Will a 9-Year-Old Change the Vaccine Debate?

(NYT) – There’s no question that the case of 9-year-old Hannah Poling of Athens, Ga., has fueled the controversy about childhood vaccines. But what’s less clear is whether it will help unlock the mysteries of autism.

Hannah was 19 months old and developing normally until 2000, when she received five shots against nine infectious diseases. She became sick and later was given a diagnosis of autism.

Late last year government lawyers agreed to compensate the Poling family on the theory that vaccines may have aggravated an underlying disorder affecting her mitochondria, the energy centers of cells. (To read more about the decision, click here.) Vaccine critics say the Hannah Poling settlement shows the government has finally conceded that vaccines cause autism. But government officials say Hannah’s case involved a rare medical condition, and there is still no evidence of a link between vaccines and autism.

Hannah’s father, Dr. Jon S. Poling, a practicing neurologist in Athens and clinical assistant professor at the Medical College of Georgia, says the case has shifted the autism debate forever and points to a promising new area of research.

Writing in The Atlanta Journal-Constitution on Friday, Dr. Poling says there is compelling evidence that mitochondrial disorders, like the one his daughter has, are strongly associated with autism.

To understand Hannah’s case, it is important to understand mitochondria, which act like batteries in our cells to produce energy critical for normal function…. Emerging evidence suggests that mitochondrial dysfunction may not be rare at all among children with autism. In the only population-based study of its kind, Portuguese researchers confirmed that at least 7.2 percent, and perhaps as many as 20 percent, of autistic children exhibit mitochondrial dysfunction. While we do not yet know a precise U.S. rate, 7.2 percent to 20 percent of children does not qualify as “rare.” In fact, mitochondrial dysfunction may be the most common medical condition associated with autism.

Dr. Poling urges the Institute of Medicine and public health officials to pursue research into mitochondrial conditions, which he describes as a “breakthrough in the science of autism.’’ He writes:

National public health leaders, including those at CDC, must now recognize the paradigm shift caused by this biological marker with regard to their current position of dispelling a vaccine-autism link. In light of the Hannah Poling concession, science must determine more precisely how large the mitochondrial autism subpopulation is: 1 percent, 7.2 percent, 20 percent?

To be sure, many health experts do not agree with Dr. Poling’s conclusions. The case has “added nothing to the discussions of what causes or doesn’t cause autism,” said Dr. Edwin Trevathan, director of the National Center on Birth Defects and Developmental Disabilities at the Centers for Disease Control and Prevention.

On Friday, many of the main players involved in this debate — including Hannah’s mother and her grandparents, prominent vaccine skeptics and some of the government’s top vaccine researchers — took part in the federal government’s first-ever public meeting to discuss a government-wide research agenda to explore the safety of vaccines.

To read Dr. Poling’s complete essay, click here. Last month, Dr. Paul A. Offit, chief of the infectious diseases division of the Children’s Hospital of Philadelphia, explained his view that the Hannah Poling case has been mischaracterized by vaccine critics. To read the piece, click here. Hannah Poling’s parents wrote this response to Dr. Offit’s report. Last month, The Atlanta Journal-Constitution wrote this profile of Hannah and her parents.

It isn’t the vaccines that are causing the problem, it’s how and when the vaccines are given. Isn’t this so?

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Toil and Trouble

WASHINGTON – Maybe it was because I was sitting in the back of the Senate chamber with three war protesters — grim-faced, chanting women dressed in black hooded cloaks, white makeup and blood-red hands — that I felt as though I were watching a production of “Macbeth” rather than a hearing on Iraq.

“Fair is foul, and foul is fair,” the witches in the play said. “Hover through the fog and filthy air.”

Many words hovered Tuesday in the Senate — including some pointed ones by the woman and two men vying to be commander in chief. But the words seemed trapped in a labyrinth leading nowhere.

The Surge Twins were back, but the daylong testimony of David Petraeus and Ryan Crocker before two committees seemed more depressing this time. As the Bard writes in “Macbeth”: “From that spring whence comfort seemed to come, discomfort swells.”

They arrived on the heels of the Maliki debacle in Basra, which made it stunningly clear — after a cease-fire was brokered in Iran — that we’re spending $3 trillion as our own economy goes off a cliff so that Iran can have a dysfunctional little friend.

Not good news, given Ahmadinejad’s announcement that his scientists are putting 6,000 new uranium-enriching centrifuges in place.

I like General Petraeus’s air of restrained competence and Ambassador Crocker’s air of wry world-weariness. But now they seem swallowed up by the fresh violence and ancient tribal antagonisms that they were supposed to be overcoming.

The guardians of Iraq offer more of the same — a post-Surge Pause or “consolidation and evaluation,” as the general generically puts it — and no answers about how we can stop our ward from aligning with our enemy.

The way forward, General Petraeus said, should be “conditions-based.”

Even in a place as prosaic as the Senate, this news spurred existential angst.

Senator Evan Bayh summed up the Dada nature of our plan in Iraq: “We’ll know when we get there, and we don’t know when we’re going to get there.”

A confused Chuck Hagel asked the pair: “So, where’s the surge? What are we doing? I don’t see Secretary Rice doing any Kissinger-esque flying around. Where is the diplomatic surge? … So, where is the surge? What are you talking about?”

Condi is too busy floating trial balloons about being John McCain’s running mate to bother about the fact that she was instrumental in two historic blunders: 9/11 and Iraq.

It’s hard to follow the narrative of our misadventure in Iraq. We went in to help the Shiites that we betrayed in the first Gulf War shake off their Sunni tormentors. But then, predictably for everyone except the chuckleheaded W. and Cheney, the Shiites began tormenting the Sunnis. So we put 90,000 Sunni Sons of Iraq — some of the same ones who were exploding American soldiers — on our payroll so they’d stop shooting at Americans and helping Al Qaeda. Our troops have gone from policing a Sunni-Shiite civil war to policing a Shiite-Shiite power struggle, while Osama bin Laden plots in peace as Al Qaeda in Iraq distracts us and drains our military resources.

Even some senators got confused.

John McCain seemed to repeat his recent confusion over tribes, mistakenly referring to Al Qaeda again as a “sect of Shiites” before correcting himself and saying: “or Sunnis or anybody else.”

And Joe Biden theorized that “The Awakening,” made up of Sunnis, might decide to get into a civil war with Sunnis, presumably meaning Shiites.

But Senator Biden asked a trenchant, if attenuated, question of Mr. Crocker about Al Qaeda: “If you could take it out, you had a choice, the Lord Almighty came down and sat in the middle of the table there and said, ‘Mr. Ambassador, you can eliminate every Al Qaeda source in Afghanistan and Pakistan, or every Al Qaeda personnel in Iraq,’ which would you pick?”

Given the progress beating back Al Qaeda in Iraq, the ambassador replied, he would pick the hiding place of bin Laden.

“That would be a smart choice,” Mr. Biden noted.

Senator John Warner asked the essential question — the one that makes it clear that W. and Cheney hurt the national interest: Is the war making us safer here at home?

General Petraeus avoided answering. But he acknowledged that the “fragile” gains there are “reversible.” “The Champagne bottle,” he told Senator Bayh, “has been pushed to the back of the refrigerator.”

You know you’re in trouble when Barbara Boxer is the voice of reason.

“Why is it,” she asked, “after all we have given — 4,024 American lives, gone; more than half-a-billion dollars spent; all this for the Iraqi people, but it’s the Iranian president who is greeted with kisses and flowers?”

She warmed to: “He got a red-carpet treatment, and we are losing our sons and daughters every single day for the Iraqis to be free. It is irritating is my point.”

Ambassador Crocker dryly assured the senator from California that he believed that Dick Cheney had also gotten kissed on his visit to Iraq.

By Maureen Dowd

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The Holocaust Declaration

(WP) – On Tuesday Iran announced it was installing 6,000 more centrifuges — they produce enriched uranium, the key ingredient of a nuclear weapon — in addition to the 3,000 already operating. The world yawned.

It is time to admit the truth: The Bush administration’s attempt to halt Iran’s nuclear program has failed. Utterly. The latest round of U.N. Security Council sanctions, which took a year to achieve, is comically weak. It represents the end of the sanctions road.

At home, the president’s efforts to stop Iran’s nuclear program were irreparably undermined by November’s National Intelligence Estimate, whose “moderate confidence” that Iran has not restarted nuclear weaponization — the least important of three elements of any nuclear program — has promoted the illusion that Iran has given up the pursuit of nuclear weapons. Yet uranium enrichment, the most difficult step, proceeds apace, as does the development of nuclear-capable ballistic missiles.

The president is out of options. He is going to hand over to his successor an Iran on the verge of going nuclear. This will deeply destabilize the Middle East, threaten the moderate Arabs with Iranian hegemony and leave Israel on hair-trigger alert.

This failure can, however, be mitigated. As there will apparently be no disarming of Iran by preemption or by sanctions, we shall have to rely on deterrence to prevent the mullahs, some of whom are apocalyptic and messianic, from using nuclear weapons.

This will be even more difficult than during the Cold War, when we were dealing with rational actors. We will, nonetheless, have to use the Cold War model in which deterrence prevented the Soviets from engaging in nuclear aggression for half a century — long enough for regime change to make deterrence superfluous. (No one lies awake today worrying about post-Soviet Russia launching a nuclear attack on the United States.) We don’t know how long the mullahs will be in power, but until they are replaced, deterrence will be an absolute necessity.

During the Cold War, we were successful in preventing an attack not only on the United States but also on America’s allies. We did it by extending the American nuclear umbrella — i.e., declaring that any attack on our allies would be considered an attack on the United States.

Such a threat is never 100 percent credible. But it was credible enough. It made the Soviets think twice about attacking our European allies. It kept the peace.

We should do the same to keep nuclear peace in the Middle East. It would be infinitely less dangerous (and therefore more credible) than the Cold War deterrence because there will be no threat from Iran of the annihilation of the United States. Iran, unlike the Soviet Union, would have a relatively tiny arsenal incapable of reaching the United States.

How to create deterrence? The way John Kennedy did during the Cuban missile crisis. President Bush’s greatest contribution to nuclear peace would be to issue the following declaration, adopting Kennedy’s language while changing the names of the miscreants:

“It shall be the policy of this nation to regard any nuclear attack upon Israel by Iran, or originating in Iran, as an attack by Iran on the United States, requiring a full retaliatory response upon Iran.”

This should be followed with a simple explanation: “As a beacon of tolerance and as leader of the free world, the United States will not permit a second Holocaust to be perpetrated upon the Jewish people.”

This policy — the Holocaust Declaration — would not be tested during the current administration, because Iran is not going to go nuclear before January 2009. But it would establish a firm benchmark that would outlive this administration. Every future president — and every serious presidential candidate — would have to publicly state whether or not the Holocaust Declaration remains the policy of the United States.

It would be an important question to ask because it would not be uncontroversial. It would be argued that the Holocaust Declaration is either redundant or, at the other extreme, provocative.

Redundant, it would be said, because Israel could retaliate on its own. The problem is that Israel is a very small country with a small nuclear arsenal that is largely land-based. Land-based retaliatory forces can be destroyed in a first strike, which is precisely why, during the Cold War, both the United States and the Soviet Union created vast submarine fleets — undetectable and thus invulnerable to first strikes — that ensured a retaliatory strike and, thus, deterrence. The invulnerability and unimaginably massive size of this American nuclear arsenal would make an American deterrent far more potent and reliable than any Israeli facsimile — and thus far more likely to keep the peace.

Would such a declaration be provocative? On the contrary. Deterrence is the least provocative of all policies. That is why it is the favored alternative of those who oppose a preemptive attack on Iran to disarm it before it can acquire nuclear weapons. What the Holocaust declaration would do is turn deterrence from a slogan into a policy.

It is, of course, hardly certain that deterrence would work on the likes of Ahmadinejad and other jihadists. But deterrence would concentrate the minds of rational Iranian actors, of whom there are many, to restrain or even depose leaders such as Ahmadinejad who might sacrifice Iran’s existence as a nation to vindicate their divine obligation to exterminate the “filthy bacteria” of the Jewish state, a “disgraceful stain [on] the Islamic world.”

For the first time since the time of Jesus, Israel (known as Judea at the time) is the home of the world’s largest Jewish community. An implacable neighboring power has openly declared genocidal intentions against it — in clear violation of the U.N. Charter — and is defying the international community by pursuing the means to carry out that intent. The world does nothing. Some, such as the Russians, are literally providing fuel for the fire.

For those who see no moral principle underlying American foreign policy, the Holocaust Declaration is no business of ours. But for those who believe that America stands for something in the world — that the nation that has liberated more peoples than any other has even the most minimal moral vocation — there can be no more pressing cause than preventing the nuclear annihilation of an allied democracy, the last refuge and hope of an ancient people openly threatened with the final Final Solution.

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Immigration, Outsourced

(NYT) – Not content to botch immigration policy all by itself, Congress has handed large parts of the job to others to mishandle. It gave the homeland security czar the czarist powers to overturn any law and ignore any court to seal the border. Now Michael Chertoff is clear-cutting a forest of regulations to wall out Mexico by the end of the year. And through the program known as 287(g), his agency is parceling out duties to a growing number of local police and sheriff’s departments, raising an army of junior deputies in the war on illegal immigrants.
To see how unhinged things have become, it pays to zero in on the squalid doings in Maricopa County, Ariz. It is home to Phoenix, the country’s fifth-largest city, and the largest 287(g) program anywhere.
It is run by the county sheriff, Joe Arpaio, who has built a national reputation for toughness through years of cruelty to prison inmates and an insatiable appetite for publicity. Where most departments have only handfuls of officers trained to enforce federal immigration laws, Sheriff Joe, as he is known, has 160. Their efforts are supplemented by what the sheriff says, without apology, is a 3,000-member “posse.”
For months now, Sheriff Joe has been sending squads of officers through Latino neighborhoods, pulling cars over for broken taillights or turn-signal violations, checking drivers’ and passengers’ papers and arresting illegal immigrants by the dozen.
Because he sends out press releases beforehand, the sweeps are accompanied by TV crews and protesters — deport-’em-all hard-liners facing off against immigrant advocates. Being Arizona, many of those shouting and jeering are also packing guns. Sheriff Joe, seemingly addicted to the buzz, has been filmed marching down the street shaking hands with adoring Minutemen.
If this doesn’t look to you like a carefully regulated, federally supervised effort to catch dangerous criminals, that’s because it isn’t. It is a series of stunts focused mostly on day laborers, as Sheriff Joe bulldozes his way toward re-election.
The sheriff says he is keeping the peace, but it seems as if he is doing just the opposite — a useless, reckless churning of fear and unrest. Mayor Phil Gordon of Phoenix has denounced him, saying the raids are interfering with undercover city police officers and federal agents. The mayor of Guadalupe implored him to leave her community alone. State and county officials have pointed out that Sheriff Joe has ignored tens of thousands of outstanding criminal warrants while chasing day laborers and headlines. They say he has grossly violated the terms of his 287(g) agreement — which calls for federal oversight of local police — and have called on Washington to rein him in.
“Do you think I’m going to report to the federal government?” he said. “I don’t report to them. If they don’t like the contract, they can close it up. That’s all.”
“By the way,” he said, “we do have a 3,000-person posse — and about 500 have guns. They have their own airplanes, jeeps, motorcycles, everything. They can only operate under the sheriff. I swear ’em in. I can put up 30 airplanes tomorrow if I wanted.”
The federal government so far seems unconcerned.
“He has stayed within the bounds of the agreement,” Matthew Allen, special agent in charge of immigration and customs enforcement in Arizona, told The Arizona Republic. Jim Pendergraph, an I.C.E. official from Washington, told the paper that after driving to Guadalupe to watch Sheriff Joe in action: “I saw nothing that gave me heartburn.”
It’s past time for Congress to hold hearings on these agreements, starting with a subpoena for Sheriff Joe.
Bet Becky at ‘Just a Girl in short shorts talking about whatever’ will get a big kick out of this one.

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Clinton Mistakes Wife’s Bosnia Trip

WASHINGTON (AP) – Former President Clinton has added to the falsehoods surrounding his wife’s tale of her trip to Bosnia 12 years ago. In Indiana on Thursday, Bill Clinton defended his wife’s mistake in claiming that she landed under sniper fire in Bosnia, accusing the media of treating her like “she’d robbed a bank” for confusing the facts.

The New York senator had repeatedly described a harrowing scene in Tuzla, Bosnia, in which she and her daughter, Chelsea, had to run for cover as soon as they landed for a visit in 1996. Video footage of the day instead showed a peaceful reception in which an 8-year-old girl greeted the first lady.

Hillary Clinton has acknowledged that she got the facts wrong in retelling the tale. Bill Clinton’s inaccuracies don’t involve long-ago memories, but misstatements about how his wife has handled the story.

THE SPIN:

“A lot of the way this whole campaign has been covered has amused me,” Bill Clinton said in Boonville, Ind. “But there was a lot of fulminating because Hillary, one time late at night when she was exhausted, misstated and immediately apologized for it, what happened to her in Bosnia in 1995.

“Did y’all see all that? Oh, they blew it up,” the former president continued. “Let me just tell you. The president of Bosnia and Gen. Wesley Clark – who was there making peace where we’d lost three peacekeepers who had to ride on a dangerous mountain road because it was too dangerous to go the regular, safe way – both defended her because they pointed out that when her plane landed in Bosnia, she had to go up to the bulletproof part of the plane, in the front. Everybody else had to put their flak jackets underneath the seat in case they got shot at. And everywhere they went they were covered by Apache helicopters. So they just abbreviated the arrival ceremony.

“Now I say that because what really has mattered is that even then she was interested in our troops,” he said. “And I think she was the first first lady since Eleanor Roosevelt to go into a combat zone. And you would of thought, you know, that she’d robbed a bank the way they all carried on about this. And some of them when they’re 60 they’ll forget something when they’re tired at 11 o’clock at night, too.”

THE FACTS:

Bill Clinton has many of the facts wrong.

His wife didn’t make the sniper fire claim “one time late at night when she was exhausted.” She actually told the story several times, including during prepared remarks on foreign policy delivered the morning of March 17.

It’s also not true that she “immediately apologized for it.” Clinton has never apologized for the comments and only acknowledged that she “misspoke” a week after the March 17 speech when video of her peaceful tarmac reception emerged.

It’s also not true that she was the “first first lady since Eleanor Roosevelt to go into a combat zone” – a claim that Hillary Clinton has also made when talking about the trip. Pat Nixon traveled to Saigon during the Vietnam war and Barbara Bush went to Saudi Arabia two months before the launching of Desert Storm.

The trip also was not in 1995, but 1996.

Clinton campaign spokesman Phil Singer responded to the former president’s remarks Friday by saying, “Senator Clinton appreciates her husband standing up for her, but this was her mistake and she takes responsibility for it.”

She’s also told her husband to quit talking about it.

“Hillary called me and said ‘You don’t remember this. You weren’t there, let me handle it.’ I said, ‘Yes ma’am,'” Bill Clinton, who was in Indiana campaigning for his wife Friday, told reporters.

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If Sen. Clinton is Exhausted at 11 pm, What Happens at 3 am?

By now you may have heard how Bill Clinton dredged up his wife’s Bosnia debacle — which began with this interview with Sinbad the comedian — at a campaign stop in Indiana Thursday night.
Defending Sen. Hillary Clinton’s (D-N.Y.) embellishment of danger in Tuzla during her 1996 trip, the former president said: “This is a big deal to her. Some of you may have seen that she took a terrible beating in the press for a few days because she was exhausted at 11 o’clock at night and she started talking about Bosnia and she misstated the circumstances under which she landed in Bosnia. Did you all see all that?”
Our question is: If Sen. Clinton gets exhausted at 11 o’clock at night, how’s she going to answer that 3 a.m. phone call? We’re just askin…

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Iwo Jima Veterans Blast Time’s ‘Special Environmental Issue’ Cover

(MSNBC) – For only the second time in 85 years, Time magazine abandoned the traditional red border it uses on its cover. The occasion – to push more global warming alarmism.

The cover of the April 21 issue of Time took the famous Iwo Jima photograph by Joe Rosenthal of the Marines raising the American flag and replaced the flag with a tree. The cover story by Bryan Walsh calls green “the new red, white and blue.”

Donald Mates, an Iwo Jima veteran, told the Business & Media Institute on April 17 that using that photograph for that cause was a “disgrace.”

“It’s an absolute disgrace,” Mates said. “Whoever did it is going to hell. That’s a mortal sin. God forbid he runs into a Marine that was an Iwo Jima survivor.”

Mates also said making the comparison of World War II to global warming was erroneous and disrespectful.

“The second world war we knew was there,” Mates said. “There’s a big discussion. Some say there is global warming, some say there isn’t. And to stick a tree in place of a flag on the Iwo Jima picture is just sacrilegious.”

According to the American Veterans Center (AVC), Mates served in the 3rd Marine Division and fought in the battle of Iwo Jima, landing on Feb. 24, 1945.

“A few days later, Mates’ eight-man patrol came under heavy assault from Japanese forces,” Tim Holbert, a spokesman for the AVC, said. “During fierce-hand-to-hand combat, Mates watched as his friend and fellow Marine, Jimmy Trimble, was killed in front of his eyes. Mates was severely wounded, and underwent repeated operations for shrapnel removal for over 30 years.”

Lt. John Keith Wells, the leader of the platoon that raised the flags on Mt. Suribachi and co-author of “Give Me Fifty Marines Not Afraid to Die: Iwo Jima” wasn’t impressed with Time’s efforts.

“That global warming is the biggest joke I’ve ever known,” Wells told the Business & Media Institute. “[W]e’ll stick a dadgum tree up somebody’s rear if they want that and think that’s going to cure something.”

Time managing editor Richard Stengel appeared on MSNBC April 17 and said the United States needed to make a major effort to fight climate change, and that the cover’s purpose was to liken global warming to World War II.

“[O]ne of the things we do in the story is we say there needs to be an effort along the lines of preparing for World War II to combat global warming and climate change,” Stengel said. “It seems to me that this is an issue that is very popular with the voters, makes a lot of sense to them and a candidate who can actually bundle it up in some grand way and say, ‘Look, we need a national and international Manhattan Project to solve this problem and my candidacy involves that.’ I don’t understand why they don’t do that.”

Holbert, a speaking on behalf of the American Veterans Center, said the editorial decision by Time to use the photograph for the cover trivialized the cause the veterans fought for.

“Global warming may or may not be a significant threat to the United States,” Holbert said. “The Japanese Empire in February of 1945, however, certainly was, and this photo trivializes the most recognizable moment of one of the bloodiest battles in U.S. history. War analogies should be used sparingly by political advocates of all bents.”

Stengel also appeared on MSNBC’s “Morning Joe” on April 17 and had no difficulty admitting the magazine needed to have a “point of view.”

“I think since I’ve been back at the magazine, I have felt that one of the things that’s needed in journalism is that you have to have a point of view about things,” Stengel said. “You can’t always just say ‘on the one hand, on the other’ and you decide. People trust us to make decisions. We’re experts in what we do. So I thought, you know what, if we really feel strongly about something let’s just say so.”

Time has been banging the global warming drum for some time now. In April 2007, Time offered 51 ways to “save the planet,” which included more taxes and regulation.

I am so disgusted – there is absolutely no reason why Brian Walsh should not be shot – better yet, let’s send him to Iraq as a soldier and see how he likes being a target. What a fucking prick. Probably went to school at Yale, the lowest educational organization in America.

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HILLARY’S TALL TALES ABOUT HEALTH CARE

Hillary Clinton had a great story to tell over and over again in her stump speech: An uninsured Ohio pregnant woman lost her baby and died because she could not afford a $100 up-front fee.

What a tale! What an indictment. What government bureaucracy could be worse than a health care system where stuff like that is permitted to happen?

But last week the Athens, Ohio, hospital where the incident allegedly happened poked a few holes in the fable: Yes, a woman died two weeks after her baby was stillborn. That much is true. But according to hospital administrators, everything else is fiction: The woman was under the care of obstetricians, she was never refused treatment by the hospital, and oops!, she was, in fact, insured.

“We implore the Clinton campaign to immediately desist from repeating this story,” said Rick Castrop, chief executive officer of the O’Bleness Health System.

To anyone with a passing acquaintance with how our health care system works, the story was always unlikely in the extreme: Hospitals in most states cannot refuse lifesaving emergency care, and pregnant women are covered by Medicaid anyway if they have no insurance and can’t afford $100.

But why ruin a good story by checking it out? You lose so many of them that way, as we journalists say.

Two more recent New York Times stories highlight the potential costs for all of us in putting health care into the hands of government bureaucrats. Take Great Britain, for example, home of the vaunted “single-payer” National Health Service. “Free health care for all” is its model, but since health care costs money, the result is the rationing of health care by government bureaucrats for whom cost-efficiency trumps patient autonomy and even human life itself.

Perhaps Hillary should start telling the tale of Debbie Hirst, a British breast cancer patient whose cancer had metastasized. Her oncologist suggested a drug, Avastin, which is widely used in the U.S. and other European nations to prolong the life of cancer patients like her. But bureaucrats had decided that at $120,000 a year, prolonging Debbie Hirst’s life would cost just too much money to be worth it. That’s bad enough, but because the government is committed to “equal care” for all its patients, the bureaucrats went even further: They told Debbie Hirst that she had to choose between buying Avastin on her own, and receiving any health care from the government at all. She could not, in other words, mortgage her own home to buy a drug to save her own life without being penalized by the loss of all her other cancer care and drugs.

Permitting patients to purchase care the government refused to provide would undermine the system, the bureacrats said. “That way lies the end of the founding principles of the NHS,” health secretary Alan Johnson told Parliament. And the system and its founding principles were more important than Debbie Hirst’s life.

Meanwhile in Massachussetts, the predictable effects of a more modest universal health insurance mandate is beginning to be seen: huge cost overruns coupled with dramatic increases in wait times for care. Only half of all internists in that state now accept new patients; between 2006 and 2007 the wait for an appointment almost doubled from 33 to 52 days.

“It’s a recipe for disaster,” Dr. Patricia A. Sereno, state president of the American Academy of Family Physicians, told The New York Times, speaking of the combination of 340,000 newly insured patients with low-reimbursement formulas for primary care physicians.

It’s a predictable disaster, of course, seen over and over again around the world: Government-financed health care means government rationing of health care, in a system where the prestige, status, freedom and pay of doctors who care for patients plummets over time.

But don’t expect Hillary or Barack to tell that truth any time soon.

By Maggie Gallagher

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Clinton leadership a study in missteps

(Politico) – Hillary Rodham Clinton wants voters to decide the nomination based on who can coolly and competently run the country. She had better hope they don’t study her recent campaign too closely for the answer.

Clinton has overseen two major staff shake-ups in two months. She has left a trail of unpaid bills and unhappy vendors and had to loan her own campaign $5 million to keep it afloat in January. Her campaign badly underestimated her main adversary, Barack Obama, miscalculated the importance of organizing caucus states and was caught flat-footed after failing to lock up the nomination on Super Tuesday.

It would be easy to dismiss all of this as fairly conventional political stumbling — if she hadn’t made her supreme readiness and managerial competence the central issue of her presidential campaign.

But since she has, a growing number of Democrats are comparing the Clinton and Obama campaigns — their first real exercise in executive leadership — and rendering harsh assessments of her stewardship.

In twin columns in Tuesday’s Washington Post, left-of-center columnists Peter Beinart and E.J. Dionne Jr. condemned Clinton’s overall management of the campaign and inability to build a durable message and infrastructure. It’s a common theme in Democratic circles these days.

“Any time you are involved in a long campaign, there are going to be major substantive and procedural gaffes,” says former Democratic Rep. David Bonior, an uncommitted superdelegate who served as the campaign manager to John Edwards. “The question is how a campaign handles those gaffes and how a candidate handles them. And I think it’s fair to say that Sen. Obama has handled [his] problems better than Sen. Clinton.”

Obama can rightly claim he has run a more consistent, disciplined and technologically savvy campaign. While Clinton has blown though nearly a half-dozen campaign slogans and failed to put concerns about her credibility to rest, he has clung to essentially the same leadership and governing message he outlined in his 2004 speech at the Democratic convention. There has been little drama inside his operation — or at least if there was, it has been kept largely concealed.

“In every campaign, the strategy is important and the day-to-day management is important. And in Obama’s case, it’s hard not to argue that they have run a great campaign,” said Steve Elmendorf, deputy campaign manager for Kerry’s 2004 bid and a Clinton supporter. “It’s been one of the best-run presidential campaigns in the last 20 years. I think they are focused and disciplined and on message. … The test of a good campaign is having a plan and keeping an operation on track to execute a plan.”

Put simply, Obama has shown he can offer a compelling vision, execute a complicated strategy to convey it and, all the while, keep the ledger in the black. That’s not a bad first step to becoming a strong leader.

There is no question he has stumbled in ways that will haunt him in the general election. His handling of the Tony Rezko affair was exceptionally clumsy. It’s still puzzling why he was so cozy with a known influence-peddler and why it took so long to make all of the details clear and public.

His relationship with the Rev. Jeremiah Wright — his pastor who railed against America and accused the government of purposely spreading AIDS to kill blacks — is a ticking general election time bomb. For now, though, many are praising his efforts to defuse it and move forward.

“Under different circumstances, that would wreck a campaign if not handled right. And so far, it’s not been a mortal wound,” said Dennis Johnson, professor of political management at George Washington University. “It seems to me it’s been a much smarter-run campaign.”

The Clinton campaign, by contrast, has been marked by strategic missteps, financial uncertainty and personnel drama. Its strengths — a supremely disciplined candidate and remarkable fundraising — have been undermined by other aspects of the enterprise, such as a headstrong, factionalized staff and a spendthrift approach. The conventional wisdom once held that it was Bill Clinton who was chronically improvisational and unable to run a tight ship. That flaw, it seems, runs in the family.

Strategist Mark Penn’s ouster was the latest staff dispute to unfold in the media, accompanied by a surplus of finger-pointing and a divulging of private details by aggrieved insiders. The pattern was a familiar one, having surfaced after Clinton’s Iowa loss and right before Clinton jettisoned Patti Solis Doyle as campaign manager.

Howard Wolfson, a top Clinton aide, acknowledges that in a campaign, blame ultimately resides at the top. But he also contends that it’s important to appreciate the value of a candidate who has the self-confidence to allow dissenting voices within the leadership structure and who accepts responsibility for tough choices — such as ousting longtime friends and advisers when they become ineffective.

“It is fair to say that every candidate is ultimately responsible for what his campaign does or doesn’t do,” said Wolfson. But, he noted, “The number of times that I’ve read [of] Sen. Obama blaming his staff for problems in his campaign, I can’t even count.”

In interviews, several veteran Democratic strategists said the business of running a campaign offers limited insight into a candidate’s performance in the White House.

And Clinton’s defenders argue that the relatively smooth-running Obama operation obscures the reality that the first-term Illinois senator is an untested, naive politician who showed little spine or genius during his unremarkable four years in the U.S. Senate. Clinton loyalists think the Obama story has a predictable conclusion: He gets torn apart by a ruthless GOP and crushed in the general election.

All of this could be true. But it is also true that a fair measurement of the candidates’ leadership skills is their management of their campaign. Easily the largest enterprise they have run in their lives — in February alone, Obama had 1,280 paid employees, at a cost of $2.61 million; Clinton had 935 employees and a monthly payroll of $1.63 million — the campaign reveals flaws and strengths that will only be magnified in the Oval Office.

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Clinton Outlines Anti-Crime Plan

PHILADELPHIA (AP) – Democrat Hillary Rodham Clinton would eliminate the federal mandatory five-year sentence for crack cocaine users as part of a $4 billion-a-year anti-crime initiative designed, in part, to steer many nonviolent offenders away from prison.

Her plan also would revive several programs started by her husband’s administration, including federal funding of community-oriented prosecutors and police officers.

The New York senator outlined her proposal in a speech Friday in Philadelphia, a key city in her contest with Sen. Barack Obama for voters in Pennsylvania’s April 22 presidential primary.

At a second Philadelphia event, Clinton chastised Obama for reportedly telling a San Francisco audience that some Pennsylvanians are bitter because of their economic frustrations.

“Well, that’s not my experience,” she told a Drexel University crowd, describing the state’s residents as resilient, optimistic and hardworking.

“Pennsylvanians don’t need a president who looks down on them,” she said. “They need a president who stands up for them.”

The Web site Huffington Post reported that Obama, speaking of some Pennsylvanians’ economic anxieties, told supporters at a San Francisco fundraiser Sunday: “You go into these small towns in Pennsylvania and, like a lot of small towns in the Midwest, the jobs have been gone now for 25 years. … And it’s not surprising then they get bitter, they cling to guns or religion or antipathy to people who aren’t like them or anti-immigrant sentiment or anti-trade sentiment as a way to explain their frustrations.”

In a written response to what it called “campaign attacks” by Clinton and Republican candidate John McCain, the Obama campaign made no direct reference to the San Francisco remarks. A McCain adviser accused Obama of “elitism and condescension.”

Following the rivals’ criticism, Obama revisited the subject while speaking Friday night at a high school in Terre Haute, Ind. “People don’t vote on economic issues because they don’t expect anybody is going to help them,” he said. “So people end up voting on issues like guns and are they going to have the right to bear arms. They vote on issues like gay marriage. They take refuge in their faith and their community, and their family, and the things they can count on. But they don’t believe they can count on Washington.”

Clinton, in describing her anti-crime plan, said she hopes to reduce homicide rates and the amount of prison space occupied by nonviolent offenders, many of them drug users.

The issue of crime has played a comparatively small role in this year’s presidential race, which is dominated by the economy and Iraq war. In introducing Clinton, however, Philadelphia Mayor Michael Nutter said many of his constituents “are more worried about Al Gangster than al-Qaida.” Philadelphia had 392 murders last year.

Clinton‘s position on minimum sentencing has drawn little notice, although she backs a Senate bill that would eliminate the five-year mandatory prison term for persons prosecuted in federal courts for possessing at least five grams of crack cocaine. The bill, and her initiative, would not affect state prosecutions.

Because black Americans are disproportionately higher users of crack than are whites, many groups want to end policies that punish crack users much more harshly than powder cocaine users, who are predominantly white.

Clinton said she would pay for the $4 billion initiative through a commission she will assign to “identify unnecessary and outdated corporate subsidies for elimination.” Critics of deficit spending generally urge campaigns to be more specific in saying how they will pay for new programs.

Under Clinton’s proposal, states would compete for $1 billion in annual grants to combat recidivism. It would “promote tough but fair” changes to probation practices and to existing programs meant to keep many nonviolent drug offenders out of prison.

The goal is to make punishment more certain for those who violate their probation, she said, while also enhancing efforts to help former drug users stay clean and thereby avoid prison. Clinton said the currently one-fourth of all former inmates who committed nonviolent crimes return to prison “as violent offenders.”

Clinton‘s plan would help local governments hire 100,000 new police officers to focus on high-crime locations. It would spend $250 million a year on “community-oriented prosecutors,” who also would work from, and focus on, specific neighborhoods.

Both programs were launched under her husband’s presidency, but the Bush administration eliminated or sharply reduced them.

“It is a sad day in America when the president can find hundreds of billions of dollars to police another country’s civil war,” Clinton said, “but cuts funds for police officers right here at home.”

Her plan calls for federal grants or special efforts by the Justice Department to help local governments battle gang violence, drug dealing and gun trafficking. Grants also would help cities and counties operate after-school programs, home visits by nurses and “early intervention mentoring programs” designed to steer “at-risk kids” away from crime.

Other provisions would target identity theft and online child exploitation. Clinton also renewed her call for reinstating the assault weapons ban, which expired in 2004.

Hillary, you ass. You should be for legislation to legalize drugs – that would take care of the deficit, the prison overcrowding, would lessen the crime rate by leaps and bounds, and by doing this we could all have free or next to free health care with all the money the government would be bringing in. Have some stones, you pathetic miscreant.

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