lloydtown 

Nannies again

Part of the Kerik coverage: maybe there was an actual nanny, or maybe he used his mother-in-law, and lied about an illegal nanny to cover up worse things.

Here's the kicker:

"He had to have known the status of his nanny," said Christine Sandrib, who has operated Nannies N More for 14 years. "If she's illegal, anybody in his position had to have known."

Like Christy Ann Bozanian, owner of A Better Nanny, Ms. Sandrib stressed that an agency was responsible for determining that any employee it placed was legal. Their own agencies require a green card or work authorization as well as a criminal background check. Both said the demand for legal, thoroughly vetted nannies had risen dramatically in recent years.

"In particular post 9/11, there's a greater concern about knowing who is in their home," Ms. Sandrib said. "This neighborhood is full of attorneys, physicians, people involved in politics at some sort of a level. They're not interested in illegal candidates. An educated person should know to ask for that." Paying Social Security taxes and workers' compensation is another story, they said. "I provide every family with information about payroll taxes, and the agency to call," Ms. Bozanian said. "What they do with that is up to them."

Ms. Sandrib estimated that 99 percent of nannies, legal or not, were paid off the books. They said that legal, agency-placed nannies commanded higher wages - about $450 a week for a live in, compared with as little as $275 for those without legal status.

Kerik and the Medals

Atrios:

"Bernard Kerik is one scandal away from winning the Presidential Medal of Freedom."

At first this seems a nearly perfect political joke: Bush and the gang have been far too determined to turn this particular lump of lead into gold. One imagines the meeting: "All we need to know is that he's tough. He kicks ass. He's not going to vacillate, hesitate, think too much like that Hamlet fella." Right, Kerik certainly doesn't have that particular problem.

On the other hand, it smears the recent recipients of the Medal )George Tenet, Tommy Franks, Paul Bremer) to associate them with Kerik. They have served their country honourably. The timing is just unfortunate in that it is so obvious they are being given a big pay off to get them to shut up concerning what they know about Iraq.

Mind you, it's a small world.

And somewhere on the horizon, the question: does Bush know any rich, successful people, other than his father, who aren't crooks?

A Tory Embraces a Liberal

Hugh Segal, who has been a hanger-on of various kinds to various Tories, and has been proud for some time to be known as a "Red" Tory, on Prime Minister Paul Martin:

There has been in the last year, engagement in Haiti, in Darfur and the Middle East; a proposal on an expanded multilateral leadership tier; support for the "responsibility to protect" doctrine; a frank admission that he was the finance minister who slashed Defence funding; an accord on health care; a start to revamping equalization and child care; a proposal on democratic reform and an historic precedent on a negotiated throne speech amendment.

House and Other Doctors

Colby Cosh has a couple of nice posts on the new TV show, "House M.D.," and now he has linked to an article about evaluating doctors that really ties some thoughts together.

The article by Atul Gawande in the Dec. 6 New Yorker argues that if doctors are evaluated rigorously, they always end up on a bell curve. A few achieve exceptional outcomes; another few are terrible; many, even if they are hard-working and have excellent credentials, end up somewhere in the mediocre middle.

Such studies are still new, but the bell curve seems to keep emerging in many fields. Gawande is a surgeon, but he looks specifically at treatment for Cystic Fibrosis. Breakthroughs have been made in the life expectancy of patients with CF--mostly by being very aggressive with fairly pedestrian treatments that quickly get boring for patients--especially teenage ones. Patients are supposed to submit to "chest percussions" on many points of their body, and inhaling medications, several times a day. Everyone in the field knows that teenagers, especially, will slack off on this.

Gawande visits a doctor whose centre has a mediocre record. The teenage patient is slacking off, but things don't look too bad, the doctor gives the speech to exhort vigilance that must be given millions of times a year, and that's about it. (A few follow-up appointments with various people are arranged).

Then Gawande visits a doctor at the Number 1 centre in the U.S. A teenager's results aren't all that bad--but they were much better only recently; in fact, this kid's lung capacity was not just normal, but above normal. This elite centre always asks the question: why not the best? The doctor asks if the young woman is doing all her treatments. "Yes, of course," she replies.

Ah hah. As Dr. House would predict, she is lying. Because of her new boyfriend, and the scene at school, she doesn't find it cool to schedule the treatments she knows she needs. Her doctor doesn't immediately accuse her of lying--he simply puts some numbers on the board--something, again, that is done millions of times. If you skip treatments for a week, that probably only lowers your life expectancy an infinitesimal amount; and teenagers like to gamble and experiment with danger and their bodies. But keeping up a bad habit for a year can be a disaster, and it gets worse after that.

The doctor gives the young woman a kind of concentrated, personal version of the "exhorting" speech: why exactly have you done so poorly this time, if you are doing your treatments? Do we need to change the treatments, or admit you to hospital, or what? What the "mediocre" doctor accepted as part of life with these patients, this elite doctor treats as totally unacceptable. The young woman fesses up. Her doctor has some creative suggestions to enjoy boyfriend, school and life (carrying meds without telling the nurse--breaking the rules!) while getting all the treatments. She starts to feel that she is off the hook, and he says: you're going to spend one night in hospital. She's visibly disappointed. He quietly says: we failed this time, and we have to take responsibility for our failures. She cries, and agrees.

This is great stuff. As Gawande makes clear, many excellent, ethical doctors, who want the very best for their patients, simply wouldn't do all this--it's too personal, too hard on the doctor as well as the patient. But what is the approach that so many good people would reject? Excellence--cutting through b.s., insisting on the truth, insisting on the best. These kids can actually have the same lung capacity as the rest of us, and they are now approaching (at the best centres) normal life expectancy. So why isn't that the literally unrelenting goal of every patient, and every person who works with the patients?

House would say: patients lie, and highly trained professionals settle for second best. Incredibly, the teenager who got the full treatment--successfully--at Minneapolis was showing better results at the time of the appointment than the one who got kind of a kiss-off at Cincinnati.

House got an unfriendly review from a doctor on Slate. The doctor suggested that modern patients and hospitals would refuse to put up with House's rudeness. Maybe. But the rudeness is always along the lines of: you've done something dumb or careless to get here; or you're lying about your history; or other doctors have been careless in diagnosing. An overall troubling message is that doctors still don't know that much about diagnosing illness. Obviously great strides have been made, but I remember reading there is still a lot to be said for an autopsy as a way to find out--too late--what a poor s.o.b. actually had. House, I think, really tries to distinguish things he knows from things he doesn't--and he doesn't hide the latter from patients.

UPDATE: The New Yorker again (Dec. 13): mammograms don't reveal as much as they seem to; they sometimes reveal too much, in a way that is misleading/causes unnecessary treatment; and generally are relied on more than they should be. A trained doctors hands can gather much more information than the eyes, even with modern scans; yet intuitively we trust the eyes more.

Nanny Trouble

Sorry, but this is hilarious.

Credit to [/blockquote]Lori Byrd for posting on it (via Instapundit).

Bernard Kerik has withdrawn his name for consideration for the top job at Homeland Security, apparently because of "nanny trouble"--that is, he hired a nanny who was an illegal immigrant, and failed to pay FICA or "social security" taxes for this person.

UPDATE: This story quotes Kerik saying, "I uncovered information that now leads me to question the immigration status of a person who had been in my employ as a housekeeper and nanny. It has also been brought to my attention that for a period of time during such employment required tax payments and related filings had not been made."

Oil for Food

Republicans in the U.S. Congress continue to say: Oil for Food was abused by individuals and companies in the West; the UN either did nothing, or provided a cover for UN officials to profit.

James Robbins says in the Washington Post that Oil for Food worked--it fed the poor in Iraq--and any money stolen was Iraqi money, stolen by Iraqis. If the UN partially failed on this front, they largely succeeded in preventing Saddam from building WMDs.

Malnutrion experts seem to agree that Oil for Food fed the poor in Iraq. (There is evidence that malnutrition is worse now in Iraq than it was at the time of the U.S. invasion).

Josh Marshall says all the major decisions about Oil for Food were made by the Security Council of the UN, and the commonly bandied figure for "losses" is bogus.

The left says Dick Cheney led Halliburton to make money from oil for food.

More on Red State/Blue State

Details from The Big Picturevia Altercation:

Blues are more educated, make more money, are more successful, and have to carry the Red welfare states on their backs:


-College and High School Graduation

Blue staters graduate HS and are more likely to go to college



-Red = Poor

Red staters are poorer


-Blue = Successful

Blue states achieve higher success rates



-Tax Burden / Parasites States

The Red states are a tax burden on the rest of the country.

What about that vaunted Moral superiority we hear so much about?

-Marriage

Blue staters are more likely to stay married


-Teen Birth Rates

Blue staters are less likely to get pregnant in their teen years


-Chlamydia

Red staters get more STDs

The Real 60s Music

Ann Althouse says the Grammy winners in the 60s were pathetic--meaning that rock, which was changing the world, wasn't represented.

I can see her point with Percy Faith and even the sillier 5th Dimension songs. I enjoyed the Tijuana Brass as a kid because I played trumpet. I still love Jimmy Webb's songs, but Glen Campbell's versions were a battle on behalf of the oldsters against the hippies. Rock is music of the libido; Carole King's Tapestry, although I feel sentimental about some of the songs, is the music of someone who vaguely remembers having a libido.

I had drafted a long, link-rich post, and then lost it. The main point was: people seem to think AM Radio in the 60s, when AM was still king, was dominated by rock. Instead it was still dominated by the boomers' parents, rather than the boomers themselves. They came to like songs with a beat--but emphatically not a rock beat.

Don't Tony Bennett and Sinatra hold up extremely well, whereas the Concert for Bangladesh doesn't?

The 5th Dimension recorded some Laura Nyro songs--as did Blood, Sweat and Tears.

Carole King wrote "Hi De Ho (That Old Sweet Roll)" and "(You Make Me Feel Like) A Natural Woman".

Lord Salisbury's Essays

Before he became the Marquess of Salisbury (inheriting from his father), he was Lord Robert Cecil, and then Viscount Cranborne. Under the first name, long before he became Prime Minister, he wrote essays on politics, primarily in the Quarterly Review.

In 1905, two collections of his essays were published: Essays by the late Marquess of Salisbury K.G.: Biographical; and Essays by late Marquess of Salisbury K.G.: Foreign Politics. These are probably his best essays.

Then there is the collection from 1972 I already cited: Lord Salisbury on Politics.

I managed to find the 1905 "Biographical" collection at the U of T library. There are only two lives: Castlereagh and Pitt; but there are two long essays on Pitt.

Both Castlereagh and Pitt were known to many as Tories, and even reactionaries; this was a description with which Salisbury was pretty comfortable for most of his life. But he also was very intelligent, and argued for an intelligent approach to politics--not fighting battles that are over, giving ground when necessary, and not only when under attack. To some extent, in writing about people from more than 50 years earlier, he is trying to correct the views of Whig/Liberal historians, especially Macaulay. Salisbury argues that there was no consistency in Whig views over these years; their sympathy for the French Revolution, and then for Napoleon, was sporadic, and led primarily to embarrassing interventions in foreign policy. They became the party that led the way on free trade and extending the franchise, yet when Pitt led the way on these issues, he was attacked by the Whigs of the day.

Castlereagh was Foreign Minister during the end of, and the aftermath to, the Napoleonic Wars. The greatest event in which he took a direct part was the Congress of Vienna in 1814. The goal of the Congress was to re-make Europe as much as possible the way it was before Napoleon's conquests. This was largely successful, and Salisbury stresses that an unusually long peace was the result. Castlereagh worked closely with, and often praised in public, some autocratic or pre-modern regimes. Was he himself a reactionary, on the wrong side of history?

"The energies of a whole school of political writers were devoted to the task of persuading his countrymen that he was the English representative of the Holy Alliance, and an accomplice in every freak of tyranny that was perpetuated from Warsaw to Cadiz."

Did Castlereagh and the men he worked with treat the peoples of Europe like "herds of cattle," ignoring the national aspirations of various peoples who were forced back into the old empires? According to Salisbury, it was essential for Castlereagh to make promises in order to keep the Coalition together during the war: the "strategy" of the allies was its "weakest" part; diplomacy was its "strongest." Afterward, besides the obligation to keep one's word, it was still essential to give the key players what they wanted in order to build a peace that would last.

Here Salisbury has some fun. Who were the nationalities who were to be liberated in 1814? In a few years, they were forgotten, and a whole new cast of characters were now constantly discussed--whose aspirations where usually in direct competition with those of the old groups. Salisbury says this makes the "conservative" point that nationalism, even at best, simply does not provide a guide for action. Is a national group truly ready to act on its own? If it does, is it able to defend itselfk, or does it simply become an attractive prey to a neighbour? Does its political independence make war less likely, or more?

Freedom means at least partly peace and security, the opposite of war. Napolean promised freedom, but kept on delivering more and more war, with wholesale confiscation of property, and martial law.

Castlereagh didn't have the knack or the inclination to deliver any high-flown oratory about any of this. Maybe the stuff that's most relevant to the present day: "...the clever world is very intolerant of plain, practical statesmen. It maintains, sometimes with very good reason, that where the imagination is stunted, it is merely because the whole mind is stunted too; and that the claim to practical common sense is often only a euphemism for a narrow intelligence straitened by an abject regard for precedents and for routine."

Ordinary people, on the other hand, supposedly tend to distrust clever or brilliant people.

Bush was seen as a plodder before 9/11--there may have been indications of a kind of ideological attack on the income tax, very much a 19th century issue, but otherwise there was a lot of attachment to precedent and routine. Since 9/11, however, he seems to be the dreamer who is leading the people on a largely uncharted course.

With Pitt, who presided as Prime Minister over the beginning of the Napoleonic war, the controversy is mainly about the crackdown on domestic security, including the suspension of habeas corpus. Salisbury has fun pointing out that the United States, the great democracy, has gone much farther in repression during the Civil War. He admits that by definition one can never say in hindsight that a government, if it succeeded in keeping down insurrection, went too far or not. He points out that Whigs in the 19th century did many of the same things in Ireland that Pitt did. And he says there was good evidence, some of which remained secret, that there really were plots brewing in England to support Napoleon.

I notice that Cass Sunstein has actually said the Bush Administration has been quite restrained when it comes to domestic security, compared to the Administration during any previous major war.

If you get a chance to read any of this, the essay on "The House of Commons" in the 1972 book has a very funny description of the actual working of that ancient institution.

UPDATE: I guess I'm interested in people who applied great intelligence to being fundamentally cautious. Bush seems to be applying not so great intelligence to being not so cautious. The "liberal" critique of the Congress of Vienna can still be seen and heard--even the charge that propping up the old monarchies helped bring about World War I a hundred years later.

Salisbury points out instead that after the Congress, the great powers in Europe were at peace (with each other) for 40 years: "Europe has not enjoyed so long a repose from the curse of war since the fall of the Roman Empire."

Of course, Britain wanted to preserve a stable status quo in Europe, in which everyone was hesitant to take bold action, because Britain already had the biggest empire going around the world, and didn't want to share with other Europeans. To his credit, Salisbury never or almost never argued that the traditions he was defending as a practical matter were actually sacred, or even better than some new alternative. It was more that the attempt to change was risky, and might do more harm than good. He argued that Britain shouldn't lecture about big countries subduing weak ones, or minorities: "England...owns, without any consent of the peoples whatever, more nationalities than she can comfortably count."

Finally (for now): I'm interested in the argument that after World War I, the Austro-Hungarian Empire should have been rescued yet again. The loss of a centralizing power in central and eastern Europe helped the Bolsheviks take over Russian, and then threaten their neighbours. Taking out the German royal family may have helped bring about Hitler. The intervention of the U.S., exactly when Wilson chose to intervene, led directly to the decision of German and Austrian officers to transport Lenin to Russia.

How Big a Threat?

Peter Beinart's article in TNR has started a discussion, in which Kevin Drum plays a leading role, about how liberals and Democrats can and should talk about national security. I take it Beinart's main point is that if they want to win national elections, liberals shouldn't take the Michael Moore position that almost anything is better than for U.S. forces to fight an aggressive war, arguably pre-emptive or not, anywhere, anytime.

Drum has said there at least has to be an intelligent debate about that, and among the issues are: is any Arab government any threat to anyone outside the Middle East?; and is any Islamic organization, no matter how radical, actually expansionist, like Communism or Nazism, in any way at all? He makes the observation that 9/11 still seems to have been an isolated attack by a small group that burned up all their agents in the West with this one operation.

Jonah Goldberg has contributed from the right, mostly posting e-mails that say: this all proves again that liberals are out of it, of course there are terrible global threats, the war in Iraq is pre-emptive or even defensive, etc.

Goldberg approvingly posts a strange e-mail.

Dave Kopel posts a correction:

Jonah, approvingly quoting a reader, posts:"Germany and Japan had no major victories after Pearl Harbor." Actually, in the months after Pearl Harbor, Japan conquered Malaya, Singapore, Burma, British North Borneo, Java, Wake Island, some Aleutian Islands, and all the Philippines. The German offensives in Egypt and Russia were, by the end of the year, unsuccessful, but there were major victories along the way, including capturing the Black Sea fortified port of Sevastapol, and capturing 32,000 British prisoners at Tobruk. Later in 1942, the Americans invaded French North Africa, but thanks to failures in the Allied plan, the Germans were able to occupy Tunisia quickly, and the Americans were eventually forced to pay a very high price to force them out.