Worship as Higher Politics

Christianity Today has an article that is a healthy reminder for Christians who are interested in politics. Here is the opening:

George W. Bush is not Lord. The Declaration of Independence is not an infallible guide to Christian faith and practice. Nor is the U.S. Constitution, nor the U.N. Universal Declaration on Human Rights. "Original intent" of America's founders is not the hermeneutical key that will guarantee national righteousness. The American flag is not the Cross. The Pledge of Allegiance is not the Creed. "God Bless America" is not the Doxology.

Sometimes one needs to state the obvious—especially at times when it's less and less obvious.

An interesting strategy for dealing with Med-Mal

The Wall Street Journal (?) took a look at how Anesthesiologist addressed their high medical malpractice insurance rates over the past twenty years.

Anesthesiologists pay less for malpractice insurance today, in constant dollars, than they did 20 years ago. That's mainly because some anesthesiologists chose a path many doctors in other specialties did not. Rather than pushing for laws that would protect them against patient lawsuits, these anesthesiologists focused on improving patient safety. Their theory: Less harm to patients would mean fewer lawsuits.

There has been a nice little side-effect from their efforts.

Over the past two decades, patient deaths due to anesthesia have declined to one death per 200,000 to 300,000 cases from one for every 5,000 cases, according to studies compiled by the Institute of Medicine, an arm of the National Academies, a leading scientific advisory body.

The article talks about other specialties, like the American College of Surgeons, are starting to follow the anesthesiologists lead in studying closed insurance claims in order to understand how poor outcomes occur.

Dr. Griffen of the College of Surgeons says that more surgeons have begun to see a connection between improving patient safety and lowering malpractice premiums. The college's closed-claims study so far involves about 350 cases, and the group hopes it will grow to 500 this year.

At the University of Utah Hospitals and Clinics, Dr. Kochenour says his institution has tried to emulate the anesthesiologists by concentrating more on identifying systemic errors and less on individual blame. But these efforts run headlong into thinking drummed into physicians since medical school, he says. "I don't think physicians are very good systems thinkers, by and large," he says. Many, especially surgeons, prize their independence, he says, and that makes it hard to achieve the kind of cooperation necessary to reduce errors.

I wonder if other medical specialties will be able to make similar improvements as the anesthesiologists. I don't know if other physicians are making mistakes of the same magnitude that anesthesiologists were 20 years ago. If not, then they would not have the room to make such dramatic improvement.

I wonder if the comments about physicians not being good system thinkers sheds some light on why they have taken the political position to focus on caps as the most important part of tort reform. This focus, I believe, largely comes from the fear of what could happen to them as an individual if they were saddled with an outrageous jury award. This is perfectly understandable. Unfortunately, they do not think as much about how caps would lead to more harm for patients across the board. Taking a more systematic approach to the problems of med-mal, as the anesthesiologists did, would protect both conscientious physicians and patients.

Being White House Press Secretary is Tough!

Editor & Publisher has part of the daily briefing from June 16. ABC correspondent Terry Moran actually expected Press Secretary Scott McClellan to answer his question! He asked McClellan about Cheney's recent assertion that the Iraqi insurgency is in its last throes.

Q Scott, is the insurgency in Iraq in its 'last throes'?

McCLELLAN: Terry, you have a desperate group of terrorists in Iraq that are doing everything they can to try to derail the transition to democracy. The Iraqi people have made it clear that they want a free and democratic and peaceful future. And that's why we're doing everything we can, along with other countries, to support the Iraqi people as they move forward?.

Q But the insurgency is in its last throes?

McCLELLAN: The Vice President talked about that the other day -- you have a desperate group of terrorists who recognize how high the stakes are in Iraq. A free Iraq will be a significant blow to their ambitions.

Q But they're killing more Americans, they're killing more Iraqis. That's the last throes?

McCLELLAN: Innocent -- I say innocent civilians. And it doesn't take a lot of people to cause mass damage when you're willing to strap a bomb onto yourself, get in a car and go and attack innocent civilians. That's the kind of people that we're dealing with. That's what I say when we're talking about a determined enemy.

Q Right. What is the evidence that the insurgency is in its last throes?

McCLELLAN: I think I just explained to you the desperation of terrorists and their tactics.

Q What's the evidence on the ground that it's being extinguished?

McCLELLAN: Terry, we're making great progress to defeat the terrorist and regime elements. You're seeing Iraqis now playing more of a role in addressing the security threats that they face. They're working side by side with our coalition forces. They're working on their own. There are a lot of special forces in Iraq that are taking the battle to the enemy in Iraq. And so this is a period when they are in a desperate mode.

Q Well, I'm just wondering what the metric is for measuring the defeat of the insurgency.

McCLELLAN: Well, you can go back and look at the Vice President's remarks. I think he talked about it.

Q Yes. Is there any idea how long a 'last throe' lasts for?

McCLELLAN: Go ahead, Steve....

Maybe I'm a Truman Democrat

Like many in my generation, I'm rather uncomfortable labeling myself and try to do that rarely. Over at democracyarsenal.org, Michael Signer wrote about something called The Truman Project. He described this as "an extraordinary new group of young people who want the Democratic Party to reclaim strength on national security and foreign policy as a basic progressive value." Singer's comments are worth checking out here. At their recent annual meeting, the group came up with six values that "grounded" their discussion. For the most part, these are values I could affirm.

1) American exceptionalism: Like the neoconservatives, we believe that America is the greatest country the world has known. We are historically, morally, and intellectually unique. Unlike the necons, however, we believe we must constantly earn our exceptionalism through our moral conduct. Our uniqueness stems from our values, and so we bear a unique responsibility for living up to those values in shaping and influencing the world.

2) The use of force: Like the neocons, we're comfortable with the use of force for morally good ends. Unlike the neocons, as a general matter, we believe force shouldn't be the default choice for achieving our ends. We're neither reflexive doves nor pacifists; rather, we're pragmatists on the use of force.

So far so good. I want to be a pacifist, but Romans 13:3-5 keeps me from it. "For rulers hold no terror for those who do right, but for those who do wrong. Do you want to be free from fear of the one in authority? Then do what is right and he will commend you. For he is God's servant to do you good. But if you do wrong, be afraid, for he does not bear the sword for nothing. He is God's servant, an agent of wrath to bring punishment on the wrongdoer. Therefore, it is necessary to submit to the authorities, not only because of possible punishment but also because of conscience." I do believe that part of a government's God-given responsibility sometimes involves the use of force.

3) American hegemony: Like the neocons, we want America to retain its supremacy as the military, political , and economic leader of the world in order that we can maintain our own security, help strengthen the world's safety and stability, and accomplish morally right goals. We are and should be a unipolar power. Unlike the neocons, however, we believe we must constantly earn and affirm the right to exercise that power.

I do believe that "we must constantly earn and affirm the right to exercise" power, but I don't know that I would say we need to be a unipolar power to do that.

But Truman Democrats also add three new principles of their own:

1) The world community. The traditionally conservative (rather than neocon, but still threaded through the current Administration's foreign policy) viewpoint borrows heavily from libertarian principles. As a matter of right and obligation, conservatives often believe people are and should be fundamentally selfish and individualistic, and that collective action is wrong. Truman Democrats believe, on the other hand, that the world is a community. America can lead that community -- but, to paraphrase John Donne, we are not an island, and any death diminishes us, because we are involved in mankind. To switch to a more prosaic metaphor, America is like a quarterback for the world. Although he's the most critical member of the team, the quarterback can't win alone; he needs the confidence and loyalty of his teammates, which he earns through leadership.

The recognition that people are selfish and individualistic AND the recognition that the world is a community are not mutually exclusive. One of the areas where liberals have traditionally failed is in trying to ignore the fact that people are sinners. The conservatives who celebrate selfishness and oppose collective action are missing the boat, too. The reason that people need to work together, and be a community, is to overcome our selfishness.

2) Liberal-mindedness: Neoconservatives believe that the discovery of ideas is basically finished. That's why they constantly return to the ancient theorists and ancient values in search of some lost nobility and greatness. Truman Democrats believe instead that knowledge is constantly expanding, and that to conclude that we have finished knowing, or that ideas are presumptively wrong because of where they come from, is both arrogant and dangerous. We believe in a resilient, flexible national mind, avoiding the calcification of ideology. We believe in learning from events and fitting our thinking to facts, not the other way around. This is why democracy (which encourages the growth of knowledge) is our political system of choice.

3) Helping the least well-off: Conservatives and realpolitikers have generally believed that wealth and power should be the key determinants to foreign policy decisions regarding other countries. Following philosophers like John Rawls, Truman Democrats believe we should instead help the least well-off before we help the most well-off. So building up the economies in many developing nations, or addressing the AIDS crisis, is not only a matter of stability -- it's a matter of moral right. Moreover, helping the least well-off also helps us. Being the only wealthy house in a poor neighborhood makes us the target. Helping the whole neighborhood become richer makes us a leader.

I think that the Truman Project is something that I will continue to follow.

US detainees

The Christian Science Monitor has a commentary on the issues related to Guantanamo Bay and Amnesty International. Amnesty called Guantanamo the "gulag of our times" and the Bush Administration flipped their lids. Here's the bottom line, according to the Christian Science Monitor.

Yet beneath this struggle over spin, the two sides appeared to be making different points. The word "gulag" is ugly on several levels - harsh on the ear, harsher in meaning. The administration focused on the Soviet gulag's human cost, making the point that whatever abuses have occurred at US detention centers are a grain of sand compared with the hundreds of thousands of casualties suffered by those who disappeared into Soviet prisons. Amnesty International was trying to make a point about the mystery and injustice it believes is inherent in the US approach to detainees - that many are being held indefinitely without trial, in unknown locations.

Leaders of the human rights group have conceded that their language may have overreached: On Sunday William Schulz, executive director of Amnesty International USA, said in a broadcast interview that the gulag comparison "is not an exact or literal analogy."

But he noted that his group is far from alone in criticizing the underlying tenets of the US detention system. US courts have ruled against certain aspects; internal military investigations have found disturbing incidents of abuse, even murder, from Abu Ghraib to Afghanistan. Secretary of Defense Donald Rumsfeld offered to resign in April 2004, when pictures of Abu Ghraib practices first surfaced. The US government has undertaken some 370 military investigations into the charges, with some 130 personnel facing some degree of punishment.

While the Bush administration has trumpeted the cause of freedom around the world, it has said much less about the corresponding value of justice, says George Perkovich of the Carnegie Endowment. Yet to advance its interests, mollify its friends, and quiet its adversaries, it must be concerned not only that justice be done, but be seen to be done, in its actions.

If nothing else, Amnesty International's use of "gulag" in relation to US actions may bring home to the administration just how much other nations' perceptions of US morality have declined.

"They're trying to jar the [US] system and say, 'You're doing what the Soviets did, remember them?' " says Perkovich.

Top 10 Things To Do for Darfur Short of U.S. Military Intervention

democracyarsenal.org is perhaps too fond of top 10 lists, but they have some interesting ideas of what we could be doing about the genocide. I think that the first two are the most likely to pay off immediate dividends.

1. Put the heat on NATO to buttress the AU – The US, UN, EU and NATO have been passing the hot potato when it comes to taking action in Sudan. NATO has its limitations, but its better positioned than any other organization to become the focal point for partnering with the AU to try to make that mission effective. The U.S. should take the lead in pushing the alliance to prove its relevance by getting involved. NATO should take the lead in negotiating terms with the AU, instead of waiting until broader help is asked for. This month’s G-8 meeting in Scotland would be a good opportunity to make the case (though other G-8 members may turn the tables wanting support for their anti-poverty plans in Africa).

2. Put NATO troops on the ground – It will be impossible to turn around Darfur without putting substantial numbers of competent and equipped troops on the ground quickly. That’s an impossibility for the AU, so partnering effectively with them means sending in a portion of the 17,000 troops NATO supposedly has at the ready. All else under discussion – airlift, training, advisers – are half-measures. But in doing this, we need to realize that a NATO "bridge" until the AU is ready to take over may wind up lasting a long while.

Paul Revere A Despicable Tattletale, Says GOP

This is the most, um, perceptive comments I've seen about the "reaction" from G. Gordon Liddy, Chuck Colson, et al. to Deep Throat's identity.

Barak Obama

This quote is one of the reasons I'm interested in following Barka Obama.

Obama said the Schiavo case underscored "one of the difficulties that Democrats and progressive liberals have always had - that they see both sides and argue with themselves."

Obama said Republicans such as House Majority Leader Tom DeLay of Texas, who led the case for federal intervention in the Schiavo case, had an easier road.

"It's a lot easier if you're Tom DeLay to say what you think because you're not really spending any time thinking about it," Obama said.