Tag: Health
Disgrace everywhere you look
Less than two weeks in, the Trump Administration is proving more malicious, less competent, and more destructive than we imagined. The President can’t even pretend to mourn the victims of a plane crash. He needed to parade his racism in front of the cameras as well by blaming the crash on diversity. It turns out the Federal Aviation Administration initiated its diversity program during his own first term. His tariffs on Mexico and Canada will jack up prices and deflate the stock market by Monday.
The firing of dozens of experience prosecutors will hamper the Justice Department for years. The consequent lawsuits will cost more than the money saved by reducing the payroll. And the incompetents he’ll hire as replacements will be mostly white sycophantic males with little experience and no integrity.
The disgrace in the Senate
Some of the worst of Trump’s minions have been testifying this week in the Senate. RFK Jr., Tulsi Gabbard, and Kash Patel lied and insulted their ways through hours of painful fraud and bluster. The results were embarrassing.
RFK Jr. demonstrated no knowledge and no aptitude for Health and Human Services Secretary. Gabbard couldn’t call Edward Snowden a traitor because she had defended his theft and publication of top secret documents. I wouldn’t call him a traitor either until a court tries and convicts him. But she could have just that: he should come home for trial. Kash Patel just denied saying things he has said. The FBI will be Trump’s personal police force by the time he is through with it.
The disgrace at the borders
Trump is having a hard time on immigration. Not many people are crowding the border, because Biden already fixed that. Trump is flying a few immigrants to their home countries at high cost, without demonstrating they are criminals. And to get some more attention he promises to store 30,000 of them at Guantanamo. The US Government found it difficult to imprison 800 there, most of whom turned out not to be terrorists. The GTMO military commission has convicted only eight. The yearly cost of incarceration was $10 million per detainee.
Meanwhile, the Administration has canceled permission for fully cleared refugees from Afghanistan and other war zones to enter the US. It continues to lump asylum seekers with criminals. And it has canceled temporary protected status for hundreds of thousands of Venezuelans.
The disgrace in the budget
Trump initially stopped all Federal grants and contracts, including for major programs like Medicaid and for foreign assistance. That it turned out upset Republicans, as a lot of the money goes to red states:
So now they have lifted the general stop order but are slow walking specific programs through approval. The result is enormous confusion inside the government and the organizations that receive money from it. Everyone is working feverishly to get exceptions. That is a tremendous waste of resources.
Trump tried once before to stop foreign assistance, to Ukraine in 2019. The House of Representatives impeached him for that. Congress appropriates money. It is the President’s responsibility to execute what the Congress says it is for. He has no power to divert the money without at least informing Congress, which of course Trump has not done.
What he wants to do with the money is worse than his effort to slow its disbursement. He wants to extend the tax cuts for the rich approved in 2017. He also wants to pay for prestige projects his billionaire friends have been advocating. Those include sending people to Mars and buying Greenland. No doubt they will also convince him to provide cheap energy for the Artificial Intelligence projects.
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Stevenson’s army, August 14
One reason for historians to revisit topics already covered by others is that later generations have new questions and new perspectives about the subject matter. Robert P. Watson, writing about the yellow fever epidemic that struck Philadelphia in 1793, tells a story we can resonate with because of our own experiences with Covid-19.
His book, America’s First Plague: The Deadly 1793 Epidemic that crippled a young nation, begins with the irony that one of the most likely vectors was a British ship Hankey that was sent to found a colony of free blacks and whites off the coast of Guinea but was driven away, with sick and dying passengers, to the Caribbean and Philadelphia. The venture was funded by British abolitionists.
The strange disease was first noticed at the Philadelphia wharf, where the Hankey and other ships from yellow fever hotspots in the Caribbean had docked. Although Philadelphia, then the capital of the new country, was the leading site for medical and scientific research, doctors were puzzled by the illness and unable to agree on a proper treatment.
Watson highlights the bitter disagreements between Benjamin Rush,the most prominent American physician of the age, and some other local doctors. Rush believed that most epidemics were caused by miasmas, bad air, and were best treated by bloodletting and purgatives. Some of the other doctors favored fluids and rest. Only in the late 19th century did doctors conclude that yellow fever was caused by mosquitoes.
After about ten weeks of high casualties, the first frost led to a quick dropoff of the disease. During and after the worst period, the Philadelphia media clashed with political messages. Jeffersonian Republicans like Rush opposed quarantines and blamed the Federalists for mishandling the plague. Federalist politicians and doctors countered that Rush and the Republicans had made things worse.
Other American cities banned entry of people and ships from Philadelphia or imposed quarantines of new arrivals.
The U.S. Government collapsed. About half the people of Philadelphia left the city during late August and September. President George Washington had long planned to go to Mount Vernon in mid-September, but most of his cabinet and other government employees were already leaving on their own. He finally returned and convened a cabinet meeting in early November and decided Congress could return as scheduled in December.
A happier story is about Philadelphians, who already had a system of almshouses and care for the poor and sick as part of their Quaker tradition. A large suburban house was seized and turned into a hospital for fever victims; doctors and caregivers were recruited and paid; and major improvements in hygiene undertaken. While the news media maintained their partisan passions, they also gave valuable and timely information during the crisis.
This was the first time, but not the last, that Americans grew scared and angry about a medical emergency, vollied political points as they tried to figure out what to do, and learned how better to prepare for future problems. Read the book.
My SAIS colleague Charlie Stevenson distributes this almost daily news digest of foreign/defense/national security policy to “Stevenson’s army” via Googlegroups. I republish here, with occasional videos of my choice. To get Stevenson’s army by email, send a blank email (no subject or text in the body) to stevensons-army+subscribe@googlegroups.com. You’ll get an email confirming your join request. Click “Join This Group” and follow the instructions to join. Once you have joined, you can adjust your email delivery preferences (if you want every email or a digest of the emails).
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Stevenson’s army, June 20
[Mark Twain was onto something when he wrote: “When I was a boy of 14, my father was so ignorant I could hardly stand to have the old man around. But when I got to be 21, I was astonished at how much the old man had learned in seven years.”]
New Yorker has several archived pieces on fathers.
Glenn Kessler explains the difference between substantive foreign policy amendments and “messaging amendments.“
Paul Kane explains the House dilemma over whether to meet or campaign.
David Sanger explains, counter-intuitively, that the election of a hard-line president may open a brief window for reviving the JCPOA.
Charlie also writes:
What should be done when a government agency does a poor job on one of its key missions? Cutting funds sends a strong message but may also feed a spiral of decline. Adding money may be wasteful. Imposing more oversight and regulation may expose problems earlier, but it may also stultify its operations. Good governance is filled with trade offs and dilemmas.
The New York Times magazine has an excellent article on the Centers for Disease Control, “Can the CDC Be Fixed?” It recounts many of the missteps CDC made in responding to the pandemic, but also makes these points:
- The C.D.C. we have is hardly a monolith: Some of its many pockets are bursting with innovation; others are plagued by inertia. But scientists and administrators who have spent decades working with and for the agency say that three problems in particular affect the whole institution: a lack of funding, a lack of authority and a culture that has been warped by both. Some of these problems come down to politics, but most are a result of flaws in the agency’s very foundation.
- Today the C.D.C. is both sprawling in its reach and extremely constrained in what it can do. It consists of more than a dozen centers, institutes and offices and employs more than 11,000 people in all, in a gargantuan roster of public-health initiatives — not just infectious-disease control but also chronic-disease prevention, workplace safety, health equity and more.
- The C.D.C.’s multibillion-dollar annual budget is both too small — it has barely kept pace with inflation in the last two decades — and subject to too many restrictions. Around half of the agency’s domestic budget is funneled to the states, but only after passing through a bureaucratic thicket. There are nearly 200 separate line items in the C.D.C.’s budget. Neither the agency’s director nor any state official has the power to consolidate those line items or shift funds among them.
- The C.D.C. is resistant to change, slow to act and reluctant to innovate, according to critics. The agency’s officers are overly reliant on published studies, which take time to produce; and are incapable of making necessary judgment calls. Agency departments are also deeply siloed. “We are really good at drilling down,” Darrow says. “But terrible at looking up and reaching across.”
Sadly, similar complaints could be made of several U.S. government agencies, including DHS and DOD. My advice is to acknowledge the conflicting pressures and try to balance between extreme remedies.
My SAIS colleague Charlie Stevenson distributes this almost daily news digest of foreign/defense/national security policy to “Stevenson’s army” via Googlegroups. I plan to republish here. To get Stevenson’s army by email, send a blank email (no subject or text in the body) to stevensons-army+subscribe@googlegroups.com. You’ll get an email confirming your join request. Click “Join This Group” and follow the instructions to join. Once you have joined, you can adjust your email delivery preferences (if you want every email or a digest of the emails).
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Stevenson’s army, May 13
– WH released a 34-page executive order on cybersecurity. And a shorter fact sheet. And the transcript of a press briefing. Now you know what I know.
– 3 defense think tanks released a defense budget simulator. But it doesn’t seem to be working yet. Bookmark for later.
-Experts released a plan to prevent the next pandemic.
-Peter Feaver asseses the old officers’ screed.
-DOD refuses to discuss Afghan relocation in open session.
– And Politico says the Afghan blame game is on.
Note: I’ll be away for a few days but a neighbor will save my papers. I’ll have more news next week.
My SAIS colleague Charlie Stevenson distributes this almost daily news digest of foreign/defense/national security policy to “Stevenson’s army” via Googlegroups. I plan to republish here. To get Stevenson’s army by email, send a blank email (no subject or text in the body) to stevensons-army+subscribe@googlegroups.com. You’ll get an email confirming your join request. Click “Join This Group” and follow the instructions to join. Once you have joined, you can adjust your email delivery preferences (if you want every email or a digest of the emails).
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Stevenson’s army, December 6
Peter Beinart disparages the goal of American foreign policy leadership.
The Hill says maybe the polls weren’t so wrong.
WaPo writer says NDAA offers an alternative China policy.
Study blames diplomats’ illnesses on microwaves.
I’d forgotten how close Congress came to abolishing electoral college in 1969. WaPo tells the story.
My SAIS colleague Charlie Stevenson distributes this almost daily news digest of foreign/defense/national security policy to “Stevenson’s army” via Googlegroups. I plan to republish here. To get Stevenson’s army by email, send a blank email (no subject or text in the body) to stevensons-army+subscribe@googlegroups.com. You’ll get an email confirming your join request. Click “Join This Group” and follow the instructions to join. Once you have joined, you can adjust your email delivery preferences.
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Stevenson’s army, October 27
Vice says US troops in Africa are in danger.
Daily Beast says FBI is sitting on its white supremacy threat report.
Why is the NSA going to shipyards and explaining Navy programs?
Maybe because, Dan Drezner argues, the foreign policy leadership is totally politicized.
Biden aides, however, aren’t allowed to talk to foreigners.
Phil Zelikow has a short list of needed State Dept reforms.
Sorry, folks, NYT health writer says marijuana has heart health risks.
My SAIS colleague Charlie Stevenson distributes this almost daily news digest of foreign/defense/national security policy to “Stevenson’s army” via Googlegroups. I plan to republish here. To get Stevenson’s army by email, send a blank email (no subject or text in the body) to stevensons-army+subscribe@googlegroups.com. You’ll get an email confirming your join request. Click “Join This Group” and follow the instructions to join. Once you have joined, you can adjust your email delivery preferences (if you want every email or a digest of the emails).
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