prone to cooperative actions, and for good historical reasons.

No doubt this is what many people probably thought all along, without the aid of any theory or computer simulations. It just goes to show how theorists can labor for years to re-discover the obvious. Then again, re-discovery often casts the familiar in a not-so-familiar light, and leads us to reconsider what we thought we already knew.

We’ve been so busy over the past half century glorifying the power of markets driven by self-interest that we’ve overlooked how many of our most important institutions depended not on self-interest but on something more akin to a cooperative public spirit. If an impulse toward cooperation rather than self-interest alone is the “natural” human condition, then we’ve been poor stewards of a powerful social resource for the collective good. The United States health care system, to take one example, has by design been set up around the profit motive, based on the belief that only this narrow motivator of individual action can be counted on to produce anything good. It’s perhaps no surprise that it is among the most expensive in the world, and far from the most effective.

In a press conference at the Cannes Film Festival, following a screening of his new film “Sicko,” Michael Moore criticized how financial interests play such a foundational role in health care in the United States. “It’s wrong and it’s immoral,” he said. “We have to take the profit motive out of health care. It’s as simple as that.”

But it’s not quite that simple. It’s not that profits shouldn’t play any role, because we are indeed motivated in part by self-interest. It’s just that we have other motivations, too, and helping others is one of those. We need to be just as open to the better parts of human nature as we are protective against the narrowly materialistic ones, whether we’re considering health care or anything else, including education.

You don’t need a new breed of experimental economists to tell you that. Just ask Braylon Edwards.

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Mark Buchanan, a theoretical physicist, is an associate editor for ComPlexUs, a journal on biocomplexity, and the author of "Ubiquity: The Science of History," "Nexus: Small Worlds and the Groundbreaking Science of Networks" and, most recently, "The Social Atom: Why the Rich Get Richer, Cheaters Get Caught, and Your Neighbor Usually Looks Like You." He lives in Normandy.

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