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“Not All Interventions Are Imperialist”: On Syria, The Left Should Not Forget History

The most vocal opposition to President Barack Obama’s promise to send arms to the Syrian rebels is coming from the political left—to which I normally would consider myself allied. Writing in the Huffington Post, M. J. Rosenberg calls it a return to “19th century imperialism.” John Nichols writes in The Nation that “the notion that the Syrian mess is an American problem, or that the United States can or should choose a favorite in the fight, is highly debatable.” Similar statements can be found in Mother Jones and In These Times.

The left’s opposition to American intervention is Syria is not tactical or prudential. These authors are not arguing that intervention is futile because the rebels have already lost or because al Qaeda has penetrated the opposition or because the war has become a proxy contest in the Middle East. These are legitimate tactical concerns, but the left’s opposition is based on principle, not tactics. It says that the United States should not engage in interventions at all. The most common reference point is George W. Bush’s invasion of Iraq. But Rosenberg also groups Obama’s intervention in Syria with the interventions in the Dominican Republic, Grenada, Panama, Lebanon, the Persian Gulf, the former Yugoslavia, Somalia, Afghanistan (in the early 1980s and after September 11), and Libya.

I think this position is wrong.  By identifying Obama’s impulse in Syria with Ronald Reagan’s invasion of Grenada or Bush’s invasion of Iraq, the left rules out any possibility of a benign intervention for humanitarian or for worthy geopolitical ends. I also think this position is contrary to the traditional stance of the American and European lefts toward foreign civil wars or wars of independence. That, of course, doesn’t show the position is wrong; but it does suggest that these leftists are betraying their own, and my, historical ideals.

What is happening in Syria is different from, say, what was happening in Iraq in early 2003, the Dominican Republic in 1965, or Grenada in 1983. The Obama administration is not using a supposed threat to American interests to intervene unilaterally and impose its will on a country that is relatively at peace, nor is it intervening (as it did in Guatemala or Vietnam) to back an unpopular regime against a rebellion. American intervention in Syria most closely resembles intervention in the former Yugoslavia in the 1990s. The U.S. is acting with other countries, and it is not trying to impose its own rule or to prop up a client regime.

In Syria, there is a civil war going on, and there is a reasonable moral case for backing the rebels against the government. The war began with the Assad regime brutally suppressing peaceful democratic reform protests. The war has already taken as many as 120,000 lives. Assad forces have laid waste to major cities.  Some dictators retain a lingering loyalty to their nation and its people, but Bashar Al Assad appears engaged in a war of personal survival. It’s not genocide, but a patria-cide—and belongs on the list of crimes against humanity that other nations should not tolerate.

My own position reflects the historical stance of the American and European left going back to the American and French revolutions. The left in the United States and Europe repeatedly pressured sympathetic governments to defend liberty and independence internationally. Nichols, following the lead of other anti-interventionists on the left and right, quotes John Quincy Adams from 1821 saying that America “goes not abroad in search of monsters to destroy.” But it’s worth looking at the context in which Adams made that statement. A whole variety of movements, editorial pages, and politicians, including Thomas Jefferson and James Madison, were urging Adams to back the Greek struggle for independence against the Turks and Latin American countries’ struggles against Spanish rule. There were a few hotheads calling for the U.S. Navy to steam into the Aegean, but the bulk of proposals, and the ones that concerned Adams, were for recognition or for sending emissaries to the Greeks or Latin Americans. But Adams rejected any initiative.

Over the next 150 years, the left in the U.S. and Europe has urged support for the Russian Revolution of 1917, the Spanish Republicans in the Civil War, the African National Congress in apartheid-era South Africa, and independence for Algeria, Vietnam, and the Portuguese colonies in Africa.  Henry Wallace—recently held up by Oliver Stone as a paragon of the left—supported American intervention in the Korean peninsula in 1950. Until recently, the left has always drawn a distinction between these kind of interventions and interventions aimed at buttressing imperial or neo-imperial rule. So the left opposed intervention in Vietnam, the Dominican Republic, and Iraq. But operating in the shadow of these fiascos, much of the left today has refused to back any intervention. That has included Syria today, the Balkans in the mid-1990s, and, incredibly, the attempt to drive Iraq out of Kuwait in 1991.

I remain perplexed about what the United States can do to help the Syrian rebels. I am not a military expert, and I don’t know what is involved in setting up a no-fly zone. I think that whatever we do, we have to do with other countries. And I believe that we have to avoid any commitment to policing a post-Assad Syria. These are reservations that the Obama administration seems to share. But I have no doubt that we should try to do something to rid the world of the Assad regime. And I say that as a card-carrying member of the American left.

By: John B. Judis, Senior Editor, The New Republic, June 22, 2013

June 24, 2013 Posted by | Foreign Policy | , , , , , , , , | Leave a comment

“Obamacare Is For Republicans, Too”: If GOP Governors Think Stonewalling Health Exchanges Hurts Only Democrats, They’re Wrong

Three months from now, Americans will get their first look at whether Obamacare works. The answer will depend a lot on Republican governors and legislatures — and they should want the law’s exchanges to be successful as much as the president does.

The new state insurance exchanges are supposed to start selling health coverage Oct. 1. The idea behind these marketplaces is that allowing apple-to-apple comparisons between health plans will foster competition and lower prices. Most Republican governors and legislatures, however, have resisted running their own exchanges; 19 states have refused to play any role whatsoever.

Continued resistance could hamper an already fraught process. In a report this week, the U.S. Government Accountability Office warned that the federal government is behind schedule in building exchanges in states that have refused to do so. This makes it even more crucial that all states pitch in to help.

Why should Republican opponents of the exchanges change tack now? First, there are the crass politics: Many residents who stand to benefit are their constituents. Federal exchange subsidies are available for people earning between 138 percent and 400 percent of the poverty level, or $32,500 to $94,200 for a family of four. According to 2012 exit polls, 42 percent of people with family incomes between $30,000 and $50,000 voted for Mitt Romney; for those earning between $50,000 and $100,000, the share was 52 percent. If Republican governors think stonewalling exchanges hurts only Democrats, they’re wrong.

Then there are the economic reasons: States with weak exchanges could become less attractive to businesses. John Hickenlooper, the Democratic governor of Colorado, said this week that his state supports its insurance exchange in part to help small businesses, which want healthy and productive workers.

Finally, and most compellingly, there is the human reason – – rather, 25 million human reasons. Well-run exchanges will make getting health insurance easier and more affordable. Even philosophical opponents of the Patient Protection and Affordable Care Act must concede this practical point. Obamacare also happens to be the law of the land.

Some Republican governors have already accepted a role in their exchanges. Iowa and Michigan are partnering with the federal government, while Idaho, Nevada and New Mexico agreed to build their own. It’s too late for other states to follow those courses, but there are still meaningful steps they could take.

One thing they can do is smooth the path for “navigators” – – people or organizations that will help others shop for insurance on the exchanges. Florida requires navigators to register with the state, and Pennsylvania is considering a similar move. This should be fine as long as registration is quick and straightforward.

States should also build solid lines of communication between the exchanges and state-run programs, especially Medicaid. Exchanges can use the information that states keep about people’s income and insurance status to determine whether they’re eligible for subsidies. Easy access to Medicaid databases will mean fewer errors and faster service for people in both programs.

State insurance regulators, who have the authority to approve insurance plans sold on federally run exchanges, can do their part by monitoring the participating insurance plans aggressively enough to keep rates down.

Perhaps the single biggest thing Republican officials could do is simply be ready and willing to address the inevitable hiccups. If states look for ways to stall progress, they’ll find them. Conversely, if governors who oppose the law nonetheless direct their officials to cooperate, the exchanges are more likely to survive those hiccups.

Governors could set a positive tone by reminding their residents that the exchanges are coming. Instead of saying the exchanges “are not going to work,” as Texas Governor Rick Perry did in December, they should encourage their constituents to see whether they’re eligible for subsidies. It doesn’t need to cost the states anything.


By: The Editors, Bloomberg, June 20, 2013

June 24, 2013 Posted by | Affordable Care Act, GOP | , , , , , , , | Leave a comment

“How Safe Are Pharmaceutical Supply Chains?”: An Organizational Mindset Is Necessary, Even If Costly In The Short-Term

GlaxoSmithKline announced this week that it is recalling some of its asthma drug Ventolin. The reason: its contract manufacturer said that the syrup bottles might have been contaminated with glass particles.

Last fall, in what 60 Minutes described as “the worst pharmaceutical disaster in decades,” 48 people died in a meningitis outbreak that was traced back to contaminated production in a compounding pharmacy in Massachusetts. The New York Times reported that the U.S. is suffering from a shortage of injectable drugs caused by quality failures at large manufacturers such as Hospira.

As a result of these and other stories, the quality of our medicines, or more precisely the failure in quality, has gained widespread attention.

Many believe the solution is to increase business investment in capital equipment. Hospira announced last year that it would spend hundreds of millions of dollars on a new state-of-the-art plant and quality and operations specialists. David Gaugh, vice president for the Generic Pharmaceutical Association, said that the perception that injectable drugs are produced in run-down facilities was “absolutely not true” and compared them to well-maintained vintage cars. This focus on technology might appear reasonable; but it is not sufficient.

The only way to guarantee that no defective drugs are ever produced is to never produce any drugs. None of us wants a world without medicine, and thus, we must live with some risk of quality failures in our drug supply chains. Because testing pharmaceuticals for every theoretically-possible contaminant or process deviation is prohibitively expensive if not impossible, drug quality must be built into the product through well-designed production processes, the use of quality ingredients and the consistent adherence to quality control procedures.

Aware of this, regulators long ago established “Good Manufacturing Practices,” known as GMPs, in the pharmaceutical industry. Operating in full compliance with these legally-required GMPs greatly reduces the risk of contaminated or misformulated product reaching the market. It seems that many of the plants highlighted in recent reports were not adhering to GMPs.

To address the problem, it is necessary that executives develop a quality-oriented mindset across the entire supply chain. For example, are employees empowered and encouraged to report deviations from GMPs, even if doing so is costly in the short term? Are deviations investigated and corrective actions put in place, even if doing so requires failing to meet promised delivery dates? Absent such an organizational mindset, quality failures will occur even with the best technology.

This soft side of quality management does not come easily. It often takes years of time to embed in a company, and even a longer time to regenerate if the culture has been undermined. Our research (with co-authors) has found that is difficult for companies to prevent a “decay” in GMP adherence even in their own factories.

When production is outsourced, ensuring adherence is more challenging. Recognizing this, the Food and Drug Administration is currently seeking comment on a “Guidance for Industry” document on quality agreements in contract manufacturing. The document focuses on clarifying responsibilities. Most companies engage in some form of certification, facility audits and product inspections with their contract manufacturers. While clear responsibilities and such actions can help to ensure quality at contractors, they do not guarantee consistent day-to-day adherence to good manufacturing practices.

Using FDA inspection data, we (and co-authors) have studied quality risk in the pharmaceutical industry. In one set of studies, we found that plants in a location with a different primary language than the firm’s headquarters operate with less GMP compliance than those with no language difference. Regarding outsourcing, we did not find an overall difference in quality risk between company-owned plants and contract manufacturer plants.

However, we did find a higher quality risk for small contract manufacturers and those subject to less regulation. Given this, we were not altogether surprised that these lightly regulated, small compounding companies like NECC were found to operate with high quality risk.

Taken together, our research provides empirical evidence that drug manufacturers are hard-pressed to consistently maintain high quality operations even in their own domestic facilities. This challenge is magnified when production is performed in offshore and outsourced plants. Our study and related studies reinforce the recent call to increase FDA regulatory scrutiny of compounders; this is clearly necessary and will help prevent future tragedies such as the recent meningitis outbreak.

However, regulatory and technical solutions alone are not adequate—an organizational mindset of compliance with GMPs is necessary throughout a drug’s supply chain, even if developing and maintaining this mindset is costly in the short-term.


By: John Gray, Aleda Roth & Brian Tomlin, U. S. News and World Report, June 21, 2013

June 24, 2013 Posted by | Big Pharma | , , , , , , , | Leave a comment

“Flapping In The Wind”: For John Boehner, It’s Job Security Vs Legacy

House Speaker John Boehner stopped by the Hyatt Regency on Capitol Hill on Thursday afternoon to pitch a gathering of the National Association of Manufacturers on the Republicans’ plans for jobs and growth.

“While my colleagues and I don’t have the majority here in Washington,” the speaker vowed, “we will continue to pursue our plan.”

Or will they?

Not an hour after those words were uttered, Boehner’s House Republicans dealt him the latest in a series of humiliations. Sixty-two Republicans defied him and voted against the farm bill, defeating a major piece of legislation Boehner had made a test of his leadership by pushing for it publicly and voting for it personally — something speakers only do on the most important bills.

The dispute this time was over food stamps and agricultural subsidies, but the pattern was the same: House leaders lost Democratic support by tilting the bill to satisfy the Republican base, but a group of conservative purists remained upset that the legislation didn’t go far enough.

Much the same dynamic confronts Boehner as the House prepares to take up immigration legislation next month. A similar set of pressures has kept Boehner from negotiating a long-term budget deal with the White House.

In all instances, Boehner faces a choice: his job or his legacy. He can enact landmark compromises but lose his job in a conservative coup. Or he can keep his job but get nothing much done.

With a few exceptions — the “fiscal cliff” deal, Hurricane Sandy aid — Boehner has chosen job security over achievement. He did it again this week on immigration, announcing that he doesn’t “see any way of bringing an immigration bill to the floor that doesn’t have a majority support of Republicans.”

That promise, which is essentially the same as saying he won’t allow the House to take up legislation that includes a path to citizenship for illegal immigrants, puts him on a collision course with the Senate, where a fresh compromise on border security negotiated by Republican Sens. Bob Corker (Tenn.) and John Hoeven (N.D.) make it likely that chamber’s legislation, which includes citizenship, will have a large bipartisan majority.

Boehner’s stance blocking an immigration compromise may preserve his speakership, but it would keep his party on what Sen. Lindsey Graham (R-S.C.) calls a “demographic death spiral” as Latino voters shun the GOP. Beyond the party, Boehner’s position raises the likelihood of failure on another high-profile issue for a Congress that continues to reach new lows in public esteem. Gallup last week found Americans’ confidence in Congress at 10 percent, the lowest ever recorded for any institution.

And that was before Thursday’s farm bill debacle, which saw lawmakers debating all manner of parochial items — olive oil, hemp, Christmas trees, shellfish, even a dairy amendment involving Greek yogurt sponsored by the aptly named Rep. Bob Goodlatte (R-Va.) — before killing the whole bill.

The bill, which had been awaiting action for a year, was never going to get much Democratic support because of $20 billion in cuts to food stamps. But Republicans lost what support they had on Thursday when they passed an amendment, opposed by all but one House Democrat, adding new work requirements to the food stamp program. That left only 24 Democrats on board, not close to enough to offset the dozens of Republicans who wanted the deeper cuts demanded by conservative groups such as the Club for Growth.

The agriculture committee chairman, Frank Lucas (R-Okla.), pleaded on the floor for colleagues to “put aside whatever the latest e-mail is” and vote with him. “And if you don’t,” he added, “they’ll just say it’s a dysfunctional body, a broken institution full of dysfunctional people.”

After the farm bill went down, Majority Leader Eric Cantor (R-Va.) came to the floor to blame Democrats for the collapse — an argument that might have made sense if Republicans hadn’t just forced through an amendment Democrats called intolerable.

Steny Hoyer (D-Md.), the minority whip, reminded Cantor that “25 percent of your party voted against the bill . . . and your side’s going to continue to blame us that you couldn’t get the votes on your side.” Hoyer invoked Newt Gingrich’s 1998 speech calling conservative holdouts in the House “the perfectionist caucus.”

Gingrich did indeed call the Republican hard-liners perfectionists and “petty dictators.” He soon lost his job as speaker, in part because of that remark, but by then he had reached compromises with a Democratic president that righted the government’s finances.

It’s an example Boehner would do well to recall.


By: Dana Milbank, Opinion Writer, The Washington Post, June 21, 2013

June 24, 2013 Posted by | Conservatives, GOP | , , , , , | Leave a comment

“Well Shut My Mouth!”: Paula Deen Played With Fire And Got Burned

I take no pleasure from the trouble food “personality” Paula Deen got herself into this last week, culminating in her firing by the Food Network after she stumbled through efforts to save herself via heavily massaged apologies. I admit to have enjoyed a couple of her recipes over the years. And I usually found her over-the-top “Well Shut My Mouth” embodiment of outworn southern cultural stereotypes annoying rather than deeply offensive–just another Cracker playing the fool for the tourists, basically.

But as a Cracker myself, not that much younger than Deen, I know that she cannot plead ignorance or even innocence of the dynamite of the South’s racial history, and how perilously and inherently her own Old South shtick has skirted the thin line that separates the light side from the dark side of our heritage. The Southern Cooking Icon who occasionally forgets she needs to play error-free baseball when it comes to race is a lot like the southern white politicians who occasionally forget they represent African-Americans.

Paula Deen will do a lot to redeem herself if she refuses to let herself be used as a martyr to the cause of anti-anti-racism–a victim of “political correctness” and all that. The campaign is already developing:

Todd Starnes, who also hosts a Fox News Radio segment, wrote on his Facebook page that the “liberal, anti-South media is trying to crucify Paula Deen. They accuse her of using a derogatory word to describe a black person. Paula admitted she used the word — back in the 1980s – when a black guy walked into the bank, stuck a gun in her face and ordered her to hand over the cash. The national media failed to mention that part of the story. I’ll give credit to the Associated Press for telling the full story.”

Starnes also defended Deen via Twitter, writing: “The mainstream media hates Paula Deen […] I think it’s because most of them don’t eat meat.”

Oh good God. The multi-millionaire celebrity Paula Deen is hardly up there on the cross, and I can testify there’s at least one white southern carnivore–a biscuit eater as well–who thinks that those who work so hard to identify themselves with southern cultural stereotypes are courting controversy and disaster if they don’t watch their mouths. There are many, many southern white chefs and TV stars and book authors and even politicians who don’t set themselves up as regional paragons, yet also manage to steer clear of discrimination suits and admissions of casual, “innocent” racism. Paula Deen played with fire and got burned. She can best heal herself by refusing to be used by those who aren’t “innocent” at all.


By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal, June 22, 2013

June 24, 2013 Posted by | Racism | , , , , , , , | Leave a comment

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